SYMPTOMS.- there are two general types of the tuberculous patient; the one with coarse thick features, rough coarse dark skin, thick lips, sallow complexion; the other with fine delicate skin, and features, blonde (“pink and white”) complexion, long eyelashes, and downy growths of hair especially in the back. The local signs are swelling and pain in bones (as e.g. the limb bones of feet and hands, vertebrae) which, unchecked, go on to ulceration and discharge of tuberculous “pus” ‘ swelling, usually at first painless, of glands, particularly in the neck, where they are readily seen and felt, but also (and quite as important) in parts where they can only be felt (e.g. the mesenteric and other glands in the abdomen – see Section 31, Consumption of the Bowels), and in parts where they can be neither seen nor felt, (e.g. the bronchial glands in the thorax).
The glands in the neck and under the lower jaw are at first hard and the skin over them is not reddened. As they enlarge they tend to get softer and to reach the skin, reddening it. Unchecked they are then apt to “break down” and ulcerate the skin. Healing then leaves usually a ragged unsightly scar. To avoid this, when the skin is markedly reddened and pus or matter has evidently formed, the help of a surgeon should be sought. Much may be done by the use of homoeopathic remedies to prevent tuberculous glands reaching this state.
CAUSES.- The tubercle bacillus. This is practically always acquired – the “seed”; but there is very often a hereditary predisposition – the “soil.” Predisposing conditions are the want of pure air, want of sunlight, and want of good food (especially of milk and animal fats) and any lowering illness, especially Measles and Whooping-cough.
TREATMENT.- This disease is often very obstinate, and months, if not years, may elapse before a cure is effected. The most useful remedies are – Arsenicum-Iodium, Calcarea, Ferrum, Mercurius, Phosph., and Sulph. A dose need not be given oftener than night and morning.
INDICATIONS FOR THE ABOVE AND OTHER REMEDIES.
Arsen.Iodium- “It seems probable that in Arsenic Iodide we have a remedy most closely allied to manifestations of Tuberculosis” (Boericke). Profound prostration, rapid pulse, fever, loss of flesh, exhausting discharges from the bowels, night sweats.
Aurum.- Various affections of the bones, and in cases improperly dosed with Mercury. Ferrum and China are deserving of attention in like cases.
Belladonna.- When sensitive organs are affected – such as the eye, ear, and the throat; heat, redness, and pain in the eye, and great intolerance of light; neuralgic pains; sore throat, rendering swallowing difficult, painful swelling of the parotid and other glands, etc. (See “Mumps,” Section 26).
Calcarea Carbonica.- General ill-health, enlarged abdomen, weakness of the bones, slow dentition, strumous swellings, great susceptibility to cold and damp, frequent discharge from the nose. When abundance of good food fails to induce a healthy state of the system – the child being pallid, cold, flabby, and dull – this remedy is of great service.
Ferrum Iodium- Is of great value in the anaemic, impoverished, and cachectic conditions common in Tuberculosis, from imperfect assimilation of food.
Hepar Sulph.- Ulceration of the eyes; tendency to abscesses, great sensitiveness to cold.
Iodium- Enlargement of the glands, emaciated appearance, with hectic symptoms.
Iris.- Scabby eruptions on lips, cheeks, ears, and head; frequent bilious Diarrhoea.
Mercurius Biniod.- Enlarged glands; hard abdomen; various eruptions on the head, face, and ears.
Mercurius Sol.6.- Glandular inflammations with much swelling and redness, the pains being worse at night in bed, particularly when the glands of the neck are swollen and painful, and there is inflammation of the eyes; copious saliva; disagreeable taste, the frequent and unhealthy-looking foetid stools.
Phosphorus-Frequently and easily disordered lungs; short, dry cough; tendency to Diarrhoea.
Silicea.- Tuberculous ulcers with callous edges; fistulous ulcers; Otorrhoea; tuberculous affections of the bone. It may follow Calcarea, especially in disease of the bones.
Sulphur.- Unhealthy skin; Phlyctenular Conjunctivitis; humid eruptions behind, or purulent discharge from, the ears; swelling of the axillary glands, tonsils, nose, or upper lip; swelling of the knee, hip, or other joints; defective nutrition; colicky pains, mucous discharges, etc.
Fuller indications for may of the remedies will be found in the sections specially treating of the disorders mentioned in this section.
ACCESSORY MEANS.- In the treatment of strumous children three points are of prime importance – nourishing food, fresh air, and regular exercise. Proper attention to these are necessary, for medicines are not alone sufficient. The air of Margate and Ramsgate has the most wonderful effect on Scrofulous patients.
FOOD.- The food should always be sufficient, nutritious and digestible, but not excessive. Beef, mutton and fowl are the best kinds of animal food; to these should be added plenty of eggs and milk, fat bacon, and the ordinary articles of a mixed diet.
Cod-liver oil, as a supplementary article of diet, has a profound influence on tuberculous processes. It may be given in the absence of acute febrile symptoms, in small doses, three times a day. A teaspoonful is generally sufficient to begin with for a dose, and if it disagrees half a teaspoonful. Later the dose may be increased. Inunction with Cod-liver oil or with olive oil is also of great advantage.
Exercise.- Moderate exercise in the open air is most essential. A bracing mountain or sea air, if it can be borne, is the best. A cold climate, if the child is warmly clothed, is generally favourable; but damp is injurious. The patient’s room should also be uninterruptedly supplied with pure air. Bathing, both in fresh and salt water is invaluable as a means of promoting a healthy action of the skin, and of imparting tone to the whole system. If sea-water cannot be obtained directly from the ocean, Bumsted’s or Tidman’s sea-salt will form a valuable substitute.
Clothing should be adapted to the season, and be warm without being oppressive. The extremities especially should be kept warm. As a general rule flannel or wool should be worn. The linen should be frequently changed, always observing that it is put on perfectly dry.
PREVENTION.- The prevention of tuberculous disease consists not alone in the hygienic or medical treatment of the patients, but primarily in the correction of the habits and improving the health of the parents, more particularly in respect to the points referred to under “Causes.”
30. Tubercular Meningitis (Acute Hydrocephalus).
This disease is frequently fatal to tuberculous children, though all ages are liable to it. Its essentially morbid character consists in the growth of tubercle on the arachnoid membrane of the brain.
SYMPTOMS.- When occurring in children, the usual manifestations of the disease are – febrile disturbance, quick, irregular pulse; Vomiting; Constipation, the motions having the appearance of clay; red tongue; and continuous high temperature. The child manifests pain in the head, intolerance of light and noise; has disturbed sleep; grinds his teeth and is irritable : is unable to stand, from vertigo; and becomes generally feeble. He also desires to be quiet; has occasional delirium; looks old and distressed; suddenly cries out; and is very drowsy. Twitching and squinting may also occur. In unfavourable cases coldness of the extremities, clammy perspiration, an exceedingly rapid and feeble pulse, and death supervene.
TREATMENT.- Aconite, followed by Belladonna, and afterwards Bryonia, are the medicines in most repute in this disease.
INDICATIONS FOR THE ABOVE AND OTHER REMEDIES.
Aconite- Febrile disturbance, especially in the early stage.
Arsen.-Iodium- In the last stage with marked prostration and emaciation.
Belladonna- Red, hot face; heat of the head; bright or unusually dull eyes; intolerance of light and noise. Calcarea Carb. given in alternation with Belladonna has restored desperate cases.
Bryon.- Suspicion of impending effusion on the brain.
Helleborus.- Enlargement of the fontanelles (the open spaces in the heads of young children at the points of junction of the bones) from copious effusion, pulsation being discernible.
Hyoscyamus.- Frequent starting, and picking with the finger.
Zincum.- Paralysis of the brain; insensibility and involuntary evacuations.
Sulphur.- During convalescence.
Iodoformum.- “Should not be forgotten in the treatment of Tubercular Meningitis, both as a local application to the head and internally” (Boericke).
ACCESSORY TREATMENT.- This should include applications of cold water to the head, liquid diet, sponging the body with cold or tepid water followed by rapid drying, and strict quietude.
31. Consumption of the Bowels.
DEFINITION.- This is an old-fashioned term, and really covers several conditions, not all tuberculous, but conveniently considered together, viz. (a) Coeliac disease, (b) tuberculous disease of the mesenteric glands (Tabes Mesenterica), (c) tuberculous ulceration of the bowel (d) tuberculous disease of the peritoneum (Tuberculous Peritonitis). The last three of these, or any two of them, may co-exist.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."