DISRAELI was credited with the dictum, “Never apologize. Never explain.” I am no Disraelite and so I feel that I must apologize for this paper for this reason: that through force of circumstance for which no one is to blame, I have had very short notice and less time to prepare it.
Believing, however, that each of us has a duty to record what we do or try to do, I usually have some notes on hand, some records of symptoms which, though they may seem trivial, are nevertheless clinical and must therefore derive some value from this fact if from nothing else.
I was interested to learn quite unexpectedly (for I had no idea that such a rule existed, though I agree with it) that our Secretary tries to give us at least a years rest between papers to this Society, whether to allow of your recovery, or like the Sab-batical year, to give us the opportunity of learning a little more Homoeopathy before having the effrontery to inflict oneself once again upon the Society. There are many of you who have imposed upon yourselves a much longer period of self-effacement than this yearly minimum.
Why you should try to improve upon the Jewish law which, if you may care to remember, prescribed six years of reaping and one fallow, not six years fallow and one of reaping (bumper crop though it might be !), I do not know; but the very fact makes me diffident in appearing before you so soon again, and I should most willingly have given place to those of my colleagues who have been digesting their material for a much longer period.
I shall try to conceal the acidity of my material, lest you should guess that it has not even been thoroughly masticated ! And I shall hope (if you will excuse the allusion) that it does not consist entirely of waste products !.
One of the criticisms levelled by the Orthodox School at the Homoeopathic method is that we are symptom hunters and little else.
“Disease is only made manifest to us by the symptoms it produces.” That is not Hahnemann, though it might quite well be, but the late Sir James MacKenzie who, though his aim was to discover certain laws pertaining to the production of symptoms as a guide to early diagnosis, still, had he known it, did more to further the science of symptomatology as a guide to treatment than perhaps any one non-homoeopath.
Many beginners have expressed their amazement when first introduced e.g. to the Repertory of symptoms, that so much detailed knowledge of disease symptoms should have been concealed from them in their orthodox medical education. Indeed, they have admitted (what we all very well know to be so) that instead they have been taught that the subjective symptoms of the patient, if not confirmed by any gross pathological signs, are usually of little value. But surely, as Dr. Julian Huxley might say, to wait for pathology seems madness !.
There is, of course, the other danger that we should consider symptoms all important and physical signs of none, but if on occasion the homoeopath is guilty of neglecting the latter, we have no monopoly of this neglect.
Of course, the neurasthenic feeds on the homoeopathic symptomatology. If in addition he should be an enthusiastic self-prescriber, then he is par excellence the symptom addict and does himself no good, nor the science of Homoeopathy, Indeed, I have always felt that it might be said of the Homoeopathic neurasthenic that it had been better that he had never been born! But he frequents other clinics than the purely homoeopathic! And so to our muttons.
This paper is a continuation of one I gave you before the war on the Value of the Peculiar Symptom in relationship to the Totality of Symptoms, and which was founded on notes kept from day to day by Dr. Duncan Russell and myself of symptoms of patients in practice, symptoms which led us to prescribe the drug indicated by that peculiar symptom and in some cases for that symptom itself, it being that complained of by the patient.
Some of the symptoms mentioned to-day were also noted by Dr. Russell, but he is with the Forces, and I must take full responsibility for all of them.
Not all of to-days list are peculiar; many are indeed known to most of us here, but they are a guide which cannot be too often repeated in our choice of remedy. So I do not expect to teach you anything, but simply to underline what you already know. For beginners they may be of value, and so it is to these that I shall primarily address my remarks.
After the publication of the previous paper one member was sufficiently interested as to look up most of the symptoms in the Repertory, and to my dismay reported that he could not find some of them at all! But, taking my cue from Kent, one or two were chosen on analogy since sometimes, as many of you must have found, the very best symptoms cannot be found when looked for.
I cannot guarantee that the same may be true of some of to-days examples but you can be assured that none of them are imaginary and all have been found somewhere in the Repertory of Kent, some may be in Gentry (which some of you may not know), and one or two in Roberts Sensations “as if– — –“. I must state, too, that no attempt has been made to draw the patient, and indeed there has been no lead in the search for the symptoms. Indeed, I have been amazed how often the patient proffers them.
Another point which may emerge, too, is the value of even the peculiar symptom in diagnosis, e.g. the Phos. vomiting, “thirst for cold water vomited a short time later” is frequently found in an acute appendicitis: just one more warning that none of us dare prescribe without examining. Incidentally, I may say that rarely have I found Phos. of any value in an acute appendicitis even as a palliative. And now to the symptoms.
Asarum. Sciatica better in wet weather. Gave quite a lot of relief in a very chronic case. Kent, p. 1006. Asarum is the one drug which has the symptom !.
Arnica. Haematuria with otitis media. Not an uncommon combination, I believe. In spite of discharging ear and haematuria with fever, the child was “feeling fine”. That is the symptom, and the result was an almost miraculous clearing up of both haematuria and discharge, the latter being more striking, I believe, as most cases of this sort takes a lot of clearing up, as Dr. Cunningham will confirm. One of Dr. Russells cases, and a very good one.
Ars. alb. “Thinks she is verminous,” An old lady with arteriosclerosis. She turned out her room, changed her bedclothes, scrubbed the house out, so convinced was she that this was so. Her efforts were nothing if not restless! The change was not rapid, but ultimately she lost the delusion completely. Kent, p. 34.
Aurum. Pain behind the sternum on exertion (anginal) in a patient with chronic rheumatic joints. Improvement in both, though the joints were not considered; cf Gold treatment of arthritis. Maybe homoeopathic: for all cases do not respond to this treatment. One wonders if we could give a hint as to which are amenable. Turn the other cheek and help the allopath. He never refuses to help us–or dont we ever need his help ?.
Arum triph. Picking spots till they bleed. In a bad case of acne after the failure of the more usual remedies this case showed marked improvement.
Ant. tart. Obstinate child who “refuses to be examined”. With chest symptoms of course a “bubbly” bronchitis. Very rapid cure. It is the speed of improvement which confirms the value of a prescription often.
Arnica. Aching all over with shivering like Gels. but no temperature. This may have been the aching of fatigue for which again Arnica is a great standby. In this connection one wonders if there is any physiologic explanation of what is called “second wind”.
Is it the accommodation of the body to dealing with fatigue products as in violent exercise, or is the beginning of a call on e.g. heart reserve whatever that may be and wherever it is contained as if one uses up the average supply of heart power and only when that is used up by some strange physiological process the extra current is switched on to allow of further effort? I must apologize for the mixture of metaphors but it does not lend itself to any known description; I very much like to hear members ideas on this subject.
Arg.nit. Pain in the ear (which was inflamed) < on lying. down but whenever this pain was experienced the patient began to cough (the old vagal connection, I presume), but Arg. nit, cured both ear and cough.
Aloes. Sudden call to stool in slimy diarrhoea. “Cannot Wait.” Child asks, but before the chamber can be fetched involuntary stool. Cleared up with one dose.
Ars alb. “Chilliness” with pain; p. 1265. This symptom is also present in Caust., Puls., Sep., but the condition was gastric (suspicious of gastric ulcer) and the same drug was given a year before with brilliant result. “Whenever the pain comes on I feel so cold.” It was the chilliness and not the pain which was the prominent symptom and the chief complaint. I think the emphasis the patient puts on the symptom is all important.
Bry. (a) Pain in hip in chronic arthritis < on coughing. Causticum is frequently quoted for pain in hip on coughing, but I have never found it act. It would seem to be the jarring symptom of Bry. so prominent with the Bry. cough affecting the head and the abdomen more frequently than other regions. (b) Pain in the head “better for eructations. Quick relief after weeks of pain. I have another patient who declares she has “wind in the thighs”, better for eructations, but I have never found anything to cure. She is a chronic gall-bladder case.
Berberis. Pain in the hip on urinating. Case of sciatica which had been very resistant to treatment, but improved quite measurably.
Carbo veg. “Wants doors and windows open” (under Respiration difficult, p.770) is in my experience much more commonly heard than that of “wants to be fanned”. But it must be definite. Thoroughly disgruntled if door is shut.
Cannabis indica., (a) Hears all sorts of tunes, mostly pleasant. Thinks she must be going “dotty”. One dose ! went in the night ! Wonders if she would not like them back again, for they were quite pleasant and made up for lack of a wireless. Present for weeks. (b) People look different. Voices sound different, on verge of insanity, Influenced by letter, walking over doormat on which letter fell ! Constant theorizing, radio location ! Exaggeration of time and space is the usual description, but the whole picture was well covered by Cannabis. Recovery was quick !.
Causticum. Urinating on coughing. Not so common unless in those cases with a prolapse. In these I have found not much value in the symptom. In this case relief was evident and very quick.
Calc. carb. Head sweat at night and on exertion in an adult. This was the patients complaint, so profuse was it. Quick relief. (How few adults are Calcarea.).
Cuprum. (a) Convulsion with colic. Complete Cuprum surely. Not in the Repertory under convulsion though I think you will agree that the analogy was justified. (b) Spasm of cough, “blue in the face” and seemed as if it would suffocate. Whooping cough. Unusually quick cure. One week ! One wonders why Cuprum is not thought of more often in spasmodic asthma. One would like to hear if any here have tried this remedy in the acute attacks of asthma. (c) Cramps in the thighs in acute enteritis. Three cases of the most acute choleric diarrhoea seen during the same week rapidly improved. Almost collapsed in each case. The sort of case which revives ones belief in the highest potencies.
Causticum. Pain abdomen “on deep breathing”. Quick relief in polyposis of the stomach. Thinks he was in for another attack which used to take weeks to wear off.
Cedron. Icy cold nose. Case of shock and grief after sudden death of husband. Usual remedies failed, but on this forlorn hope Cedron was given. Whether post or propter, V. M. B.
Diphtherinum. in membranous tonsillitis not K. L. B. One a very acute Vincents and another a staphylococcal infection. Rare to get membrane here, but it was so.
Dioscorea. The pain is so severe must get up and do something, cf. Cham. (a) The facial neuralgia so bad that she rocked herself about in bed and had to get up and do something ! after failure of Cham. (b) Another, an anginal case, had to get up and do something. (c) Another probably a ureteric stone. Here the symptom helped in diagnosis. Might have been appendix, but what appendix wants to get up and walk about ?.
Eup. per. Pain in the bones. Here the pain was in the sternum, unusual site, and was not related to cough. But the description was “in the BONE.” Quick cure of severe cold, which usually lasted for weeks.
Ferrum. Vertigo on rising from stooping. Not on going down but on coming up ! Old man with high B.P. but was grateful for relief !.
Guaiacum. Dreams of being cut up with a knife. KENT–p. 1237. Dreadful nights GONE, and very grateful!.
Ipecac. Bubbling chest with vomiting of phlegm. This is a winner if given early enough. Here is an interesting history for those who are interested in the Sulphonamides.
A child who usually responded to Ipecac. with very acute bronchitis was given this when the usual attendant was not available, with no result. She was then given M. & B. as there was evidence of congestion and no bronchitis. She was said to have recovered in a night which I believe, but when I saw her three days latter she had her old bubbly bronchitis which Ipecac. quickly cured.
Now this does seem as if the M. & B. was specific to e.g. the pneumococcus but not to the organism or organisms of bronchitis, and yet Sir Almroth Wright has recently stated that the sulphonamides are not just specific to one organism but aid leucocytosis generally. It is an interesting problem in which we ought to have a say. Ipecac. apparently did nothing for the early condition, just as we should expect, for Ipecac. symptoms were not present, but when they were it did. So dont prescribe on old history, lest the condition be not the same.
And then, one cannot be available always !.
Iod. Cough worse in a warm room. Also from tickling in the throat pit like Rumex, but Rumex is usually worse cold air.
Kali nit. Pain like a knife in sternum on coughing. Severe cold and cough quickly cleared up.
Kali sulph “Bubbly base” after congestion. Cleared chest after failure of Nat. sulph. Like Kali carb. BUT “productive,” as the orthodox prescriber would describe it.
Kali carb. Earache with M.P. Other drugs have it. Grumbling symptoms of Kali carb. confirmed, and administration proved the wisdom thereof !.
Kali iod. Sore throat, worse talking. Often helpful. I cannot say I find most throats Mercury, as some do.
Kali ars. Pain of diabetic neuritis worse 1-3 A. M. after failure of Arsenicum itself. (Remember to correct your times according to the changes !).
Kali carb. Cutting in right side chest < lying that side. The sort of pain which makes patient grunt ! Often R. basal pneumonia, often, too, referred pain simulating appendix or G. B. cf. Localization. Aconite. R. apex. Apical pneumonia, often delirious. Why ? But Aconite confirms, for it has all the delirium we could wish for.
Lyssin. Fear of water, of swimming, or even of having a bath. A case of frequent micturition with no organic cause V.M.B. and this case had all sorts of treatment, including many months psycho-analytical investigation.
Lueticum. Pain “dusk to dawn” in shingles pain : relief after years of suffering.
Lycopodium. Desires warm drinks during fever. I had never found it useful before, but just recently acute chest with fever, T. normal in 12 hours and much better every way. Eup, per. also has it, but one should expect some other symptom as a guide.
Medorrhinum. Pelvic cellulitis not G.C. Three cases very much improved on analogy.
Merc. Desires “butter”. Quite an obsession. Half an inch thick. Led to great improvement in general condition.
Merc. Throbbing pain vagina. Profuse vaginal discharge. Pain improved and discharge. It was not a trichomoniasis.
Muriatic ac. Aching pain in the legs > moving, after failure of Rhus tox. Patient with a chill complained bitterly, not of cough or headache, but of the constant aching in legs behind knees. After failure of Rhus, Mur. ac. cleared all up. KENT– p. 1087, aching yet not in general rubric.
Nat. mur. “Coldness round the heart in coronary artery thrombosis; very speedy recovery though he had another and final one a year later.
Nux vom. Nasal discharge worse eating or drinking; KENT–p. 338.
Nat. mur, Pulsating pain in the deltoid muscle. Acute. Quick recovery. Thanked me for the relief !.
Phos. Pain in chest, > lying on the back, possibly more common than R. or L. modalities, Mostly pneumonias < lying either side, both cough and pain.
Phos. Cough worse change warm to cold and cold to warm. Remember Rumex also has both, but < cold is more frequently emphasized.
Pic. ac. Hot burning feeling over the back, worse excitement. Nervous subject, but said afterwards, “I wish you could cure my tonsils as quickly as you have cured my back.” She has chronic septic tonsils which want removing but she wont have an operation.
Platina. Tight feeling like a band above the knee. Painful knee due to a wrench which had been so severe as to cause patient to lie up. Relief. No swelling, no difference in measurements of the two knees. Useful symptom in phlebitis.
Pneumococcin. After failure of Puls. and Kali sulph., cleared up an obstinate chest; symptom, sweetish sputum !.
Sulphur. Pain in the ear with eructations ! Tarentula also has it but so has WAX, and wax it was which, when removed, removed the pain !.
Sulph. Hot, thirsty, irritable, dirty. Pulmonary congestion, but received Nat. Sulph. before it cleared, the signs at the left base being the last to go. Often one finds another drug allied to that first chosen is the real remedy; but then the case does change, e.g. Bry. to Rhus. and not infrequently Rhus. to Bry. are quite frequently seen in my experience.
Spigelia. “As if blood bubbling in the legs.” I think this was from Roberts Sensation “as if— —“, another very valuable book, though one would like to know his authorities.
Spigelia. Pain in heart < lying L. side, can lie only on the right. Pericarditis three cases; KENT–p. 850 (must know diagnosis). Pain constant as well as < various modalities, size of ones hand, suggests diagnosis !.
Thuja. (1) Involuntary urination in the daytime only, on walking or in a bus. Not at night. Quick relief. Ferrum also has this symptom. This in an old man with no prostatic symptoms. Never had any trouble that way before.
(2) Pain in the bladder extending to the tip of the penis. This is Thuja but also frequently it is stone in the bladder. One case which I missed had the stone removed elsewhere. The next case I got with the symptoms (both had had their prostates removed about a year before) I had X-rayed immediately, with the report “large stone in bladder”. I thought, “This will make up for my first failure”, but he was having no more operations. So Thuja he has had, but as yet without relief.
(3) Foul-tasting expectoration < after eating; KENT–p. 815. So foul that cancer had to be suspected. X-ray negative, bacteriology negative. Thuja covers both < eating and foul- tasting sputum, and cleared it up.
Tarentula hisp. Fidgety legs in bed at night. Gave great relief after failure of Zinc and Rhus in a chronic kidney case. This would seem to show cerebral irritation and not local circulatory disturbances.
It has been said by the critics that the homoeopath is as curious as the symptoms he deals in. Well, to be curious is to be “eager to learn”, “inquisitive” if you like, “minutely careful” and only in a very secondary sense “strange” apparently because “rare”. Need we a better epitaph ?.
But there are two aspects of this curiosity which I as a final word should like to emphasize. (1) To be curious as to the significance of our symptoms not only from a prescribing point of view-but, as I have tried to indicate, from that of diagnosis, etiology, physiology, and even pathology !.
A patient who suffers from severe migraines pointed out to me recently the relationship of Iris (so useful in such headaches) to the pancreas and gastro-intestinal tract. Here, then, is a lead to those interested in etiology of this most obscure subject, gained directly from symptomatology.
Or, reversing the process, “headaches on waking” according to recent authority are due to a toxic process. What more toxic than Lachesis, and that has the waking symptom in black type !.