It is comparatively easy to select the first remedy in an acute case, but only the master knows when to change for another.
————-
GELSEMIUM IN ALBUMINURIA
Mrs.–, during her first pregnancy, complained of great lassitude, with pains in the limbs, and scanty urination. About the seventh month, the urine examined, showed an abundance of albumen. As yet there was no Dropsy. She had cough, worse lying down, before 12 pm.; weakness from the shortest walk; flushed face, especially cheeks, afternoons; anxiety before a thunder-storm or during sultry weather. Phosphorus 2c was given, three doses per week.
At the ninth month, the condition of the urine was unaltered; but still there had been no Dropsy. At the beginning of labour, the patient sank into a semi-stupid state, out of which she could be aroused by shaking, but she would soon relapse. If any answer could be forced from her, it was spoken with a thick tongue, like on intoxicated. She had had no labour-pains, yet on examining her per vaginum, the os was noticed fully dilated with the unbroken membranes protruding. The face was pinkish, as if uniformly blushed, and the pulse was slow, full, about 60 per minute. The semi-comatose condition, the color of he face, and the atonic condition of the uterine walls being characteristic of Gels; this was given in water every fifteen minutes in the 200the potency.
Hoping that an erect position might excite labor-pains, she was seated in an arm chair. In about half an hour, the nurse thought that the child was partly protruding from, the vulva. The patient was returned to be and a soft fluctuating tumour, about four to five inches long, was felt exteriorly. The exploring finger was easily pushed between this and the labia, and the head found buried in the perineum. The child by its own gravity, had fallen, until the resisting perineum checked it. The bulging tumor was, of course, the unruptured amnion. Slight, twitchings of single muscle were noticed. In fifteen or twenty minutes, she complained of sharp pains, running from before backwards and upwards (very marked in Gels). Hence the medicine was discontinued.
The pulse increased to 80, and genuine pains began to announce the distension of the perineum. The labor was successfully terminated. One month later, no traces of Albuminuria were to be found. In a subsequent conversation, the patient related that, at times, when in her dreamy state, she had felt, as though her head was “growing big”. Such ominous symptoms may well lead one to fear puerperal convulsions.
MENTAL DERANGEMENT.
Mr. C.,— after severe brain work, developed a long train of symptoms requiring patient and lengthy treatment. The most satisfactory effects were obtained from potentized Alcohol, the indications being very similar to those recorded on pages 138, 139, and 140 of the Encyclopaedia of Materia Medica, Vol. I.
Quarrelsomeness, even from imagined insult. Impatient, of contradiction. Headache, with stupidity. Memory weak, forgets what he was about to say Congestive headaches, Sensation benumbed here and there, especially about the scalp; even his brain feels hard and numb. Mental inquietude, compelling change of work frequently during the day. Apprehensiveness; thinks some one will injure him, that he is in danger, etc.
So decided was the improvement after Alcohol, that it was, no doubt, the remedy for hate case. The symptoms were almost in the very words of Dr. Allen, s collection. It will be seen that they closely resemble Hyoscyamus and Kali Bromatum.
OVARIAN TUMOR.
Mrs.— after her last confinement in December, 1874, complained of intense soreness in the left inguinal region. Hamamelis externally, and the 30th internally. Relief only temporary. When she began to menstruate, which happened when her child was four months old, her suffering was extreme. The ovarian region was swollen; pains burning as from fire; agony; restlessness; numbness of the left limb; cold sweat; fainting Arsenic 2c in water, every half-hour, seemed to relieve.
During the succeeding month, an examination was permitted. Left ovary was found enlarged, rising above the bones and laterally pushing the vaginal wall in towards the median line, and pressing the os firmly against the right side of the vagina. The tumor was extremely sensitive. It seemed to be about the size of a baby’s head. Sepia 2c was given twice weekly for the following symptoms; Irritable temper; at times in different to her household; headache every few days over the left eye, with intolerance of light or noise; sallow complexion; gone feeling at the stomach; dragging pains, heaviness in the abdomen; better sitting. Feeling in the rectum, as if for stool, yet none passed; smarting, cutting during urination. The next period was ushered in with even worse distress. The bladder became involved, and with the burning ovarian pains there was frequent urging to urinate, with tenesmus and burning; urine passed in drops. Cantharis 30 relieved, and the menstrual flow became established. Some emotional excitement, however, stopped it one the second day, and the following symptoms resulted;
Bearing-down in the uterine region, worse walking, better holding up the abdomen with the hands; tenderness over the swollen left ovary; stinging, burning pains from ovary up into the abdomen and down the thigh; shooting pains from left ovary across to the pubes; urine causes a smarting sensation. Digital examination determined a prolapsed and sensitive uterus. Lilium Tig. 30 twice daily. In three weeks ovarian swelling entirely disappeared. Has since menstruated with very little pain. On two or three occasions, when the pains returned severely, the Lilium effectually removed them.
PARALYSIS FROM SPASMS
The following case, lasting through a year, presents several points of interest and profit. It is given as succinctly as possible
Miss H.– aged 17, was found in a comatose state. Her brother had died of uraemia, her mother and father each of heart disease. Belladonna, Opium and Gelsemium were given respectively. Still there was but partial relief until the ninth day. The return to consciousness was, however, only temporary; for, the afternoon found her in spasms. Previously she had complained of hunger, and on eating, went to a convulsion. This led to the choice of Hyos 2c Changed to acute Mania, declared she was being poisoned, was crazy, was in an asylum. Hyos 10m relieved, but on the 18th day she commenced singing, praying, reciting poetry; eyes injected; wild look, stram. 2c. The mind became quiet, but the inevitable stupor returned, interrupted by occasional whispering: “ice, ice”, Thinking that perhaps such a succession of narcotics had injured, she was allowed to suck a lemon by way of anti-dote. Within an hour she became conscious, and so remained for over a week.
Inquiry now revealed something of her history. Menstruation either did not come on at all or remained but a day, followed by blood-spitting, cough, tightness across the chest. The day she was taken sick was the proper time for her menstruation, but hard study had prevented its onset and determined the cerebral congestion, which had ended in coma. Phosphorus 2c was given and the next menstruation was nearly normal. At its close however, the patient was seized with spasms, varying in number from three to six a day. They were not followed by prolonged stupor, but by left-sided Hemiplegia, seemingly intensifying at each new attack of spasm. After a week, only the right half of the body would be convulsed.
There were total blindness, loss of speech, and dysphagia. For twelve days nothing cold be swallowed but ice-cream. The breathing was rapid, and so increased the painful dryness of the throat and mouth. As water could not be swallowed, a plan was tried which proved very grateful to the sufferer. Over the mouth was laid a thin piece of muslin, from which extended a wick into a tumbler of water. By capillary attraction the cloth was kept damp and the in-going air bore enough moisture to diminish the all but intolerable thirst. AT the approach of a spasm, she would make signs that she desired water. Of course, she could not swallow, even powdered ice choked her, but she would angrily bite at the proffered tumbler, a symptom, which, with the Paralysis following, led to Cuprum 2c. and higher.
Swallowing soon became normal, but the spasm persisted, menstruation remained irregular and finally both legs lost sensation and motion. Sul. cm helped. Later, by the advice of Dr. M. Macfarlan, who had seen Paraplegia result from the persistent use of Sulphur cm, this preparation was given every three or four hours for several weeks. Soon the sight returned, menstruation became regular, the attacks of spasms grew less and less frequent, until now they appear to have ceased entirely. Locomotion is still imperfect, but each day adds new strength and renders crutches less needful.
Pathologically, this case owes its phenomena to congestions of nervous centres.
After beating about the bush with medicines, selected according to their characteristics, but not according to the characteristics of the case, or at least medicine but partially similar, sul. 100,000th cured. It relieved the congestion in the corpora quadrigemina, and restored the sight; it constricted the spinal vessels, relieving the Paraplegia; it caused absorption of such effusion as generally follows venous stasis and so removed undue pressure on important nervous centres.
