The symptoms of cocain poisoning usually appear quite promptly. They are ushered in by a period of nervousness and excitation, sometimes almost of hysteria. Respiration is rapid and deeper than normal, and the pulse is markedly accelerated. The throat is dry, and the patient may complain of a choking sensation. The pupils are dilated, owing possibly to direct action on the muscular fibers of the iris.

CONCERNING EXOPHTHALMIC GOITER.-At the annual meeting in May of the American Association of Physicians, the results of iodin administration to patients having exophthalmic goitre were discussed by several old school men of prominence. The Journal of the American Medical Association publishes the proceedings and discussions and states as follows:


“Dr. H.S. Plummer, Rochester, Minn.: It has been taught that iodin should not be administered to patients with exophthalmic goiter, on the ground that it causes hyperfunction. There are two entities included in the term hyperfunction. There are two entities included in the term hyperthyroidism: first, exophthalmic goiter, second, hyperfunctioning adenomatous goiter. In the latter, the basal metabolism is more nearly normal. In exophthalmic goiter there are certain symptoms: (1) nervous phenomena, (2) eye symptoms. The first include purposeful but useless movements. The higher psychic processes are chaotic.

The patients cannot explain why they cry or laugh. In the vegetative nervous system there is the same process of imbalance. These signs have given rise to such terms as sympathotonic or vagotonic goiter. These symptoms seem to be due to underlying metabolic disturbances. Often, after slight operations, the temperature rises and death occurs in a few hours. We judge the differential diagnosis by the nervous phenomena, which, if excessive, point to a great surgical risk. The eye phenomena are two: the exophthalmos, or protrusion of the eyeball, and the stare which fluctuates with the nervous phenomena.

Anything that will overstimulate the thyroid can give the clinical picture of exophthalmic goiter. In such cases, the normal hormone, thyroxin, is not completely iodized. This incompletely built up thyroxin, as it leaves the gland, can enter into catabolic reaction faster than the normal, stable molecule and raise then metabolic rate more rapidly. If, therefore, we can change the character of the molecule, we can change the basal metabolism. If there is intense metabolic stress for lack of iodin, death occurs from lack of iodin.

From this it follows that if we can change the production of abnormal substance to properly iodized substance we can cut down postoperative mortality, avoid crises, and change the picture of the nervous phenomena. Acting on this plan, we administered 10 drops of compound solution of iodin for ten days following operation, with the result that we have found there is no such things as postoperative deaths from hyperthyroidism if this dosage has been administered to the patient with regularity. In other words, the patient is relatively short of iodin, and dies from lack of it. When we replace the iodin, we do away with postoperative deaths.


“Dr. H.A. Hare, Philadelphia: Is it not true that, in districts of the United States in which goiter is very prevalent, iodin is lacking? Would it not also be true that in such an area there would be a higher percentage of poor operative results? It would be interesting to know whether in non-iodin-bearing areas, the surgeons would need to reinforce their procedures by iodin administration.

“Dr. Haven Emerson, New York: In Rochester, N.Y., there is a lack of iodin, and the municipal health authorities have been putting iodin into the water supply. This would forestall any tendency on the part of the community to develop endemic goiter. The proportion of iodin in the thyroid gland has some relation to the kind of food, and that varies in the individual, and from time to time, and also in geographic areas, so that the average clinical picture may very according to the geographic location. In England, the iodin-bearing sea breezes produce a different atmosphere than that in the Mississippi Valley, for instance. Probably, the mortality in geographic areas inferior in this respect could be overcome, or balanced, by sufficient iodin supply. In any case in which the gland is cut short of iodin supply there is a potential stimulus to hyperthyroidism because of production of abnormal thyroid secretion”.

The remarks of Dr. Plummer are especially interesting and valuable to homoeopathic prescribers, who know that the “iodin patient” is distinguished by certain definite, unmistakable symptoms, easily recognized. Whether in a given case, there is too little or too much iodin present in the body tissues, the administration of iodin, homoeopathically chosen i.e., based upon the symptoms of the patient, will correct the condition. It is perfectly possible, as Plummer states, that in some instances at least, iodin must be given in rather large dose of the tincture itself.

The plane of the disease for which a remedy is given, must always be considered; the more gross the pathologic process, the cruder the dosage is likely to be, although, of curse, this rule is not invariable and admits of numerous exceptions. In any event, the question of homoeopathicity comes first. Dr. Emersons statement that iodin is put into the water supply of Rochester, is calculated to arouse mingled emotions of doubt and opposition, in the minds of old-fashioned Hahnemannians. With state and municipal health regulations on every side protecting the dear sovereign “peepul” from all kinds of evils, goodness knows what the American citizen of the future is going to look like.

He is a pretty well controlled and harmless specimen now, gradually giving up one constitutional right after another and doing precious little thinking for himself, to judge by the steamroller methods of our dominant political parties and of “big business.” Majorities rule, but minorities more often have the right on their side. It iodin is to be put into our water supplies, why not add calcium carbonate and phosphate, sodium chloride and silicic acid, all great remedies, capable of preventing much illness or curtailing it, if started?

Let us launch upon a grand “prevention drive” and prevent everything from housemaids knee to smallpox! Why not? There are medical reformers who advocate the removed of appendix and tonsils in every child before the age of eight; this prevention craze is highly contagious and when the fanatical medical reformer is let loose, heaven protect the innocents from his wild fury!.

But truly friends, isnt a little sober, straight thinking in order? Not everyone develops goiter, even in regions where it is common; not everyone develops tickets, nor even smallpox when exposed. As for housemaids knee, many an overworked woman has scrubbed floors for years without developing this pet malady of Jerome K. Jerome and described in “Three Men in a Boat.” We cannot foresee everything, but straight homoeopathy can so put our houses in order, that little fear of disease need ever be felt by those who have been systematically and carefully prescribed for.

After all, people must be treated as individuals, each one according to the conditions, mental and physical, in him. As Dr. Rice, in his able paper, points out, a knowledge of morphology will greatly aid us in correcting many evil tendencies in their incipiency and in this work of correction, homoeopathy can play an important part, if rightly and intelligently used. It has been done, but as Hahnemann said: “Machts nach, aber machts genau nach!”.

COCAIN POISONING.-Physicians in general practice as wells as specialists, are likely to see cases of cocain poisoning. Frank, Strauss and Smiley, of Chicago, in J.A.M.A., for June 30, 1923, report upon their experiments to determine the antidotal power of calcium in experimental cocain poisoning. Their conclusions are not final, but the introduction to their interesting accounts is of value. They say as follows:

“Toxic symptoms arising after the use of cocain have been observed by practically all men with an extensive practice. Their frequent occurrence was recently emphasized by a report on anesthesia in nose and throat work. This report was prepared by a committee of the Section on Laryngology, Otology and Rhinology of the American Medical Association, and cites the occurrence of thirty-two- deaths from local anesthetics in a period of about three years. Of these, twenty-two deaths were verified, and eleven of the twenty-two were due to cocain alone. Cocain combined with procain, apothesin or alypin was responsible for seven more deaths, while the other four were due to procain or apothesin.

“The symptoms of cocain poisoning usually appear quite promptly. They are ushered in by a period of nervousness and excitation, sometimes almost of hysteria. Respiration is rapid and deeper than normal, and the pulse is markedly accelerated. The throat is dry, and the patient may complain of a choking sensation. The pupils are dilated, owing possibly to direct action on the muscular fibers of the iris. Convulsions generally follow promptly in the severe cases, but may be absent. They are at first tonic in type, later becoming clonic. Respiration may be entirely suspended during a convulsion, the patient becoming markedly cyanotic.

Rabe R F
Dr Rudolph Frederick RABE (1872-1952)
American Homeopathy Doctor.
Rabe graduated from the New York Homeopathic Medical College and trained under Timothy Field Allen and William Tod Helmuth.

Rabe was President of the International Hahnemannian Association, editor in chief of the Homeopathic Recorder, and he wrote Medical Therapeutics for daily reference. Rabe was Dean and Professor of Homeopathic Therapeutics at the New York Homeopathic Medical College.