Having, by the use of the repertory narrowed the group of possible remedies down to three or four, it is then not difficult to make a cheerful study of the provings of this small number and thus to determine the probable similimum. This is a simple and orderly procedure not over-taxing, and, while it may consume one or two hours at the beginning of a given case, it is really a time-saving method in the end, for it your first choice does not prove satisfactory you are then able to draw on other drugs of the group already considered for further study and use.
The acme of our homoeopathic art as elaborated by Hahnemann is reached in the treatment of our chronic cases. Acute diseases are largely self-limited. Their symptoms are easily discernible, often dramatic in their rapid development and clear-cut form. It is comparatively easy to recognized the symptoms of the conditions calling for such remedies as Aconite, Belladonna, Bryonia or Phosphorus.
It was when Hahnemann felt that this his success should not be limited to these comparatively simple cases that he began the study of the class of drugs which he termed Antipsorics and their application to chronic states which he had heretofore been unable to reach that he developed the foundation of all our later work in this field.
In order to better illustrate the method of a few cases have been selected for brief survey.
Miss G. presented herself at Woodside in October, 1904, at forty years of age, a “nervous wreck” after a summer of European travel. When she was two and one-half years of age her mother and died of tuberculosis; a brother had recently succumbed to the same disease; a sister was a nervous invalid.
The patient had suffered severely from dysmenorrhoea, for which an operation had been performed ten years before. She had scarlet fever in childhood and had long been subject to “collapse” under any nervous strain so that for many years she had been a confirmed semi-invalid. She was frightened, apprehensive, tearful; averse to company or to effort. In speaking of the development of symptoms along lines of least resistance, whenever sick, this patient always exhibited a very pronounced group of stomach symptoms so that it was felt by her friends that there must be a serious digestive fault. Fullness, sensitiveness to pressure, the eructation of great bursts of gas with loud noise that could be heard all over the house; quivering, aversion to sweets and desire for acids, bitter taste–very slow and imperfect digestion, cutting pains and nausea.
Her sleep was indifferent and insufficient, waking, as if the habit of these cases, around 2 A. M., with only restless naps during the rest of the night! Frightened sensations in the night, perspiration, confused dreams. Menstruation regular and normal, followed by great exhaustion; some pain down the thighs on the first day.
The patient is warm blooded. wears light clothing and desires cool air and open windows. She was not as well at the seashore when a child. Her condition was a good illustration of that of many individuals who have a marked hereditary tendency to tuberculosis. Through the influence of good care and environment they never develop the disease itself, but they have a greatly diminished resistance to disease in general and the nervous system is especially susceptible to overstrain from causes that would mean nothing to a normal individual. This patient up to forty years of age had never had normal, sustained strength enough to enable her to undertake a permanent occupation.
The first prescription was Tuberculinum 1m., in an effort to correct in some degree the underlying constitutional tendency, and under which her general and mental condition improved considerably. Phosphorus was the net remedy and it exerted a very helpful influence. During the following two months she improved steadily and the more active symptoms were much modified. After the action of this medicine ceased she received two or three medicines that were ill chosen and accomplished little. Finally Nux vomica was selected and under its influence practically all of her acute symptoms gradually disappeared and she was able to leave the sanitarium by the first of June, 1905, after about eight months.
And now began the really interesting features of this case. For the next year the patient spent most of her time either in her own camp in the White Mountains or with relatives, not attempting constructive work of any kind. While free for the most part from her old symptoms and quite and quite comfortable, her general strength remained below what we have a right to expect in a normal individual. During this time I was in touch with her at intervals and in the summer of 1906 after further study, decided on Calc. phos. as a constitutional remedy and it was given in the 1m. potency with most happy results. Improvement began at once, slowly at first and with breaks from time to time yet her general strength increased constantly.
She spent the following year or two in the Middle West and through several trying periods in which her strength as tested to the limit in the care of friends. In spite of all this she began to develop initiative as well as strength, and life began to have a new meaning for her. She took up the study of domestic economy, and, to make a long story short, she has now been for some years at the head of this department in one of the well known Eastern colleges for women. In addition to this, she has, for the past two years, conducted a similar department at the summer school of Chicago University. During all these years, whenever a period of great anxiety or of some acute sickness has brought some of the old symptoms to the front a few doses of Calc. phos. have never failed to set things right.
Another case of a very different nature is that of a young woman of 32, Miss B., and individual of marked vigor and endurance and with a superabundance of energy, stout of body and fearless in mind. For years, in fact, for most of her adult life she had suffered periodically from chronic headache or migraine, occurring mostly at the beginning or close of menses, coming on during the night, dull aching, through temporal region, shooting pains, entering about the right eye; worse from loss of sleep or from overuse of eyes; nausea and belching but no vomiting; great desire for stool, bowels usually constipated. Formerly the headaches appeared only at the menstrual cycle, but now they occur after any unusual loss of sleep as well.
The patient is of an emotional nature, tense, emphatic. There is some posterior displacement of the uterus, and slight prolapsus; menses are scant, the flow coming for one day, stooping for a days then going on for one or two days longer.
Here we find a chronic disease of a more simple character then the former case, yet a condition not always easy to overcome as we all know from experience that these woman are quite prone to suffer on until the climacteric unless relieved by correct homoeopathic medicines.
Furthermore, this case will illustrate the fact mentioned a few moments ago of the necessity, in diseases of this nature, of paying chief attention to the symptoms which concern the individual patient, the “general” symptoms of Kent, rather than those pertaining solely to the disease. In this instance we have only the symptoms which are common to a large majority of such cases of chronic headache, they are almost meaningless. But we have here a strongly individual type of woman, stout, inclined to take in flesh as she gets older l her trouble begins or is at its height during the night; her menstrual habit is scant and short; she is emotional.
If we pay not attention to the particulars of the paroxysm itself we would surely select Graphites as the only possible remedy, a deep acting drug as are all the carbons; one capable of causing longstanding disturbance in the economy of the healthy individual and likewise of curing similar conditions in the sick. In this instance, a very few doses of the medicine repeated only two or three times over a period of several months has put an end to all manifestations of the trouble.
In closing let me say that these cases are not selected as showing anything unusual, but merely as illustrating again the wonderful help that simple medicines, carefully chosen according to the homoeopathic principle may be in the handling of our chronic cases.
I am sure most of you can call to mind many similar experiences with Alumina, Baryta, Calcarea, Carbo animalis, Kali carb., Lycopodium, the Natrums, Platina, Silica, Sulphur or Thuja. A few of the drugs which are capable of effecting deep and permanent improvement in cases that otherwise would drag out a miserable existence to the end.
