Eight Years In China

No treatment is possible on purely objective symptoms. I pity the many beginners who, instead of starting with the Organon and a Materia Medica, proceed with a manual where diseases are being treated. They bungle for years, and abandon the Homoeopathy, looking for consolation to complex-electro-Homoeopathy, etc. China was a great experience for me as I learned the British and American Homoeopathy there.

In writing about my experiences as a physician in China, I shall bring forth no surprising discoveries. The value of this paper rests in the comparison of therapies; the writer having found him compelled to work as an allopathic doctor (being a missionary doctor) and as a Homoeopathist. Eight years of work, with tremendous material furnished especially during the war, gave me ample opportunity to compare the results of both methods. (In the Mission Hospital and three dispensaries during this period, I saw about 60,000 patients; in my own clinic nearly 12,000 patients. In referring to my own patients in this paper, I mean those treated Homoeopathically.

The most common diseases met by the physician in China are tuberculosis and malarias. On top of these epidemics appear in certain seasons of the year: typhoid, paratyphoid, typhus, dysentery, dengue fever, acute malaria. I will mention also the great pneumonia epidemic in the winter of 1942 and an epidemically-appearing syndrome – a mixture of a glandular fever (Pfeiffer) associated with acute rickets.

I begin first with descriptions of treatment of the typhoid group. This group is represented by some 400 cases treated allopathically and 160 cases treated with homoeopathic principles in mind during the great epidemic of 1943. What a difference of results obtained! Who will ever forget the marvellous results after a 2-4 day administration of bryonia, nux vomica, baptisia, stramonium, in the first stages of the disease.

What could I do as an allopath to meet the feverish delirium, all the toxic symptoms of anger, delusions, fright in fever? This epidemic was a bad one, the fever setting in high from the beginning. Glucose with vitamin C injections, the usual antipyretics and washings could not meet all the emergencies. Whereas late complications such as otitis, pyelitis, periostitis (and in some cases of paratyphoid a lymphadenitis) were as high as 20 per cent, I saw as few as 5 per cent in those Homoeopathically treated. In general the latter class presented a picture of quicker recovery. I very often succeeded in aborting a case within 5-7 days.

I must say it was no easy undertaking to embark on a treatment of an acute case. Day by day the MAteria had to be studied, the more unfamiliar particulars repertorized, especially hourly aggravations. The aftermath treatment of such severe diseases was perhaps more efficient from an allopathic standpoint, still there were lots of symptoms which were covered by our drugs (loss of concentration, weak memory for names, drifting of thoughts, alopecia, etc.).

The same observations apply also to the treatment of typhus. How effective pyrog., rhus t., arnica were. The only means for the allopath to meet the most dangerous symptoms, especially those of spoilation of the blood, was transfusion.

Dysentery represents a somewhat different picture. Whereas the typhoid epidemics did not change much as regards virulence, the dysenteries (amoebic and bacillary) changed each year with the genus epidemicus. I could handle both types Homoeopathically during the epidemics of 1940, 41, 43, and 45, but in 1942 the toxic symptoms of bacillary dysentery, especially in children, were so severe that none of the usually indicated and usually efficient drugs met or alleviated the symptoms.

I must admit that I had only a 30x dilution of merc. cor. Lack of alcohol and bottles prevented me from preparing higher dilutions which I needed, particularly for malaria, where, with the exception of China sulf., no drug was of any value below the 30x. I am certain higher dilutions would have met the severest symptoms. But I had to resort to the use of a Japanese preparation of sulfaguanidine, using up to 4 gms. daily compared to 15-18 gms. daily administered by my Chinese colleagues.

The homoeopathic treatment of dengue fever (70 cases) proved much more efficient than the allopathic. The typical headache on turning the eyes could not be alleviated by means of the usual analgesics, whereas bry., bell., gels., were most beneficent. IN over 100 cases allopathically treated I did not experience a shortening of the attack until the rash appeared on the sixth or seventh day. Homoeopathic prescribing shortened the course of fever up to four or five days, alleviated the general soreness and brought forth a quicker recovery.

The most dreaded disease, malaria, I learned to handle after many an unhappy trial. No drug below the 30x would be of any avail. I did not find drugs acting specifically on a specific malaria, as in Boerickes Repertory; i.e. either tertiana or subtertiana (tropical), a vivax of any plasmodium giving in to a smile. The problem is different as far as the quartana is concerned. Here a tendency of a change from an intermittent into a remittent type of fever is to be observed. Here is the domain of what I would call the homoeopathic specific for those cases: psorinum. It took me quite a while to follow up the whole symptomatology extremely rich in particulars, but it paid off in the end.

With over 1,100 Homoeopathically treated cases I dare say that there is no other treatment as profoundly acting as ours. 2,000 observed cases of orthodox treatment (quinine, atabrine, plasmochin, eucalyptus oil, salvarsan, stovarsol) did not give the feeling of satisfaction that one felt when administering a couple of homoeopathic powders. Whoever has seen the heavy discoloration of the skin after a prolonged treatment with atabrine, the flabby features, edema of the deathly pallor of lips and gums, loss of appetite, ear troubles after quinine, will hardly decide for this sort of treatment, especially knowing that there is much more effective therapy in a couple of doses of nat mur., ignat., ars., or any indicated remedy.

Whoever thinks of symptoms like cough during chill or fever, nausea in smokers when smelling cigarette smoke, the reversing of the succession chill-fever into fever followed by chill, the motley picture of gastro-intestinal symptoms associated with either of the three periods, the manifold symptoms during apyrexia, the endless chain of symptoms in chronic malaria? This alone would justify the study of our Materia Medica. And the studying of the manifoldness of the semiology will engender a different outlook on diseases generally. During seven years of homoeopathic practice in Europe I never saw a case of malaria, but after having been confronted with this disease in China I learned a lot more about handling feverish states.

I have to point out the differences in treatment of acute and chronic malaria, a very delicate problem of dosage and repetition. The suggestions as to the treatment of acute malaria made by Stauffer cannot be applied – at least no in China. Contrary to my knowledge received in Europe, acute malaria, which in my opinion represents an acute neurosis with loss of equilibrium in the vegetative economy, reacts solely to far higher dynamizations than chronic malaria. Whereas 52 chronic arsenic cases reacted favorably to the 30x, eight acute cases had no reaction or amelioration on 30x, but the 200x produced a brilliant effects.

U must include that I had followed up more than 50 per cent of all cases with repeated blood tests and most detailed histories. Some cases, 40-60 per cent, of acute malaria did not respond at all. By taking refuge in quinine or atabrine I could suppress the worst symptoms and after a time (one week or 10 days) go on with homoeopathic treatment. Most of such cases after a short period of orthodox treatment represent the changeability of symptoms of pulsatilla and in some cases sepia (changing paroxysms).

As to the repetition in acute malaria, I gave 3 single doses of the 200x a week before retiring, altogether 6-7 doses. Potencies from 12x to 30x, 3-4 times a day, continued for 2-3 weeks. With improvement, the daily intake was reduced to 2 doses. In chronic cases a single dose a week or every 2 weeks when using the 200x, continued 3 months, altogether 9 doses. Potencies of 30x 3 time a week were continued for one month.

The chronic diseases are tuberculosis of the lungs, bones, glands (with and without fistulae), syphilis of secondary or tertiary stage, chronic gonorrhoea, and all sorts of gastro- intestinal disturbances with or without hemorrhages.

One of the most brilliant but also most difficult chapters of Homoeotherapy are the many hemorrhages. In Europe a lung hemorrhage will be found in cases corresponding to what is called the second stage according to Turban. It is different in China where wounds bleed freely, and accordingly hemorrhages occur in beginning affections of lungs, sometimes as a result of an injury (hard racking cough), anger, vicarious bleeding in suppressed menses, etc. Hemorrhages from any orifice, especially from lungs after malaria, and fistulae are most common.

To get into ones mind the drugs in Kents rubric: expectoration bloody, and chest hemorrhages; and all the other corresponding symptoms (at the bedside I used Boerickes Repertory) so as to speedily work out a homoeopathic procedure of a cure is much more difficult than an allopathic approach; but the results! Of course an artificial pneumothorax will stop any hemorrhage (in case there are no adhesions); on the other hand no homoeopathic drug will stop copious bleeding gushing out of a huge cavity.

But the whole range of even very severe lung hemorrhages reacted better and sometimes quicker on homoeopathic drugs than on 10 per cent natrum mur., calcium or K-vitamin injections. What is an allopath going to do with cases corresponding to Nitr. ac., carb. veg., lachesis (sputum raised under choking when falling asleep – a symptom so often in cases of pulmonary-laryngeal phthisis)? What sort of an allopathic procedure can be recommended to fit the symptoms of weakness in chest? How many of our colleagues missed the opportunity of getting to know the causticum and pulsatilla personality, types representing to often the beginning phthisis?

I could not observe any good results in intestinal tuberculosis. But 210 cases of glandular and bone-tuberculosis, mostly with fistulae of all sizes (in one case four cervical and two sternal fistulae or three perianal fistulae alternately opening up and closing under fever and terrible sufferings) owe to homoeopathic treatment improvement or clinically a complete recovery. Many cases improved after first producing a eczema, especially the arsenic cases. I once had a miraculous cure in a case with a deep cervical fistula and huge bulks of glands, suffering from an intercurrent cough like whooping cough, the symptoms of which corresponded to drosera. Six doses of drosera 30x cured not only the cough but the fistula too.

The glands became softer and diminished in size. No allopathic treatment will give you results still possible in the severest cases of pulmonary tuberculosis. We cannot produce through internal allopathic drugs old eczemas which have been suppressed. Eczemas are wide spread among Chinese, also all sorts of lichen. They all are treated with ointments. You may rest assured that after a weeks time the skin will be affected in the majority of cases treated with arsen., arsen. iod., and tubercul.

A very interesting chapter for a Homoeopath is represented by the annually appearing cases of fever in children. As I pointed out it is a sort of glandular fever associated with rickets. So far I observed 300 children in the Missions orphanage and hospital and 107 children in my own clinic. It is an epidemic. Starting from Shanghai you will find the very same sickness in the whole Yangtse valley at the very same time, from March till October or November. It occurs in children of one to seven, seldom beyond eight years, and begins often in children after weaning.

Chinese children are breast fed till their third year, according to Chinese conception, for, the uterine stage is counted as the childs first year. The disease begins with slight fever which increases gradually after 8-10 weeks, (when there is no treatment or an inadequate one), to reach daily temperatures running as high as 104 F., mostly in two daily climaxes, the first and lower at about 5 p.m., the second at about midnight. The fever is associated in almost all cases with thirst for huge quantities of cold or hot water, the lips are bright red, parched with no herpes. The face is sallow with sunken eyes, and wrinkles appear early on the neck which gives the jugulum the appearance of an old woman. In the mental sphere this stage is characterized by restlessness before midnight.

The child wakes up screaming which becomes in its intensity the character of a regular cri encephalique. In the second or third month it wants to be carried. After 2-5 minutes of being carried and drinking greedily 100-200 cc of water it falls asleep to wake again after half an hour or an hour. This goes on till about 4 a.m. At this time the fever subsides and a profuse perspiration ensues. The sweat is at first hot, drenching the forehead, but more on the occiput, neck, palms and soles. Now the child may sleep for 4-5 hours without interruption. The childs character changes considerably; it becomes moody easily excited.

In children of 5- 6 years a premature intelligence along a slow development of a hydrocephalus is to be observed. In some children a sudden desire to bite people, even their parents, while being caressed, is a common symptom. Most of the children turn malicious and become extremely sensitive to touch and jar. Sensitive to cold air and draught during the daytime, they want to uncover the body when asleep, all but the head. In cases of a more acute character the fontanelles open up in the fourth month, the parietal bones become brittle and with these signs the following symptoms are associated: a running nose or ear or both: the child stops walking, dropping of hair in bunches on the slightest pull.

This is the stage the old Chinese doctors consider the most favorable for an acupuncture which is performed with short golden needles in the childs palms. There are two methods of acupuncture treatment: in children with open fontanelles but without convulsions or anticipated convulsions, the puncturing of all finger tips except those of the thumb along the adductor to the metacarpus. I have never used acupuncture but I have noticed the following facts: on first treatment no blood comes from the wounds, but a kind of a sanguinolent moisture. As the treatment is repeated every 4-5 days, the appearance of blood oozing from the wounds is hailed as the beginning of convalescence.

I could verify this statement in cases of hydrocephalus which have been treated elsewhere by Chinese methods and relapsed in to the second stage of this disease usually coming on in June or July, (after 4-5 months): the gastro-intestinal stage. From the beginning, the child develops bundles of painful elastic glands (mostly without signs of inflammation, but sensitive to touch). In the third or fourth month the abdomen swells up drum-like which contrasts with the emaciated limbs and chest. The blood test shows from the onset a leucopenia (4-5000) with high amounts of huge lymphocytes, gradually increasing anaemia with macrocytes appearing more and more in the blood. I never found an emaciation going upward (abrotanum).

All children showed the very same type of emaciation starting from the neck and going downwards. Discharges, which were more of a mucous character, change into purulent, cheesy and offensive ones, like all excretions become more and more offensive. The appetite has changed from the beginning; there is a marked desire for ham, smoked fish and ducks, fermented duck eggs (eggs put into earth for three months after having undergone treatment in a mixture of clay and bran; a process of putrefaction, making the whites appear green and the whole egg tastes like a Roquefort cheese). Later there is a morbid desire for chalk, earth, coal.

Vomiting is a bad omen as it points towards the last stages associated with oliguria, acetonuria and comatous stage lasting sometimes for 8-10 days. In this stage a noma is likely to appear, especially in boys, which marks the end of a tragedy full of torments and suffering, especially for children under bad hygienic conditions, children whose abode is a couple of mats hung over bamboo-poles. The bowel movements become more frequent. It is first a sort of papescent diarrhoea with lots of flatus at the start. The single amounts are not big, the color is yellow or green, microscopically fat crystals in large amounts.

In the third or fourth month it changes into a lienteric type with even milk not being digested and lastly hemorrhages set in. Brown, dark-red, mostly coagulated blood comes on during and after stool. This latter symptoms is a real crux. Nat. mur. and nitr. acid. were mostly indicated, and I could save a lot of children. As a matter of fact, I have not lost one child treated Homoeopathically for hemorrhages (also oral and nasal) – whereas I was at a loss as what to do as an allopath. Calcium, coagulen, ferr. sesquichlor., tannin were in most cases of no avail. Liver and spleen visibly not affected. The uro-genital organs manifested their participation in form of an oliguria with albuminuria (hyaline cylinders), in two cases with lipuria, mucus, phosphates.

In cases after measles a cheesy leucorrhoea, staining in linen, mostly at night. (A fact very interesting in china are the many complications following measles: infantile tuberculosis, otitis, moist eczema, especially on the scalp). Even in recovering children, there is very often the symptom of open eyes on falling asleep (later in deeper sleep they are closed). Towards the end, there is the atrophy of the helix of the ear, a pointed nose and the deaths head appearance of the face. Motion of limbs becomes slower, the child looks for hours fixedly in one direction. The end is either gradual emaciation (with or without cerebral symptoms) or a pure cerebral death with convulsions and respiratory stop.

X-ray findings reveal an enlargement of the hilar glands, seldom broncho-pneumonic infiltrations or pleuritic effusions. I had no other means to examine the state of incretory glands or to go into details as to the further pathological and chemical changes in the blood, and excretions. But I was allowed to help. How can I describe the wonderful results obtained by cham., calcar., mercur, silic., cina, natr. mur., sulf., tubercul., etc. In the Missions clinics I had all sorts of vitamins, cod liver oil, acidophilus milk on hand; but the mortality reached nearly 35 per cent, and in 1940, even 50 per cent.

Who would believe, that among the Homoeopathically treated, only 15-20 per cent were lost? And the whole treatment performed with tasteless drugs and placebos, without crying as after the oily drugs (which by the way, the Chinese, adults and children, detest moist.)

The subject I have chosen to write about is not destined to bring new methods of Homoeopathic treatment. As to dilutions I will mention that under unspeakable difficulties I managed to produce the 200x of the most prominent polychrests and from some drugs I found especially suitable under local conditions: causticum, pyrogen, tabacum, syphilinum, tuberculinum Koch I managed to dynamize up to M, starting with a 100. It took me nearly four weeks (out of these, three whole Sun days). Most of the drugs I used in the 30x, except certain drugs whose efficiency I found only in lower dilutions, f.i. ceanothus (4x), crataegus tinct. or 1x), chin. sulf. (1-2x). But these were drugs with a small range of action.

The difficulties of dosage and repetition I experienced in the beginning were numerous. But still more difficulties were to be overcome under so different condition as given in China. It is not easy for a Homoeopathist and foreigner to embark on a thorough questioning. Patients over there suppose that all sorts of examinations and apparatus make any questioning superfluous. But the most formidable difficulty is the linguistic one. But once this valuable instrument has been forged, it is a real joy for a Homoeopath to penetrate into the details which a chinese patient will furnish you with.

Little by little they learn and appreciate the fact that the doctor is interested in the patients case, that there is nothing which would interest the doctor so much as this patients particular case. The Chinese language gives the most detailed description of symptoms, and a Chinese will accompany this description with the most elaborate characterizing of his pains, their extension, depth of layer affected (e.g., pains after malaria in the “upper skin,” or below the skin, which is identified with the nerve, or in the muscles, in superficial or deeper parts of the bones).

But the whole scenery changes as soon as you are interested in a patients mentals. First, those are matters not to be divulged (touching f.i. the question of consolation, aversion of company, weeping), to a man or to a foreigner (this is the case in the lower classes), secondly all these questions are, according to patients opinion, muddling the relationship of a doctor and his patient; he just came to get rid of an age-old lung tuberculosis and as a sign that he is right, he will gladly spit a sample of his purulent or bloody expectoration on his palm to present you the very important symptoms you have got to remove.

Another difficulty to fight, is the idea that any treatment should be performed with many drugs whose symposium has to follow the idea of combination of a sort of antiphlogistic with a tonic treatment (hot or cold in its intrinsic quality). But this would lead me too far away from the subject I had in view.

Norbert Galatzer