DISEASES OF THE BONES
NOT least among the baneful effects of specialism is the artificial separation of cases into medical and surgical. There is no use crying out against specialism: the enormous development of special departments renders specialism a necessity; but at any rate we may be on our guard against its dangers. There is no hard and fast line to be drawn between medical and surgical cases: most surgical cases are medical to start with. This is particularly true of cases of disease of bones. By common consent diseases of the bones are classed as surgical. This I maintain is a very grave error. In many cases diseases of the bones are perfectly amenable to medical treatment, and only when medicine fails should surgery be allowed to step in. Not long ago I dealt with this subject in an editorial article in the Homoeopathic World (Mar. 1, 1894), entitled “Healing up” versus “Cure,” from which I may quote the following passage:-
There is all the difference in the world between these two ideas, curing a patient constitutionally and making a part heal up quickly.
A true homoeopathic cure of a patient leaves the patient for ever free from his disease; the removal of carious bone by operation, and the consequent healing up of the part, may take only a few weeks, but the “patient” is not by any means cured: he is for ever liable to a renewed outbreak. We have seen patients kept under treatment for years with frequently recurring bone abscesses; and by persistent homoeopathic treatment the patient has been completely relieved of his tendency to the disorder, and has recovered with the perfect use of the limbs affected, and his constitution thoroughly renovated. This requires years of treatment, it is true; but it ends in cure and not in mere “healing up,” which is the thing allopaths aim at. We are not saying that operation is never demanded: the circumstances in every case must decide: but the first thing to be considered is the patient, and not the diseased limb.
One reason why homoeopathy makes no more progress in this country than it does, is the difficulty men have, in the present advanced state of the physical and, so to say, materialistic sciences, of p73 apprehending Hahnemann’s point of view. We constantly talk about “mind,” vitality,” “the organism,” but we are at great pains to explain whenever we do so that we really do not mean anything by the terms. “Mind” is the mere excretion of individual brain cells; “vitality,” “the organism,” are phrases to represent the sum total of the activities of all the cells of the body.
Modern science has excluded the “soul” or the “vital force” from our confessed philosophic creed, although in our common speech it is perpetually cropping up. It was amusing to find in Dr. Burdon Sanderson’s Presidential Address at the 1893 meeting of the British Association the “living soul” re-asserting itself in that very centre of science under the name of “specific energy” which interfered with all calculations. “Heidenhain has proved,” said Dr. Sanderson, “that the process of lymphatic absorption, which before we regarded as dependent on purely mechanical causes, is in great measure due to the specific energy of cells, and that in various processes of secretion the principal part is not, as we were inclined not many years ago to believe, attributable to liquid diffusion, but to the same agency.”
Commenting on this passage, The Times had some very caustic remarks, reflecting on the philosophical acumen of physiologists in that it was possible for them so recently to hold such narrow and inadequate views of living things.
Hahnemann’s clear vision saw in disease not merely an outward alternation of tissues and functions, but a disturbance of the living, “spirit-like” organism which animates the outward frame.
This was to him the seat of all diseases (as distinguished from external injures), and the remedies he employed were of the same “spirit-like” dynamic nature, capable of reaching the essence of the disorder. The cures wrought by Hahnemann’s method are not mere “healings up,” but realise the ideal of John Hunter : “What I call a cure is an alteration of the disposition and the effects of that disposition, and not the destruction of the cancerous parts.” So long as so many homoeopathists are blinded by the visible effects of disease, such as tumours and alterations of solid parts, to the alterations of the organic disposition underlying them, proficiency in the homoeopathic art must necessarily be rare.
I will now proceed to give instances of the medical treatment of diseased bone, and will begin with a tolerably acute case.
CASE XXIV.- NECROSIS OF SMALL PORTION OF LOWER JAW: SEPARATION OF DEAD BONE WITHOUT OPERATION.
In my early homoeopathic days, I was consulted by a lady suffering from an offensive discharge from the gum of the lower p73 jaw. It was in a part where teeth had been extracted, and the probe showed the presence of dead bone. It occurred to me then that the best thing to do would be to take out the dead bone; but the patient was wiser than I, and would not consent. I therefore treated her with medicines – Silica and Phosphorus- and in a few weeks the bone came away of itself, and the patient was soon well.
This result was very much preferable to that of an operation, for many reasons :- (1.) An operation to remove carious bone necessitates the removal of a certain amount of healthy bone, whereas Nature makes a clean division between the living and the dead. (2.) The shock of an operation was avoided. (3.) The treatment of the patient improved her general health, and left her constitutionally better than before, whereas an operation leaves a patient constitutionally worse.
At the risk of being tedious I will give this case at considerable length, as it gives a good picture of the evolution of the disease, and shows how the disease of the bone was merely one symptom of a depraved constitutional state. Surgical removal of the dead bone would not have touched the constitutional condition, though it might have accelerated the healing of the sores.
CASE XXV.- SCROFULOUS DISEASE OF BONES OF FACE, HAND, AND BACK. PROLONGED MEDICAL TREATMENT. CONSTITUTIONAL CURE.
Frank C., 12, schoolboy, was brought to my clinic at the Hospital Nov. 22, 1884. Five years before, he began to suffer from scrofulous disease. Wherever he receives a blow ulceration takes place, and if a bone is struck the bone ulcerates. He has an open wound on the back, along which a probe passes for 2 inches, coming then upon dead bone (the sacrum). The face and right hand also affected. One of his brothers has rickets.
Rx Silica 3, gtt. ii. ter die.
Jan. 5, 1885.- Better; less discharge and less pain. General health better. Sometimes is ravenously hungry.
Jan. 24.- Has irritating pains at anus after stools.
Repeat Silica. Teucrium 1x, three pilules at bedtime.
Feb. 14.- Irritation better. A piece of bone the size of an almond has come out of the wound on the face. The back looks better.
Repeat. Add a lotion of Silicea 6 (3ij.- z3 viij.)
March 14.- Has passed many thread – worms. Now irritation gone. Has a cold.
Rx. Arsen 3 three times a day alternately with silic.
April II.- Has had hurt to thumb. Has a painful swelling under left malleolus. Repeat.
April 25.- Back better; face better. Thumb swelling has broken. p73 Rx Calendula ointment. Silica 3 and Teucrium 1x as before.
May 23.- Has felt worse a little. Rx Cina 1, three pilules at bedtime. Silica 3.
Aug. 29. – Side has healed up. Some pieces of bone have come out of thumb. Has cough; worst in morning.
Rx Bryonia 3 every three hours. Silicea as before. Calendula ointment.
Sept. 12.- Cough better; better generally. Repeat. Sept. 26.- Rx Cod Liver Oil, in addition to silica.
Oct. 10.- A piece of bone has come away from thumb. Face healing. Back remains healed.
Jan. 23, 1886.- Another bit of bone came away from thumb. Often sees coloured lights, especially before right eye.
Rx Calcarea phos. 3, gr. iii. ter die. Calendula ointment.
Feb. 13.- Ferrum phos. 3, gr. ii., alternated with Calcarea phos.
March 12, 1887.- Still improving. Repeat.
Sept. 5.- Hand much better. Pieces of bone have come out from time to time. Had a cold in June. Has had another, with sneezing and cough in morning.
Rx Allium cep. 6, one drop four times a day.
Sept. 22.- Cold still continues. Has been troubled with worms lately, and has passed many.
Rx Teucrium 1x, one drop four times a day.
Dec. 13.- Cold persists. Worm symptoms no better.
Rx Natrum mur. 6, one drop four times a day. Jan. 14, 1888.- Cold not yet gone. Worms less troublesome. Repeat.
Feb. 18.- Throat nearly well. No worm symptoms. has fresh cold.
Rx Cepa 12, one drop four times a day.
Mar. 17.- Gland in front of ear swelling, and behind neck. Still has cold.
Rx Calcarea c. 30, one pilule three times a day.
April 28.- Fresh cold. Headache. Hand inflamed.
Rx Mercurius bin. with kali iod. 3x, gtt. i. ter die.
May 12.- Cold better. Glands going down. Hand is better. Has bad taste in – mouth.
June 16.- Cold better. Glands swollen about face. Still a little discharge from throat. Glands at times painful.
Rx Sul. 30 ter die for a week, then Calcarea c. 30 ter die for three weeks.
July 21.- Has had toothache; bad taste in mouth. A new place has opened in the hand.
Rx Iodium 30 ter die.
Sept. 7.- Fresh cold. Glands bigger in face.
Rx Hepar s. 30 ter die.
Sept. 29.- Still had cold. Acne on shoulders.
Rx Ac. nit. 12 ter die.
Oct. 6.- Abscess in gland on face has broken. Thick white matter p73 has come away. Cold better. Shoulders better.
Rx Sacch. lact.
Oct. 27.- Still has cold. Much defluxion from nose. Hand better. Face discharging and painful.
Rx Silicea 30, gtt. i. ter die for a week, then sacch. lact.
Dec. 1.- Hand better. Cold in head again. Has not slept well lately.
Rx Mercurius b. with kali iod. 5 ter die.
Dec. 15.- Cold better. Hand better. Piece of bone coming out of face. Repeat.
Jan. 18, 1889.- Eyelashes falling out. Ringing in ears.
Rx Staphis. 12, gtt. i. ter die for fourteen days, then Sacch. lact.
Feb. 13.- Eyes well. Face better. Has another cold. Cough night and morning.
Rx Ac. nit. 12, gtt. i. ter die.
May 30.- Bad headache during the week. Ringing in ears at times. Hand better. Face bleeding.
Rx Arnica 30, gtt. i. ter die for fourteen days, then Sacch. lact.
July 6.- Bad taste in mouth.
Rx Psorinum 30, gtt. i. ter die for seven days.
Nov. 7.- Varicocele of left testis. No pain. Has cold. Chills and heats. Bowels relaxed. Cough at 4 P.M.
Rx Lycopodium 12, gtt. i. ter die.
Nov. 27.- Varicocele better.
Rx Sacch. lact.
Oct. 21.- Cough better. Still coughs from 4 to 5 P.M. Hand discharging. Repeat Lycopodium 12 for seven days, then Sacch. lact.
Jan. 18, 1890.- Cough gone. Has had influenza. Hand still discharging.
Rx Baptis. 3, gtt. i. ter die.
I have recently seen this patient. He is now a well-grown man and in perfect health. His disease while it lasted was unsightly and tedious, but by the aid of medicinal treatment he was able to continue his avocations without being laid up a day.
I will now give two cases of disease of the bones of the spinal column: one in an infant, and one in an adult.
CASE XXVI.- COMMENCING POTT’S DISEASE OF THE SPINE. CURE BY MEDICINES ONLY.
Sydney W., the child of delicate parents, and born when his mother was far advanced in consumption, was noticed by his mother when he was fifteen weeks old to cry out when put in certain positions.
On examining his back I found that the spine was distinctly more p73 curved than normal, and one of the spines was prominent and tender to pressure. The boy had also difficulty in passing water and stools. When a few weeks old he had bronchitis.
On the 24th of July 1888, the day I discovered the condition of the back, I gave him Calcarea carb. 6, four times a day. He was rather fat, of light complexion, and inclined to head sweat.
Aug. 20.- Still screams at stool and on passing water, Has a rash about him. Head sweat offensive.
Rx Silicea 6 ter die.
Aug. 31.- Bowels loose, motions slimy and green. Less pain on urinating. Has spots all over him. Looks pale.
Rx Mercurius sol. four times a day.
He soon got over this attack.
Sept. 25.- Has many spots about him. Bowels confined. Cries before passing water.
Rx Sul. 200 three times a day for three days, then no medicine.
From this date he improved rapidly. The disease of the spine went no further. I treated him satisfactorily for various ailments, including a scrofulous condition of the eyelids, and he has grown a strong boy, with his spine perfectly restored.
In so young a child artificial supports were impracticable, and the medicinal treatment rendered them quite unnecessary.
The next case was one of a much more serious kind; but in this, again, medicine – that is, the specific medicine of Hahnemann – manifests its vast and inherent superiority to surgery.
CASE XXVII.- CARIES OF THE SPINE WITH PARALYTIC SYMPTOMS IN AN ADULT. ARREST OF DISEASE AND CONSOLIDATION OF THE SPINE UNDER MEDICINES ALONE IN THREE MONTHS.
On jan. 15, 1889, I was consulted by Mrs. P., aged 67. She lives in the country, but had come to stay with her sister in town to be under my care. She had had many illnesses throughout her life, but the present one dated from sixteen months back.
In her village she was very active philanthropic worker, and her present illness, crippling her as it did, was a great distress to her. She was fair, ruddy, naturally of a happy temperament. At present she was almost motionless from the pain in the back and chest occasioned by movement, and was very much shortened in stature.
As a child she was quite strong. A the age of 19-20 had “liver complaint” (intense cutting pain, vomiting of bright green stuff; was unable to lie down for six weeks). After this she had the “grape cure” in Germany. The following year had an eruption on p73 her face. For this she had been given Sulphur, and had even had the sulphur waters of Cheltenham, but Sulphur always made her very ill.
Erasmus Wilson treated her for the skin, and gave her. Strychnine with benefit. She is still exceedingly sensitive to Sulphur, and cannot take it without its having a bad effect on the face. She had had bronchitis, jaundice, inflammation of the lungs, and years ago had abscesses, and on one occasion a boil. Has been married twenty-seven years. No family.
The particular points in the history of her present illness were as follows:- Thirty-five years previously she strained her back by lifting, and for several days was unable to do anything; twenty years ago sprained her ankle. Five years ago had lumbago or sciatica. Fifteen months ago fell over some chains on a wharf, and had to twist herself in order to prevent herself falling into the water.
For a long time she has had pain up the back, nape, and head whenever she hurried. Sixteen months ago she noticed a little stiffness on moving in the morning. Then her head became drawn. She found great difficulty in turning round. Finally, her legs gave way, and she was unable to walk unless supported round the waist. Three weeks ago she became suddenly worse.
When I first saw the patient she was in bed, lying on the back, the head being unnaturally poked forward. She complained of pain under both scapulae, the left being much the worse of the two. The pain seems to centre under the left breast, extending round to the left scapula and up to right shoulder. When she lies on the right side the pain is worse on the left, and vice versa. The pain is constant, not periodic; it is relieved by lying in bed, and again at 12 noon, after getting up.
In the upper dorsal region is a large curve, caused by the giving way of several of the bodies of the spinal vertebrae. There was no tenderness on pressure.
Some months back the pain was constant in the right side below the breast, and at the back. She thought she must have cancer. Suddenly the pain went to the left side, where it remains.
It was in September 1888 that she first suspected there was anything wrong with the spine. The pain she described as like drawing the chest and back together; with sometimes jerking pain in cartilages of the free ribs. At times constriction all round, as if by a band. On account of the spinal curve the ribs are very much pressed together on both sides. When walking, she has a sensation as if she was walking sideways. p73
Among the general symptoms of the case, I noted the following:- She is rather deaf, but can hear well in an – omnibus; in bed she is quite deaf. She is rather constipated; the water is scanty and high coloured. She perspires a little. For ten years she never perspired at all, when she was ordered a Turkish bath.
She remained three hours in it without perspiring, but four days after perspired profusely. Feet dry and cold.
Here was evidently a case of rapidly progressing disease of the spine with accompanying paralytic symptoms. The indication was to arrest the decay of the bones and and promote consolidation. There was no chance of restoring the bodies of the vertebrae which had collapsed, but if healthy action could be restored, new bone could be thrown out so as to form a kind of natural splint for the part. I was asked how long I thought it would take to bring about the change, and I said about three months.
It was important to estimate the time, as the patient’s sister, who undertook the care of her, could not continue it indefinitely. My estimate was fortunately correct. By the 15th of April the patient was able to walk up and down stairs unaided, and before the end of the month she was able to walk up and down stairs unaided, and before the end of the month she was able to leave for her home.
There were many medicines which occurred to me, and especially phosph., sepia, carbo veg., and lycopod. phos. has, in addition to its well-known relation to caries, “loss of power of limbs,” and “tenderness of dorsal spine and muscles; “sepia, “tensive pain in right side of back under scapula, especially when lying on right side;” “great aching between shoulders and under left scapula, extending into left lung, worse on expiration;”
Carbo veg., “stiffness of back, spine becomes bent;” “rheumatic drawing in back worse on stooping;” “pain in scapular region;” Lycopod., “burning in scapular region;” “drawing under scapulae.” Lycop has also the transference of symptoms for right to left. I selected the first of these four.
Rx Phosphorus 30, gtt. i. Sacch. lact., gr. ii., a powder every four hours.
Jan. 18.- Less pain in back and chest. Has had a return of some of the old lumbar pain, which has made her more helpless than she was. Bowels constipated. Since taking Phosphorus her mouth has become dry, and she has much thirst. Omit medicine.
Jan. 19- Better; more strength: moves limbs more freely. Less dryness of mouth. Has profuse sweat of face; has had this for p73 some months.
Jan. 21.-Stronger; less pain and stiffness. Throat less dry, but lips still dry- a very unusual thing with her. Bowels not yet moved; no feeling of it.
R Opium 3 every four hours.
Jan. 23.- Bowels moved twice. Much better generally; less pain in chest; no pain in loins; more strength in arms; can walk better.
Jan. 25.- Has had a good deal of pain on left side, worse at night, making her restless; nevertheless she moves more, more easily, and can stand better. She feels a grating sensation on one point in the back. Has very little pain in right side, but cannot lie on it. Bowels act naturally every morning.
R phos. 30, one dose.
Jan.28.- Had a very good night 26th, but not last night. Still has pain on left side, but moves more easily, can turn in bed, and can cross her legs when sitting. Throat is dry in the morning; roof of mouth sore. No more medicine.
Jan.30.- Better. Less grating Throat less dry.
Feb.6.- Steady improvement till now. There is tenderness to pressure over the spine of the most prominent vertebra of the curve, and she has a feeling as if lying on a bread-crumb when she lies on the back. She can sit upright in bed, propping herself with her hands. Holding anything in left hand makes her side ache.
Rx Phosphorus 1 m., one dose.
Feb. 13.- Better. Can breathe better – almost naturally. If she sneezes she does not now have pain. Still feels pain left side on turning to right. Repeat one dose.