So few cases of disease of the pancreas have been recorded that but little can be said in regard to the prognosis of the various forms of affections to which this gland is liable, but from the known favourable action of remedies, when applied under the Law of Similars, in the treatment of diseases of kindred glands, we would be led to believe that a favorable prognosis might be given in many cases of Acute Pancreatitis, also in the early stages of Chronic Pancreatitis.
As regards morbid growths, cysts, concretions, etc., we are at present unable to speak favourably, as most of such cases, thus far recorded, have been unrecognised prior to the autopsy. In general, owing to the uncertainty surrounding the diagnosis of pancreatic disease as well as the fact that many cases of supposed gastric, hepatic, or intestinal origin, have in reality been dependent upon disease of the pancreas, it is but fair to infer that many unrecognized cases have recovered.
The therapeutics of diseases of the pancreas are very deficient. Works on poisons, as those of Wormley, Taylor, Reese and Ziemssen, seem to make no mention of the action of poisons on this viscus; nor do they include its pathological changes in their description of autopsies. Equally unsatisfactory is the medical literature of all schools.
In our own text-books and works on therapeutics, Iris Versicolor is mentioned as a leading remedy in acute inflammation of the pancreas; and Phosphorus and Arsenic, in fatty degeneration.
Since a prominent function of the pancreas is the contribution of a juice, which behaves like saliva, we may, perhaps be allowed to examine drugs which act upon the salivary glands and determine if they have any of the symptoms supposed to indicate pancreatic disease.
We add, then, in tabular from, the symptoms of Bell, Mercurius, Conium, Carbo, An, Carbo Veg., Rhus Tox., Hepar Sul., Kali Carb., Dulc, Lycopodium, Silicea, Sul, Thuja, Calcarea Osts, Iodium, Podo, Nitric Acid and Colch, with a few others, whose symptoms are suggestive.
Soapy taste: Iris Vers, Iod, Dulcamara, Rhus Tox.
Raises a watery fluid; bell, Carbo Veg. Dulcamara Mercurius, Hepar Sul., Uranium Nitrate, Iris Vers.
Icterus: Merc, iris Vers, Podo, Lycopodium Dulcamara, Sul., Digitalis, Aurum.
Pains in the region of the coeliac axis; Iris Vers., Colchicum, Phosphorus, Arsenic, Plumb., Rhus Tox, Stann, Platina, Kali bichromicum
pains deep in between the pit of the stomach and navel; in addition to the above: Zinc, Carbo An., Carbo Veg., Conium, Thuja.
Ulceration of the duodenum; Arsenic, Kali Bich, Uran. Nit.
Stools contain fat: iris Vers., Iod, Phosphorus, Arsenic, Asclepias Tuberculinum, Thuja., Polyp. Offici, sulphur, Calcarea F. Fagop, Ferrum Met., Pic., Acid.
Stools undigested; Arsenic, Phosphorus, Calcarea Ost. Iris Vers., Graphites, Nitric Ac.
Stools with emaciation: Arsenic, Phosphorus
Fatty degeneration of the pancreas; Phosphorus, Silicea, Arsenic., Diabetes Mellitus: phos., Arsenic, (Uranium Nitrate).
Dr. Buchner recommends the following: Catarrh of the salivary ducts: Belladonna, followed with Mercurius.
In chlorotic girls; Puls, Calcarea Ost.
For hypertrophy of the pancreas: Salts of Lime.
Inflammation; Bell, Conium, Hepar, Mercurius
Inflammation with suppuration: Calcarea, Hepar, Silicea.
Erythematous patients, or skin affections: CalcareaAcet. Cardiac or renal diseases: CalcareaArsenicum
Gangrene or softening: Kreos, Secale C.
Pancreatic stones: Bell, Salts of Lime, Potash and Soda.
Cancer: Phosphorus, Silicea, CalcareaArsenicum (latter with burning.).
icterus: Bell, Merc, Digitalis, Aurum.
In epidemic diseases: Rhus Tox, then Calcarea Arsenicum
Iris Versicolor:- Burning distress in the region of the pancreas; vomiting of a sweetish water; saliva has a greasy taste; green watery diarrhoea, worse from 2 to 3 A.M. offensive flatus, smelling like copper. Diarrhoea contains undigested fat; bilious vomiting; sick headaches return periodically every week; dull, throbbing or shooting over one eye, usually over the right, with dim vision, nausea and vomiting.
Congestion and rupture of minute vessels in the pancreas of a cat poisoned with Iris.
Iodine: Great emaciation; hungry, anxious if he cannot great food at the appointed times; eats enormously, yet grows thin; soapy taste; fat in the stools; glands enlarged or atrophied; lungs affected.
Phosphorus:- May prove valuable in tuberculous patients; or when there are evidences of fatty degeneration of various organs, especially of the heart, liver or kidneys; distressing burning pains in the coeliac axis; stools undigested, containing particles of fat; face pale-yellow; anaemia; atrophy of the pancreas with Diabetes Mellitus. One of the best remedies in neuralgia of the coeliac plexus.
The Phosphorus diarrhoea containing small particles like sago, or, as expressed by some, like tallow, is not the fatty diarrhoea which suggests the drug in pancreatic diseases.
Arsenicum:- Organic changes similar to those mentioned under Phosphorus; but distinguished by greater restlessness and anxiety, as if, the pains would drive him to despair. Ulceration of the duodenum, which, by extension, involves the pancreatic duct. This ulceration may be a result of burns, of malignant disease, etc. Neuralgia of the coeliac plexus. Stools undigested, containing fat.
Uranium Nitrate:- Causes ulceration of the duodenum and also of the pyloric end of the stomach. It should, therefore, be remembered as a possible remedy, when the pancreas is secondarily involved. The stomach symptoms are: Vomiting of a white fluid; putrid eructations; pains worse from fasting. The kidneys are usually affected; the urine deposits a muco-purulent looking sediment, and contains albumen, Phosphates, Lithic Acid, in excess. Glycosuria.
Lycopodium:- According to Dunham, causes a chronic Duodenitis; pressure on the hypochondrium, produces tender pains in the epigastrium and vice versa. If, then, the pancreatic duct is involved, and we have the well attested dyspeptic symptoms of Lycopodium and Jaundice, it may prove curative. It should also be remembered in pancreatic stones.
If a pancreatic tumor is diagnosed, we may study the Calcareous preparations, as advised by Buchner, and also; Conium, deep- seated lancinating pains: tumour feels hard, nodulated: (Zinc has a hard tumefaction over and below the stomach. It has relieved enlargement and induration of the left lobe of the liver. We introduce it here merely as suggestive of its employment when the tumor is pancreatic, instead of hepatic.) Carbo An., Carbo Veg. Iodine, Phosphorus, Silicea and Arsenic.