In November, 1910, I received the following letter, which is self-explanatory:
“DEAR DOCTOR: Read these symptoms and see what remedy had better be given at present.
“A young woman of 23 years, Weight 140, and plump. She has had a haemorrhage, and is a case of incipient tuberculosis, with, of course, no cavities: only an area of dullness in upper right lung and a laryngeal spot of infection.
“Her brother died of acute pulmonary tuberculosis in April, 1910.
“There is hoarseness and central soreness in the throat every morning until after breakfast time. She never eats breakfast, never has very much. Cough, a single explosive effort, generally dry, until after several such efforts a small amount of viscid expectoration is raised, with relief (contains tubercle bacilli).
Cough worse in cold weather; worse in damp weather; worse eating cold things, as ice cream, Menses getting less and coming late. Feet swell every morning, a puffiness of whole foot. Feet inclined to sweat. Numbness of single parts, shoulder, back (low down), sides (high up). Numb spots. Frequent urination at night. Yours,
What can be made of this symptoms-complex, much of which consists of ordinary symptoms, with no uncommon characteristics or peculiar ones?
Another thing to be noticed is the absence of mental symptoms, said to be the sine que non of a successful repertorial case case-study. Hence, as
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Aco. 2 2 4
Ambr. 3 1 2 3
Arg. 2 2 1
Ars. 4 2 3 3 3 2 4
Aur. 2 3 2
Bar-c. 3 1 1
Bell. 5 4 3 3
Bry 4 4 4
Calc,c 5 2 2
Canth. 6 3 2
Carbo.v. 3 2 3
Caust. 2 1 3
Cham. 2
Chin. 4 1 3
Cocc. 2 2 2
Con. 4 1 4 2
Dulc. 4 2 1
Graph. 2 2 1
Guai. 2
hYOS. 2 3 3
iOD. 5 4 2 2 2
Kali-c. 5 1 2
laur. 3 1 3 4
Lyc. 6 2 1
Mang. 5 1 1
Merc. 4 2 3
Nat.m. 3 2 4
Nit-ac. 4 2 2 2
Petrol. 2 1 3
Phos. 7 3 4
Phos-ac. 4 2 4
Pb. 2 1 3
Ran-b. 3 3
Rhus-t. 2 2 3 2
Ruta 2 1 1
Sars. 3 1 1
Seneg. 4 1 4
Sep. 6 2 4 4 2 2 3 1 2 2 4 4 3 3 4 4 3 4 1
Sil. 3 4 3 3 2 2 4 2 2 3 3 3 1 2 4 4 3 4 3 4
Spig. 3 2 2
Stan. 8 1 3 4 4
Staph. 2 1 1
Sul. 6 3 3
Thuj. 2 1 4
Verat-a. 3 3 3
Zinc. 3
As Silicea covered not only here but also in the materia medica, I answered the doctors letter, telling him that was the remedy and adding a word of caution as to using it.
The answer come at once- “Thank you. She is on Silicea now, nothing else. Covers the whole case so well. I wanted to be sure of it. No, sir, I am not afraid of Silicea in such a case, namely a plump, 14-pound girl in incipient stage. No cavities, nothing but an area of dullness in upper right lung and the laryngeal spot of infection.
“I suppose Silicea is to be doubted in advanced cases and then only because the patient can not stand it way of curing.”
Having heard nothing of the case since, I wrote within a month asking the present status of the patient, and received the following reply:
“Dear Doctor: The young woman seems to be all right now; she has gained in weight as much as she is inclined to. Her menses come on regularly, which they never did before. If she gets a cold the cough takes on its old character, but there is never any temperature.”
So much for help derived from Boenninghausen in this case of tuberculosis and the way to study it in his repertory.
The letters, which are before me, confirm the choice of Silicea.
