In 1923 a book was published by Edward B. Ochsner, B.S., M.D., F.A.C.S., physician,surgeon, and adjunct professor of clinical surgery at the University of Illinois, the title being Chronic Fatigue Intoxication.
Early in his medical experience he occasionally found patients complaining of certain symptoms which did not seem to fit anywhere into the known classification of diseases. As his practice grew he found many of these apparently detached manifestations of deviation from the normal, and after twenty- five years of careful observation and study he was able to piece them together and obtain a clear cut symptom complex which he called Chronic Fatigue Intoxication.
Acute fatigue had been carefully studied but this was the first study made of what he termed Chronic Fatigue. He found it to affect exclusively the ambitious, spirited, strong-willed people who drive their bodies beyond the limit of safety, and a continuance of this life so changes the whole physical, psychic and moral nature that even the judgment becomes so wrapped that they cannot by themselves get back to normal. The laggard, the phlegmatic, and the weak-willed are rarely affected.
Physical overwork or overstress continued too long, producing waste far in excess of the power of elimination, he believed to be the basis for the development of this condition which most frequently affected professional men, social workers, big business men, social butterflies, teachers, nurses, private secretaries, woman who try to do a good job in business and also take care of a home, and mothers with very trying families.
A great many of these cases have one important symptom which you and I have frequently seen the inability to be comfortable in a temperature below 68 or above 72 degrees. Every part of the body seems to be affected. One peculiar condition that all of them have is the contraction of voluntary muscles, and either at origin or insertion there appears a very tender movable node. One on the cartilage of the seventh rib is sometimes mistaken for gall stone tenderness. One over the mastoid is so very tender that it seems to indicate mastoid involvement. (I have seen quite a number of these tender mastoid nodes).
The digestive tract is so involved that Dr. Ochsner admits that he wrongly operated some cases. Organic stricture of the bowels was a frequent incorrect diagnosis. Every part of the body produces serious symptoms. This is sufficient to show the inspiration he had for a searching study of these cases. Operations, drugs, and even trips around the world had no beneficial effect on his patients, but he did find that thorough body massage with manipulation of each nodule, continued for a number of years, gave very good results. I was much interested in his descriptions of a number of cases suffering from what we now recognize as a loss of perception or nerve deafness.
Dr. Ochsner, a surgeon anatomically trained, investigated these cases anatomically and pathologically. Had he studied psychology he would have recognized that ambitious business men, physicians, nurses, teachers, and mothers are subject to the tension of tragedy, competition, financial stress or unbalanced living, and he would have placed them in what is now termed Psychosomatic Medicine. A well trained Homoeopathic prescriber would have answered the piteous appeal of these shocked and sick nerves with Nux Vomica, Ignatia, Hypericum, Chamomilla, Pulsatilla, and many other drugs.
In 1943, Dr. Edward Weiss, of Temple University Medical School, published a book on Psychosomatic Medicine. In the preface Dr. Weiss says: “Understanding illness and treating sick people consists of something more than a knowledge of disease.” This he learned quite forcibly some twenty years ago when he entered Clinical Medicine through the door of pathology. He was consulted by a young woman with obscure headaches. With pathological knowledge and scientific zeal he vigorously proceeded to investigate, with physical and laboratory studies, her various organs and tissues and wound up with lumbar puncture. She became worse and was bedridden for nine months. He arrived nowhere and could not understand why he was retained on the case.
The time came when the parents decided to make a change. They called in an old doctor who took care of her during her childhood. He knew what the young scientist did not attempt to discover. The young patients only brother, to whom she was closely attached and who acted as head of the family, was interested in a young woman whom he would probably marry. The patients illness was her infantile way of expressing disapproval of her brothers marriage and when the meaning of her brothers marriage and when the meaning of her illness was made clear to her she promptly recovered. Dr. Weiss realized that he was not fitted for the practice of medicine and he corrected it by associating Dr. O.S. English in his investigations.
Dr. English is a professor of psychiatry. Together they analyzed many cases with some very interesting results.
The book by Dr. Weiss on Psychosomatic Medicine is really a case book in which he reports at great length cases which come under every department of medicine. He says that standardized histories contain no information of the patient as a person. The constitution is in most cases a small component in personality formation when compared with the importance of the impact of experience on the individual.
Anxiety, even in children, plays a great role in the development of illness of emotional origin. The world of the child is very small and what would seem to be of little importance in the life of an adult may be of permanent importance in the life of a child. Sometimes the conditions under which a child is fed, such as impatience while feeding him, bring about an emotional sickness, and gastro intestinal conditions develop.
Dr. Weiss says that the greater our success in switching the conversation from symptoms to personal affairs the sooner we come into possession of the real problem which is disturbing the patient. Yet we know that we must have these symptoms.
A man forty-two years old was sent to me by one of our physicians in a neighboring city who thought I might be able to analyzed the case. This man had suffered severe pains in head and body for twenty years. A surgeon sought to relieve the head pains by operating a sinus. The results were negative. For the severe abdominal pains the appendix was removed but the results were not satisfactory. The man was discouraged and losing weight. On four occasions he had come to himself in another city and could not tell how he came to be there.
He was very much afraid of a mental breakdown. On reviewing his very unsatisfactory family life I was able to assure him that it was merely an escape mechanism. When his nervous system could stand no more nature pulled down a shade over his conscious self, and the unconscious self took him away from his trouble. When the nervous system was rested the shade flew up and there he was. The most interesting symptom, one which we do not frequently meet, was the entire relief of all pain while digesting food.
As soon as the meal was digested all the pains returned. There was one remedy which covered his case completely,including the relief from eating. He was given one dose of anacardium and a bottle of placebo. After thirtysix hours he had no more pains of any kind for three months when he was given another dose. His escape mechanism never worked again. He gained weight and became cheerful. This case may be considered a psychosomatic case. One wonders if the remedy alone, or friendly explanations alone, could have resulted in a cure. I think that a combination of the two methods produces the most satisfactory results. Give Ignatia when you can find no pathology to account for the sickness.
In his book, Dr. Weiss mentions phobias. An unpleasant experience in church, theatre or store may bring on a sensation of suffocation. Were you ever right and at the same time wrong? I have been. One of my ear patients asked me if I would try to find a remedy for his daughter. She was nineteen years old and for a few years had been unable to enter stores or theatres if there were many people about. She always stood near the door of an elevator and if many people entered she had to get out or faint.
She was confined to bed with severe cramps the first day of menstruation. She also had a great deal of intestinal suffering. I studied her case very carefully with the aid of the repertory and was sure that I had found the best remedy. I tried another remedy, very close in its symptomatology, with no effect. I asked the father if he would take his daughter to Chicago and he willingly agreed.
An appointment was made with Dr. Grimmer who studied the patient, gave her a powder and sent her home. Within thirty-six hours improvement began and in two years she was in perfect health. I had told Dr. Grimmer nothing about the case. My prescription was Lycopodium 200. Dr. Grimmer gave her Lycopodium 10M. I was right in my selection but wrong in my potency.
