THE DISEASES OF THE LIVER
THE issue of a second edition of this treatise on Diseases of the Liver affords me an opportunity of adding somewhat to the clinical demonstrations already contained in Part II.
Particularly would I call attention to what is here related of the sphere of action of Chelone glabra of which no mention is made in the first edition, because I was, at the time of its issue, not clear on the subject. At this place I would also take the opportunity of pointing out the omission by Dr. Dudgeon of a very important point in regard to the clinical use of Carduus marioe. Some time since Dr. Dudgeon translated and published in one of our journals some very important cases of pulmonary disease and coughs as cured by Carduus. The impression conveyed by this eminent writer’s translation is that Carduus in these cases acted as a pulmonary remedy whereas the cases were really considered by their author as of hepatic origin: the pulmonary manifestations being consentaneous, or secondary to primary liver affections in all the cases narrated. This point is of the highest importance as Dr. Dudgeon’s translations give one the impression that Carduus is a lung medicine which I think is entirely erroneous: the lung affections that are curable by Carduus have their starting point in a primary affection of the liver. All the clinical writers on Carduus with whose works I am acquainted are of this opinion, and Rademacher, the greatest of them all, is very clear and positive on the subject. *I am very well aware that Dr. Dudgeon does not share in my organopathic views, but as translator he is bound to faithfully render the original. I will now relate a case of hepatic disease of great interest which had baffled some of the best physicians in London and which very clearly exemplifies the therapeutic range of Bellis perennis and again of Carduus marioe. It is one of:
ENLARGEMENT OF LIVER REMAINING FROM HEPATITIS AND PERITONITIS.
The wife of the Vicar of St.B. brought a young lady, about 24 years of age, to me on February 20th, 1893, for considerable swelling of the abdomen and such severe varicosis of lower extremities that the patient had been confined to her couch for nearly a year. Patient had had thrombosis of the veins of her lower extremities repeatedly and the swelling in the right side of the abdomen dates from a severe attack of peritonitis and hepatitis. All idea of a cure had been abandoned. Percussion and palpitation revealed an enlargement of the left lobe of the liver and a painful lump lying between the liver and the navel about the size of a small first. Glands in the groins feel like marbles, lower extremities large and unshapely, clearly the remains of the original thrombosis. In as much as the whole series of phenomena-thrombosis, peritonitis, hepatitis-began with getting a chill (cold, wet) six years ago, I ordered my old friend Bellis perennis ten drops in a tablespoonful of water night and morning.
March 20th.-Very greatly improved, indeed, lump nearly gone and the lower extremities are now shapely. The left lobe of the liver however remaining enlarged, I ordered Carduus marioe seven drops in water night and morning.
April 28th.-Patient at this date was walking about like other people, and the only thing that remained was a little transverse swelling of the liver and this was removed by a short course of Chelone glabra.
In the fall of the year 1893, a slight relapse occured which was quickly righted by Bellis perennis. The Vicar’s wife was with me on October 15th, on another matter and mentioned incidentally that Jessie’s cure had proved complete and lasting.
The common sunflower is an old horticultural as well as clinical friend of mine that has here and there helped me in splenic affections. Here I use it more as a liver remedy:-
Helianthus Annuus AS A LIVER MEDICINE.
Although I regard the sunflower as specially a spleen medicine still it has a distinct action across from the spleen toward the liver and possibly it influences the liver also.
I have lately cured a stubborn case of a throbbing swelling in the pit of the stomach involving the left side of the liver and the spleen and the tissues lying between the two organs.
No defined epigastric tumours could be satisfactorily distinguished but the whole epigastric region was very tender on pressure and patient could not bend down with out getting giddy and feeling much distress at the epigastrium. The particular interest in the case lay in the long duration of the ailment and the pulsating epigastric mass.
Patient took five drops of the matrix tincture of Helianthus, night and morning for some weeks when the only abnormal thing remaining was the very slight enlargement of the left lobe of the liver and for which he was put on Chelone glabra. The spleen was put right and also the epigastrium of which the pulsation ceased, together with the tenderness and distension and in view of the difficulties one encounters in dealing curatively with pulsating epigastric swellings I think this short narration worth penning and preserving.
I know of nothing in the way of diagnosis offering more difficulties and pit-falls than “pulsating tumours” in the abdomen, and indeed all abdominal tumours take a deal of diagnosing.
I will now invite my reader to a short yet closer consideration of an hepatic that is a comparatively new friend, viz. Chelone Glabra-AN IMPORTANT HEPATIC.
I think I have discovered an important differential point for the scientific use of Chelone glabra.
A Commander in the Royal Navy, about two years ago, came under my observation for an enormous varix in the right groin, just on Poupart’s ligament. The varix was about the size of a very small orange and the thing was certainly becoming alarming on account of the thinning of the wall of the dilated vein. And being in the bend of the groin it was almost impossible to apply mechanical support. The patient was thoroughly healthy fellow and though I diagnosed him up and down and questioned him unto very weariness, still there was absolutely nothing findable beyond a slight enlargement of the left lobe of the liver. I first used Chelidonium majus. with some advantage, and under Carduus marioe the varix certainly diminished somewhat, but under the remedy in question the varix disappeared and patient hastened off on active service. From this (and similar observations I have laid it down for my own future guidance that the seat of action of Chelone glabra is the left lobe of the liver and its line of action is in the direction of the navel, bladder and uterus. That this is really so the competent will have no difficulty in verifying whether Chelone acts upon the liver itself as a true hepatic I would not venture to affirm; perhaps it reduces the swellings of the left lobe of the liver by its action on the veins running up to the liver.
Many of the “New Remedies” have come and gone; Chelone has come to stay: its sphere of action is small, its action sharp and withal well defined.
CASE OF RIGHT-SIDED VARICOCELE FROM ENLARGED LIVER, MUCH AMELIORATED BY Chelone Glabra.
A gentleman, who had long been under me, consulted me again in the spring of 1894 for varicocele of the right side. Casting about to find the primary dam I found the left lobe of the liver notably swelled, patient himself being however in capital health. There was besides the varicocele a moderate degree of varicosis of the large veins of the whole of the right leg. I prescribed Chelone glabra, five drops in a tablespoonful of water night and morning.
I did not hear from him for eleven months when he called to see me telling me he had gone on with the remedy steadily all the time as it seemed to be doing him good.
On examining him I found the varicocele had gone down about one half and the varicosis of the leg had also notably diminished, so that he can now safely dispense with the elastic support. I was here led to prescribe Chelone because of its line of action from right to left and from above downwards.
The testimony afforded by this case is very high indeed because patient has been under me for years for his varicosis with but small benefit, and his being an officer in the Royal Navy rendered it very important that he should have his varicosis mended. He is not entirely cured now but the amelioration is such that in his own words “they (the authorities) will let me go now on any expedition.” I had before made use of a number of vein medicines and constitutional remedies, but Chelone alone did ten times more than they all.
Carduus Marioe AND Chelone Glabra.
There are cases of enlargement of the left lobe of the liver that are ameliorated by Carduus marioe, and by Chelone glabra also, though not radically cured by either and these cases beautifully exemplify the limitations of the curative spheres of organ-remedies as I have more particularly dwelt upon in my work on “Diseases of the Spleen” The subject is so important that I will go into the matter at this place somewhat more in detail. It is a great help in the drug treatment of disease to be able to get clean-out constant indications for our remedies; and so it is very helpful to see where the remedial action certainly leaves off Now the curative sphere of organ-remedies stops short of blood diseases; they do not reach the diathesis, and they therefore do not cure, e.g., Chronic Skin Diseases; skin diseases are commonly diathesic.