Shortly after I began practice in the Hawaiian Islands I was called one morning to see the daughter of one of the local sugar magnates, a child of 12 years. It was with no small degree of pride that I walked up the broad steps leading to the expansive verandah of the mansion. In the drawing room I was met by the mother, and after a few words of greeting was led to the bedside of the sick child. Here I found a room in total darkness. As the curtains were drawn aside the child drew the covers over her head. Here was a symptom not to be overlooked. So severe was the photophobia that a cloth had to be put over her eyes while the examination was made.
A hasty examination of the eyes revealed severely injected conjunctivae, dilated pupils and some lachrymation. The face and body were red, hot and covered with perspiration. The temperature was a fraction above 104, and the pulse was correspondingly high, full and bounding. There was throbbing headache, dry mouth, thirst, coated tongue, sore was throbbing headache, dry mouth, thirst, coated tongue, sore throat, etc. In short, every characteristic Belladonna symptom I had ever heard or read about was presented in classic order. Moreover, the child was of the typical Belladonna type, as that type is always described–fair skin, large blue eyes, golden hair, etc.
Obviously there was but one remedy that could reasonably be chosen, and that was Belladonna. This was given in the 30th potency, and with a degree of confidence greater than ever before or since felt when prescribing. A brilliant result, I felt sure, would not only reward my efforts, but I could see myself installed as the family physician for all time, as a consequence. Knowing that I should be welcome I returned in the evening. Imagine my surprise to find my patient, if anything, a little worse than she was in the morning. Belladonna had not made the slightest impression. Further examination and questioning of the mother and nurse elicited nothing new. No other remedy could possibly be indicated.
I could ascribe the failure to no other cause than a faulty potency. I, thereupon, gave the 200th, and assured the mother, as best I could, that there was no occasion for uneasiness.
The following morning found my patient in exactly the same state she was in the day before. Imagine my chagrin! There was now nothing else to do but give Placebo and go back to my office and study to find the reason why Belladonna had failed to cure characteristic Belladonna symptoms, and, if possible, to find the next best indicated remedy.
For my first problem I found no answer, after a careful search of the literature. For the second I found, after careful scanning of several repertories, that Ferrum phos. had many similar symptoms, that it was the next best remedy. I returned at once and gave Ferr. phos. in the 30th potency. Imagine my surprise when I called in the evening to find that this remedy had done just what I had expected to Belladonna when I first prescribed it! Under the influence of Ferrum phos. my patient made a speedy recovery.
Now, why didnt Belladonna cure? The answer, of course, is that it was not indicated. But, if symptoms of disease are a sure guide, and, as many maintain, the sole guide to the selection of a remedy, what other could possibly have been chosen? To have chosen any other either at my first or second visit, seems to me, would have violated all the precepts laid down on the method of choosing a remedy. I had made it a habit to scrupulously comply with the teachings of Hahnemann, of Kent and others.
For three years I had been a pupil of H. C. Allen. In short, I knew of no other method than the method of these men. The obvious reason for the failure in the case is that I had not taken the case properly. But in the measure in which I failed I must be forgiven, for I had never been so instructed, nor has anyone else. Ferrum phos. brought about a perfect cure, and probably I should have been satisfied, especially as the parents of my little patient were deeply appreciative of my skill. But I was not at all satisfied with my skill. Indeed, I was quite ashamed of it. There was neither art nor science displayed in it. The appropriate remedy was chosen on practically one symptom, namely, the pulse.
All the other symptoms, because as characteristic of one drug as of the other, had to be set aside. Not being able to correctly evaluate the symptoms I was unable to differentiate between the two drugs in a scientific manner. Later study of human morphology solved the problem of how a case should be taken to truly get the totality of the factors in a given case.
Here it may not be inappropriate to call to your minds some words form the address of Dr. Royal delivered at Montreal last year. When speaking of the requisites for successful prescribing he said among the other things: “Next come the knowledge of human nature, the ability to read, interpret and evaluate the make-up of a patient, and to visualize the totality of the symptoms in some homoeopathic remedy.” That this knowledge is of tremendous importance no one will question. But on what does it rest?
Surely it must have something more substantial than some fanciful conception; and if we are real teachers, we must be able to give a student better advice than “watch all people” in order to acquire this knowledge. If we can do no more then we are but “sounding brass or a tinkling cymbal”. For it to have true scientific value we must be able to discover the facts on which it rests, and analyze and classify them.
Now in all but two things the Belladonna type and the Ferrum phos. type are strikingly similar. The former has a dominant development of the nervous system while the latter has a has a dominant development of the vegetative and lymphatic system. These two things make the difference. In the thoracic region, especially, are they alike; hence the similarity of the symptoms in all inflammatory processes-the sudden onset of symptoms, rapid rise in temperature, the flushed face, injected conjunctiva, throbbing carotids, throbbing headache, throbbing pains in affected parts, hot, moist body, etc.
However, while there is equal degree of arterial and cardiac excitation, the pulse of Ferrum phos. is always compressible while that of Belladonna never is. It was this one symptoms which led to give Ferrum phos. When Belladonna had failed me, and it was this which ultimately led me to understand the fundamental differences between led me to understand the fundamental differences between the two types. The dominating nervous elements make the Belladonna individual positive, vigorous, tense, and in severe inflammatory diseases, excitable, at times wildly delirious, while the dominating lymphatic elements make the Ferrum phos. individual negative, pseudo vigorous, relaxed and phlegmatic.
These difference, some may think, one should easily recognize. But this is not so unless extremes are manifested; borderline cases present great difficulty. A youth or girl of 14 or 15 in otherwise good health may be far from exhibiting a phlegmatic state yet have a strong tendency in that direction, as was the case with my little patient. I had often seen her galloping through the country lanes on her horse, and in other ways display athletic activity and skill. There was every reason to consider her a very energetic and virile little person. In such a case nothing but a careful morphological examination will enable one to reach a sound conclusion, for in no other way can the basic factor be discovered.
How is the morphological examination made?.
Time does not permit a full description of the method, obviously. But these few points I want to mention: The one absolutely certain mark of a dominant development of the nervous system is shown when the bi-lateral reach is greater than the stature. Why this is so I am not prepared to say. The fact, however, has been confirmed by the ablest clinicians and anthropologists, covering a period of no less than 75 years.
My own observations cover no less a period than 20 years, and so uniformly have I found this true that I now put every individual down as having strong neurotic tendencies in whom I find this disproportion. These may not necessarily be pathologic in character, but the dominant disposition of the individual will always be one of great earnestness, positiveness and tenseness. There will be more or less unnecessary strain made in all efforts. There is difficulty in relaxing.
Add, now to an habitual state of this character the strong reactions which are produced by large and vigorous thoracic organs, such as we find the Belladonna type to have, and one can readily understand the origin and mode of manifestation of the symptoms which are so characteristic of this drug-the reason for their positive and violent character.
Now while the Ferrum phos. type is not especially deficient in either the nervous or thoracic sphere, the vegetative over- shadows both to such a degree as often to make them appear so.
The signs of a dominant vegetative development are, gladio-public line greater than one-fifth of the stature, and a bi-iliac diameter greater or equal to four-fifth of the lengths of the abdomen. If the epigastric circumference is greater than the thoracic, and the sagittal diameter likewise greater then the evidence of vegetative dominance is still stronger. A development of this character means large organs, vigorous functions, excessive production of lymphatic material, sluggish reactions, soft, even flabby tissues.
A young person in otherwise good health will appear rosy an robust, but closer examination will usually reveal a bluish tint in the skin, especially in the cold. The pulse, as has before been said, will always be compressible no matter how violent a morbid process may be. Another characteristic of the Ferrum phos. inflammatory process is its strong tendency to suppuration. This is because of the lymphatic saturation of the tissues and the accompanying lack of reaction. During my twenty years in ear work I found that an otitis media in this type of individual almost invariably ended in suppuration, and frequently in mastoiditis.
Moreover, I found Ferrum phos. to come as near being a specific in the early stage of such process as a remedy can be for any morbid process. The sudden onset of the symptoms, the severe throbbing pain, the flushed face, rapid rise in the temperature, etc., lead many to give Belladonna at the start and follow with Hepar when suppuration begins. In my opinion Ferrum phos. will do the work of both and do it better, and because it is the similimum to both the symptoms of the disease and the underlying morphological state.
This brief and admittedly sketchy morphological study of these two drugs is but a hint of a method which when full developed will, I believe, enables us to disclose all the facts which make an individual what he is, and so enable us “to read, interpret and evaluate the make-up of a patient” in a truly scientific manner. These facts when added to those which have already been complied will broaden the scope of the materia medica to a degree few of us can now realize; and it is my firm conviction that the future of homoeopathy depends on this work being done.
NEW YORK, N.Y.