STRUMA OR SCROFULA.
SCROFULA, or struma as it is also called, is a constitutional state which manifests itself in peculiarly intractable inflammations, especially of the skin, eyes, eyelids, and glands, and in a tendency to tuberculosis of the lungs, abdomen, or membranes of the brain. The constitution is generally inherited, but it is remediable, either completely or to a very large extent. The underlying cause of it all is the presence of the psoric “miasm” as described by Hahnemann in his “Chronic Diseases.”
Though not identical with “psora,” scrofula forms a large section of the diseases described by Hahnemann as psoric. It is analogous to constitutional or inherited syphilis, and not unfrequently the two “miasms” are combined in the same person.
Scrofulous individuals are much more susceptible to morbid influences, and are thus more liable to take colds and inflammations than other people, and when they do become affected, they are longer in getting well. The processes of life are more sluggish, and as the lymphatics are intimately concerned with the process of repairing waste tissues, they naturally suffer more almost than any other part. It is for this reason that in the public mind the presence of enlarged glands in the neck has come to be regarded as the sign and proof of scrofula.
And though there are many scrofulous persons who have no diseased glands, and many who have had gland abscesses who are not scrofulous, still the popular view may be accepted as in the main correct. Abscesses in the glands of the neck are a very common sequel of the ordinary fevers of childhood-scarlatina, measles, chicken-pox, and diphtheria.
In a perfectly healthy state lymphatic glands are not discoverable by either sight or feeling. When inflamed and enlarged they feel like “kernels” (a popular name for them) under the fingers; and if near the surface are more obvious to sight. Simple inflammations of a gland does not make that gland scrofulous.
The truly scrofulous gland is a gland affected with tubercular taint; and by the time a gland is affected the constitution is p73 also affected. Hence it follows that the only philosophical treatment is one which is directed to the constitution, and seeks to so change that for the better as to make it heal the gland itself.
CASE IV.-CHRONICALLY ENLARGED GLAND IN NECK REDUCED BY MEDICINE.
In May 1893, I was consulted by Miss D., aged 14, who had a gland in the neck under the right ear, about the size of a filbert, which had been troubling her for three years. She was tall (had grown much lately), stoop-shouldered (possibly due to short sight), pale and delicate-looking. She came of a very consumptive family.
May 31.- Bacillin 100 every eight days.
July 1.-Very much better. Gland smaller but not gone. Calcarea phos. 30 thrice daily. Bacil. every eighth day.
July 28.-Better Repeat.
Oct.28.-Gland all but gone.
I have seen her brother repeatedly since, and hear she has kept quite well.
CASE V.-GLAND ABSCESS IN NECK ABSORBED WITHOUT DISCHARGING.
Matt. B., aged II, a very delicate boy, was under my care for enlarged glands in the summer of 1891. Under Bacil. 200 chiefly he got quite well.
In February last, after a blow on the side of the neck, one of the glands under the ear inflamed rapidly, and by the time that I saw him, a few days later, there was already suppuration present, the sensation of fluctuation being distinct. I forbade poulticing, and treated him constitutionally-Bacillin, Hepar s., and Psorinum being the chief medicines given. Maturation went on, but at no time did the matter seem like pointing, and I refused to open the abscess.
On the 12th of March he developed measles, for which I gave Morbillin 30. In a few days all fluid disappeared. The abscess dried up. I sent him away to the country, and he came back with no swelling of the neck to be seen, and only the remains of the gland to be felt.
CASE VI.-SUPPURATING GLAND AFTER DIPHTHERIA IN EMACIATED CHILD. SPONTANEOUS OPENING. INSIGNIFICANT SCAR.
Herbert B., aged 5, but not looking more than 2, extremely emaciated, without any power in his legs, which were no longer than a three months baby’s was admitted to the hospital in the autumn of 1893.
He had lived in an underground room without sunlight and proper food. Under Bacillin 200 he made progress, gaining very slightly each week in weight. Under Thyroidin 3X he gained 3/4 lb. a week.
Then an attack of diphtheria threw him back, but he recovered well under Mercurius cyan., but it left him with swollen glands on each side of the neck, and on the left side suppuration took place. He received Hepar, and afterwards Silica, and no external treatment. The abscess opened spontaneously with a very small opening, and healed rapidly, leaving a scar so small as to be hardly visible. The boy then gained weight again, and was sent for a change into the country.
CASE VII.-ENLARGED GLAND FOLLOWING INTERNAL THROAT AFFECTION, SIMULATING NEW GROWTH. THREATENED SUFFOCATION. SUPPURATION AVERTED BY TREATMENT. CURE WITHOUT OPERATION.
I was sent for late on the evening of Oct. 31ST, 1893, to see a boy, T. W., aged 18 months. Eight days before, he had been taken ill with sore throat, which caused him to make a peculiar noise in breathing. The obstruction to breathing had gradually become worse, till he seemed in imminent danger of choking. Two days become I saw him he had come out in little red patches, which only lasted one morning. He had also complained of pain in his ear. The practitioner who attended him was so much alarmed by his condition that he proposed examining the condition of the throat under chloroform, and operating if necessary. This the parents objected to, and sought my advice.
I found the patient looking very ill, sitting up on his mother’s lap, as he could not be laid down for fear of his choking. He had an enlarged gland, painful and tender, on the left side of the face under the ear. Saliva was running from his mouth, and a discharge from his nose. He was very peevish and irritable, and exceedingly difficult to examine. He had very little appetite, and there was great difficulty in swallowing. The bowels were regular. The urine was scanty, slightly alkaline, and contained a copious deposit of white urates.
The chest sounds were clear. Temperature normal; pulse 120. It was hardly possible for him to sleep, as he immediately woke up choking.
I was unable to examine the state of the throat on account of the child’s condition, but it was evident that the whole difficulty lay in some swollen or paralytic condition of the soft parts at the back of the nose. The difficulty was all in drawing in the breath; he could breathe out easily. As there was no fetor of the breath I excluded diphtheria. There was much working of the alae nasi. He was constantly picking his lips and nose. The last symptom decided me to give Arum triphyllum in preference to many other more or less appropriate remedies.
The last symptom decided me to give Arum triphyllum in preference to many other more or less appropriate remedies. I gave it in the 30th every two hours. I took upon myself the responsibility of avoiding surgical measures.
Nov. I.-The next morning I found he had had a very bad night, had coughed more, in choking. One, but had more rest in p73 the morning. The gland was less swollen and less painful. He had not taken any more milk. More running from the nose. He still picks his lips; still making the same noise on breathing. I now gave Bromine 30 every two hours.
At 9.30 P.M., the same day, I found him no better; the nasal obstruction was rather worse.
I gave now Laches 30 every ten minutes.
Nov. 2.-Very bad night. Breathing very bad; cannot lie down at all. More gurgling in throat. Clammy forehead. Much discharge from nose. Has taken a little nourishment, and in spite of the bad night seems a little better when awake.
Rx Hepar 200 every half hour.
4.30.-A quarter of an hour before I saw him he vomited white phlegm, very sour. Is crying because he cannot go to sleep. is more lively when awake. His cry is stronger. The Hepar seemed to relieve him very soon. The neck is much less swollen. He is very peevish.
Taking into account his constitutional symptoms, some what rickety enlargement of wrists and ankles, backward state of dentition, head-sweat, which he had till he was five months old, and also the fact that his father had had a foot amputated for some disease of the ankle, I gave now one dose of Bacillin 200, without interrupting the Hepar.
Nov. 3.-In the evening he seemed brighter, and wanted food. Slept an hour and a half this morning. Is better; breathing better. The bowels have moved twice: the first motion like white jelly and blood, very offensive; the second, slight, dark and offensive. There is now very little running from the nose; just a little dribbling of saliva.
The swelling is still diminishing. He cannot yet lie down, but sleeps with his head on his chest.
Nov. 6.-Has kept improving. To-day for the first time I was able to examine the throat. I found the soft palate depressed and bulged forward on the left side. Tongue white; nothing like false membrane seen. Repeat Hepar.
Nov. 7.-Poor night. Breathing difficult. Passed a very dark motion. Lump less large and less hard. Every now and then a croupy noise in throat. Is brighter, and takes a little food. He screams if laid on left side.
Rx Calcarea phos. 30 every hour.
Nov. 9.-Yesterday vomited undigested food twice. Swelling is larger; has extended lower down. Does not make so much noise in breathing. Tongue and roof of mouth white. I gave one dose of Bacil. 200, and followed it with Phytolac. 30.
Nov. 14.-One hour after taking the Bacil. he seemed altogether different, and has been steadily progressing ever since. On the 10th an abscess which formed over the two upper incisors burst, and he has been better since. Has a cough, and is p73 unable to lie down. The cough is in fits, coming on almost every hour. I found slight dulness and some moist sounds at base of right lung. There was a case of influenza in the house at the time, and I attributed this cough to that cause.
Rx Sanguinaria c. 30 every hour.
Nov. 16.-Has been better. Not coughing so much. Breathing better. Mattery discharge from nose in night. Not eating so well. Repeat Sanguinaria, and one dose of Bacil.
Nov. 18.-The cough has been very bad; worse between II and 12 at night. Vomited phlegm. Wheezing and rattling in chest. Nostrils sore. Has a fit of coughing every quarter of an hour. Has difficulty with solid food. Glands much better. He is very cross.
Rx Cina 30 every hour.
Nov. 21.-Very much better. Brighter; appetite better. More discharge from nose. No longer picks nose or lips.
Right side of the neck is a little swollen, but not at all sore. Still has a cough in fits, worse in the night or on lying down, but there is less rattling of phlegm in the chest.
NOv.-27.-Has got quite well in all generals respects; runs about, eats and sleeps. Has no cough. Cold almost well, but he still talks thick. He lies on his face, and sometimes seems as if he would choke in his sleep. On looking into his throat I found still a large swelling at the back. The glands externally were insignificant in size. He has cut three teeth during the illness.
Rx Bacil. gl. iv.; Calcarea sul. 3, 2 grains three times a day.
I saw him for the last time on Dec. 4th when he was practically well. I gave another dose of Bacil., and ordered Calcarea phos., leaving instructions with the parents to send for me in the event of his not getting perfectly well.
I will now give two other cases of a similar kind.
CASE VIII.-ENLARGED SUPPURATING GLAND ALLOWED TO OPEN SPONTANEOUSLY. INSIGNIFICANT SCAR.
K. G., 10, subject to enlarged glands and sore throat, had an acute attack of sore throat about the beginning of May 1892. He came of a rather scrofulous family, his elder brother having had painful abscesses in the glands, leaving scars.
Two years before, he had had influenza. He had also had severe bleeding from nose, and had never been quite well since. He was rather short of breath, and I found the mitral valve of the heart defective. When the acute attack was over, the gland, previously enlarged, became inflamed. Under Bacillin, Silica, and Baryta carb., he made good progress, the cardiac bruit disappeared, and the inflammation of the gland limited itself. I did not allow any p73 poulticing, but had it bathed with hot Calendula lotion. On June 30 it opened spontaneously by a very small opening, and healed without leaving a conspicuous scar.
CASE IX.-ENLARGED GLAND AFTER CHICKEN-POX. SUPPURATION IMMINENT, BUT AVERTED.
Robert M., aged 5, had chicken-pox in October 1893. There was a history of consumption on both sides of the family, and one of his father’s sisters had suffered from enlarged and suppurating glands after chicken-pox. Whilst the eruption was out the boy had been exposed to a draught which played upon the left side, and on the same side a gland under the angle of the ear swelled to a considerable size and threatened to suppurate. A certain amount of softening took place, and any indiscretion in the way of poulticing would undoubtedly have precipitated that result.
At one time during convalescence he caught influenza, which aggravated matters, but in the end, after persistent treatment, the gland disappeared without leaving any trace behind. Bacil. 200 and 30, Calcarea phos. 30, Arum triphyllum 30, Hippozaenin 30, Arsen. sulph. rub. 30, and Calcarea carb. 30, were the principal remedies. The treatment lasted several months, but the result left the patient with a whole skin and an organism sufficiently strong to overcome the disease by its own efforts.
I will now give a few cases from what I may call the pre- Bacillin times.
CASE X.-POST-SCARLATINAL SCROFULOUS GLANDS OF THREE YEAR’S DURATION.
Mary A., 9 of large growth, sanguine temperament, was brought to me at the London Homoeopathic Hospital on the 19th of April 1881. For three years had suffered from enlarged and suppurating glands in the neck, which first began to appear after an attack of scarlatina. The father is strong, but has a depressed bridge of the nose; the mother is strong, and all the children are healthy except this one. Tongue rather white; appetite poor; cannot take milk; sleep good; is nervous has had worms. Calcarea was first given, with improvement in general health; the suppurating gland had discharged.
May 28-.Silicea 6, pil. i. ter die.
June 16.-Complains that the pilules “made her sick and gave her diarrhoea.” The neck, however, was much better; swelling much reduced.
Silicea 30, one pilule night and morning.
July 23.-Upper gland very much swollen lower gland still discharging; general health good.
Sept. 3.-Neck very much better; discharge ceased; health very much better. This was her last attendance.
Here is a case of less duration.
CASE XI.-ENLARGED GLANDS, WITH ERUPTION ON THE SKIN. Daniel W., 12, a thin, delicate, nervous subject, was brought to me on Feb. 25th, 1882, with enlarged cervical glands and an eruption of sores on the back of the neck. The condition had lasted two months.
Bellad. 3., one drop in water three times a day.
Mar. 11.-Better. Repeat.
Mar. 25.-Better; once had some bad sores on back of neck, but now better; glands better.
He was now practically well.
CASE XII.-ABSCESS OF NECK AND INFLAMED GLANDS. ACTION OF ACONITE.
Annie D., 22, pale nervous, and low, came to the Hospital on Oct. 11th, 1884.
She had had an abscess in the neck, which was opened at St. Thomas’s Hospital, where she had been for five weeks. Under the right jaw is an enlarged gland. Over the vessels of the neck there is heard the venous bruit indicative of anaemia.
Barytac. 6, one pilule three times a day.
Oct. 18.-Gland the same; has a very bad cold in the head.
Mercurius sol. 6, one drop four times a day.
Nov. 15.-Has been absent, and for three weeks has had no medicine. Cold better; face about the same.
Nov. 29.-Cold in the head is better, but has a cough, worse during the day; raises much phlegm.
Mercurius s. 6, Bryonia 3, every alternate three hours.
Dec. 13.-Cough better; general health better; gland the same.
Jan. 17, 1885.-Gland same.
Aconite 6, one pilule four times day.
This completed the cure. Under Aconite the gland soon disappeared, and I quote this case in full to show the affinity of this drug for indurated glands.