PART I A-SENILE PRURITUS.
There are two reasons for presenting this subject:.
First: Because there is no other disease (conditions) except cancer, for high the apparently indicated remedy,. prescribed by me, has so often completely failed to cure the patients.
Second: Because the number of patients suffering from the disease is large and is constantly increasing.
In order to more clearly understand each other and thus get more out of the discussion let us consider pruritus as disease-an entity-and prurigo simply as a symptom,the entrance complaint, not only of pruritus, put of many other diseases.
1.”This is a form of paraesthesia which is unique, infant, that itching is the sole symptom of the disease.
2.”Pruritus is characterized by the occurrence of itching, in fact, priorities is itching.”.
3.”Dermatology, itching of the skin.”.
My own definition is: An incurable disease of old age.
TISSUES INVOLVED are: Brain and nervous system, primarily; skin, secondarily.
ETIOLOGY;Atrophic changes, both central and peripheral, of he nervous system, of the aged. The causes of these atrophic changes are numerous, varying from a simple cold to syphilis, tuberculosis or that still more dreaded and yet less understood term, cancer. These causes may be acquired or congenital;general or local. I have had two cases of traumatize-one fracture of the skull at the base,the other concussion of the brain and in addition a featured leg, thigh and arm, and dislocation of the shoulder.
My experience also confirms me in the brief that heroic treatment by antipyrin, antifebrin,etc., prescribed by manufacturing druggists and administered by the physician, as caused or aggravated the suffering of many pruritic patients.
PATHOLOGY;In the simple, uncomplicated cases of senile pruritus, no structural changes have been found in the first stage. The only structural changes are caused by the patients diggings,rubbing, scratching or he local application of some drug. In the complicated cases and also in the later stages of the simple cases,. the structural changes are those of the complicating disease, and those caused by the scratching and local applications.
SYMPTOMS: In the simple form, first stage , there are only three symptoms, itching,the entrance complaint: insomnia caused by the itching; and prostration, caused by the sleeplessness.
In the later stages and complicated cases the symptoms are legion Dr.W.L.Kitchens, in his book, Symptoms and Diseases Applied, on page 105, Part II, gives twenty diseases of which itching is a symptom. The diseases are of all grades from “ivy poison and pediculosis to common duct carcinoma and chronic interstitial nephritis”. Under C.I.N., page 183, Part Iv, he gives 36 symptoms and old age (senile) is one.
DIAGNOSIS;Never tell your patient or his family you can cure him. Tell him you can relieve the itching, to some extent; that you can make sleep. artificial; and that such sleep will help his prostration.
HOMOEOPATHIC DRUG THERAPY:The indicated remedy must have itching of the skin as the keynote-the determining symptom-and also an elective affinity for both nerves and skin. In addition, they must have the make-up and the modalities of each individual patient.
Ars.alb., in potencies from 3x to the 1m, has served me the best of any.. My notes 4.See also Allens Handbook of T.F.Allens lectures, 1880-2, contain the following leading, general symptoms: “No drug in its proving and report of poisoning has caused more profound prostration, greater irritability of the skin, i.e., itching and burning, than Ars.alb.”.
Sulphur ranks second in both frequency and results. Like Ars.alb., Sulph. has been used in all potencies.
Dearborn 5 Diseases of the Skin, page 393. ranis Sulph. above Ars.alb. Boger 6 Repertory, page 185. says of Sulph: “Unbearable itching, especially from warmth.” Kent 7 Materia Medica, pages 920 and 921. devotes much space to the skin disease of Sulph, e.g., “All attended with much itching.” “Wherever there is a Sulphur patient you will burning.” The above under Sensations.
Under “Modalities”, Kent has:”May complaints come on from becoming warm in bed.” And, “As to time aggravations,nightly complaints are a feature.”.
As to the “make-up” of the Sulphur patient, kent is equally clear, concise and convincing, e.g. “He is a lean.,lank, hungry, dyspeptic fellow.””He is dirty.” “The Sulphur patient has filthiness throughout, he is the patient has filthiness throughout; he is the victim of filthy odors.”.
Radium I am going to give third place because from its use internally with electricity, and also externally, some patients have had much relief.
Boericke 8 Materia Medica has the following under skin: “Itching all over the body, burning of skin, as if afire.” Under sleep we find:”Restless, dreams,vivid, busy.” Under Generalities, we find “great weakness,” and “severe aching pains all over ,with restlessness,” also” marked increase in the polymorphin clear neutrophiles.”Boericke states that the 1,800,000 radio-activity was employed. He also recommends the 12th and 30th triturations. I have only used the 12th and that in five grain doses, repeated at long intervals.
Antipyrin is another remedy mentioned , by Boericke”, 9.Materia Medica, pages 69 and 70 for pruritus. Under nerves,he gives “crawling and numbness,” also “general prostration.” Under skin he puts, “intense pruritus,” also the disease “erythema, eczema, urticaria,and angioneurotic-oedema,” Boericke suggests the “second decimal potency.”.
T.F.Allen 10 Handbook, page 67 says Antipyrin “reduces the temperature of the body, allays pain, promotes sleep and causes perspiration.”
Clarke” 11.dictionary, page 134, Vol.I tells us “Antipyrin is know from the poisoning effects it has produced in old school practice.” From my experience in a case, which will be related later, I am inclined to believe that Antipyrin is an excellent remedy to antidote the ill effects of aspirin and many other substances which are given to, or taken by patients suffering from the itching and sleeplessness of senile pruritus.
Anshutz 12. Old, New and Forgotten Remedies, page 133. gave me my first knowledge of Fagopyrum. Allen did not mention it is his lectures,s nor does he in his Handbook neither does it appear in the Cyclopedia of Drug pathogenesy, Nevertheless Fagopyrum is a well proven,though sadly neglected remedy.
Wm.Boericke 13 Materia Medica, pages 327-8. says, “its action on the skin, producing pruritus, is very marked.” “Pruritus senilis:” under sin he gives, “itching; worse, scratching, touch and retiring. Itching of hands deep in. Itching of knees and elbows and hairy portions.” Under Female, Boericke has: “Pruritus vulva, with yellow leucorrhoea, worse, rest..
Both Anshutz and Boericke stress the time aggravation, i.e., late afternoon,and Boericke stresses scratching.
Let me relate two cases illustrating two causes:.
Case I.Mrs. E.G.B., age 32,mother of three healthy children with a good family and personal history presented the following:”I came to see if I could get relief from my terrible itching.” “Where is it? All over my body, arms, legs, especially about ankles and knees, but the worse is in the hair above my privates.” “Do I have any vaginal discharge? No, only a little once in a while, just after the menses. Is ther anything visible on the parts? No ,not until I scratching, which I co, and then there are streaks and scabs. Worse? After scratching: in the p.m.when I am tried.”.
She was given Fagopyrum, Luyties 12x trituration, five tablets morning and evening, until relief was noticeable. She returned after five weeks with, “It did the work, I am much better, in fact I call myself with, “It did the work, I am much better remedy is as my sister and family who life in Chicago are just as I was.” When I said buckwheat she exclaimed.”Why I have just been in to visit them and they have buckwheat cakes every morning for breakfast.” The sister was advised to go to B. & Its get some of he 1M and take 10 drops before breakfast every Sunday. Two months late she came in and reported: “Isnt it funny that Fagopyrum high should relieve the itching caused by eating buckwheat cakes!
I do not know,however,whether the sister got the 1M or some other “high” potency.
Dolichos is the remedy I found most difficult to differentiate from Fagopyrum. Boericke 14.Materia Medica gives the following in his general statement, “a general intense itching without eruption. Exalted nervous sensibility” and “senile Pruritus.”.
Under Skin he has “intense itching, with no swelling or rash” worse across shoulders, also about the elbows that knees and hairy parts;itching exclusively at night.” And under Modalities, “worse at night, scratching.” Boericke also gives “a medicine,. with pronounced liver symptoms, constipation, bloated abdomen, haemorrhoids, skin yellow in spots. Herpes zoster.”.
My patient had no live symptoms. In fact, the only uncomplicated or senile pruritus I have ever had.
T.F.Allen 15 Handbook says of Dolichos.”it has been found valuable in the intense itching of jaundice: itching worse at night and from scratching.: the above symptoms I have verified, hut only when the constipation and haemorrhoids were in the totality.
Now let me relate three cases bearing on the etiology and complications of senile pruritus.
Case I.Mr.F.R.F., age 69, (was under my care for over thirty years) , light complexion; well educated, extremely neurotic, personal history; auto accident resulting in feature of one leg, one thigh, one wrist and concussion of the brain, with unconsciousness for ever eighteen hours. there was lack of union in the high and a second operation was required.
Beginning about four years after the accident, itching began, more in the legs and arms, also in his bread (he never shaved). there were no objective symptoms until he scratched, but after scratching all sorts of conditions, mostly bleeding and scabs, He tried everything suggested by this neighbors,m by what he read, etc. Radium, x-ray, all sorts of ointments,even kerosene oil,with but little if any help.
Arsenicum alb,. 30th internally with a solution of 1 to 1000 Arsenious ac. was the treatment which I gave him that afforded the most relief. The next was Fagopyrum 12x months before his death he developed a dull pain in this liver soon followed by yellowness of the of the sclera and skin. The itching was greatly increased. I kept him comfortable during the last fifteen days of his life with hypodermics of morphine sulph., 1-4 grain. Post mortem revealed a liver four times the natural size, studded with cancer nodules.
Case II. Mrs. I.F.H. dark, neurotic, housekeeper, mother of one child, died at the age seventy-one of cancer of he breast. F.H.Father died of T.B.C and ,other of cancer of the uterus when patient was only eighteen months old. P.H.Sickly until she matured. Good health from then on until five years before her death,when, in an accident,she severely lacerated her right breast. The wound only partially healed. Soon ulceration begun and extended over the entire breast. Being a faith-halter,” she would not have treatment for the cancer. But about four weeks before her death her sister came with statement that because of a “terrible itching” the patient had not slept for four days and nights and now wanted me, her old family physician,to sent her something to make her sleep. The sister added, “and if you have something we can use to stop the awful odor from the breast,give that too.”.
The patient was given five one grain tablets of Fagopyrum, 12th,and a prescription of Carbolic ac. dr.ss. Glycerin oz. O and Listerine ox. iii, to be mixed and applied to the lacerated spots of the skin. The patient got “quite a little sleep” as the result.
In this case as in Case I, I feel that the cancer was the strongest etiological factor; also that Fagopyrum helped relieve the itching and permitted some sleep.
Case III.Miss E.T., a school teacher of exceedingly neurotic make-up, a poor sleeper, very susceptible to pain; made the following statement: “I am in bed today because I have a high fever and itch from head to food. Nothing seems to help the itching. In fact,scratching or rubbing makes the itching worse and I thin increase the fever. My skin is dry now,as you see, but an hour ago I was wet with sweat from head two foot.”Her face was flushed, temperature 104.3 and pulse that of Bell., which I gave in the 30th (B.& Ts) tend drops in water. I promised speedy relief and that she would be able to be in school Monday ()this was Saturday a.m.). But I was called again in the evening and found her no better, infact worse every way.
Questioning for a cause brought a confession that for several weeks she had come home Friday “so tired and used up” she could not sleep and that at the suggestion of a friend she had taken antipyrin. there had been nothing the first few weeks,. but lately ther had been not only itching but some fever on Saturday. These two symptoms had gradually grown worse. I changed the potency of Bell. to the 6x five drops every 2 hours. The next morning the temperature was 99.5, pulse nearly normal and she had slept from 11 p.m. council nearly 6 a.m. The Bell. was discontinued and I made her promise not to take any more antipyrin.
The following Friday was called again about 11 p.m. because she had become more tired than ever and the itching was worse than ever. I gave five tablets of Fagopyrum 12th in a cup of water. this gave sleep after 1.30 a.m. She had to repeat the Fagopyrum only a few Fridays after than to effect a complete cure.
Carb.ac. is mentioned by Wm.boericke in the Repertory, page 1011, and also in the Therapeutic Index, page 1095.Neither Dearborn nor Douglas mention it for senile pruritus; clarke in his Dictionary gives eczema and smallpox in italics, as diseases calling for Carb.ac. Clarke also mentions neuralgia, Psoriasis,and pityriasis, but not in italics.
I have tried in may times for complicated senile pruritus, but only with partial success or utter failure, with one exception, when prostration was the determining symptom/.
Case IV. J.B,. age 68, married, Congregational pastor, both F.H. and P.H.Excellent. Extremely neurotic,has been obliged to lie down and rest after preaching a sermon; all the organs except the nerves and skin functioning well,reported s follows: “Doctor,I came to you to se what you could to for my itching, You know we have had a course of protracted meetings and I have worked far beyond my strength. Towards the last f the meetings, and worse since, I have had an itching all over my body, so bad that I cannot sleep and am completely prostrated.
I am so weak after stools that I feel faint, in fact did faint once.” when asked to be more specific, he replied: “When this began, I thought I had the old-fashioned itch, but there were no eruptions o scabs anywhere until I scratched. I used sulphur ointment,but that did not help. Soon these spots seemed to have a watery matte and then pus. Our doctor said it was not smallpox. He gave me all sorts of external applications. The one which seemed to do me the most good was carbolized Vaseline. That allays the itching some and gives me more sleep,but it seems that I am rapidly growing weaker, all the time.”.
He was given Carb.ac (B & Ts) 130th on disks, five before each meal and at bedtime and advised t keep u the carbolized vaseline. The result was a rapid and complete restoration to his normal condition. P.S., Had I been familiar with Dr.J.H.Clarkes latest on Ars.Sulph.fav., which leaflet came with my March, 1931,copy of the Homoeopathic World, I would have given that instead of Carb.ac.30th.
Clarke quotes from Hahnemanns Materia Medica Pura and from Kents article published in the August, 1907, Critique. From Kent we have , “Ars.Sulph. flav-one of our deepest acting remedies- unbroken down constitution, old people with lack of reaction”. Also,:faintness after stools”. And again,”weakness is a red-string indication”.
Under Relations we read,m “Ars. sulph. flav. closely resembles both its elements and to other sulphide, Ars.sulph. rub.
the auxiliary treatment for Pruritus senilis will be given after we have considered the homoeopathic remedies for the other varieties of Pruritus.
This is another condition affecting both the nerves and the skin.
DEFINITION:Dearborn 16 Diseases of Skin, page 419 writes” “An acute vesicular eruption, situated on a red base, and distributed along the line of one or more cutaneous nerves.” Douglas,17.Skin diseases, page 197. The neuralgia which precedes or accompanies zoster may exhibit any degree of severity,and may indeed persist for an indefinite period of time after all symptoms of cutaneous irritation have disappeared. Instead of neuralgia,a more or less intense pruritus may be present,confined to the affected region, and persist for a long time.
Dearborns definition is in italics: Douglas is not. My definition is: 18 Diseases of the Brain and Nerves, pages 36-40 A neurosis with an eruption of the skin over the course of the affected nerve as an end product.
20 Practice of Medicine,page 445 Bartletts definition is: “An acute inflammatory disease believed to be of infectious origin affecting the posterior spinal ganglia,the Gasserian ganglion or other ganglia connected with sensory nerve trunks, and characterized clinically but neuralgic pains and vesicles along the course of the tributary nerve trunk.”.
ETIOLOGY 18Disease of the Brain and Nerves, pages 36-40 Irritation of the spinal ganglia from mechanical injuries: exposure to the elements; strains; and excitement,,like fits of anger, fright, etc. Gurschmann 19 Neuralgia,page 96. states: “That many of he intercostal neuralgias are tabetic or spondylitic root pains.”.
I am aware that some authors claim that the neuralgia is the end product of the skin manifestation, rather than the reverse, but my experience with a large number of cases convinces me that the nerves are affected first. A close study of the history of the case is the reason for my opinion.
PATHOLOGY;This will depend upon the cause. It may be all the way from a simple irritation to sclerosis; or all the way from a papule to a scab or ulcer.
SYMPTOMATOLOGY:ITCHING,burning, rawness; smarting; pains of all kinds resulting in INSOMNIA and prostration.
PROGNOSIS: In all cases of simple irritation the prognosis is good. In complicated diseases it will depend upon the complicating disease and the stage of that disease.
HOMOEOPATHIC REMEDIES;Dearborn, in his book, gives twenty remedies for this condition, while Douglas gives twenty-four. Lilienthal 21 Therapeutics, page 412 gives fourteen, Farrington names only five, and among these five are the four whose symptoms are given in my Diseases of the Brain and Nerves 22. Brain and Nerves,. page 287.. For the benefit of our readers who do not have access to my book, let me give the leading symptoms of the four, i.e., Ars. alb., Ran., bulb., Mex., and Rhus. tox.
Ars.alb in addition to itching has burning, restlessness, shooting , sticking , weakness subjective symptoms exudate dark and bleak crusts large and deep, also bleeding(objective symptoms) worse from 12 to 4 a.m. (modalities).
Ran.bulb., burning, bruised, sticking (subjective Symptoms); vesicles of bluish color. Location of the eruption,under the shoulder blade and around the chest (objective symptom); itching worse as the eruption dries; when exposing the body to open air, motion,and damp weather (modality).
Mezereum, pains severe and aggravated by the slightest touch (subjective), vesicles coalesce and form large scabs under which pus, rarely blood,exudes (objective); worse from cold and from 12 go 4 a.m. (modality).
Rhus tox.,stiffness, drawing, tearing,crawling (subjective); vesicles contain first water then pus,but do not coalesce like Ars. or Mez.(objective); and the well known (modality) aggravated cold and wet; ameliorated dry and heat.
Agaricus musc: In my book 22 Brain and Nerves, page 287 you will find,under the head of Neurotic OEdema,the following: :Agaricus affects the nerves much more than the skin.” Agaricus affects the nerves much more than the skin.” Then, for sensations: “Twitching, itching, jerking numbness and tingling; but PRICKING AS IF BY ICE-COLD NEEDLES is the ranking, determining symptom”. Also in the case: “The pains were followed by redness, and then hard, light-colored spots down the left of the spine and then around on the three lower ribs of the left side. These and the twitching of the right upper eyelid were the objective symptoms.
In the two cases reported were two marked modalities, viz., “worse from cold and better from heat,and the cause, exposure to cold.”.
Since writing the above I have had one case calling for Agar. A maiden lady; age 32; F.H.and P.H. good; school teacher;came with the following: “I froze my feet nearly two months ago and since then have suffered from what my folks call chilblains. The worst trouble with my feet and legs is an intense itching and trembling. My hands and face, especially the latter, also twitch and jerk. I notice some of my boys trying to imitate me. and then your see these red spots on my feet and legs with white blisters.”.
She was given (B & Ts) Agar. 30th five disks morning and evening and a 1 to 50 solution of the tincture and water for local application, also morning and evening. The cure was complete in two weeks. DES MOINES,IOWA.
We have among us a turbulent class who vehemently denounce as chimerical and unreliable all experiments with highly dynamized substances,and who clamor loudly in favor of proving obtained by crude drugs;; they seem oblivious to the fact that several of our most potent remedies are powerless, or have no marked medicinal properties in their crude state, as for instance Silex, Carbo. veg., Natrum mur, etc. These men rarely or never resort to dynamized drugs in practice and therefore are incompetent witness. ?
They delight in seeing, feeling, smelling and tasting the remedy; they turn their backs on the proffered manna and hanker for cheeks and onions of Egypt; they attribute all effects to the material action of the drug, to the greater or averse to recognizing the dynamic theory of Hahnemann; they have no conception for the potency of spiritual forces and,in the face of abundant and capable affirmative testimony, they of the face of abundant and capable affirmative testimony,they offer about as reasonable a general denial as the old man in the familiar story , who know the world did not turn round, because if it did, the water would spin out of his mill pond-A.R.MORGAN, M.D.,1866.