The patient, who was of medium size, dark, rather florid, was subject to occipital headaches, but had been freer from them since the operation; she was also subject; to neuralgia in the face which kept her awake at nights. The commissures of the mouth were sore. This was the case before the operation, and had recurred recently. Appetite bad. Intolerance of eggs. When younger, used to have indigestion. No appetite for breakfast. Aversion to beef and mutton. Dislikes salt; is fond of ham and vinegar. She had sinking at the epigastrium from 10 to 11 A.M., and after tea. Had much flatus.
Abdominal organs normal. She was constipated, and always had been; she was in the habit of taking liquorice powder every other night. She had had three children, now aged 19, 20, and 23. The periods had always been excessive, lasting a week, and recurring every fourteen days. Used to have pain No leucorrhoea. With the second confinement had flooding, and after that inflammation of the womb from a chill. She nursed her first child three months. After the second confinement she was too ill to nurse. The third child she nursed eight months. Right breast removed in July 1900. Now she has sharp, shooting pains in left breast, and the breast is indurated.
The left arm is painful, and glands in axilla enlarged. Sleep bad; dreams badly, of falling in the water, of dead people. This is worse the last two or three years. Cold both relieves and aggravates. She is worse out of doors. Is nervous, depressed, fears solitude, and is better in company.
Her family history is as follows: Father living, 84. Mother died, aged 50, of troubles at the change. The sister died at 50, of phthisis. Three brothers died of the same disease, and so did her own eldest son. She had only been vaccinated once.
The occurrence of pain and induration in the left breast so discouraged her that she declined to have any more surgery, and put herself under may care.
I prescribed Carcinosin 100, three doses to go over the month. And to assist her over the difficulty of constipation. I also ordered Ulm. fulv. 0, gtt. x, in a wineglass of water in the morning on rising, if required.
October 7;th, 1901.-Breast much less painful. Breast feels more natural, and is somewhat smaller. She can lie down with more comfort, and move arm better. Has slept well all night through. Appetite much better Less sinking. Has had a good deal of flatulence. Bowels more confined. Stools solid, dark; but has not passed blood in stools (which used to be the case) since a few days after beginning the powders.
On waking, has headaches across the forehead. Some neuralgia in face.
Repeat Carcin. Rx Ulm. fulv. gtt. xv, in hot-water in the morning on rising.
November 4th, 1901.-Has had a cold, which seems to have aggravated the condition. Has had very bad headache in the morning, which gets better on going to bed. Pain in occiput. Pains in breast have been severe, shooting inwardly, as if a knife thrust in suddenly. Breast tender, especially the outer side, where the pain is worst. Gland felt in axilla. Appetite better; sinking less; not so faint. Bowels not so confined. Sleep good; less dreaming. Feet very cold.
Rx Sulph. 200, two doses the first week; Calcarea 200, two doses the second week; Lycopodium 200, two doses the third week.
December 9th, 1901. The head is better; bowels better, less confined-no longer requires the Ulm. fulv. drops. Appetite fair. Pain rather less. Breast better, very little pain in it; when pain is present it is a bruised feeling, towards the axilla. Mouth corners still sore. Is very nervous; jumps with every knock at the door. Feels the cold much; gets a cold feeling down the back.
Has now a new symptom crawling sensation, as if an insect were in the ear. Wakes up at night with it, and tries to get it out.
Repeat.
January 20th, 1902.-Crawling in ear better. Head better. Less jumping. Bowels confined, but not as bad as they were. Appetite not so good. Faint feeling not as bad. Much wind latterly, especially at night when she takes her clothes off. Period as usual. Has had a good deal of pain in sixth rib, below the breast.
Has had a bad cold. Is feeling the cold very much this year. Sleep keeps good, and the dreams are less troublesome. Mouth corners cracked.
Thinking there was probably an influenza element in the colds, I ordered Tuberculinum k.100, once a week; and also Cepa. 12, to take if a fresh cold was taken.
After this I did not see the patient for over four months.
March 12th, 1902-she reported that she had been much freer from pain; but she had had a severe cold and cough again. Breast more natural. Left corner of mouth very sore; right also, but less. The first and second powder “turned acid in the stomach, and she had acidity through the night after them.” Bowels regular, though still a little confined. Wants food at 11 A.M. Period excessive, worse when lying down. Dreaming much again.
Headache not quite so bad, cannot raise head from pillow in the morning. Still very nervous; shakes and trembles.
Rx Cundurango 1, gtt. v in a tablespoonful of water ter die. April 21st, 1902.-The drops caused the bowels to act two or three times the first day. Sores at mouth corners better, but not well. The last fortnight, breast has not been so well; it is more swollen, lumpy, and harder. No acidity. Tongue fairly clean. Appetite not so good. Much flatus upwards. spleen big. Sleep not so heavy. Headache in occiput, more in daytime or on getting out of bed in the night. Has had a trickling sensation in the heart.
Temper is bad. Gets very tired. Has no. flushings; has a sensation as if the floor was rising up. Has had no period for seven weeks. Pulse 96.
Rx Thuja 30, three doses in the month.
The flatulence, excessive tired feeling, and the irritability of temper. Besides, there were the general constitutional indications of the remedy.
May 21 st, 1902-Thuja got promptly to work. The period came on after the second day, and she felt much relieved. She felt better altogether, and the breast was smaller and less hard. Tricking sensation in the heart not so bad.
Headache bad, this time at 4 A.M.
Thuja acted very deeply, and appeared to stir up the old trouble in the thumb, for it had been the seat of severe pain during the last week of the time. The inquiries now made led to my learning the story of the gathered thumb of three years before.
Repeat.
June 20th, 1902-Is generally stronger. Gets through her work better than she could formerly. Can use her right arm (which had been considerably crippled since the operation) better. Can reach with it. A little pain now in left breast. Head bad at 3 A.M. (This does not occur if she omits to take a powder.)
Mouth still sore at both angles. Ear better; crawling gone. Eyes itch and ache. Thumb has got all right.
Rx Cundurango 30, three doses in the month.
July 30th, 1902-Breast very much better. Left breast quite soft and natural. No pain. Mouth rather worse this month. eyes better. No period for seven weeks. If she sits still she comes over faint. This causes palpitation, trembling, and perspiration. Hair gets wet. Can move arm better. Sleep good; fewer dreams. These powders don’t cause headache so much. Headache at 11 A.M. The thumb keeps all right.
Repeat.
September 15th, 1902-Has been very much better; better than for some time. Mouth nearly well. Has a bruised sensation where the lump is; on inspection there is some indentation. Except in this part, the breast is soft and natural. She feels the breast when lying down. Headache from 10 to 11 A.M. Pulse 96. Comes over in heats, but has no palpitation. Period fourteen days ago; excessive; no leucorrhoea.
Repeat.
October 27th, 1902-The night after taking the first powder she had much burning in the breast. On waking, her hands were stiff. Next day did not feel well.
I found a good deal of tenderness in the left breast, lower segment. Has good deal of wind; it is bad at 2 A.M. Strong acid like vinegar comes up into the throat. If she vomits, this is better. Bowels regular. Head has been very bad, as if something tied tightly round it. this makes her low-spirited. Has had one period, not quite as copious. The thumb has been painful again, pricking and throbbing.
Rx. Nat mur 30, four doses in six weeks.
December 8th, 1903-Much better. Scarcely any pain in breast. Head much better; all tight feeling gone. Spirits better. No raising of acid. Much wind in the morning.
Acidity after breakfast and after supper. The breast very much better though still slightly tender, and still a lump to be felt. In the axilla I did not find any gland on this occasion, though later out. Period once in seven weeks lasted three days. Mouth corners very much better. She feels the changes of the weather at the site of the operation whether the drainage tube was.
Repeat.
January 19th, 1903- Has been very well. Mouth is well. After beginning the last course, the wound began to smart-felt as if it would open. Soreness of ribs below left breast. A very small gland felt in axilla.
No period for seven weeks.
