SOME CLINICAL ASPECTS OF AESCULUS HIPPOCASTANUM


Several years ago a woman came to me from Pittsburgh. She had been under the care of two different homoeopathic physicians. Each one of them had insulted her almost as she claimed by telling her that she was neurasthenic; there was nothing the matter with her. She had a long range of most striking and I might say “high fault in” complaints. A careful study showed they were all contained under the remedy Agaricus, and that cured her, made a new woman out of her.


If the physician clearly perceives what is to be cured in each individual case of disease, and what is curative in each individual medicine, and if he knows how to adopt what is curative to what is undoubtedly morbid, according to clearly defined principles, then he understands how to treat judiciously and rationally, and he is a true practitioner of the healing art. These few lines taken from the third paragraph of the Organon present the essentials of correct homoeopathic prescribing.

Unfortunately, they are ignored by the majority of those who claim to be loyal members of the homoeopathic school or a given an interpretation so liberal, that they would appear to admit of any system of treatment that appeals to the mind of the prescriber. Thus have arisen keynote and pathological prescribing, indifferent results, and the necessity for restoring to unhomoeopathic methods.

AEsculus hippocastanum furnishes us with an excellent confirmation of this. A brief study of its pathogenesis will reveal a wide range of action and many clear cut characteristics. Yet, to the routinist, it usually spells haemorrhoids. He may have read somewhere that people used to carry a horse-chestnut in the pocket as a cure for rheumatism, but would not think of prescribing it for that disease unless there was an accompanying portal stasis. To give AEsculus in neuritis would seem to him a waste of time. But here is a typical case:.

Mrs. A.E., aet. 52, light complexioned, rather stout; cheerful and vivacious. For two weeks she had been suffering with an intense neuritis of the right shoulder and arm which felt full and heavy. Shooting pains of great severity, started from the spine, passed to the point of the shoulder, and followed the course of the circumflex down along the radial nerve into the thumb and adjacent fingers. There was numbness of the hand which increased with the severity of the pains, especially acute in the tip of the thumb. Worse from motion and cold, better from applied heat. Always worse from emotion and excitement.

On August 19, 1929, she received one dose of AEsculus hipp.

45 M. Relief was almost immediate and in less than a week she was almost entirely free from pain, but the numbness and heaviness persisted. On October 17th she reported aching and bruised soreness in the forearm, numbness of the tip of the thumb, caused, apparently, by apprehension over sickness in the family.

She has been afflicted for years with psoriasis which is now improving rapidly under Petroleum.

It will be noted that this patient was not despondent and irritable, which is the usual mental state of the AEsculus subject, nor did she have piles or venous plethora in the slightest degree. She was unaffected in general, by either heat or cold. The sense of fullness, the heaviness of the suffering parts and the shooting pains and numbness were the guiding features.

Authorities on homoeopathic therapeutics tell us that AEsculus is useful only in functional heart ailments. Here again we must revert to Hahnemanns axiomatic paragraph: “If the physician clearly perceives what is to be cured in disease.” To restrict the prescriber to either functional or pathological condition is to limit the range of remedies he has at his command and to cause him to miss the similimum in a large percentage of cases. Doubtless this is the reason that the horse-chestnut is not considered as a heart remedy.

Mrs. Irene A., 68 years of age, dark complexioned, obese and flabby. A long life of grief and anxiety resulted in heart disease. Diagnosis: mitral regurgitation.

Despondent, apprehensive, somewhat petulant but not irritable.

Flushes of heat in the face, with anxiety.

Pulse regular but soft and rapid, increased by slight exertion.

Palpitation and dyspnoea < on walking, climbing stairs and eating, > by belching; accompanied by anxiety and flushes, of ten driving her out of bed at night.

Shifting pains, especially in the cardiac region, left ear, temple and the knees.

Numbness and tingling in the forearm and hand on the side lain on, with full feeling, > letting the part hang down.

< morning, walking, from cold air.

> warm weather.

Craves acids; bowels slightly constipated, but no haemorrhoids.

February 13, 1927, she received a dose of the remedy in the CM potency with marked relief of all symptoms. The same potency was repeated on June 22 and July 20. She improved in general health until the following January when the symptoms changed somewhat, a distinct aggravation after sleep was added and Lachesis was given. A complete cure could not be expected in a case of this character and no doubt other remedies will be required in the future, but were the patient here now she would testify to the comfort the AEsculus gave her.

One more case completes the group I have culled from my records Mrs. L. V. R., aet. 60, had been a patient of mine for over twenty-five years. She was always bright, cheerful and energetic. But, after her house burned down and her business of corset making declined, she became despondent, indifferent and lazy, neglected her family of seven children, continually made mistakes in fitting corsets and even neglected her own personal cleanliness and attire. Her husband made a small salary but it was sufficient for a modest living. She refused medical treatment, saying that it could do no good. Finally her husband persuaded her to come to the office. She presented the following symptoms and conditions:.

Rheumatism for years.

Bruised soreness all over, but more marked in the cardiac region and down the whole right side.

Numbness of the side lain on.

Sensation of fullness in the region of the heart, alternating with a feeling of emptiness, the latter worse at night, and relieved by eating. Heart seems to stop, then start with a thump; pulse 64.

Fullness in the right side of the head and face.

Palpitation on slight exertion, lying on the left side and after a full meal.

Stopped feeling in the right ear; noise as of a waterfall. This troubled her more than the more serious symptoms. Metallic taste in the mouth.

October 23, 1929, Aesculus hipp. 10M.

At her next visit, February 4, 1930, she reported great improvement and noted with great satisfaction, that the ear had entirely cleared up. But as the heart symptoms were beginning to return, she was given another dose of AEsculus, this time in the 45M. It was repeated in the CM on April 10th. Soreness, numbness, strange full feelings, palpitation and all symptoms referable to the heart had entirely vanished by June 2nd. This was indeed gratifying to both patient and doctor, but the change in mental state, her increased energy, and the return of her old neatness in personal appearance and interest in the wanted activities of her life, showed a deep and radical action of AEsculus.

CHICAGO, ILL.

DISCUSSION.

CHAIRMAN J. HUTCHINSON: It is most helpful and gratifying to have new things brought out as to the authentic values of remedies, and I think this paper is a good example of that. Will you discuss it?.

DR. A.H. GRIMMER: I think perhaps there is one phase of this paper that we ought to be thankful for and that is the point the doctor stressed about AEsculus covering a greater ground that what it is so commonly used for , haemorrhoids. The doctor has shown how we should study our remedies, in relation to the patient, regardless of pathological conditions. And while it is true that remedies do have affinity for certain organs, parts, and tissues, still I want to thank the doctor for bringing that points to the fore.

DR. D. MACFARLAN: What the doctor just said is interesting. We have certain predilections for certain remedies. I know my father, who knew Dr. Lippe very well, said he was fond of silica. He used Silica very often. Dr. Boger probably uses Phosphorus too often. And I think probably I use Sulphur too often. But I think we have all special predilections.

Dr. C.M. BOGER: I want to confirm what has just been said. The reason for it is that we get used to using certain tools, we get to be a little more proficient with that particular tool and we use it more than others. That is all.

DR.C. A. DIXON: I wonder if the same thought occurs to others that this paper brings to me. Sometime I start in at the office at two oclock in the afternoon and the first case say , offhand, is a Nux or Calcarea case. Before the day is over I have prescribed that three or five or ten times. It seems as though everything I see is Calcarea or Nux or whatever it is that I prescribed for the first case. Is it psychological, or what is the reason for it? I noticed, as Dr. Farrington read those papers and dated them, that last fall he was especially interested in AEsculus.

CHAIRMAN J. HUTCHINSON: Dr. Farrington ought to be allowed to answer that, but before he does I should like to say that I think at times the same weather, even in different localities, brings out in patients the need of the same remedy. I find sometimes of a winter day when there are indications of a scourge of grippe that patients (I may not know of those patients) from the environs come in, and although one may be from Mount Vernon and another from Newark they seem to require the same remedy.

And then I Know that the grippe is coming, or whatever it may be. Personally, I think that temperature and weather have an enormous effect on our patients complaints, and on their complaining and those conditions help us select a remedy. I am not so sure when we prescriber Calcarea carb. six times in a morning but what it is a similar remedy, at least.

DR. T.G. SLOAN: In my Rockville practice, when I am in doubt about a remedy, I always give Sulphur and nine times out of ten it is the right remedy I dont know why but it has worked out that way for years.

DR. A. PULFORD: We find that certain cases will come in on certain days that require the same drug. We have tried to figure it out and have come to the conclusion that it is coincidental, rather than accidental. But we have found that it does happen quite frequently.

CHAIRMAN J.HUTCHINSON: My reading is rusty, but it seems to me that Hahnemann made a good many weather miasms. Didnt he?.

DR. A. PULFORD: He did.

DR. C.L. OLDS: That simply means dynamic influence, I suppose.

CHAIRMAN J.HUTCHINSON: Dynamic is a big word.

DR. H.A. ROBERTS: We are not prescribing irrationally when we prescriber the same remedy several times a day. Why is it in actual practice, that when we strike one case of appendicitis we will strike two or three within forty-eight hours? The same thing is true with pneumonia. You run into one case and you will get some more. Why should it also apply to the application of the remedies that are called for? They necessarily fall into the same channel because they are caused by the same atmospheric and climatic conditions.

DR. G. ROYAL: There are several reasons why I enjoyed this paper very much indeed. First, because it is the first time that I have ever listened to the writer read a paper; in fact that is the first time I have ever met him. I knew his father pretty well. The second reasons is because of the manner in which he grouped his symptoms, which was very good. The third reason and perhaps the least important is because it gave me a great deal of satisfaction. he uses the word diagnosis again and again. He uses the word neuritis, which is nothing more than pathology. He talks about haemorrhoids. That was very very satisfying to me because he was talking in a language which I under stood.

Here is what I think about diagnosis. A patient comes to you to make a diagnosis, which I say is essential to the selection of the remedy, that is, before you have taken your remedy. It is a part of the totality of symptoms, because to me it indicates the tissue that is affected and the manner in which that tissue is affected. Then I have that on which to build my grouping. This is what he has done in this paper and so I say I have enjoyed it very much.

DR. C.M. BOGER: Dr. Royal has opened up something here. It is quite the custom to deride diagnosis at some of our meetings, but all who do so should read Hahnemanns Preface to the Pathogenesis of Colocynth in the Materia Medica Pura, and see what he says there about the minor symptoms. I am not going to talk a whole lot about what he says there because you can read it yourself. But, he distinctly intimates that the minor symptoms must be in the picture. That bring up the other end of the subject and that is the thing that I discussed with Dr. Royal last night. We have in every proving the reaction of the system to the potency from the highest down to the lowest, and then the gradient all the way down to the lowest potency and down into the toxic effects. You will find that even in the chronic diseases.

You will find in acute diseases like pneumonia and typhoid, and so on, that the provings of the potencies exhibit the symptoms which come in as concomitants in acute disease. If you come down the scale to the mother tincture and then to poisoning effects you will find the toxic effects from the medicine and the toxaemia in the disease. Did you ever think of that?.

The toxaemia of the disease is the basis upon which the allopath makes his diagnosis mostly, not entirely.

He takes into consideration the toxic effect of the disease and from that draws his diagnosis.

So we should not deride these men too much who base their prescription on the toxic phase of the disease.

In taking with the doctor last night I asked what was the first indication which led us to prescribe Merc. cyan. in diphtheria. It was a toxic case, right here in the city of New York, where the patient died and a post mortem showed a membrane on the velum palati. That was the first thing that drew us to the use of cyanide of mercury. And we know now that that is one of our main remedies in diphtheria.

Take Arsenicum. The toxic symptoms of Arsenicum are the toxaemic symptoms which you see in diphtheria and typhoid fever, for instance. That is the way it is in every disease.

So that a knowledge of toxicological effects is quite helpful in finding the remedy, especially when you are up against a very acute disease. In other words, you must bring in everything. You cant limit yourselves to high or low potencies. If you take a high potency and make a toxicological effect it is purely coincidental and occurs only once in awhile, such as in the case Lippe pointed out–the thirst of Arsenicum. That symptom occurs frequently in toxic effect of Arsenicum, rarely from a potency.

DR. G. ROYAL: May I have just a second more? I know it is against the rules but I want to emphasize one point. Dr. Boger said if you give a high potency and get a toxicological symptom, that is purely coincidental. I want to say to you if you get a toxicological symptom and can find a remedy that has produced it, I am just as sure that you are going to get rid of that symptoms by giving it in the potency that produced it.

DR. C. M. BOGER: Sure, that is true.

DR. D. MACFARLAN: What I believe is important is to get reliable symptoms. When an ophthalmologist wants to operate on a case of cataract he injects homatropine sulphate and he gets a dilatation of the pupil. He gets it not once out of a hundred times but one hundred times out of a hundred. That is the beauty of making provings; you know what you are doing and you get it first-hand.

Then there is an intimacy between yourself and the man who makes the proving. I made a proving of China on a man once. In my relationship with him I talked him every day, while I was making this proving; he gave me an indelible proving as to what China would produce, which I never would have gotten from reading Hahnemann, because there is a personal touch in making the proving that you never can get otherwise.

And you prescribe so fast. Dr. Griggs makes provings. I used to work with him in the hospital. We would often prescribe for thirty-five cases in an hour or two.

I remember a case, for instance, that Dr. Griggs had, and the cure that he made. The case had been treated by an old homoeopathic doctor, a fine old fellow, but he only used three and four xs. He didnt believe in high potencies and hadnt made any provings.

The case was a child. It was a very bad skin case, the worst eczema I ever saw. He had a new color salve on about twice a week, but he was always sick. Dr. Griggs prescribed for it and in a month the child had a beautiful complexion.

That is the way you can get those results: from making provings. I dont see how anyone can practise homoeopathy unless he makes provings. My father had no confidence at all in anyone who didnt make provings.

DR. C.M. BOGER: As an addendum to what I said a little while ago I want to point this out: some months ago a neighbor of mine came to me after having been to many physicians with no relief at all. He had this symptom, an uneven contraction of the muscles of the abdomen. The abdomen was growing into little hillocks, as it were, all over.

The rest of the symptoms were rather nondescript. And on the strength of that symptom I gave him Plumbum, but I made a mistake.

In a short time he came back and said that he wasnt any better. In the meanwhile I had looked up his case a little more in my spare time-and it is a good practice when you have spare time to look up old cases that are not getting well -and I found that symptom as a toxicological symptom under Arsenic. I gave him a dose of Arsenic and now that man is getting well.

CHAIRMAN J. HUTCHINSON: We will return to AEsculus and I will ask Dr. Farrington to close.

DR. H. FARRINGTON: I want to thank you for your kindly remarks. Though you did not discuss Aesculus directly it is of no particular moment because I think the points that have been brought out are interesting and useful.

I want to especially thank Dr. Royal for what he has said because I think that many of his contentions are really true. We are perfectly justified in using a diagnosis in helping us select our remedies. All that we ask is this that we do not make it the principal thing unless it is (and that is a matter of individual judgment) because our provings have not been made on diagnosis and whatever we know about remedies that will cure certain diseases has been obtained only by clinical experience.

Pathology is also important but we must be careful also not to make this the principal thing as I tired to point out in the beginning of my paper I wanted to say that a remedy is useful practically only in a certain pathological condition, and to limit the use of that remedy. As the doctor suggested pathology may be important and often is, when it is of a peculiar nature and different from pathologies in similar cases or similar diseases.

We cannot expect every physician to think the same as every other one, or to prescribe in the same manner. Each one will do it naturally, according to his own mind.

For instances, you will note that provings in the potencies will often show pathology that is exactly the same as the chemical or even the escharotic action of a drug. Kali bichromicum will produce round, punched-out ulcers. Arsenicum will produce flat, shallow ulcers. Argentum nitricum will produce ulcers that go no deeper than the surface of the mucus membrane, and so on.

We do not know all there is to know about our materia medica and I brought these cases forward because I thought that they were unusual and contained certain things that were not to be found in the materia medica. I might have taken the time to point out those things that are not to be found in the books but I have left this to you, and AEsculus is not used as often as it should be.

I have passed over numerous cases of follicular tonsillitis, mentioning diagnosis and sore throats and colds that cannot be given any special name which AEsculus will cure promptly and completely. I have passed over many other conditions such as lumbago, haemorrhoids (Which I merely mentioned); rheumatism I did not emphasize but it is a useful remedy of course in that connection.

Harvey Farrington
FARRINGTON, HARVEY, Chicago, Illinois, was born June 12, 1872, in Philadelphia, Pennsylvania, son of Ernest Albert and Elizabeth Aitken Farrington. In 1881 he entered the Academy of the New Church, Philadelphia, and continued there until 1893, when he graduated with the degree of B. A. He then took up the study of medicine at the Hahnemann College of Philadelphia and graduated in 1896 with the M. D. degree. He took post-graduate studies at the Post-Graduate School of Homœopathics, Philadelphia, Pa., and received the degree of H. M. After one year of dispensary work he began practice in Philadelphia, but in 1900 removed to Chicago and has continued there since. He was professor of materia medica in the Hahnemann Medical College of Chicago, and was formerly the same at Dunham Medical College of Chicago. He was a member of the Illinois Homœopathic Association and of the alumni association of Hahnemann Medical College of Philadelphia.