Cases
CC Coryza. CC
(97) Case. – Miss E., aged 23, book – keeper, rather tall, thin, but counting herself in good health complained of a single annoying symptom of long standing, as follows:
Since fourteenth year of age had suffered from attacks of sneezing and lachrymation. The slightest change in temperature, the most trivial irritation, would bring on violent paroxysms of sneezing, lachrymation and watery coryza going from one room to another, a draft, the opening of a door, the chilling of the hands or a bright light striking the eyes were any of them sufficient to precipitate an attack, and when such exciting causes appeared to be lacking occasional attacks would come on anyhow. There was no organic catarrh, no discharge (except at the time of the paroxysms), no symptoms of any kind left afterwards.
No headache, no menstrual trouble, no pains, no aching, no modalities except as above mentioned in regard to the sneezing. Sabadilla 200, a few powders, cured completely and permanently.
Remarks. – This case was absolutely hopeless for a pathological prescriber or for an allopath. The pathology is not mysterious almost anyone, if he knew enough, could talk learnedly about it. It would be a description of how puerperal irritation, inconceivably slight, affected by branches of the sympathetic nerve and carried by paths and routes absolutely unknown to the mucous membrane of the nose, produced an undue afflux of blood, tumefaction and irritation of the Schneiderian membrane until another reflex was thereby started, setting up the whole complex mechanism of stimulation, there occurred a powerful, sudden contraction of the diaphragm, producing a friable expulsion of air through the nasal passages, accompanied by such a stimulation of the lachrymal apparatus as to produce copious tears, and also by such an activity of the nasal mucous membrane as to cause a profuse flow of watery secretion from the nose to the great detriment of many fine linen handkerchiefs. What is all this but words, vain words? Miss Eberle could go through the process forty times while the pathologist was describing one sneeze. How could the most profound understanding of the pathological process show that Sabadilla was the remedy? I leave that problem to the prayerful attention of the devotees of pathology, Epsom salts, castor oil and calomel. As to the remedy sneezing lachrymation and thin nasal discharge are characteristic. I count it a fault in our materia medica that it does not dwell with sufficient emphasis upon this important feature of Sabadilla This drug in the days when the allopaths used Galenical medicines rather than coal tar products was of considerable prominence as an antiparasitic and vermifuge. Like nearly all the drugs of the old school, more than a year old, it has fallen into disuse, but was retained in the last pharmacopoeia for the purpose of manufacturing the alkaloid veratrine of which it is the source.
The present pharmacopoeia drops it entirely, retaining its alkaloid only. I know by experience that it is impossible to powder Sabadilla seeds without taking precaution against the inhaling of the dust as it is provocative of most powerful stimulation; the alkaloid has the same property but in a milder degree.
It is said that the celebrated Schneeberger Schnupf Taback owes its property of causing powerful nasal titillation to the presence of Sabadilla in its composition.
Sabadilla is almost a polychrest, and indicated probably twenty times where it is once used. I have no doubt that Ipecac, Pulsatilla and Lachesis are frequently useful to zig zag a case to health when Sabadilla would do more powerful and direct work than any of those mentioned. The semblances and differences between it and Lachesis are worthy of carefully study.
In the Materia Medica we find the following symptoms, showing its power in the direction of Miss E’s symptoms; “Lachrymation, worse when walking in the open air or looking at light; sneezing, coughing or yawning, lachrymation as soon as the least pain is felt in some other part of the body, for instance, the hand.”
“Margins of the lids red.”
“Spasmodic sneezing; fluent coryza.”
“Either nostril stuffed up; itching nose.”
“Violent sneezing from time to time, shaking the abdomen, following by lachrymation.”
“Coryza with savage frontal pains and redness of eyelids; violent spasmodic sneezing, influenza and lachrymation on going into the open air. Cough with lachrymation.” (J. B.S. King.)
CC Plasmodium Malaria. CC
(98) Case. – Well nourished woman, strong, of about twenty – eight years of age, of dark hair, eyes and skin, who was in her second labor. She is the possessor of a fine mind and a charming disposition, consequently had the ability to keep herself calm during the trying ordeal of hard labour. The following conditions were present; Cervix three quarters dilated, a ruptured sack, a right brow, which later, was reduced to a face presentation. The labor had been on for several hours, the pains were hard and tendinous, keeping up uninterruptedly without apparent progress being made, terminating in about five hours after seeing her.
Soon after the second stage of labor had been completed the patient complained of coldness all over body, which shortly after eventuated in a terrific chill.
The air was hot and sultry that July night. the heat of the room, the hardness of the birth, the copious sweating, the draft of air passing on patient covered with a moist sheet, which was so from perspiration, the subsidence of mental tension, all, as I thought, had much to do with inducing that chill. Aconite was given with apparent good results. The third stage of labor having been completed, no further attention being required from myself, the patient was assigned to the care of nurse, who called me in about one hour after leaving the lying – in room to inform me that patient had a temperature of 105* and much mental excitement. I sought the bedside of the afflicted one and questioned her as to her feelings, thereby hoping to find an appropriate remedy covering this extraordinary phenomenon coming on so soon after the termination of labor. Patient complained of frontal and occipital headache, with vertigo like floating away, chilly feeling in the back moving upwards, numbness and trembling of body and extremities, no thirst, a moist, hot skin, a rapid, bounding pulse, slow action of mind, and a labored use of tongue, for which group of symptoms Gelsemium was suggested to mind, but not given, trusting that Aconite would relieve the patient temporarily, at beat. There had been no perverted feeling noticed just before labor began nor during the previous weeks leading patient that morning she expressed herself as improving. The day passed with no new developments. Gelsemium was left to be given later if necessary. the following morning at about the time the previous chill came on a slight chill occurred, a fever developed and continued until latter part of forenoon, when I saw her. The situation had changed from day before in that there were tenderness and pain in abdomen on pressure, some tympanites and an arrest of usual local discharge. I now tough it wise to make an examination of uterus, and after which a curettement was decided upon and made revealing no indications of there having been an infection induced through the birth track to show cause of disease.
The third morning following birth there was another terrific chill and fever, the latter lasting the greater part of forenoon, some tenderness and pain with tympanites continuing. The fourth morning was practically a repetition of the third. With this addition, the disease had now made a change in patient’s appearance, which was noticeable in the color of skin and marked prostration. I realized that I had a hard problem to solve in curing the sufferer of a depressing illness, and that something must be done as soon as possible to check its progress.
The family became anxious about prognosis and sought speedy relief for the afflicted one. An obstetrician of experience was asked for by husband and relatives, to which request I yielded.
Medical literature has on record cases of inactive pelvic abscesses resulting from previous infection, specific and otherwise, which remain dormant until aroused by the bruising incident to labor, some becoming active immediately and others following within three days to some weeks after labor. In this particular case I had no definite knowledge precluding any previous infection resulting in a latent abscess, therefore, held to the theory that an abscess might be the cause of trouble, being partly confirmed in the idea by the course of treatment pursued, although her health had been good during gestation.
Infection can be conveyed to patient by attendant, a common source of such unhappy occurrence. It may happen through meddlesome interference from one having no business to interfere; I had had one such in a nurse making repeated vaginal examinations at the request of patient, and without my knowledge till after an infection had taken place. As to my having been the cause that might be a possibility, and yet I had not been exposed to an infection of any kind during the previous several weeks, neither in private nor in hospital practice. It has been my habit to carry out strict aseptic precautions in personal cleanliness, no digital examinations of birth – tract being made till after thoroughly scrubbing arms, hands, fingers, and especially finger – nails to avoid a possible chance of carrying infection.
