Plainly I was opposed here by a force of remarkable power, and I requested advice from my former teacher. Medorrhinum was given with a severe aggravation of all his complaints but little improvement after the lapse of some weeks. Once more I returned to Dulcamara, one dose of the 200. This time my action was immediate, complete and permanent, if a period of two years may be said to be permanent. Plainly this was a history of sycosis, not in the child to be sure, and perhaps not in the father, as his other children were all well, and his asthma dated from childhood. From the other generation I could glean no information. This case, then, may be said to be instructive but again may well be misleading. If, however, it is segregated with a number of similar cases it may contribute a mite of value. I bring to your attention the fact that there is listed nowhere a relationship between Medorrhinum and Dulcamara.
Now as to the father who was aged 42. This man had had asthma so long that he also had a chronic bronchitis and his sputum contained at times hard lumps and portions of the lining of the bronchi. Although he was worse in a feather bed and in the stable he gave no positive skin tests. I was tempted to begin with Medorrhinum, on the basis of analogy, but decided to take his case in the usual way. This revealed that he had been taking hydrochloric acid before meals on the advice of a columnist, for he had gastric complaints of a vague nature. There was also a severe left sided sciatica characterized by knife like pains. I have already mentioned the time modality of midnight, a modality which I ignored in this case as well as in that of his son. Prescribing on the two outstanding characteristics of knife like pains and the concomitant gastric condition, together with the type of expectoration, this man received Kali carbonicum in a low potency.
I was rewarded with a comparatively rapid improvement in his sciatica and his asthma although, because of the far advanced changes in his bronchi, I hesitate about claiming a complete restoration to normalcy. Perhaps the most interesting aspect of these cases is that which calls our attention to the necessity for an anti-sycotic remedy in the child and the lack of such a necessity in the parent, when it might well have been supposed that the reverse would obtain. The second thought that gives us pause is that, in spite of the identical and pronounced time modality present in both cases, the indicated remedy was best selected without its being considered.
The third case is one in which a consideration of the time modality was of primary importance. This is a case of a woman of fifty-eight years whose mother and father had both died of diseases of a pulmonic nature, and she herself had always been subject to chest colds. This gives us liberty to assume that in the event of anything occurring to her which would seriously influence her general health, she would manifest her potential reaction in ways pulmonic. Four years before her present illness set in she had all of her teeth removed, the net result of which was to impair her health so that she stated that she had never been really well since that time. Two years later she had influenza which left her with her present asthmatic condition well developed. A sinus operation aggravated this trouble and was followed in turn with pneumonia. As we see her she is a tall, thin, emaciated woman with a long and prominent nose. Her hair is white. She is intelligent, in good spirits with a general build suggesting Phosphorus.
She has a constant dyspnoea and a cough of varying intensity. She cannot lie down comfortably. The cough is hard and dry as a rule increasing the dyspnoea, and the frothy mucus which she does raise is raised with difficulty. It contains no blood. She complaints of a constant tickling in the throat which, together with the cough, is aggravated by inspiration, dust dampness. She is susceptible to coldness and dampness but during attacks she desires the windows open. There is a constrictive pain about the heart which organ is not fundamentally at fault. Her chest is full or rales especially in the larger bronchi. She has no sense of smell. She is habitually accustomed to migraine settling over the right eye, accompanied with nausea and vomiting.
With the chest condition there is associated a black or dark mucous diarrhoea, old blood, with the formation of gas in the left lower quadrant which ascends to the heart causing the aforementioned pain. These symptoms are relieved by a bowel movement. At present the patient is apt to take from four to six injections of adrenalin a day, for the choking up and cough is very distressing. She is always distinctly worse at two oclock in the morning. But before using this modality I had to weigh the possibility of this modality being another illustration of the modality of worse from cold, as at this time country homes begin to get cold as the fires die down.
The fact that this modality persisted in the warm weather as well as in winter was instructive. In any case Rumex was the first and last choice. Its effects were immediate, but, strange to say, although this patient improved continuously under dose of the 3x she experienced little or no improvement from any of the higher potencies. After two months of periodic medication she was so much improved that she had discarded her adrenalin, had returned to her house hold duties after a years sojourn in bed, and was once more enjoying a full nights rest. Unfortunately at this time I moved away from that vicinity and lost track of the case.
At this point it is apropos to broach the subject title of this paper. What is the criterion by which we judge one symptom to be of particular value in one case while in another case of similar nature we relegate a symptom of like nature to a place of secondary importance? Next to the ability to interpret symptoms, this ability to assign to each symptom its relative degree of importance is that elusive something which differentiates the successful from the unsuccessful prescriber.
Unless one possesses or acquires that ability it is a foregone conclusion that he will hardly remain a practitioner of the homoeopathic art. On the other hand, he who possesses that ability will continue to develop into a better and better homoeopathic physician. a pitiable few seem to be naturally endowed with this particular type of genius and a larger number by dint of concentrated mental effort develop a commendable technique. Still others by virtue of persistent application and long experience acquire the ability to some degree short of proficiency.
From the standpoint of the teacher it presents a problem which is difficult of solution. It is not sufficient to say that it is intuitive or imaginative although many times the one or the other factor plays a large role. With the passing of the preceptor, the necessity for teaching to assume a didactic aspect became apparent and it is obviously difficult to reduce the matter of homoeopathic prescribing to didactic methods.
Still another criterion of the successful prescriber is his ability to keep his head when, as has been poetically said, “all about you, are losing theirs.” This, combined with the willingness to refrain from any but the measures called for in the individual case under consideration, marks the physician as the confident artist or as the over anxious, though well intentioned, heteropath. As an illustration of this let me cite the case of B.w., a girl of eighteen. She was a buxom wench, whose mother was endeavoring to marry her to a farmer with some money. She however, persisted in gratifying the desires of a pleasant though poor young Scotch laborer.
The mother, ever alert, produced a worthy abortion following which the girl developed an illness which is every respect was typical of acute rheumatic fever. The joints of the upper extremities, wrist, elbow, fingers, were involved. There was the excessive sweating, high temperature and the excruciating pain in spite of which the patient was constantly in motion. Rhus tox. was given with a change in the picture to Pulsatilla, as the upper joints improved and those in the lower extremities became involved, with a concomitant cessation of the excessive thirst. The uterus was soft, enlarged slightly and from it came a discharge which was bloody but bland and odorless.
At no time was any other remedy than the above used. The attack lasted three weeks in all, but at the end of that time a mental condition appeared. She became irrational , spoke of seeing bugs, etc., on the walls and failed to recognize her parents. The skin became sweaty and the sweat was offensive. Sulphur eradicated this in twenty-four hours. Seven months later a thorough physical examination revealed no cardiac lesion, no dyspnoea, and the fact that her menses had been normal for the last five months. No curettage had been resorted to in spite of surgical authorities to the contrary. Pulsatilla and Rhus were used in the third and Sulphur in the twelfth.
