I present the following cases for their clinical interest, realizing that the question as to whether a case is surgical or not, like all of our clinical judgments, is a matter of individual opinion. From this point of view, one cannot claim that any particular case that has been relieved by therapy was not one for the surgeon. However, if responsible physicians have given the opinion and have advised a patient that the only recourse open to him for improvement in his condition is an operation, and the patient is made to believe that the only relief to be expected, is from an operation, we might call it a surgical case.
In these modern days, it takes considerable nerve and a deep conscientious belief in the correctness of his homoeopathic logic for a practitioner who is filled with the desire to cure his patient, to follow the course that the old masters in homoeopathic prescribing have proven is the correct and only one by which he may reach that goal. The old masters in prescribing, being ignorant of the modern claims of science as to the value and efficacy of serums, antitoxins and the value of foreign proteins as agents for exciting curative reactions, blithely and with a feeling of assurance, practised the subtleties of the Hahnemannian philosophy and were remarkably successful in curing their cases.
Today an important task of the homoeopathic prescriber is to guard himself against a too active therapy. One is too prone to resort to the simpler method of injecting anti- toxins, or serums, to the alternation or repetition of remedies, and now, thanks to the wonderful improvement in surgical technique, to the surgical operation. We should guard against this tendency to take the easier path and follow more assiduously the technique of the old masters in homoeopathic prescribing, for it is in this technique that we have the true essence of the cure of sickness.
We must persist in prescribing upon the general symptom picture in the developing of which too much care cannot be exercised by the prescriber. How often does it not come to pass that the deciding factor of a successful prescription has been a modality or modalities peculiar to, and characteristic of, the individual and it will be beyond the prescriber to explain this modality on the basis of our present knowledge of pathological changes. In reference to this point, allow me to quote Dr. Alexis Carrel from a recent article in Science. Vol. 73, N. 1890, March 20, 1931, entitled The New Cytology:.
Although descriptions of the changes produced in cells and tissues by pathogenic factors fill many books, the mechanism and the significance of these changes remain practically unknown. This shortcoming must be attributed to the fact that cellular pathology, like histology, is based on an incomplete conception of the nature of tissues. The adaptation of the body to diseased conditions cannot be understood as long as cells are conceived to be mere structural units. However, by taking into consideration the physiological properties of tissues as manifested under the influence of bacterial and other chemical changes in the organic medium, the doctrine of Virchow could be rejuvenated and extended to the whole field of pathology. . . .
The new cytology is considering cells and tissues, not only as elements of the dead body, but as living beings which are themselves parts of organisms of a more complex order. With the help of the auxiliary sciences of physiology, it is progressively discovering the properties which make these cells and tissues the structural and functional units of an harmonious whole.
Perhaps here we have the dawning of a scientific explanation of the intriguing homoeopathic “key note” –why certain characteristic and peculiar symptoms are developed by a remedy and why an individual will develop similar characteristic and peculiar symptoms.
I hope the lengthy description of this case will not bore, but it is one, I think, of peculiar interest and I have tried to give a portrayal of the homoeopathic thought that was devoted to its solution. The patient was a man 45 years of age, well developed and unmarried. He came to me on January 16, 1929. He was not very prolific with words and hence did not give me many details at his first visit. He was fearful that something was wrong with his lungs but wished to have the doctor say that his condition was only one of indigestion.
As a result, he carefully refrained from mentioning anything, outside of his cough, that might possibly relate to his lungs. He did lay great stress on his stomach symptoms and remarked that he thought his cough was due to the state of his stomach. A careful physical examination of his chest revealed normal vesicular breath sounds over both lungs and percussion did not reveal any noticeable disturbance. Heart was O.K.
Carbo vegetabilis 200, one dose was given on the following modalities: Large amount of gas from any food that he might eat. Distention was relieved by eructations and flatus. Upon eructating, he noticed a burning sensation in his oesophagus; this sensation extended into his mouth. He felt irritable and restless–but otherwise well and strong.
Five days later: The Carbo vegetabilis had the effect of ameliorating the stomach condition, decreasing the amount of gas and allowing the cough full expression with its accompanying modalities. The cough was now more pronounced, causing expectoration of a yellowish-white secretion and, as patient coughed, I now got a distinct foetid odor from his breath. This made me think of a possible bronchiectasis, especially as the cough had now persisted for several weeks after his last cold. I again examined his lungs but did not find any definite signs of a pathological change and his testimony of general well being was so favorable that I was non-plussed.
On the modality of foetid breath with each cough and only when he coughed, I gave him Capsicum 200, one dose.
The next day, he came with the testimony that, during the night, he had coughed up a large quantity of dark red sputum that “stunk to heaven”. He had saved this secretion. I had him send it to the laboratory for examination. The laboratory report stated that the odor of the specimen was so disagreeable that no one could work in the room in which the container had been opened until a deodorant had been applied and all the windows opened. No tubercular bacilli were found, but the secretion abounded in various strains of other bacteria.
The next day another specimen was sent, having been collected in a sterile jar, and the following bacterial content was noted: Tubercular bacilli absent. Other bacteria were extremely numerous. There were many forms of Gram positive and Gram negative cocci and bacilli, the only bacteria that grew on culture media were staphylococcus aureus and albus, pneumococcus, and streptococcus.
I now called Dr. Guy Beckley Stearns into consultation, explaining my uncertainty in regard to the lung examination, and asked him to make an examination of the chest. Upon percussion, he located an area of dullness about the size of a fifty-cent piece in the third intercostal space just to the left of the left border of the sternum. Whether the action of the Capsicum, in releasing the pent up secretion made this area apparent to percussion or whether the technique of Dr. Stearns was more refined than my own, one cannot definitely say, but I am inclined to believe the latter was true. Be that as it may, we have here an instance revealing the importance of modalities in prescribing; for I prescribed the Capsicum on modality alone and I think it was the correct prescription.
We had the patient undergo an x-ray examination with fluoroscope and sterioscopic photographs. This revealed an area of shadow in the left lung at the level corresponding to the third intercostal space.
At the x-ray examination, the patient was put through a sort of third degree examination and, for the first time, brought out the fact that about December 27, 1929, white playing in a swimming tank and laughing heartily, a companion suddenly forced the patients head under the water and held it there for a time. During the immersion, he swallowed a quantity of water and it was very difficult for him to get his breath when released. He felt very ill after this experience and experienced a terrible nausea.
He had to lie quiet for about one hour. After this experience, he developed his cough. This testimony in conjunction with the circumscribed darkened area on the film and the character of the secretion suggested a developing abscess in the left lung in the region of the hilus. The roentgenologist asked that another picture be taken in about fifteen days as then the tissue would have liquefied and a level would have been established and we would have an idea as to where it would be best to open the chest for drainage.
The patient was now put to bed. The foot of the bed was raised about twelve inches and he was adjourned to lie on his right side, changing only when it became tiresome and then only long enough to give relief to his muscles. He was allowed to go to the bathroom to defecate. He was put upon a diet rich in vitamins and salts.
As patient continued to cough up bloody streaked sputum and as the cough was induced by tickling in the larynx and behind the sternum, was aggravated by talking and laughing and by swallowing, as he was thirsty for cold drinks, and as he was intelligent and of a bright temperament,I prescribed Phosphorus 200, one dose on January 22nd. After the Phosphorus, the sputum changed to greenish-yellow in color and occasionally had a disagreeable odor. The patient felt generally well up to February 8th when, during the night, he had a severe coughing spell in which he brought up a small piece of tissue with considerable bloody secretion which had a very foetid odor and his general condition was unsatisfactory.
During the night of February 12th, patient coughed up considerable fresh blood. Appetite was good and he was thirsty. Gave Phosphorus 200, one dose. This held fairly well, but not as satisfactorily as one would wish, until February 17th when a very definite picture was presented. During the latter part of the night of February 16th, patient had a severe coughing spell, lasting continually for one and a half hours. The immediate cause of the cough was a tickling sensation in the throat and behind the sternum. For the first time he complained of a stabbing pain in the left chest upon coughing and upon deep inspiration, relieved after coughing ceased. Secretion contained much dark blood, was of a strong foetid color, and caused a burning sensation when it passed through his throat.
He felt very restless in mind and body and could not lie still during the night. Mouth and lips were dry and he desired frequent drinks of cool water in small quantities. As I entered the room, I noticed a strong foetid odor and that the sputum cup contained considerable prune colored sputum which had the same foetid odor. This picture corresponded so well with the one so strikingly described under Arsenicum album by Kent in his Lectures on Homoeopathic Materia Medica that I prescribed Arsenicum album 30th in water, a teaspoonful every four hours.
That night and the next day there was a decided improvement in the general condition, but in the evening of February 20th, the sputum changed again to a prune color and had a very decided foetid odor and the temperature rose to 102 degrees. I prescribed Arsenicum album 200th, one dose.
February 21st. Patient complained of the fact that his throat felt dry during the night, especially toward morning and that he had a pain in the left side of his throat when he swallowed empty. Food, hot or cold, did not bother him. He felt thirst for small quantities and felt generally restless. The whole body seemed to be in a dry heat. He complained of a light dull pain behind the sternum and that a tickling sensation in this region caused him to cough. The skin had a cachectic color. I read this picture as indicating a remedy aggravation.
February 22nd. Patient is much brighter and feels easier in every way, is cheerful and has a good appetite.
February 25th. During the night and today, patient has had frequent urge to stool. At two-thirty p.m. shortly after taking some nourishment, patient had a severe coughing spell during which he brought up much bloody secretion, having a strong foetid odor. Shortly after the coughing attack was ended, he had a severe chill which began with the sensation as if a cool breeze struck his head and traveled down through his body to his feet. At the same time, his body felt warm to the nurse. Temperature, 102 degrees; pulse, 120, weak and thready. The increase in the amount of strongly odored sputum accompanied by the chilly reaction and the condition of the pulse caused me to prescribe Arsenicum album 1M, one dose.
February 26th. Patients morale rather low. All food causes him to cough and he feels uncomfortable in the abdomen. Food eaten causes urge to stool at which he passes much gas and a little fluid. He has been very thirsty for small amounts, the mouth and throat are dry. All food causes urge to stool, but warm soup is the most troublesome. Sputum has strong foetid odor and is prune colored.
February 27th. Last evening about 9 p.m. after a coughing spell during which patient brought up much prune colored sputum with an extremely foetid odor, the temperature was 104 degrees and the pulse rate 150, very irregular and thready. During the rest of the night, he had several coughing spells which were not so severe and the sputum was thicker. It took on a grayish color, and did not have so strong an odor. He had several urges to stool during the night and passed much gas and small quantities of a brownish fluid which came out with considerable force. This morning the patient looks refreshed and bright. He says that he feels much fresher than yesterday. Temperature 101 degrees, pulse rate 160, full and large excursion.
From this date on there was a continual general improvement. The patient slept well until after midnight after which time his sleep was disturbed by occasional coughing spells which varied in intensity. His thirst for small drinks continued. His bowels became regular, his appetite improved, and he felt so generally strong and well that, on March 14th, he was allowed to sit up in an adjoining room for one-half hour. Day by day as his improvement held, the time was increased. His sputum was occasionally prune colored at which time it burned his throat on passing and had a strong foetid odor. His temperature ran from 98.3/5 to 101.2/5, and his pulse rate from 100 to 126. While the general condition showed a constant improvement, one had to realize that the source of his trouble had not been eradicated, so we followed a policy of watchful waiting.
March 24th. On Saturday, March 22nd, patient sat up only one-half hour instead of the two hours that he had been up the immediate previous days, because the atmosphere of the room felt chilly although his body felt comfortably warm. During Sunday he sneezed several times and during the night he coughed up a quantity of blood which had no odor and did not burn. Today there is a soreness in the mid-line of the larynx and the nose feels stuffed and secretes a thin fluid. He is thirsty for small amounts. A sensation of warmth spread through his body towards evening, a sensation that he had had constantly until about March first, but has not had since then. I considered this picture an indication for a repetition of his remedy and gave him Arsenicum album 1M, one dose. Temperature 100.3/5, pulse 120, regular and fair excursion.
March 25th. Pulse 105, regular and not very strong excursion, temperature 99.2/5. Nose feels decidedly more free. Slept more and better last night than since the beginning of his illness. Feels generally better than yesterday.
March 26th. Coughed occasionally during the night due to constant tickling in the larynx and behind the sternum. During the coughing, he brought up a dark lump that had a foetid odor and he perspired freely on his thorax, more profusely on the left side. Occasional twinges of pain in left thorax which come at any time. When he takes a deep breath, he gets a foetid odor if he allows the breath to pass through his nostrils. Feels generally strong and has a good appetite. Spontaneous and formed stool.
March 31st. Temperature 98.3/5, pulse 100, regular and good excursion. During the night of Friday, March 28th, patient coughed up two small lumps of a dirty grayish material which had an extremely foetid odor and caused a burning sensation in his throat. After this had occurred, the nurse remarked that she could no longer get the foetid odor from his breath as before and that the subsequent secretion did not have the usual disagreeable odor.
From this point there was a gradual and constant improvement in the patients condition. An x-ray examination of the chest on April 14th showed an area of scar tissue at the region of the left hilus, surrounded by normal lung tissue. The temperature remains constantly at 98.3/5. His quick recovery from now on was shown by the fact that from April 21t to May 15th he gained twelve pounds and 11 ounces in weight.
The subsequent course of this case is rather instructive. He had been earnestly warned against the danger of drinking alcohol to excess and also as to exposure to wet and chill. On June 27th, 1930, he was caught in a severe rainstorm during which he was drenched to the skin and was compelled to ride a long distance in his wet garments exposed to cool breezes. As a result of this exposure, there developed a severe coryza and bronchitis with a consequent flare-up of the infection. Careful homoeopathic prescribing did not prevent a relapse of his condition and an abscess developed in the lateral aspect of the base of the left lung.
September 16, one dose of Nitric acid 200th was given and during the night, he coughed up a large quantity of stinking, bloody sputum. After he had cleared this matter from his lung, his temperature dropped from 103 degrees to 98.3/5 degrees and he felt a great relief. At this point, relatives intervened and he was put into the hands of an allopath. After months of allopathic treatment, the results were so unsatisfactory that the patient took matters into his own hands and returned to homoeopathy in the person of a relative who recently returned to the United States. This attendant physician wrote to me as follows: “You will be interested to know that in spite of China off., Thuja, Phosphorus, Psorinum, Carbo vegetabilis and Silica, I did not get very far with Mr.W. until I gave him Pix liquida 30th, which is doing wonders for him. I have every reason to believe that the remedy will cure him.”.
We have in this case a remarkable test of the two different forms of therapy. Here is a patient with a virile constitution affected with a severe infection who, under homoeopathic treatment by which his native vitality, was carefully nursed, over-came that infection, while under the allopathic treatment during which a sthenic form of therapy was used, the results, after four months of treatment, were so unsatisfactory that the patient went back to homoeopathy and after a few weeks is now convalescing.
One other point should be emphasized from our experience in this case and that is the necessity of a prolonged convalescence in these severe infections during which the patient must be protected from the vicissitudes of life for a period of at least six months, so that the system can develop enough resistance to prevent the development of any bacteria that may remain in the tissues.
On July 7th, 1930, Rudolph D., a well developed, sturdy man of fifty-five years of age, came to me for advice. On the day before, his dentist had pulled his two remaining teeth, veritable tusks, from his lower jaw. In doing so, there resulted a splintering of the jaw bone and the dentist said that he could not fasten upon the loose pieces of bone with his instruments and advised the patient to go to a surgeon and have him cut down upon and scrape the jaw bone. The patient asked my advice as to this.
I told him to wait a few days and in the meantime I would give him some pills to take. I gave him Silica 12x in the form of one grain tablets and instructed him to take one tablet night and morning. The next day, he reported considerable less swelling in his jaw and a greater sense of comfort. On the third day, he reported to his dentist who, upon examining the jaw, was much surprised to find several chips of bone so near the surface of the wound that he could pick them out with his instruments and that the wound was well on the way to complete healing. By July 14th, the wound was entirely healed and the dentist was able to continue with the work of fitting the denture.
Mrs. K., 37 years of age, married, with two children by two different husbands. In 1924, patient was told that she had a tumor on the uterus, but that it would not interfere with her becoming pregnant. A few months after this, she became pregnant and in due time, gave birth to a boy baby. Now she has been told by two different gynaecologists that she has a large tumor on the uterus. One surgeon said that she must be operated on at once, the other, that she should go to the country, rest up and get strong in preparation for an operation in six weeks or two months. She has asked me to install the building up process.