The consideration of the subject before us presupposes first of all the wisdom of surgery as an adjunct to medical treatment, and secondly its evaluation with respect to the individual case requiring surgical intervention.
First let us orient ourselves,as followers of Hahnemann, as to the proper relationship of surgery to homoeopathy.
In Hahnemanns pre-Homoeopathic days, to use the phrase of Dr.Richard Haehl and the late Dr.William Boericke, we find him meeting with a good measure of success in the treatment of bone ulcers by a combination of curetting and the local use of alcohol as a clearer and stimulant to graduation. this method he described as follows: “the diseased bone, I scrape clean and separate out the unhealthy portions,bandage it with alcohol and wait for the result”. (For a more extended account of this treatment, vide Richard Haehl Samuel Hahnemann: His Life and Work, Supplement, vide richard Haehl Samuel Hahnemann: His Life and Work, Supplement 198, Vol. II, p.398).
Later in his life,writing in the Organon, Hahnemann states that external conditions are too often treated from the purely local standpoint,especially surgically, which procedure is, in his opinion, correct only in so far as the affected parts require mechanical aid (and he often speaks of these measurers as an exemplification of the “mechanical art of surgery”). In section 186 of the Organon, he includes, in these measures. the reduction of dislocations, by needles and bandages to bring together the lips of wounds, by mechanical pressure to stem the flow of blood from the open arteries; but the extraction of foreign bodies that have penetrated in living parts;l by making an incision into a cavity of the body in order to remove an irritating substance or to procure the evacuation of effusion or collections of fluids; by bringing into apposition the broken extremities of a fractured bone and retaining them in exact by an appropriate bandage, etc., (Haehls 6th Edition).
Hahnemanns method of treating bone ulcer was quite contrary to Heckers method of using mixtures of medicine in bone caries, the only ingredient of which that could possibly be curative according to HahnemANN BEING QUICKSILVER.
The various operations designated by Hahnemann as “:being right in so far as the affected parts require mechanical aid, whereby the external obstacles to the cure (note here Hahnemanns use of the word, external, in contrast to those obstacles in the way of recovery;mentioned in Section 3 of the Organon) which can only be secure by the agency of the vital force”, would be included in modern surgery under such operations as, for example; the treatment of fractures and dislocations, the suturing of wounds, the control; of haemorrhage (by logician,torsion, pressure and other means,such as the use of electric cautery when nothing else availed); operation for the removal of bullets, or other foreign bodies (located by the use of the electro-magnet, the x-ray or other means) operations upon the various body viscera for the removal of “irritating substances”, which might mean the removal of tumors, causes, diseased organs such as the appendix, spleen, etc.: operations for the removal of gall- stones,renal or cystic stones; paracentesis for removal or pleural, peritoneal, or joint fluids, etc.; the proper treatment of open or closed fractures, by incision, drainage, wiring or plating of unhealed fractures of the long bones, etc., in fact, many and all of the unavoidable or inevitable operations of aseptic surgery. In this category may be found any one, if not all, of the cases about to be presented.
As a foreword to their citation, it may be well to recall the courageous and truly wise words of the large Dr.James B.Bell of Boston, who stated at one of the meetings of this Association that recourse to surgery in any instance was and should be put down as a frank acknowledgment that such a case was impossible of cure by the physician,either through medicine or any other means,save surgery alone.
CASE I-BRYONIA FOLLOWING OPERATION FOR GALL-STONES.
The case given her could be carefully substantiated by records on file at the Newton Hospital. It is taken from the records of a former patient of he late Dr.Richard S.True, a woman past the climacteric, who had received chiefly Lycopodium for hepatic symptoms, and after receiving no -permanent relief was operated on by Dr,Henry L.,Houghton, and a large number of gall- stones removed.
Following the operation the patient died well for a time, the wound healed uneventful but in spite of this patient developed a moderate temperature, with pain under he shoulder blade,and x-ray plates showed a well marked pleural effusion. Bryonia 1M was then administered by Dr.Houghton. It action was prompt ,the fluid disappeared and the patient made a good recovery. The indications, though not clear in this cases,were the stitching pains,aggravation on motion, localization on the right side, late evening aggravation, thirst, dry mouth and coated tongue. the interesting feature of the case was the prompt alleviation of what was a very distressing and serious complication after a difficult and serious operation.
CASE II-AURUM METALLICUM AFTER GALL-STONE OPERATION.
This case was satisfactory in respect to the comparative ease with which certain of the symptoms were accounted for by x- ray of he abdomen,which disclosed a large (single)_ stone. The patient had been melancholy for some time, had been treated by a great many different physicians without benefit,and when high blood pressure, the operation was approached very cautiously, a preliminary fast being observed for four or five days, Upon operation,which was skillfully done by Dr.A.J.Shadman, the gall- bladder was opened and the stone removed,without removal of the viscous itself.
The patient made a good recovery, and for some time thereafter the depressed state was greatly lessened through the use of Aurum met. 1M, and some hope was ventured that she would ultimately recover. The blood pressure, however, continued with, in spite of careful diet and prescribing, and the patient passed out of my hands, only to die a year or two later from arteriosclerosis.
CASE III-SEPIA BEFORE GALL-BLADDER REMOVAL.
In have previously reported this case in the I.H.A.Transactions. The patient had been under my care for some time, and after careful repertorizing, Sepia was found to be her remedy, and it was given in a series of potencies from the 30th to the 5t0M, with good effect, Magnesia phos. 6th and 12th decimal had also given relief for the acute symptoms. this case was examined by Dr.Shadman and a diagnosis of chronic abdominal adhesions was made. The question of gall-stones was left to be determined at operation, as the symptoms had been so obscure.
The patient had been X-rayed on two different occasions without determining the presence of stones. After the adhesions had been carefully taken care of, exploration of the right hypochondrium disclosed a all-bladder enormously distended with stones. Though removed with difficulty,owing to the presence of many deep adhesions, the gall-bladder was extirpated and the a patient put to bed. In the report of this case,mention has been made of he quick action of Veratrum album 1M for the collapse and after effects of shock. The patient made a fine recovery.
CASE IV-X-RAY FOR AFTER-EFFECTS OF RADICAL BREAST OPERATION.
This case is excerpted from the records of the Union Rescue Mission Medical Clinic,and has to do with a case for cancer of the right breast in a woman whom we had previously treated at the Clinic for various troubles, including an injury occasioned by a fall, for which ARnica 1M was given, This relieved the soreness in the side to some extent, but later a well-defined bunch was made out in the breast,and with the sharp pains, history of injury, and other attending symptoms, Conium 1M was prescribed.
Without acting upon our advice or a waiting the action of the remedy the patient sought voluntary admission to the Massachusetts Memorial Hospitals, where she was operated upon for the removal of the breast,under the supposition of malignancy., After the operation the patient again applied for treatment at the Clinic. She was suffering with severe pain,and great swelling of the arm and despaired even in relief from the torturing pains. She was given then a single dose of x-ray in the 200th potency. The result has been so satisfactory that she has been greatly relieved of the pain, the swelling is now almost entirely dissipated, and we entertain hopes that these remedies, despite the ill-advised operation, (if this judgment be correct), may stay a result which too often is provided for by no known remedies, not excepting the well-tired prescriptions of homoeopathy.
CASE V-LACHESIS AND BELLADONNA AFTER APPENDECTOMY.
This is a case in which the careful selection of Lachesis 1M brought some relief to a young lady who had spent ten days in a hospital near New York City, in the vain search for evidences of a duodenal ulcer, or other occult condition.
She had been operated upon the year previously for appendicitis. the only venture I could make in this instance was that too often perhaps fallen back upon, namely-abdominal adhesions. the symptoms extended from left to right across the abdomen, from the left to the right hypochondrium, suffering perhaps a gall-bladder reflex, but the sensitiveness was more definitely localized in the symptoms for about one week,the pains shifted in direction from right to left,were very sharp and intermitting. There was slight fever, rapid pulsed, redness of the face,and extreme sensitiveness and hyperaesthesia of the abdomen. Belladonna 1M was then given, and the a patient was quickly relieved, and, sop far as I can ascertain,there has been no return during the past nine or ten months.
CASE VI-BRYONIA IN APPENDICEAL ABSCESS.
The case here given was than of a grand-aunt,in her eighty- second year, who became suddenly ill with severe abdominal pains, on the evening of March eighth, in the present year. She has had a good many similar attacks which had been diagnosed (and rightly) by Dr.Richard S.True,her former physician,as appendicitis. Up to this attack there had been tenderness and intense pain, but no deeper pathological reaction. She had previously (in my own experience) been relieved by Bryonia, usually in the 1M potency. The symptoms in this instance seemed to call for a Magnesia phosphorica, which was given.
No improvement followed this medicine, which, despite certain superficial symptoms,was not apparently the correct remedy. The pain continued, the tenderness was extreme. and the patient was apparently forming worse rapidly. Dr.H.E.Maynard saw her at this juncture,and gave as his opinion that we were dealing with an abscessed appendix. A blood count showing a marked leucocytosis confirmed the presence of pus, and there was a welldefined mass that could definitely be made our in the lower right quadrant of the abdomen. Dr.Maynard concurred in my feeling that the symptoms again called for Bryonia,which had previously relieved, and she was given the 1M in water. the case progressed fairly well for about forty-eight hours,with relief of the pain and tenderness.
Then appeared great weakness of the pulse, with much irregularity,and delirium and labored dreams. Dr.Maynard did not favor draining the abscess owing to the age of the patient, and the risk involved. In this her family concurred. the Bryonia was again given in water (it had been discontinued after the first twenty-four hours and the mental phase soon passed. the patient continued to improve, with gradual subsidence of the major symptoms. After the Bryonia had done its work, there developed a great deal of weakness coldness,and abdominal fermentation with peripheral cyanosis, especially of the left arm and hand. She then received a dose of Carbo veg. 1M,with marked improvements in the circulation. Things went on without interruption, will at the present time she is up and about the house, pain, swelling and soreness gone-in fact quite recovered.
CASE VII-BRYONIA AFTER ASPIRATION IN STREPTOCOCCIC PLEURISY.
This case was a pleuritic effusion,occurring in a colored man about forty-five years of age, who was aspirated at the Massachusetts Memorial Hospitals by the surgical staff, after which the effusion showing a pure culture of streptococcus and he was turned over to the medical service,with a bad prognosis. Our internee at the time stated that time stated that cases showing this pathological date were practically doomed so for as any treatment was concerned. He was seen by me on a Sundry afternoon, and as it seemed in my judgment as much a matter of life as death,and the indications being clear, he was given Bryonia 1M. He showed much improvement under this remedy, which was repeated by much improvement under this remedy, which was repeated by Dr.Houghton in due time,and the a patient made uninterrupted progress to recovery , with no other remedy.
In conclusion I may say that homoeopathy is missing great opportunities in not publishing its proven results as established prior to treatment by modern methods of diagnostic precision. Comparatively small expenditure along this line would make possible the establishment of homoeopathic prescribing upon a scientific basis that would be secure and unavailable.