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.