Papers on materia medica are based largely on the personal opinion of the essayist. To minimize the effect of the personal equation we chose the records of the last 100 women who were discharged from the Allentown State Hospital as having recovered from their mental illness. In this way a more or less homogeneous and still somewhat comparable group was found. We have tabulated certain statistical data regarding these people:.
Manic Depressive:.
Manic type.
Depressive.
Stuporous.
Mixed and Circular
Dementia Praecox.
Catatonic
Alcoholic
Psychosis with.
Somatic Disease
Involution.
Melancholia
Psychosis with.
Encephalitis
Psychoneurosis
No.of cases.
25.
42.
11.
2.
3.
1.
2.
4.
2.
8
—-
100
Duration Before Administration
Low.
2 da.
3 da.
3 da.
9 mo.
2 da.
14 da.
4 mo.
14 da.
1 mo.
High
24 mo.
30 mo.
6 mo.
22 yrs.
7 da.
3 da.
1 mo.
11 yrs.
12 mo.
10 mo.
Average.
2 mo.
5 mo.
12 mo.
112 years.
4 da.
21 da.
3 yrs.
6 mo.
5 mo.
72 mo.
Months in Hosp.
Low
1
1
2
6
4
3
1
5
3
1
High
48
94
24.
7
61.
4
80.
4
22
Average.
10
10
72
62
24
22
27
72
52
10
Age when Discharged.
Low
18
20
24
48
23
46
39
43
25
24
High
64
71
50
66
42
42
50
47
64
Average.
36
43
38
57
31
402
46
36
422
402.
It is seen from the table that 80 per cent. were diagnosed manic-depressive, the depressed cases predominating. At least one of those diagnosed as dementia praecox probably should have been put into the manic-depressive group. In the second column we have tabulated the duration of the mental illness before admission to the hospital. Two of the cases had only a two-day duration, and the maximum duration before admission was twenty-two years, with an average duration before admission of 72 months. If we eliminate the two having duration of twenty-two and eleven years respectively, the average in reduced to 32 months.
In the next column we have detailed the date regarding duration of treatment in the hospital, this being in months. This varied from one to ninety-four months and even including three rather prolonged cases with a hospital residence of 94, 80 and 61 months, the general average stay was ten months. Omitting these three gives an average of less than eight months.
We next considered the age of these patients at the time of discharge and find that it varied from 18 years to 71 years with an average of 40 3/4 years. This age is slightly lower than the general age of our admissions, for which we usually find an averaged of between 43 and 43 years. The patients in this group were carried on our books as out on visit for a period of one year be time to beginning of treatment would average a little less than thirty-nine years.
On going over the recorded prescriptions for these people we find 234 entries. The following list shows the frequency of choice of the various remedies, these all being given as single prescription without resort to alternation or combination:.
Belladonna 25
Bryonia 20
Cimicifuga 16
Nux Vomica 11
Gelsemium 11
Pulsatilla 10
Cannabis Ind. 9
Ignatia 8
Aconite 8
Rhus tox 6
Arsenicum 6
China 5
Phosphorus 5
Phos. Acid 5
Sulphur 4
Thuja 4
Merc. Sol 4
Cactus 4
Causticum 4
Arg. Nit. 3
Anacardium 3
Baptisia 3
Hepar 3
Stramonium 3
Sanguinaria 3
Ars. Iod. 2
Ant. Tart 2
Alfalfa 2
Aurum Mur. 2
Apis. 2
Chininum Ars. 2
Cocculus Ind. 2
Hydrastis 2
Ipecac 2
Lycopodium 2
Moschus 2
Onosmodium 2
Sticta 2
Staphisagria 2
Ver. Vir. 2
Aloes 1
Abies Nig 1
Arnica 1
Actea Spicata 1
Ant. Crud. 1
Camphor 1
Carbo. Veg. 1
Calcarea Carb. 1
Cantharis 1
CAffeine 1
Coffea 1
Collinsonia 1
Fer. MEt. 1
Fer. Phos 1
Lachesis 1
Lycopus 1
Plumbum 1
Stan. Iod. 1
Trillium 1
Ver. Alb. 1
Xanth. 1.
It will be observed that of all the remedies Belladonna was by far the favorite, next in order being Bryonia, Cimicifuga, Nux vomica and Gelsemium. When we studied these various prescriptions for the different diagnostic groups we found the following results:.
Manic Depressive, Manic.
Belladonna 14
Bryonia 10
Cannabis Id. 8
Cimicifuga 5
Aconite 3
Arg. Nit. 3
Gelsemium 3
Nux 3
Ignatia 2
Rhus Tox. 2
ver. Vir. 2
Ars. Iod. 1
Anacard. 1
Apis 1
Caffeine 1
China 1
Fer. Met. 1
Fer. Phos 1
Hepar 1
Ipecac 1
Lach. 1
Lycop. 1
Mosch 1
Merc.Sol. 1
Onos. 1
Puls. 1
Phos. 1
Phos. Acid 1
Sulph. 1
Staph. 1
Sang. 1
Thuja 1
Ver.Alb. 1.
M.D.Depressed.
Nux 8
Cimicif. 7
Ars. Iod. 6
Gels. 6
Aconite 4
Cactus 4
Puls. 4
Phos.Acid 3
Alfalfa 2
Aur.Mur. 2
Belladonna 2
Bryonia 2
Causticum 2
China 2
Cocc.Ind. 2
China Ars. 2
Hydr. 2
Merc.Sol. 2
Phos. 2
Rhus. 2
Sticta 2
Sang. 2
Sulf. 2
Thuja 2
Ars. Iod. 1
Aloes 1
Ant. Tart 1
Apis 1
Abies 1
Arnica 1
Anacard. 1
Act. Spic. 1
Bapt. 1
Camph. 1
Carbo.Veg. 1
Coffea 1
Collinson. 1
Calc. Carb. 1
Hepar 1
Ipecac 1
Ign. 1
Lycop. 1
Onos. 1
Plumb. 1
Stan. Iod 1
Staph. 1
Trillium 1
Xanth. 1.
M.D., Other Types.
Bryonia 8
Bell. 3
Ign. 3
Puls 3
Cim. 3
Bell. 6
Bapt. 2
Caust. 2
Cimicif. 2
Ign. 2
Gels. 3
Rhus 3
Stram. 2
Anacard. 1
China 1
Puls. 2
Phos. 2
Ant.Crud. 1
Acon. 1
China 1
Hepar 1
Lycopus 1
Merc.Sol. 1
Thuja 1
Can.Ind. 1
Mosch. 1
Phos.Acid. 1
Stram 1
Sulf. 1.
The reason for the preponderance of Belladonna among the prescriptions is that it was given fourteen times in the manic cases. Belladonna, of course, in its symptomatology shows the effects of cerebral congestion, has the symptoms of over-activity and increased reaction of stimuli. The frequent appearance of Bryonia was somewhat of a surprise, my preconceived notion being that Can. ind., which was used eight times among the manic cases, would be in a much more prominent position. From the mental symptoms Can, ind. ought to be often prescribed because of its symptomatology of ideas crowding upon each other, the loquacity, exuberance of spirits, the uncontrollable laughter, emotional excitement and changeability of mood.
Among the depressed cases Nux vomica is the leader with Cimicifuga second, and Arsenicum and Gelsemium tied for third place. Cimicifuga is indicated in both the excited and the depressed cases although we usually think of it more in the latter.
When those of my medical friends who read their materia medicas walk through the wards and listen to some of the patients they often think we ought buy Anacardium by the gallon. It however makes up little more than one per cent. of the total prescriptions. We try to prescribe on the totality of symptoms, taking into account the mental manifestations but not overlooking any of the physical aspects. We are more and more impressed by the uselessness of the attempt to delimit realms of the physical and the mental. The distinction is is theoretical because in actuality the two are inseparable, the physical and the mental interacting constantly.
Ars. alb. certainly is a very useful remedy in the depressions, especially when accompanied by restlessness and subjective sensations of burning, and nocturnal aggravation. Ignatia at times is useful, especially when the symptoms are inconsistent or contradictory. Pulsatilla we found chosen a total of ten times, but in order to expect any results we must have more than the loquacious weeping blond. It appears to be necessary to have some alimentary symptoms calling for Pulsatilla in order to be reasonably sure that this remedy will produce results.
Statistics, we know, can be produced to prove any desired statement. While we are not members of the American Statistical Association it is incumbent on us to emit more or less statistical data from time to time, and it occurred to the write that a tabulation of this sort might be worth the time and effort, indicating what our practice has been in prescribing for people whose cases terminated in recovery.
