MAHLON PRESTON, M. D.
I cite the following case of venereal infection, with the hope of further fortifying my belief in the possibility of prompt and radical cure in such cases, avoiding the long train of troubles that commonly follow when managed by villainous modes of treatment other than purely homoeopathic.
My earliest knowledge of the present case dates to within ten days of first exposure, up to which time no topical or remedial measures of any kind had been used, and there is the best reason to suppose that no similar infection had ever taken place.
The first inspection disclosed an oedematous prepuce, rather firmly closed in front of the glans-permitting a painful and difficult retraction which discovered three large and deep chancres the size of half a common soup bean-one on either side the fraenum, a third behind the glans on side to left, extending midway round the glans. The ulcers were eroding rapidly n the edges, their bottoms appeared dark, granular and dry.
Induration, in and around the sores, seemed to threaten the parts with rupture at each retraction of the foreskin; the slightest manipulation was extremely painful. Merc. sol. 6 m. was given, fire doses, and a light pledged of cambric muslin, moistened with milk and water, was closed in by the prepuce over the sores, and renewed as required.
The medicine being allowed to act for three days, a second examination revealed the margin of the foreskin, knotted with numerous small chancres, similar in quality to those on the glans, at the same time those beneath had so deeply eroded that half the glans seemed destroyed from below and behind, leaving simply the urethral channel intact.
The horrible gap evidently severed the confining hold of the prepuce, since it had retracted beyond the remainder of the glans in a vice like and most discouraging manner. The conditions of the case now reviewed with great earnestness presented the following points:.
Patient aet 20, slender in stature, of good flesh, ruddy and robust appearance, inheriting no dyscrasia. Sores deep, hard, of dark reddish color, rapidly extending; burning, pricking and itching in them; stiff feeling of whole penis to its root; not very copious discharge of strong looking urine, containing mucus, giving it a ropy look. Tired aching in renal region, and absence of any sexual instinct whatever.
This last, with the deep, corroding chancres, decided for Kali bi. cm., of which 3 doses were given dry. Signs of improvement became evident 24 hours later, and medicine withheld while improvement lasted. Granulations established steadily and continued rapidly during fourteen days, when the healing process had so nearly restored the destroyed parts, that little of it could have been noticed. In a little more than three weeks from the first observance of the chancre, this had taken place.
If the priapism, usual to such a state of affairs, had prevailed in this case, remedial measures might possibly have failed to pressure the penis intact. The coincidence of deep and rapidly rodent ulcers, with such lack of sexual power, as here co-existed, brought Kali bi. to the rescue, with just the force that similia, and it only, can exert, and preserved the organ.
Now, for a short period, the restoration appeared quite complete, and so it might have been had the sexual power, recently dormant, thus remained. But erections amounting to priapism supervened, causing phymosis to occur, subjecting the well nigh perfect parts to great danger from sloughing, through strangulation.
Around the fraenum, the prepuce became oedematous, and the size of a large gross egg, and extended without delay to the pubis, giving the penis the appearance of a filled shot-bag, constricted at three points as by the finest cord, forming three separate sacs, as it were, within the outmost of which was contained somewhere the glans penis, its presence only indicated by the thin purulent discharge which exuded from the surrounding oedematous folds.
A good deal of uneasiness was caused by jerking in he penis, a particularly if the patient fell into a doze.
Merc. cor. first given when the phymosis occurred, having brought no relief, this jerking, in combination with the oedema, and the itching, pricking and burning about the seat of discharge caused me to choose Cinnabaris 500; three doses were given, followed by placebo for a day. This put a damper on this luminous state; by the next examination in four days the swelling was enough reduced to permit a through view of the remains of the chancres, and they presented the best evidenced of having borne the stress in a creditable manner; but slight marks of the deep erosions remained.
Yet a few days later a difficulty was encountered in the left eye. It became injected and swollen, with a very sore spot, above the limit, at the upper edge of the cornea, described as a swelling, protruding and pricking the upper lid; on everting it a red swelling was noticed from which vascular rays radiated, thickening the coating of the eye, and obscuring the upper portion of the cornea.
Stitching pains were felt as if penetrating the inner canthus into the eyeball, and causing floods of tears, with inability to open the eye or to bear the slightest degree of light. There was also much general smarting, pricking became obscured and vision lost.
I observed the pupil fixed and distorted in shape, having a sort of quadrangular form. That these symptoms foreshadowed not only an ulcer, a secondary chancre on the cornea, but also iritis, I was fully aware, and that they demanded prompt relief if the eye was to be saved. Yet this demand had been momentarily sacrificed at the first outbreak of the pain and lachrymation, by the hasty administration of Crocus. A careful review of the symptoms from first to last completed a picture of Clematis which would be difficult to mistake. It gives: .
“Stitches in left inner canthus as from a pointed instrument”.
“Pressure in the middle of the left eyeball”.
“Reddened conjunctiva; smarting, burning eyes, sensitive to light and extreme lachrymation and fear to open the eyes”.
Clematis 200 repeated three times and its effect allowed to develop a few hours, made short work with this iritis. The patient, a man with rather sanguine anticipations, reported himself for duty in a week’s time from the giving of Clematis. This haste was of course discouraged, but the eye regained both normal vision and appearance in two weeks.
From this time forward, but a single phase of abnormal action has demanded remedial aid. The secondary eruption occurred of brown spots on face, chest and arms, and scaly patches on elbows. These not deterring the patient from duty, have been thoroughly removed by an occasional dose of Nit. ac. 5 m. administered at long intervals. The duration of this treatment did not exceed seven weeks.
I desire the assurance, if I may receive it, from those willing and capable of giving it (for my experience in this line is not extensive), if I may expect that this patient will be exempt hereafter from revivals of his complaint from the recent infection, it now being more than seven months since the last symptom disappeared or any fresh ones have been developed.