APPENDIX
SINCE the foregoing was in type, a paper on “Homoeopathy in Bone and joint Diseases,” by Mr. Gerard Smith, has appeared in the Homoeopathic Review of August 1894. In this paper a case is recorded by Mr. Smith which illustrates so pointedly my contention that the boundary line between surgery and medicine is in urgent need of reconsideration, that I cannot forbear to quote it in full. Mr. Smith admits that the surgical treatment in the case was quite “correct” according to the recognised canons of practice; and yet, in his opinion (and, I may add, I quite agree with him), this perfectly “correct” treatment was the immediate cause of the boy’s death.
Could there be clearer evidence that the recognised canons of treatment need to be revised? I will now quote Mr. Smith.
“I will mention one case which is instructive, – a boy of twelve, in November 1888, fell on the pavement while running, striking p73 his right knee violently; acute synovitis followed. The joint, after complete rest for three weeks, Aconite and Arnica followed by Bryonia, apparently completely recovered soundness; but during the following month walking became painful, and the knee commenced again to swell without any rise of general temperature at first, but with the usual “white swelling” and all the subsequent symptoms of a strumous knee-joint; the joint became very greatly swollen, and lost all the normal outlines, with the usual painful spots and general swelling round the joint; it was fixed in a poro-plastic support, the boy being confined to bed; Silica was given steadily, with occasional doses of Bryonia, for three months, when the joint had been reduced to nearly the normal size.
Treatment of this kind was kept to for two more months, and the movements of the knee became again fairly free, though restricted. Active disease seemed at an end, and I had doubts as to the correctness of my diagnosis, since the knee scarcely seemed like one which had been affected with tuberculous disease. No doubt the joint membranes had not as yet be come destroyed, and if there were any morbid deposits they were in the heads of the bones, and had presumably quieted down. A period of a month then passed,- the boy resting mostly on a sofa, and only walking with crutches, with the knee in a splint, and then, with no accident to account for it, unless it may have been from cold, all the former symptoms came back, but with greater severity. The same treatment again prevailed to reduce the swelling and restore the movements; but a third onset induced the parents to take the boy to a general hospital, where the knee was excised, the articular ends of the femur and tibia being found full of caseous deposits, and commencing disintegration of the joint structure in evidence.
After the operation all seemed going well, and the healing proceeded in a hopeful manner, but at the end of a fortnight the boy commenced to have-some symptoms which were quite new to him,- he got severe headaches, which increased rapidly in severity, and were followed by convulsions. I need not go fully into the details : it will be sufficient to say, that after losing sight and hearing, and becoming entirely paralysed, the poor child died, and at the post-mortem examination there were found a cluster of tuberculous masses at the base of the brain and in the cerebellum, with widespread meningitis.
“I formed the opinion at the time that the operation had disturbed and set in movement the morbid deposits in the bones; this was a fatality quite out of the power of the most skilful surgeon to anticipate, and the operation was, by all rules of modern surgery, one quite justified; but I am confident that under homoeopathic treatment the operation would have been much further delayed, and possibly a final recovery might have taken place without it. p73
“However mistaken I may be in this opinion, the case was one of great importance”.
