[ Read before Bureau of Clinical Medicine, I.H.A., June 22, 1949.].
H. R. January, 1950.
As a rule, a case defies our efforts to find the curative remedy, not because there is no remedy which would cover its symptom totality, but because we have failed to consider or to recognize this remedy. Every single substance of the mineral, plant and animal world represents a potential medicine which may be required in a given disorder.
Of all these millions of therapeutic possibilities even the most encompassing of all, Boerickes Materia Medica, lists approximately twelve hundred. Yet even of the greater majority of those we have only a very fragmentary knowledge as far as symptoms for exact prescribing are concerned. We usually limit our prescribing to perhaps a hundred of our best proven polychrests.
It is often held that a really through knowledge of those polychrests is sufficient to cover every and any case we may be confronted with. After all, these drugs are polychrests because their nature and composition bears such a fundamental relation to the human organization that the majority of disorders requires their prescription. On the other hand we ought to admit to ourselves that, because we are more familiar with them than with the other medicines, we tend to lean upon the polychrests more heavily than is sometimes justified by the patients needs.
No remedy can ever take the place of the simillimum. Undoubtedly, the polychrests are most basic substances and of deep action. Yet, when a remedy of only a superficial sphere of action happens to be indicated by the symptoms, any other one, though of constitutionally deeper repute, will act no better than distilled water. Often we meet with references to certain drugs as “good” remedies for this or that.
This way of thinking is contrary to Homoeopathy. There are no “good” or “bad” medicines, but only indicated or not indicated medicines. Sulphur or Calcarea may be quite “bad” medicines and some little obscure herb with but a supposedly superficial effect a “good” one, if required by the symptoms of the individual case.
It has been the writers experience that from among every ten patients seven or eight, in the average, will actually require and satisfactorily respond to a polychrest. The other two or three, however, require a more unusual remedy, at least temporarily. From among these cases we recruit the bulk of our failures and unsatisfactory improvements. Often we assume obstacles to recovery where the only obstacles lie in our yet fragmentary knowledge of the Materia Medica.
The case presented in this paper at first defied the best effort of diagnosis and of prescribing. Failing to respond to the apparently well indicated polychrests, this case furnished valuable, well-defined symptom material for the relatively unproven drug which turned out to be the correct simillimum.
Mrs. S., 36 yrs. Two years before the onset of the present illness she had lost a little son through an accident. She never regained her peace of mind. During the last preceding months she was under great additional strain, emotionally and physically, caring for her disabled parents. At the end of December, 1948, in a state of utter physical exhaustion and nervous strain she contracted a cold. A few days later, at the exact anniversary of the childs death, she was completely immobilized by an excruciating pain in the right lumbosacral area. The next day found her unable to void urine and to move her legs at all.
Examination showed an area of muscular constriction along the lower spine with somewhat accentuated but normal reflexes and undisturbed skin sensorium. However, the patient was in a state of frenzied restlessness, screaming and crying with pain, unable to lie still, yet aggravated by any motion. There was no urge for stool what-so-ever and urination could be induced only by pouring warm water over the perineum. The temperature was between 99.5 and 100. An orthopaedic specialist ruled out a slipped or ruptured disk, though an incipient caries remained a remote possibility.
The modalities were: worse at night; very chilly, yet better open air; tearful disposition; restlessness; and the fact that the last period had been extremely scanty, almost completely suppressed. Rx Pulsatilla 200. Relief moderate and shortlived. Pulsatilla 1M followed by a temperature rise to 101; for a day the pains became somewhat more tolerable. The paralysis, on the other hand, increased. The possibility of a myelitis was considered now, and neurological consultation was requested.