In cardiac weakness, Oubain is a marvellous remedy no doubt, but it is a remedy to which one become habituated; one cannot make himself free from its power.
Digitalis in massive doses is also extremely dangerous in the weakness of the heart. There are cases of suicides by taking Digitalis. Digitalis causes tachyarrythmia.
As regards the toni-cardias there is now tendency to react against their abuse for a long time and in massive doses.
They are now replaced by bromohydrates of quinine and also quinidine.
For the homoeopaths it is a great problem to settle the question of toni-cardiacs. We are sometimes obliged to apply to these patients in certain cases some toni-cardiacs but they they hamper the action of the Homoeopathic ground remedies.
I had two very curious cases. A case which I treated long time ago. The patient was suffering from mitral disease. A young patient having hyposystole, with periodic asystole. He used for a long time Digitalis. When we treated him we applied a dose of Arsenicum Album M or 200 which will be followed by a maceration of Digitalis. He took Arsenicum but he didnt take the maceration. The urine augmented from 400 grammes to 1 litre and a half after the use of Arsenicum.
On the other hand we often see that Phosphorus augments the diuresis in astonishing manner in old asystolic patients.
ACUTE AND CHRONIC DISEASE
It is evident that in acute cases of heart, such as endocarditis, rheumatic endocarditis, pericarditis, the application of Homoeopathy according to the symptoms will give interesting results. But when it is the question of a chronic disease, the case becomes completely different. Take for example a patient of endocarditis who has a lesion of the endocardia. In such case the endocarditis will not settle the prognosis. It is myocardia, and the general condition which will settle the prognosis. We will have to treat the patient according to his temperament; we will have to give him some diluted Tuberculins.
We will have to treat the patient long time beforehand, then we will come to the disease. And the most important and general rule in Homoeopathy is: IN EPIDEMIC, IN ACUTE DISEASES IT IS OFTEN NECESSARY TO TREAT THE DISEASE FIRST. In epidemic diseases there is a kind of epidemic genus, which is the cause that all the patients require the same medicine. In certain epidemics of typhoid Baptisia will be the only remedy, in others the remedy will be Arsenicum.
During the epidemic of flu called “Spanish”, in 1918 all the Homoeopaths of Europe and of the United States cured the disease with Eupatorium perf. The Homoeopaths of Brazil used Gelsemium. The patients of Brazil had the symptoms of Gelsemium, while Gelsemium is a remedy of acute disease in a cold country.
Then in acute epidemics, the diagnosis of the diseases leads directly to the Homoeopathic remedy, indicated by the symptoms, while in chronic cases, it is the diagnosis of the patient himself is of the first importance: His temperament, his constitution, his morphology and deep etiology of his troubles.
I believe that here we have to avoid many errors. The first is that we must no base our treatment purely on symptoms. The second is that inversely we should apply only the medicine having a far away action in relation to the lesions in question. And this brings us to another consideration, which will be much more apparent as regards the disease of other organs; which is: It is that there is very often in the organism a kind of antagonism between the local interest and the general interest of the patient and very often we are forced in homoeopathy to watch and treat the patient in such a way that, we do not aggravate the lesions or the local troubles or inversely, by respecting the general condition.
In a general way we may say that the Allopathic therapeutic has always the tendency to consider the disease locally; the homoeopaths practice a therapeutic, which is quite different and has the tendency to make a general treatment and does not occupy itself with the local lesion. But the local lesion has also its importance. Some homoeopaths were right to make us wise in this regard. You know that Sulphur for example of which the child has all the symptoms, will ameliorate the general health but it may aggravate the otitis. We cannot however aggravate a suppuration which will cause some local disorders only because it is the best remedy of the general health.
There is another consideration which is the following:
Very often in chronic cases the most evident symptoms are the symptoms of an organ or of a system which suffers while it is another organ or another system which was really or primarily affected.
DISEASES OF THE STOMACH AND OF INTESTINES.
I will at first give you the example of aerophagia. In all aerophagia there is a vago-sympathetic syndrome and a hepatic syndrome. We can cure marvellously aerophagia by the help of Homoeopathy, but we can ameliorate more surely with triturations of the LIVER and of the PARATHYROID, than by Carbo vegetabilis. If we follow directly the homoeopathic therapeutic, and if we try to search for the simillimum then we will find that China will suit to Aerocolia, Carbo vegetabilis in aerogastria, and Abies canadensis in aerogastria which causes heart troubles. Then we will not think of the liver which is really the cause of the disease. Here the suffering organ is the liver, and it is a dumb organ, and the organ which cries for the pain is the stomach, but the latter is not really the cause of the disease.
This is therefore a case in which the homoeopathic therapeutic should really be etiologic and should be applied basing not only on the etiology but on the pathogenesis. We will cure aerophagia with Thuja, with Ignatia, a remedy of spasms, with Kali Carbonicum, with extracts of liver and of parathyroid in small Homoeopathic or in ponderable doses, while very frequently Carbo Vegetabilis and Graphites will be but some medicine of secondary importance.
Let us take another case: The ulcer of the stomach, with hyperchlorhydria, syndrome of Reichman, rather a pyloric ulcer. According to the law of similars there is no other remedy but Robinia which is the best indicated by symptoms. Robinia will cause amelioration no doubt because it will act on hyperchlorhydria. Besides, Sulphuric Acid will be indicated, or another remedy of the same type may be indicated but these remedy will have only momentary effect. Anacardium may also have a deep action if it is used according the to modality: Painful hunger, ameliorated by eating.
Kent had already shown that very often from the Homoeopathic point of view the symptom itself is not so important, but it is the modalities by which the syndrome is established, which are much more important. It is for this reason we give so much importance to the modalities which translate the temperament and the reaction of the organism. While reaction of the organism is nothing but the pathogenesis itself.
Thus in order to cure the ulcer of the stomach we apply on the one hand some autospasmodics and on the other hand some medicines having special action on the liver, such as Lycopodium. We also apply a remedy having local action because we are obliged, it may be said, to act on a particular point according to its similimum. It is also important to use the medicines of hyperchlorhydria, i.e. of the pain of the patient, but these remedies will be of secondary importance.
This is the reason why in the whole Homoeopathic treatment of chronic diseases, in order to avoid this kind of antagonism between superficial and evident symptoms on the one hand and the general symptoms on the other, Dr. Nebel has rendered a great service by first codifying the rules of the Drainage and Canalisation. He has built the bridge between these two types of phenomena.
I am giving you some examples in order to make clear to you this point of view and to show you the errors that should be avoided. It is very curious to see how in a general way we get an action much more deep with the diluted and dynamised medicines given according to the law of similars on the hollow organs, having some autonomous movements and this is rather true as regards the digestive apparatus. It is on the digestive system where we can act better, while apparently it is the question of some phenomena which seem material, visible, energetic and palpable and which are before all due to a question of energy, to the sympathetic action, on the nervous system, on these hollow organs that can be contracted at will.
Well, there again, when we speak of Nux vomica, canaliser of the small intestines, when we speak of Aloe, the canaliser of the large intestines and the rectum, we have in view some medicines that act on the sympathetic system and which have no direct action neither mechanical nor physiological on the intestines or on the rectum. Our medicines act because we make a treatment according to the pathogenesis of the observed troubles.
While treating the acute and the chronic intestinal troubles sometimes some interesting facts are observed. A patient told me this: when I work or when I become nervous and fretful. I have soft and fetid stools. When I am at rest, I have formed stools having no odor. Try to understand the story: You will understand that his nervousness augments the velocity of his intestinal transit because of the sympathetic action on the peristalsism. Thus you understand why some times he has soft stools and why he has formed stools when he is at rest.
But at the first thought you will not be able to understand why in certain cases the stool are fetid and why in certain cases the stools are not fetid. If you think a bit you will understand the reason. When the intestinal transit is very rapid the bile flow is not sufficiently abundant and cannot act enough well to check the intestinal putrefaction. And very often when the stools are fetid the medicines like Podophyllum, or Arsenicum will act better that Benzo-naptha or other allopathic medicines capable of deodorizing the stools. We must come to the sympathetic system if we want to know what really happens. Arsenicum album will be the important remedy for intestinal putrefaction.
(Even if the other symptoms of the patient are not of Arsenicum, this remedy may be used. Arsenicum is a difficult remedy to manipulate in chronic cases. It does not act as one wishes. In acute cases it is marvellous remedy. Extraordinary from the digestive point of view.