EDITORIAL NOTES AND COMMENTS


EDITORIAL NOTES AND COMMENTS. Rabe R F

 

CONCERNING EXOPHTHALMIC GOITER.-At the annual meeting in May of the …


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:

“RESULTS OF ADMINISTERING IODIN TO PATIENTS HAVING EXOPHTHALMIC GOITER.

“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.

“DISCUSSION.

“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.

Death may follow quickly from respiratory arrest or from exhaustion, the convulsions following one another in rapid succession. Recovery may occur after a convulsive dose of cocain, but it is the exception. The pharmacologic action of cocain is at first that of a stimulant. The cerebrum is first affected, and later the lower segments of the nervous system. The period of stimulation is short in the severe cases, being quickly followed by a period of depression. Cushny states that both stimulation and depression may be present at one time in different segments of the brain and stem. The period of stimulation may be so short that it is scarcely noticed, depression being present from the onset of symptoms.

“The treatment of cocain poisoning has been entirely symptomatic. General anesthetics have been used to control the convulsions. Morphin has been used to for the same purpose, further depressing the exhausted respiratory center. Strychnin has been used for its stimulant effect, but it increases the convulsions. Hoffendahl has used chloral hydrate, barbital sodium, and sodium diethylbarbiturate in the treatment of experiment cocain poisoning”.

The stage of excitement is often quite violent and in one case, Stramonium 200th relieved this very quickly. The excitement was of the typical maniacal character and appeared soon after an injection into the gum for the extraction of a firmly embedded root of a solution of cocain.

IN THE LONG AGO.-We recently received from one of cur subscribers in Kansas an interesting letter in which the writer states:.

“In January 1876, and February of the same year Dr. Malcolm McFarlan, of Philadelphia, held the surgical clinic in the Hahnemann Medical College, near Eleventh and Filbert Streets. Many of the citizens were busy preparing for the big show called “The Centennial Exposition”.

“I had been reading under a preceptor and studying in the Lehigh University and went to Philadelphia to look over the medical schools. While there I was invited by Mr. E—, a member of the Senior Class of Hahnemann Medical College, to investigate homoeopathy. What did the investigation show?.

“I need not tell you how loyally Farrington stood by the principles enunciated by Hahnemann and ably demonstrated by Hering; but one thing impressed me indelibly: many patients came into McFarlans clinic expecting to have some operation performed, who carried away a little vial of a remedy in the 200th or some higher potency and a week or two later showed himself cured. Does THE HOMOEOPATHIC RECORDER still hold aloft the banner of Similia like the youth depicted by Longfellow bearing a banner with the strange device Excelsior?”.

In answer to the good doctors question, the pages of THE HOMOEOPATHIC RECORDER must speak for themselves; in any case it is our constant aim to keep the banner of Similia Similibus Curantur floating proudly in the breeze. But times do change and we no doubt change with them! Life today is far more rapid and complex than at the time of the Centennial Exposition, when the telephone did not obsess us and the Edison electric lamp had not yet appeared. Men had time to think and to reason calmly, who will or can give a remedy, instead of resorting to the knife- why, we opine that, as Rastus says, “there is aint no sick animal”; at least we do not meet him in the large cities, where competition is keen and office rents just have to be paid.

The mine of riches which homoeopathy presents, has been but superficially scratched and alas, the scratchers in the school are too few and far between to make much of an impression. There is still so much to be investigated and learned, so much to be verified and tabulated, so many important questions to be solved, that the mine of homoeopathy will require strenuous digging for years to come. The wealth of treasure is there, but, as our faithful subscribe observes, it needs a strong, devoted band of the followers of Hahnemann, Hering, Lippe and of the rest, to carry on under the banner with the strange device, “Excelsior”.

SIGNS OF THE TIMES.-In his presidential address, delivered before the American Association at the seventy-fourth annual session in San Francisco, June, 1923, Ray Lyman Wilbur, M.D., of the Stanford University, California, among other wise things, said:

“The success of modern man in medicine must rest on the same three factors of safety given by Allbutt as the guides of the wise Greek physicians of more than two thousand years ago-freedom from magic, mastery of hygiene and, in spite of abstract notions, never to forget to treat the individual”.

The italics are ours, used to point out again, the salient, distinguishing feature of homoeopathy, individualization. Without it homoeopathy cannot succeed, for it treats not the disease, but the patient in whom the disease is manifest; no two cases of disease are exactly alike, hence there cannot be any specifies for diseases. There are remedies for patients, and the latter alone, as Dr. Wilbur has admonished us, are to be treated.

TIMOTHY.-We were busy this afternoon helping to gather the hay; it is a time of drought, no rain for days, but a hot burning sun with just enough air stirring to cure hay quickly; cut one day and haul in the next is the rule just now; with loads of 1800 to 2000 pounds at a time and some thirty acres to harvest, we are making rapid progress; but there is the corn to be cultivated and this work must not be neglected either, if a good yield is to be expected.

Have you ever mowed hay away up under the roof of the barn, with the temperature high in the nineties; if you have, you know what heat is and you also know what it really means to sneeze. Well, one certainly does sneeze in haying time; especially in the hay-mow. And as we were sneezing our editorial-farmer head off this afternoon, we could not help but think of hay-fever. Phleum pratense will certainly excite it, if the susceptibility to it be present; fortunately for us, we are apparently immune, at least we have never had aestivo-autumnal catarrh, to use the correct high-brow medical term. In the July issue we reported on the good effects of Phleum pratense in potency; 6th, 12th, also 30th was used, in several cases.

In one, the symptoms, including the asthmatic respiration, were immediately controlled and soon disappeared and we are happy to report that thus far there has been no backsliding. In another severe case, there has been a decided amelioration, though not complete relief. This patient presents one of the worst cases we have ever seen and treatment of every known variety, including chiropractic, has been resorted to; even Christian or un-Christian Science, if you prefer, has been invoked, but in vain. Homoeopathy has done more for this patient than anything else. Poor girl, she has been through the old school mill of cutaneous food tests, until finally poor outraged nature could stand no more. Almost the only food she was not tested for is Frankfurter sausages, otherwise known as “hot dogs.” No doubt the canine hair test answered for them.

Another case has likewise responded nicely to Phleum pratense 30th. Those victims who come down with trouble in August are more likely to require our common, too common by far for farmers, American ragweed, Ambrosia artemisiae folia. With this remedy in the 30th and higher, we have frequently obtained excellent results; though golden rod, Solidago virga aurea, should not be forgotten. But- and there is always a but-do not prescribe any of these unproved medicines, if you have decided, well-marked indications for our well-proved remedies. Be sure that your case does not demand Allium cepa or Euphrasia, Arsenicum iodatum. Silicea or Psorinum, before you resort to the “specific antigen.” The totality of the symptoms must always prevail, if it can be found; let the law of similars be your guide at al times and you will then not go far astray.

DEMINERALIZATION IN TUBERCULOSIS.-“An appreciable loss of calcium due to progressive tuberculosis could not be proved in any case by Barkus. Spontaneously healed tuberculous lesions produced by infection with a strain of low virulence, which should, in the light of the theory of demineralization, yield a low calcium content, showed, on the country, quite normal values.”-J.A.M.A.

An interesting observation, but one needing further confirmation; however, from the standpoint of homoeopathic therapy the consideration of calcium and its salts is of value, for we all know the importance of Calcarea carbonica, Calcarea hypophosphorica and of Calcarea phosphorica in the treatment of tuberculous patents. The “Calcareas” are indeed a large family, worthy of cultivation and careful, close study. Calcarea phos. have received extensive provings and are, therefore, well known to most of us.

Not so with Calcarea hypophos., Calcarea iodata and calcarea picrica. The latter is, of course, the picrate of calcium and is a truly wonderful remedy in the treatment of boils in the auditory canal and meatus. As for Calcarea iodata, think of it in a sort of hyphenated Calcarea and Iodin patient in whom, in addition to characteristics of both these great antipsorics there are found enlarged tonsils and hard hypertrophied glands. Clarke states, that the enlarged tonsils of Calcarea iod. are “honeycombed with little crypts”.

Calcarea sulphurica is one of Schuesslers remedies and clinically relates more to abscess formation, especially when the abscess has been opened and is discharging. Unlike Hepar sulphur, calc. it is fond of the cold open air and feels better in it; incidentally it lacks the sensitiveness to touch of the latter remedy. Allen gives a general aggravation from “working and washing in water” as well as a general amelioration “after eating.” Paste these in your mental note-book for future reference. They may come in handy.

“DISH TOWEL AS SOURCE OF INFECTION WITH TUBERCLE BACILLUS.–In a series of twenty-five instances of guinea-pigs innoculated from the washings of dish towels used by tuberculosis patients no positive results were obtained by Floyd and Sikorsky. In three control experiments, in which gauze was thoroughly impregnated with viable tubercle bacilli and thoroughly washed, no positive results were obtained. The most reasonable explanation of these negative results would seem to be that the strong alkali soap or soap powder used for a period of weeks in the home must very deleteriously affect any viable tubercle bacilli that may be caught in the meshes of the dish towel and either kill them or so impair their vitality as to make them unable to produce infection in small numbers.”-J.A.M.A.

If this will lead some of us to eschew strong and dangerous antiseptics, such as carbolic acid, lysol, mercuric chloride, etc., it will have served a useful purpose. Truly, the lowly dish towel has been raised to an exalted position and goes to prove that simple cleanliness is quite sufficient. Since dishwater is quite commonly fed to these justly prized “mortgage raisers,” it is comforting to know that the hog industry of the county is safe. Personally we prefer the corn-and alfalfa-fed porkers of the Middle West, rather than the swill-fed squealers, fattened on hotel table refuse, in Hudson Country, N.J. Hogs do contract tuberculosis and a tuberculous pig is in truth a pitiable object. However, now that we know that dishwater containing strong alkali soap or soap powder is perfectly safe, we shall henceforth double our order of Kirkmans or Babbitts, when the grocer boy comes around. And bring another box of Uneedas please, dont forget!.

Rabe R F