“About the end of August he again began to get worse, and steadily lost ground until the time of his admission. For over a year he had suffered from indigestion, a catching or shooting pain from the right mamma to the left shoulder, with a feeling of a lump at the root of the neck.
“Physical examination showed that there was consolidation of upper part of right lung with formation of a cavity, with slight indication of the left apex also being affected. The heart and other organs were normal.
“The cough was worse on rising in the morning, and in the evening. Expectoration scanty, hanging about throat and difficult to get away. An examination showed it to contain tubercle bacilli. The cough caused pain in the right side. The irritation which caused the cough seemed to be in the chest. Movement or any exertion aggravated it. He could not lie on his right side. At times he felt as if he could hardly breathe. Was very weak. Had night perspirations. Appetite fair; bowels regular.
“Under Bryonia 1 the pain in the side improved; under Acid nitricum 12, and afterwards Arsenicum iod. 3x, there was some improvement. Later he became troubled with constipation, feeling of nausea and mental depression. Nux 3 and Sulph. 30 did good in these respects. Phosphorus6 had no particular effect.
“On November 9, as he was still complaining of the weight on the right side of the chest, the cough symptoms continuing, I gave him on his tongue three globules of Tuberculin H. 100. Improvement was noted on the 14th. On the 16th the dose was repeated. He then reported himself as feeling better. He had gained 1 1/4 lbs. in weight since October 27th. He now complained of a lump at the chest coming on when he had eaten a little; much flatulence passing downwards, so he was put on Lycopodium 6, and continued on this for a week, during which time the flatulence and other symptoms of disordered digestion improved much. At the end of the week a sharp attack of diarrhoea supervened, stools sudden, watery, light brown, with much wind. Colocynth 3 soon put this right.
“On the 30th of November another dose of Tuberc. was given, and again on the 10th and 17th of December.
“Up to the 17th of December there had been steady improvement. On that day the patient was feeling less well. More cough, tickling and wheezing on chest, tongue rather dirty, no appetite. On the 19th a rheumatic attack began to develop, with pains in ankles and wrist. There was fever and heavy night sweats, with night aggravation of the cough. The pain was chiefly in left ankle and across instep, and under left knee. There was also pain in right great toe (which he had before). Under Mercurius sol. 12 these symptoms passed away by December 30th; but the cough continued to be troublesome, occurring between 12 midnight and 3 A.M., first thing on waking. Sinking sensation on getting up. Kali carb. 12, Arsen. 30, and Bryonia 30 were given in succession without producing any observable effect, and on January 4th Tuberc. was repeated. After this he made rapid progress, but the cough still troubled him a good deal. There was a tickling behind the middle of the- sternum. The cough came on in the afternoon. He was put on Lachesis 12, one drop every two hours, on the 12th of January, and by the 23d the cough had left him completely, and did not return. He regained the flesh he had lost, and was quite free from all symptoms referable to the chest.
“The condition of the right lung on February 2d was as follows: Tympanitic note on percussion above and below right clavicle; tubular breathing. Expiration prolonged and harsh over the upper lobe anteriorly, and as far down as the sixth rib at the back. No moist sounds.
“The patient left the hospital, looking and feeling quite well, on February 3d. The consumptive process was completely arrested and the patient practically cured. Of course the lung tissue that had already been destroyed could not be restored, hence the physical signs of a cavity remained. But the cavity was a healed cavity, and not an ulcerating one.
Although other remedies were given, I am inclined to give the chief share of the credit of this cure to Tuberculinum, for the first marked change for the better took place whilst under its influence. I have never given this remedy in more frequent doses than one a week; and I have never found that it interfered with its action to give intercurrent doses of other remedies that might seem indicated by the symptoms.
“P.S.-Since the above was written I have seen the patient again (March 22d) and found him looking the picture of health. He has returned to his old employment and is able to run up and down stairs more briskly than many of his fellow-workmen.