DISCUSSION Dr. McCRAE thought the paper was masterpiece. There was nothing in it criticize there was details of valuable help to everybody which were like the artist sharpening his pencil to produce some line of particular splendour which would make the picture complete. Most had pencils but they were blunt and the homoeopath would always be grateful for these amazingly useful hints. He hoped Dr. Borland would soon return so that the members could thank him personally. He also thanked the president for the way in which he had read the paper.
Dr. JOHN PATERSON said that they had listened to a real clinical paper. There was not much which one could criticize but one might add a little with regard to the cardiac cases, Arsenic and sulphur his experience was that ARsenic was often the acute of sulphur and on the mental side they were the exact opposite.
One found that a sulphur patient swung in the acute condition to “Arsenic and Dr. Borland had brought out that point. He was interested in the question of Aconite acting in the first attack but not in the second. There had been many discussions about covering the totality of the symptoms and here was evidence that the homoeopathic remedy could be prescribed on the mental symptoms which worked in the first instance but it did not cover the whole of the case. It was possible to prescribe homoeopathically without covering the whole of the case, only covering a phase because obviously on the next occasion the pain was present but not the fear the Aconite had removed one phase of the case mental fear. Aconite came out very strongly in the air raids. Another remedy was Natrum Mur.
He wondered if any orthodox practitioners were surprised that there was no mention of Digitalis but Digitalis was quite useful in these slightly relaxing hearts in massive doses given in allopathic medicine.
With regard to renal colic, in examining the stools of patients the Bacillus Morgan came out very frequently and he associated Lycopodium with it. Lycopodium had always been considered to be a right-sided remedy but the peculiar point about a case in which it had proved successful was that the pain had been left-sided and when the case had been x-rayed it had been found that the right kidney was more involved than the left, so that it looked as if the actual renal colic condition started in the left kidney but gave no trouble. It was only when the right kidney was involved that the first symptom developed so that even with a left-sided renal colic Lycopodium should not be excluded.
Dr. STONHAM said that the paper was excellent and the sort of paper which would appeal to the general practitioner, who was always coming up against acute cases. To have such cases so plainly stated with the drug indications for them was very valuable. There were one or two points he would like to mention with regard to “Aconite which as Dr. Borland had said was very useful in many cases. The case which which he did not mention was the acute pulmonary oedema.
He had given Aconite 30 in such cases and it quickly calmed the patient in that distressing ad somewhat dangerous condition and he had found it valuable not only in the first case but also in case when the attack has been repeated. Dr. borland said he gave Laurocerasus in acute heart complaints. He had had an acute case with Cheyne-Stokes respiration it looked as if the patient would die, he gave Hydrocyanic Acid and he recovered very nicely. Many people would substantiate the value of Dr Borland’s Paper.
Dr. G.R. MITCHELL said that a clinical paper was most useful. He wanted to criticize something Dr. paterson said when he took the Aconite example as not prescribing on the totality. He would have thought it was an example of prescribing on that procedure because in the first case, on all the manifestations there was a different totality and the Aconite did not work. That was the way he would have regarded the matter.
Dr. HARDY added her grateful thanks to Dr. Borland for his paper. With regard to medicines for heart complaints she agreed with Dr. paterson that Digitalis 200, one dose was very effective in the semi-chronic or chronic case of the right sided congestion blue face and blue nails, but not in the acute patient. She also used mother tincture Crataegus for heart patients because it was specific for the cardiac muscle. Another drug which was used in russia was Adonis mother tincture, five drops to a dose. there was a remark which she did not like about chelidonium that the patient did not respond and that it must therefore be cancer. The case was Lachesis to start with and that did not exclude the possibility of cancer. She has a very bad case of cancer which was cured by Lachesis, a liver case with constant pain. In her personal experience Raphanus was indicated in the hepatic lesions, and Momordica in splenic lesions.
Dr. LE HUNTE COOPER did not think too much could be said about the work which had been put into this paper and the wonderful collection of details on which indication had been given and which were of the greatest possible value.
The paper would require a great deal of study so that these indications could be taken for future use.
He was rather in favour of trying to keep the remedies which were very definitely specific for particular conditions because in cases where there was an emergency, there was no time to seek for all the exact indications which might help, but he was rather surprised that Dr. Borland do not make more use of the snake poisons in heart cases because he must admit he would not be without Lachesis. If there was any suggestion of heart failure he would give Lachesis and would be surprised if it did not answer; There was one rather interesting point from the homoeopathic point of view with regard to snake poisons and that was to think of the first thing which an individual felt when he was bitten by a snake which was death, threatened the patient the prescriber should think of the snake poisons. He mentioned this in a paper he read on snake poisons in a paper he read on snake poisons in Berlin just before the war and it attracted the attention of reporters who were present. In the Berliner Tageblatte there appeared in Headlines “When death threatens, think of the snake poisons.
Another point was the that he thought a little more might have been made of pulsatilla for the ear. His experience was that a pain in the ear was met by pulsatilla irrespective of the indications of the pulsatilla patient. One liked to have something at the back of back of one’s mind which could help immediately without having to think too completely of other remedies. If one had too many remedies they came in afterwards but at first one might fall between two stools.
Dr. ALVA BENJAMIN said regard to the collapse cases one would one would have thought that Dr. Borland would have mentioned Veratrum Album for cases of great coldness and excessive sweating. With regard to heart cases he had had a lot of help from chamomilla, particularly when the pain was very severe. With regard to ear cases he was surprised Dr. Borland did not mention Bryonia for inflammatory condition; he had found it admirable.
In one case the child was developing mastoid. Dr. Cunningham to come to see the case, meantime giving the child Bryonia 10M, and almost immediately there was no need for him to attend. He had had other cases in which he found Bryonia 10M extremely valuable.
DR. HARDY added that Bryonia was very useful. In one case she gave a dose of Bryonia where the patient was lying on the painful side and did not want to move, which cleared up in ten minutes.
DR. FRASER KERR said that the Aconite cases had interested him; he thought that the mental aspects were not so much mental as characteristic of the whole case. In one of his own cases of a child of 11 or 12 with asthma who was in a dreadful state he gave Aconite and within a few moments she was relatively easy. The mental aspects characterized the whole case.
DR. GHAI said that during the last four or five years he could not remember a case where he had used morphia in a very large panel and private practice. He could recall three or four cases of children with earache, flushed, dilated pupils with the pain coming and going constantly, for which he gave Belladonna 30 and the next day the child was better. Pulsatilla was very useful but usually in the Pulsatilla patient the pain did not come and go constantly.
DR. C E. WHEELER thought that as all the members felt the same about Dr. Borland’s paper a special message should be sent to him the meeting. Dr. Borland would be gratified to know that his paper had been enjoyed so much. From the earlier years that he knew Dr. Borland he had always realized that he had the gift of classifying his experience to himself and getting the maximum value of it and that was why he could express himself clearly. He had managed to get what he wanted to say into a succinct space, although the paper was long there was no over-elaboration of detail.
His principal feeling as he listened was certainly one of enjoyment but also of regret that he had not been able to sit under Dr. Borland.
He must have made it easier for beginners by his ability to get into the other person’s mind the essentials of a very wide experience. It was not merely one or two cases, he had watched these things and had been able to classify them. It was not that the drugs Dr. Borland had mentioned were unfamiliar, although the speaker would admit that he had never given Oxalic Acid in heart emergencies, and would like to see the next case which came along; in this way they classified.
There were one or two points which he would mention. The first was the relation drawn between Mag-phos and Colocynth. He personally had never been able to decide whether neuralgia. The most prominent ingredient in tincture of colocynth was Mag-phos so that in prescribing colocynth one was giving mag-phos which raised an interesting point, and he made it because it was the general observation which enabled one to see whether the point had substance and one which should be studied. It had been in his mind since he realized that tinctures were mixtures; Lycopodium contained a lot of silica and so on, so did Belladonna and the balsam compounds. He did not think atropine was a pain reliever, it was a relaxer. That was the point in his mind, whether the drug which presumably was responsible for the relief of a group of symptoms would be just as effective if it were given alone. The Colocynth was chosen on the whole symptomatology which was all in Mag-phos the pain etc. Did Mag-phos indicate colocynth? was it not probable that the vehicle was important and that it would not be so effective if the Mag-phos had not been given?
If there was to be research he would suggest that this was a suitable subject. A far more detailed knowledge of the proportions of mineral ingredients in the vegetable tinctures was needed. Such research might throw a great deal of light on some symptoms when they would be associated in that way. There were potassium salts in pulsatilla and it was the potassium salt which stood out in a particular tincture.
With regard to dysmenorrhoeal pain where there was excessive periods and nausea, he would have thought of ipecac and Verat-Alb. In podophyllum the one outstanding symptoms was that there was normally a gastro-colic reflex-taking food into the stomach stimulated the movement of the colon and there had to be a motion after every meal; that would be a strong indication to him.
He would suggest that a definite expression of pleasure for his paper should be sent to Dr. borland.
Dr. W. LEES TEMPLETON said that most of them felt that they had been back at school and he felt not only humbled but humiliated, for he must admit that he did not get such good results, possibly because one did not always get the symptoms. Most of the emergencies he saw were unable to give symptoms and one had to judge on appearances. He was glad, therefore that Dr. borland had elaborated on the appearance of the patient, because that was important. With regard to drugs he did not find find Ant-tart was useful in heart was useful in heart cases because he believed the pathology was different. He thought Ant Tart. had a pulmonary pathology not cardiac. Carbo Veg. had a great and justifiable reputation as the corpse reviver” and it did work when the appropriate symptoms were present. cold sweat he looked upon as a guiding symptoms for Verat Alb. and he had verified its value in collapse. He was sorry that Dr. Borland was not more specific in his diagnoses, e.g. if pain was due to coronary thrombosis he doubted if the high potency alone would ease this particular pain in a matter of minutes.
The wait with the patient for four or five hours for the second presentation was a serious matter when one was called out in the middle of the night and like confinements many of these emergencies did occur at night. Why was this, he wondered.
With regard to otitis media he felt that the success obtained depended on the stage at the doctor was called out in the middle of the night and like confinements many of these emergencies did occur at night. Why was this, he wondered.
With regard to otitis media he felt that the success obtained depended on the stage at which the doctor was called in. If he got in early and there were good indications the result could be very good, but how rarely on e did get to it early! Beyond that stage it was not so easy, and people talked as if a mastoid arose suddenly; it did not, it was not a question of an earache today and a mastoid tomorrow.
He had seen capsicum successful where there was tenderness and swelling of the mastoid, but with otitis media and a purulent discharge he would not delay in seeking the advice of the aurist Pulsatilla and silica were the great polychrests in otitis media with discharge. Belladonna and Chamomilla to abort and avoid discharge.
Again with fifth nerve neuralgia it was a question of the stage at which the doctor saw the the patient. If it was a chronic case the treatment was not easy. Supra-orbital neuralgia after sinus trouble was interesting and frequently he found that China Sulph was indicated and proved efficacious. Post herpetic pain was another difficult condition to influence. If there was scar tissue present in the posterior root it would take more than one dose of Ranunculus to remove it. Many of these cases had already received Ranunculus in the acute condition. The drug he found most useful in the acute condition was Arsenic where the eruption was widespread, and Arsenic covered the pathology of the condition as well.
Sciatica was rarely easy. The typical Colocynth case where the pain was better for lying on the painful side was often quoted, but how often did one get it? kali Iod was the drug where the patient would not SIT DOWN in the consulting room; Rhus had to be considered in the fibrositic conditions. This was not a true sciatica, as shown by the improvement from exercise; a true sciatica rarely was.
With reference to the colics glad Dr. Borland mentioned the symptoms of Dioscorea where the patient rolled about and did not know what to do a very useful indication. Here the amelioration of Dioscorea was rarely obtained, but Clarke stresses the symptom “moves all the place to get relief” As well as giving the homeopathic remedy in these colic cases he confessed he often left something more palliative, but he was frequently surprised how rarely this was required. One useful indication for Lycopodium in renal colic was pain in the back better on passing urine.
Some might say that it was a mechanical relief, but he doubted if this was so.
He would like to stress again the importance of the objective description of the symptoms in these emergencies the appearance of the patient his colour position and movements were usually all one had to prescribe on.
In painful condition so much depended on circumstances. If of sort duration and there was little pathological change speedy results could be obtained; but if the condition was chronic he feared that to claim too much would only lead to disappointment. Not that results could not be obtained but only as a result of a serious study of the whole case.
In his clinic advised that if local modalities were good, to prescribe in the first instance on these alone, and only when this failed to take the whole case, but he emphasized this method only where the local symptoms were good.
Dr. A. MONCRIEFF added her thanks to Dr. Borland whom she considered our most brilliant prescriber in acute condition and what success she had in acute prescribing she felt was due to his teaching. In her children’s clinic she had a great number of cases of otitis media and most of them came not necessarily in the very acute stage when probably Belladonna might be indicated but with a history of acute earache for one or two nights. On examination of the drums there would be redness and possibly bulging and she had found pulsatilla so often indicated if the condition affected the right ear that she almost tended to use it as a routine remedy. If the left ear was affected she often found silica useful and Hepar Sulph if the child was so hypersensitive to pain that he or she cried before begin g touched. Most of her ear cases either cleared up or discharged the exception being the very tough drums which she occasionally had to refer to Dr. Cunningham.
With regard to colics she agreed with Dr wheeler that Verat- Alb was very useful in dysmenorrhoea accompanied with vomiting ad had found Dr. Tyler’s experience of Tuberculinum also most effective in this conditions.
The PRESIDENT said that a message would be sent to Dr. Borland. He had found great pleasure in reading the paper. He would not say very much about the drugs but Arnica for a tired heart was useful. Very often there were no indication on which to prescribe at all. He did not agree with Dr. Cooper. He saw two boys brothers the other day: John sat on the chair, kit sat on his mothers knee but John would not do so although he would do anything for his mother. He was a typical Bryonia case and the other child was a typical pulsatilla. With regard to Dr. Ghai’s remarks on Belladonna in earaches, there was no drug for any one complaint it often depended on the season of the year. There were remedies suitable for summer autumn, winter and and spring just then with the high cold winds it was Belladonna.
With regard to dysmenorrhoea very often Mag-Phos would help in the acute attack and the remedy which had helped him the most was Tuberculinum 6, and it very often eliminated the need for Mag-phos. They all knew that Carbo Veg was a “Corpse reviver” with regard to Veratrum Alb. He had a very severe diarrhoea one day, with a cold clammy sweat. He took a dose of Veratrum Alb. and in twenty minutes was relieved. A patient came to him with neuralgia in the face he got her X-rayed and found a black speck in one of her teeth. For two years she had amalgam in that tooth and she had to have it removed. One had to be careful that there was not some such cause for pain in the face.