CASES THAT MIGHT HAVE BEEN SURGICAL


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.


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.

CASE I.

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.

W J Sweasey Powers