HERPES S. TINEA TONSURANS.
THAT Ringworm (Herpes s. tinea tonsurans) is due to a specific fungus is one of the certainties of practical medicine; that the recognised treatment of the same is by external applications with the view of killing the fungi, no one needs to be told. Hitherto its medicability by internal remedies has been admitted by a certain section of the homoeopathic school of medicine. Indeed the more staunch Hahnemannians have always fought for this view, and time and again have proved its practicability; on this point I have been able to verify their views clinically.
For years, in common with many others, I have been constantly in the habit of treating and curing ringworm by internal remedies with relative success. For all that I have thus far never had anything approaching to a clear notion of its true nature, and some of the cases would persist in not getting well; and this lack of a definite idea of its nature, and also the uncertainty of its cure, is I believe fully shared by those who have thus habitually considered and treated ringworm constitutionally. It is due, let us say, to psora, but we have no clear conception of what psora is. Psora needs to be split up into its roots in the vague, its trunk and boughs run away into anywhere. The psora of the homoeopaths seems somehow true, but it has no proper beginning, no definite course, and ends in pathological chaos.
Perhaps we study it in Hahnemann, and in the best writers on the subject, and after doing our best to master it, we rise from our studies with no clear idea, and we finally decide to abandon psora as an intangible myth, and then we proceed with our clinical work; but, before long, we stumble against a very tangible something, and on looking at the stumbling block, we find writ large upon it the word Psora! Have I then hit upon a solution of the psora-problem? No; but if we cannot break the whole faggot, we may perchance break one stick of it.
Hughes, in his Manual of Therapeutics, says that Herpes circinnatus (ringworm of the surface) is usually treated, and with fair success, by Sepia, but that when the proving of Tellurium produced so similar an eruption, he (Dr. Hughes) followed Dr. Metcalf in prescribing it instead of Sepia for this disorder, and has never failed to cure it speedily thereby.
Of ringworm proper of the scalp, Hughes thus writes:-( Manual of Therapeutics, p. 520) “That this disease is, when recent, amenable to internal remedies alone seems to disprove the theory of its parasitic origin. The medicine for it is Sepia, at about the 6th dilution; but if this fails, you must resort to some local parasiticide, of which I suppose a solution of Sulphurous acid would be about the best.”
Some time since I published a small volume, entitled Five Years’ Experience in the New Cure of Consumption by its own Virus, and the fifty-third illustrative case therein runs thus (p.95):-
The influence of the virus upon the teeth and their growth and appearance is very striking. What I regard as tubercular teeth are those-often more or less rudimentary-with holes in their external surface. Whether this is a recognised pathological fact I do not happen to know, perhaps is it not. But it is an important clinical observation. I recognized it clinically some three years since, while treating a highly strumous lady with many scars and glands in her neck.
While under the virus I noticed an extraordinary improvement in her teeth, they became a nice color, and the numerous superficial holes cleaned and partially disappeared. It was even more apparent and striking in the following case:-
A girl of 11, with ringworm on the scalp; the lymphatic gland everywhere palpable, and her ribs very flat; strawberry tongue; a bad cough, worse at night; although 11 years old she had practically no teeth, that is to say, they were rudimentary and not above the level of her gums. All her mother’s brothers and sisters and died of consumption; after three months’ treatment with our ordinary remedies we had made but small progress, and then I kept patient altogether five month under the bacillic virus, with the result that her palpable glans ceased to be palpable; her ringworm disappeared; her ribs took on a better form; her breathing was notably better; and, mirabile dictu, her teeth and has a mouthful of teeth which are quite passible.
It may be noted that the ringworm had disappeared, and in respect to this nasty thing I find it generally disappears under the influence of the virus. I learned this very important fact also purely clinically in the following manner:- A whole family of children of different ages had ringworm for a full year, and the mother told me on bringing them that she had already spent over 60 pound on medical fees for its cure, but in vain. All known remedies had been applied by the local doctors in two neighbourhoods, and several skin specialists had worked hard at their poor heads, but to no avail. Their heads were shaved and their scalps were well scoured night and morning but still the ringworm persisted.
Finally, a distant cottage had been- hired, and the afflicted ones were there isolated, and the services of a noted ringworm curer of the non-qualified variety had been secured; but these also failing, they were put under my care. I have had no great cause to complain of the homeopathic treatment of ringworm with our antipsorics- indeed, quite the contrary-but it is apt to be a bit tedious at times.
Now their mother had been cured by me of incipient tuberculosis with the virus, and it occurred to me that ringworm might be a manifestation of the tubercular kind,*( I find Tilbury Fox and Startin were of this opinion; so are, doubtless, many others.) and so I forthwith put the whole lot under the virus, administered in the usual way, internally in dynamic dose; this I did all the more readily, as they all had numerous superficial palpable glands. And the result? In a very few weeks they were all well of ringworm and of the glands, and have thriven splendidly ever since.
Something like a dozen bad ringworm cases have come to me since then, and they were all quickly cured by the virus, and in each case the general state has been greatly improved. No doubt some bacteriologists will cultivate, some fine day, the germs of the ringworm; and astound the world with their subcutaneous injections. It is well that medical men should approach each subject from a different standpoint, as they serve to correct one another.
Since then I have systematically subjected almost all my ringworm cases to the influence of Bacillinum in high potency and infrequently administered, and of this later experience I will now proceed to treat. Ringworm is a fairly common complaint, and sends terror into the hearts of masters and mistresses of house; and schoolmasters and school mistresses give but a short shrift to any unfortunate weights who show on their scalps or necks, or elsewhere, anything approaching to a scaly, ring like patch.
They know well that if it spreads, or is reported to the children’s homes, the depletion of their school is imminent. ” No Doctor; I am very fond of Gerald, he is my own nephew, and a dear good boy, and his father is in India,- but I cannot take him back to my school unless you give me a written certificate, and that round patch on his neck is quite cured!” The very Prince of Darkness is less dreaded in a school than ringworm. Definite information, therefore, on the subject of the nature and cure of ringworm will be welcome to not a few.
Moreover, it marks a new era in the treatment of the disease. When I say it marks a new era in the treatment of the disease, I should say that for the first time it gives us a clue to its aetiology, pathology, and, best of all, to its really radical cure. The metamorphosis wrought in the bad or poor constitutions of ringworm patients subjected to the influence of Bacillinum (light, and mark well, in very infrequent doses) is simply beautiful, and a delight to the heart of the physician who loves his work for its own sake, and the more so if he has a fair share of the milk of human kindness in him.
I do not agree with those who consider that the amenability of ringworm to internal treatment- say to Sulphur, Sepia, or Tellurium-militates against it parasitic nature. *( I think Erasmus Wilson could never be brought to believe in the parasitic nature of ringworm.) There can be no question of its parasitic nature, however, it may be cured. We must read the facts thus: the disease is parasitic in its external manifestation, and if this external manifestation-the scaly, annular patches-be the disease, and the whole of the disease, then, of course, internal treatment must be regarded as little less than silly, and the only sensible thing to do is to apply to the ringworm parts something that shall kill the fungi and therefore cure the disease.
Well, few need to be told that the task of treating ringworm successfully by external means, i.e., killing the fungi, is so unsatisfactory, so uncertain, so tedious, so often an entire failure, that I well understand the state of mind of an eminent London skin specialist, who six weeks ago exclaimed to Lady X, who wished to known how long it would be before her little boy would be quite cured of his ringworm, and fit to return to school, “How long? Heaven knows, I don’t; perhaps by the end of next term, I really cannot say!”
And thus it is: the external treatment of ringworm is wrong, because it only deals with the external manifestations of the internal organismic ailment. RINGWORM IS AN INTERNAL DISEASE of the organism having for its outward sign the ringworm consisting of fungi are the guests of the diseased host; cure the host’s diseased state, and the fungus-the ringworm-dies off from lack of a proper medium. Ringworm may be regarded as mould on cheese, bits of bread, oranges, or lemons, and warm moisture favours its development. Mouldy products love darkness rather than light-a sort of half light, moisture, warmth, and hiddenness; decaying organic matter is their food and life, and I am satisfied that those who get ringworm have in their scalps something whereon the ringworm mould can live, thrive, and multiply.
Inveterate Case of Herpes Ton- surans, or Ringworm.
A lad of eight years of age was brought to me at the end of April 1891, to be treated for ringworm, under a very severe form of which he had been labouring for over a year. At the date in question it was nearly all over his body, scalp, neck, upper extremities, in large numbers of rings, varying in size from that of a sixpenny piece to that of a halfpenny. His scalp is one mass of scabs and scales extending all down his neck (said to have come from gunpowder). The scalp is at times moist. He has no feelable glands in his neck, but those of his groins are like so many very small marbles. Sparsely strawberry-like tongue; teeth yellow and decaying. “What have you tried for your son?”
“Tried! everything, but he gets worse and worse, and since that gunpowder his head has gone like that.”
I am sure that any experienced practitioner of medicine, who places his faith in the outside treatment of ringworm, recognises the picture I am drawing as that of a type of ringworm cases that will not get well do what we will. I have had them myself in olden days, till I hated the very sight of them, with their closely shaven scalps that seemed to consist in a number of little exits of sticky, mattery ooze that then dried into scabs. Such was this boy’s aspect, but some of its hideousness was covered by a natty, well-fitting skull-cap.
Bacillinum C. was given for two months, when on the 24th June, I find noted that the red pips of his tongue were nearly gone; the lower half of his scalp was clean and healthy; appetite better; teeth much cleaner and whiter. “He is much better in his health.
To continue with the same remedy.
July 29th, 1891.-He is quite well of his ringworm, though his scalp is slightly scurfy, and his teeth still rather dirty looking. He then had the same remedy (1000th), whereafter the only one thing wrong with him was the greenish state of his teeth, which presumably was from another aetiological source, and therefore not amenable to the bacillinic influence. A worse case of ringworm would, indeed, be hard to find: a prettier, cleaner, or more accurately scientific cure I do not ask for. When cured the boy was a picture, with his splendid crop of hair stubbles about an inch in length- and, moreover, in excellent general health.
I used no external remedies at all. I do not for one moment suppose that the medical world (and still less the surgical) will accept my statements in regard to the true nature and cure of ringworm; nor do I imagine that they will fairly try my treatment. Past experience teaches me, that really radical curing on lines of scientific precision with high homoeopathic potencies is not in harmony with prevailing views, and, therefore, totally incomprehensible and unacceptable to the profession at large, and hardly more acceptable to eight-tenths of the medical men practising homoeopathically. Even the homoeopathic practitioner seems very commonly quite unable to crawl out of his own old ways. Well, medical progress will pass him by and go on.
The internal treatment of ringworm by Sulphur, Sepia, and Tellurium is good, but I trust I shall be able in these pages to show that the treatment of ringworm by the internal administration of very infrequent doses of high potencies of Bacillinum is direct, exact, radical, and beyond compare; the remedy being pathologically homoeopathic to the whole morbid state and crasis of the individual, and not merely pathologically similar to the superficial cutaneous manifestations.
I have long maintained the organismic or constitutional nature of skin diseases, and have time and again defended the thesis in medical literature, notably in my small treatise, Diseases of the Skin from the Organismic Stand-point, which is here confirmed in a manner I had not even hoped for, viz, direct clinical proof of the thesis that skin diseases are indeed general, constitutional, or organismic; and, therefore, for very joy I will dwell upon ringworm pretty fully, for as I have discovered that it is curable by the administration of Bacillinum in high potency, it so comes to pass that I can demonstrate clinically the organismic nature and cure of an affection of the skin that is clearly outside, to all intents and purposes, in its own life-history, being admittedly and demonstrably due to the fungus known as the trichophyton. And this demonstration is all the more powerful, because we cannot deny that the herpes tonsurans, or ringworm, is due to the fungus, the trichophyton. No; we cannot, of course, since the thing is scientifically demonstrable, as Kobner inoculated himself and certain animals with its products, and ringworm was the result.
Ringworm, is, therefore, an external disease due to an external infection, the trichophyton, and (next to the itch) the skin disease of which people have the very greatest horror. This is due, in the first place, to the fact that its favourite seat is the hairy scalp, or near it, though we find it often in other parts of the body, and it causes the hair to fall out in circular patches as if eaten away in a ring by little worms, and hence our English name of ringworm. Therefore, any lady’s imagination readily paints herself to herself with any number of these round “spots” with loss of hair, and thus an object to be shunned,- and ladies do not, as a rule, wish to be shunned. Next to this horror is the disgrace (!) of being subject to such a disgusting disease; and, finally, it is very well known to be often exceedingly difficult of cure.
“Oh, I have tried all our big doctors and two quacks, and all the sure cures, but M’s head is worse than ever!” But all these trials were on the same lines, viz., external applications to kill the fungi.
What first struck me was fact, that in a given household infected by ringworm only some of the members got the disease, and these were invariably the weaker ones, the weedy, and the unhealthy. I have known households in which ringworm existed in one or two of its members, and although towels, brushes and combs were used almost indiscriminately, still the disease did not spread. Conversely I have known others in which only one child would have, perhaps, just one small patch, and in which the greatest care was taken to prevent the thing spreading, yet many of the children finally caught the complaint.
I have noticed the same with cattle. Thus, a herd of heifers of my own observing two years ago, numbering eighteen when mustered in the yard, were examined by me for ringworm, and five had it-three pretty badly. These five were relatively weedy specimens, and those that had it worse were the most weedy. I noticed that the infected ones rubbed the diseased parts against posts and the like, and the healthy ones living with them, grazing in the same meadows, eating out of the same bins, herded with them in the same bins, herded with them in the same yard at night, all rubbing against one another, and against the same hard objects. The healthy and did not take ringworm in the smallest degree.
A practical cattle-kenner standing by was questioned by me as to this ring worm. “Oh,” said he, “the healthy, strong ones will get it.” “And what do you do to cure the diseased ones?” “Oh, that’s nothing; keep them dry, litter the yard well, feed them well, and they will all get well of the ringwormy as soon as they get strong.”
I took particular notice of this herd for many months, and found, indeed, that the ringworm ones mended of their ringworm exactly in proportion to their general improvement, and in the end only one remained unimproved, and that one had always been the most weedy, and it was thought that she would die. I had no further opportunity of observing the herd, but I had seen quite enough to satisfy myself that strong, healthy heifers do not get ringworm although exposed to the infection closely and constantly, and those that have it get rid of it in direct proportion to the improvement in their general condition. In other words, the ringworm fungi cannot live and thrive in really healthy animals, and the ill condition of those that have the disease is not a necessary antecedent condition of the animals before the trichophyton can thrive.
Whether ringworm in itself is beneficial or hurtful, I am unable to say with certainty, but incline strongly to the belief that it may be beneficial, I mean that the presence of the fungi being sequential to internal ill-conditionedness, and being on the outside of the economy, may live on what harms that individual, and thus determine the hurtful matter from the within to the outside, thus acting as living derivatives. Inquiring of my practical cattle-kenner whether the men who tend ringwormy cattle catch the disease or not, he said,-“Oh, yes, sometimes, but not as a rule.”
The man who attended to this particular herd of heifers did catch the disease; and I found on examining him that he was phthisically disposed, he was phthisically disposed, he was very dusky, he tanned unduly in the sun, was morose and taciturn, and always felt tired and weary. I found, further, that he had had to give up a good situation in a large town, and had been recommended to find an outdoor occupation in the country, the doctors telling him he would go into consumption if he stayed in the town.
I remember years ago attending the family of a farmer, when several of the children were presented to me as having caught ringworm from the cows, and one of the boys afterwards became very distinctly consumptive, and was given up as past praying for, and then he was sent up to London to me. Four months of Bacillinum, high, quite cured him, and he is now thriving.
This all confirms me in my view, which is the underlying idea of this book, that there is some close relationship between tuberculosis and ring worm. the precise nature of which deserves attention and study.
I have already quoted from the first London edition of my Five Years Experience in the New Cure of Consumption, which see.
In the second (American) edition of this same work the following may be found:-
Case of Ringworm.
In the first edition as just stated, I communicated the important fact- many smaller things are called great discoveries that ring worm yields readily to Bacillinum, and that I therefore regard this cutaneous eruption as a tubercular manifestation. A little girl, five and a half years of age, was brought to me at the end of January 1891 to be treated for ringworm; there was only one ring on the back of the neck, but this was well defined. Bacillinum C. was ordered, and the whole thing disappeared within the month, and the little lady has been very thriving ever since.