E. CARLETON, M. D.
Our Chairman has suggested the topic to be discussed. There can not be any great diversity of opinion, probably, in our ranks as to the proper treatment of individuals having syphilis; but it is well to put our cases on record as proof of the supremacy of similia. Accordingly the following cases have been selected from many as illustrative of the points which will be stated in conclusion.
CASE I. –
H. M., aged 22, contracted soft chancre. Shame kept him from me until ulceration had involved glans penis and prepuce. Great depression of spirits; apprehensive, full of fear, no confidence in himself, easily fatigued by mental or physical exertion, could not be driven to work (bank clerk). Susceptible to all sorts of pains; on thinking of them, he imagined he already felt them.
All symptoms worse at night. he had been a so- called “scrofulous” child, and never robust. In childhood and youth he had been afflicted with running from the ears and eruptions upon the skin. He was a psoric person. The similimum seemed to be Aurum, and he received a dose of that medicine cm. (Fincke). This was followed by improvement, but it failed to cure. He rallied enough to go to work for a few days and them gave it up again. A minute spot of ulceration remained, the prepuce was swollen and tender, large buboes appeared in the groins, his throat became slightly sensitive.
Some the following symptoms were added: Feet held to the earth as by a magnet, when attempting to move; when moving, felt as if pricked with needles, the pain running quickly from feel to head; every joint and muscle of body and limbs, stiff and sore; sour night sweats; great emaciation with loss of appetite. Ledum, 200th, in water, completed the cure speedily.
CASE II. –
H. S. young adult, dark complexioned, of good physique and perfect health, became poisoned with soft chancre. he first employed a quack doctor, and rapidly grew worse, as this specialist gave no medicine, but applied caustics and washes. When he first consulted me, the frenum had sloughed away, and numerous sinuses allowed the urine to pass unnaturally from the urethra. This was one of those very rare cases where syphilis becomes fastened upon a previously healthy organism. Mercurius alone worked a complete cure. This patient came under my observation in the early years of my practice. He has remained well since.
CASE III. –
Mr. C., about forty-five years age, became the victim of true, Hunterian chancre, twenty-six years ago 91864). He received medical treatment of uncertain character, and all traces of the malady disappeared with the primary lesion. Eight years later (1872), or eighteen years ago, he was surprised by the appearance of suppurating buboes and alopecia of the scalp and eye brows. He denies the pre-existence of any other lesion in that attacks, and says that he was perfectly well between the two attacks just described. Again he put himself under treatment, and was apparently restored to health.
May 17th, 1890, he consulted me for the following symptoms: In the early part of the night formication, first in the anus, extending to glans penis; disagreeable sensation entire length of urethra as of desire to urinate; next, a feeling in anus as if some agency were “pulling down;” then an involuntary escape of a few drops of burning hot urine, and a feelings as of more to follow.
After sleeping a short time, aroused with great itching of anus and desire to urinate; micturition difficult; herpetic eruption on thighs and groins; skin becoming gray and falling off; stomach cold; limbs feeble. Physical examination of anus, rectum, prostate and bladder yielded negative results. Microscopical -chemical examination of urine, revealed a few crystals of uric acid, very few mucous corpuscles and one round epithelial cell; otherwise normal.
I felt no hesitation in diagnosing his case as of syphilitic origin; and as the symptoms pointed to Mercury, he received a dose of that medicine (Fincke’s cm. potency), dry upon the tongue, with plenty of saccharine placebo to reinforce it. He has improved steadily ever since; in fact, barring the skin symptoms, which were not entirely removed, he considered himself well at our last interview, a few days ago.
CASE IV. –
The subject of this number was the unsuspecting wife of a man who contracted syphilis while absent from home on a prolonged business trip. When he reached home, February 5th, 1886, his scalp and forehead were covered thickly with a popular eruption, which would act as if about to suppurate, and would then become dry and scale off. This was followed repeatedly by a new crop of the same character. The only other symptom present at that time was a mottled zone, about five inches in width, around the waist, which he said was the mark of a previous eruption.
About the first of March an abscess formed in the left parotid gland. On March 22d I was called to lance the abscess, he being unable to separate his jaws. It discharged much thick, green, offensive pus. The skin eruption disappeared when the abscess was fully developed. The latter healed slowly, under homoeopathic treatment. Before the abscess had quite healed, iritis set in (both eyes). For this he went to a hospital and remained there a long time, the staff unanimously diagnosing syphilitic iritis.
The wife was poisoned about the twentieth of March, she began to feel tired, apprehensive, and, as she described it, “sick all over.” Eight days later, discovered dark red, hard lumps in the skin on both sides of the nose and checks. Then the face and scalp were completely involved in the same manifestation, and in sixty days from the first tired feeling, the entire person was covered. The soles of the feet show the peculiar, mottled appearance of syphilis to this day.
A New york physician prescribed Mercurius 200th which was taken in water. Amelioration followed. While the skin was improving, throat, cars and eyes became involved together, about the middle of June. Full feeling in throat, with sensation of sufficient; lack of sensitiveness of affected parts to touch; hawking of great quantities of glairy; white mucus; deafness; eyes terribly swollen and dark red; examination by a specialist disclosed iritis; aching in forehead, from midnight until morning. patient felt exceedingly cold, could scarcely keep warm, even with the aid of much clothing, stove fire and closed doors and windows, in mid-summer.
Thoughts of suicide. Great fear of death developed at this time; also dread of death of death by suffocation; dizzy; afraid of falling down stairs. A frequent sensation was of flatus, incarcerated in left hypochondrium, causing intense fear of immediate death. Pounding, manipulating and changing position would cause eructations, bringing relief, not only from the feeling of incarceration, but from the fear of death. Constant hunger; great desire for eggs; required food every two hours, even during the night.
The case came under my observation, and from the symptoms, I decided to give Hepar 200th, in water, a teaspoonful every two hours until improvement should appear. Improvement did appear within twenty-four hours. It is interesting to note that, first, hearing was restored; the eyes began to improve at about the same time. By the way, the oculist-one of the most noted in the country-said at first that the left eye was “good for nothing.” She now sees with it very well, indeed, even to reading the newspaper without glasses.
All symptoms gradually disappeared. Such cases are put down in the books as of extremely long duration, even if the patient should be so fortunate as to ever recover. at the end of eighteen months from the very beginning of this case, she was discharged, cured. So far, three have been no signs of relapse.
CASE V. –
Miss -, was the daughter of a well known New Yorker, who died full of sin and syphilis. She inherited a weak constitution and a great deal of money, and was an estimable lady. Soon after reaching her majority, she began to have one sided headache and other symptoms which I can not now recollect with distinctness. Her attending physician is dead and his memoranda not to be had. My own connection with the case was (with the attending physician and others) in emergency.
With a sudden, sharp exclamation of pain, she had clasped her hands upon her head and immediately become unconscious. Numerous opinions were advanced. My diagnosis was apoplexy, and one other physician held to the same view. At the autopsy, next morning, a large quantity of blood was found to have escaped from a rupture of the middle meningeal artery. a bony growth from the inner surface of the skull, nearly an inch in length and pointed, had been the means of destroying the integrity of the artery. Inherited syphilis was responsible for all the trouble.
CASE VI. –
Mr. P., tall, slender, wiry, active, dark complexioned, forty-two years of age, had chancroid seventeen or eighteen years ago, he is not sure which. It appeared a number of days after an impure connection. He was cauterized by an old school gentleman, who also administered internal remedies. Despite all this, inguinal buboes formed and opened both sides. He had some soreness of the throat, but recollects no eruption upon the skin. Finally all symptoms disappeared and the doctor pronounced him well.
Nothing occurred after that to disturb his serenity until this spring, when he presented the following inventory; Languor and indisposition to work; low spirited; worrying without cause; sensation in the head, at a spot near the posterior border of the left parietal bone half, way between the ear and coronal suture, as if the skull were pressing upon the brain, worse at night, preventing sleep, though patient was very sleepy in day time; buzzing, as of insects in left ear; constipation.
There was no aphasia, vision was natural and the reflexes right; the examining hand found on fault with the head nor caused pain to the patient. In my own mind there was no doubt that a morbid process had began, which, if left to run its course, would end in disaster. Memory took me back to case No. V. I could not demonstrate the existence of a spicula of bone encroaching upon the brain tissue in this case; let the doubters have their way and say “not proven.” I am content. It does not seem necessary to me to wait for the post mortem examination before announcing to you my belief that danger of pressure upon the brain menaced my patient.
The similimum being Mercury, he received a dose of that drug (Fincke’s cm. potency), dry on the tongue. Reaction became apparent in ten days and has continued without interruption since. He is now very nearly restored to health apparently, and I firmly believe that the pathological process has been stopped.
Having presented the evidence it is now proper to “sum up,” as the lawyers say.
I. The soft chance or chancroid is as certainly the manifestation of constitutional disease, as the hard or true Hunterian chances is. It has a period of incubation. If not at once cured, it ends with severe general expression. .
II. Caustics and other local applications do not cure either soft or hard chancres. They produce suppression and metastasis.
III. Secondary syphilis is communicable. The person thus inoculated, may never exhibit the primary lesion, but slow the disease in its secondary form ab initio.
IV. Syphilis may lie dormant in the system for seventeen or eighteen years, after treatment (non-homoeopathic) and apparent recovery from the first and second stages, and then arouse to destructive activity.
V. There is no royal way of curing syphilis per se. Each case must be individualized. The proper selection will cure at any stage. In the words of Hering, “any remedy is good for any disease-if the symptoms correspond.”
VI. The co-existence of psora or sycosis with syphilis, greatly complicates the case and retards the cure.