COMMENT: Adapted more to later stages. Marked enlargement of the lymphatics is more apt to require Arsenicum iodatum. In irritability of the stomach we have a rival remedy in.
PHOSPHORUS.
The first thing that strikes one in a Phos. case is the desire to have a stream of cold water going down the throat continually, which relieves, but which may be vomited as soon as it gets warm on the stomach; or wants ice in the mouth. Bodily and mental exhaustion. Bloodstreaked discharges. Throat purple, foetor horrible. Desires: Cold food, especially meat; must eat often or he faints. Restless. Weak, gone sense in abdomen. Burning pains. Sleepy daytime, and after meals. Is worse evening until midnight, touch, pressure, and lying on left side; better after eating. Hoarseness after diphtheria.
We have another remedy desiring cold drinks in.
PHYTOLACCA DECANDRA.
The first thing that strikes one in a Phyt. case is the vertigo and nausea on attempting to sit up. The aching of the head, back and limbs, stiff muscles, and pain in knees. Membrane predominantly gray or white, like dirty washleather, on tonsils and uvula, usually right side; sometimes dark, or ash color, or small white or yellow spots coalescing, or dirty white, or pearly.
Tongue heavily furred and thick, mostly with fiery red tip, with great pain at root on protruding it. Throat dry, sore, dark red, almost purple, worse hot drinks (Lach.; Lyc. better), wants cold things; burns, often as from a red hot ball; dysphagia; fauces congested, dark red; pharynx dry, raw, scraping; tonsils bluish, swollen; purple color of throat; pains shoot to ears on attempting to swallow. Mouth and tongue ulcerated. Soreness across kidneys; urine scanty, dark red; albuminous. Worse at night. At beginning chills creep up back; weak, faint on sitting up in bed. From exposure to cold and damp atmosphere, or from sleeping in damp, ill ventilated rooms.
Another remedy having pain on protruding tongue, is.
KALI BICHROMICUM.
The first thing that strikes one in a Kali bich. case is the peculiar toughness and adhesiveness of the secretions, usually profuse and yellow. Membrane predominantly greenish (Merc. cy.) especially on tonsils and uvula, next in importance: Blood- streaked; deep seated; elastic; gray; isolated patches; pearly; white; yellow; fibrinous; on palate, tonsils and pharynx; extends to nose, trachea, and especially larynx. Tongue is red, dry, smooth, cracked, and, like Phyt., pains at root on protruding it. Uvula swollen, little redness, oedematous; tonsils inflamed and very red, and swollen; neck swollen. Discharges foetid. Clinkers form in nose leaving sore places when detached. Pulse soft. Tendency to perspire. Weary. Weak; prostration profound.Sensitive to cold. Ulcers, if occurring, are round, deep and very red. In line with this remedy is.
KALI CHLORICUM.
The first thing that strikes one in a Kali chlor. case is the contrast of the extreme whiteness to the yellowness of the exudation and secretions of Kali bich. Membrane is predominantly white. Saliva tough and stringy. Mouth ulcerated, bases gray; gangrenous; extreme foetor. Is always better by a warm bath, which is apt to be followed by perspiration and quiet sleep.
In color contrast we have a splendid remedy in.
NATRUM PHOSPHORICUM.
The first thing that strikes one in a Nat. phos. case as soon as the patient opens his mouth, is the bright yellow color. Moist, creamy, golden yellow coat at root of tongue and on soft palate, rest of tongue thinly coated and moist. Discharges all yellow, creamy and thick. Sour eructations. Aversion to open air, and to bathing.
Our next remedy is one that has been said to be the basis of antitoxin and responsible for antitoxins apparent success, I refer to.
CARBOLICUM ACIDUM.
The first thing that strikes one in a Carb. ac. case is the whiteness about the nose and mouth. Great tendency to destruction of tissue (Diphth. Merc. cy.); to gangrene. Liquids regurgitate. Breath foetid. Face dusky red (Bapt.). Discharges putrid, offensive. Urine highly albuminous; dark, black or olive green. Pain sudden, burn, stick, prick. Prostration profound, collapse, cold sweat; vital force sinks rapidly. Sopor. Pulse thready. Secretions burn.
Realizing that this paper is already too long, and that any remedy in the materia medica may be called upon in diphtheria, IF AND WHEN THE SYMPTOMS AGREE, we will stop here with.
BROMIUM.
The first thing that strikes one in a Brom. case is the unusually large parotids. The disease begins in the larynx and runs upward. Membrane, not characteristic, extends to larynx. Weak; perspiring. Worse: left side, cold air, cold water, cold food, heat of sun, and evening until midnight. Especially indicated in cases coming on from being overheated, in people who are sensitive to it; also for children if it comes on in the night after a hot summer day.
COMMENT: Said to be useful as an intercurrent (Kali bich.).
I have been often taken to task for not giving the exact potencies used in cases and in remedies given. In standardization this may be possible, but neither homoeopathy nor the individual permit of standardization. Individualism is the real raison detre of homoeopathy. I will say, however, that I do not use any potency from a curative standpoint below the 30x. I find a safe rule to follow, not alone in diphtheria, but in all cases, is the nearer you know yourself to be to the similar remedy, the higher the potency, all other things being equal, and the less frequent the repetition of the dose. This method should shorten, if not abort, any disease, and reduce all after-effects to a minimum.
TOLEDO, OHIO.
DISCUSSION.
DR. EUGENE UNDERHILL, JR.: I am sure we have all enjoyed this paper. I have been carrying Dr. Pulfords Leaders in Pneumonia in my bag for several years and find them valuable not only in pneumonia but in other acute conditions also.
He has a very fine way of bringing out the essential features of each remedy and I hope, Dr. Pulford, you will soon have this in book form and I will put this in my bag, too.
In each case here he has taken the outstanding characteristic feature of a remedy. When you walk in to see a patient, this particular feature may be in some particular cases objective, and again it may be subjective, and then he has built up around that all the general characteristics of the remedies. He has brought out only the particulars relating to diphtheria so you can use this paper and the information regarding these remedies in every kind of acute condition, diphtheria, pneumonia, influenza, any acute condition at all.
DR. A. H. GRIMMER: I want to thank the doctor for this paper. I think if all of our men could have differentiations they wouldnt feel the need of antitoxin.
The great trouble with diphtheria is the cultivated fear that has been broadcast. Doctors go to the bedside with fear and trembling of diphtheria, pneumonia, etc. Homoeopathy takes that fear out of one. Homoeopathy makes one go to the bedside with a confidence born of knowledge, born of the knowledge that you are acting in accordance with a natural law and your results merely depend on your ability to see the symptoms in the case that will tell you the remedy that you need; hence, the homoeopathic doctor is without fear in such cases, such dreadful cases.
DR. H. A. ROBERTS: I am very glad indeed to get this paper. We always get something from a suggestion of a paper like this that is of immense value.
I at one time asked the doctor to teaching our post-graduate school. He said he couldnt teach. I think one of the most difficult places we have to fill is the clinical medicine and I am going to make a suggestion that he has the power to teach and he may.
DR. RAY W. SPALDING: I want to thank the doctor for his paper. One of the hardest things the undergraduate has to face is the built-up awe of diphtheria.
I have used the homoeopathic remedies, and the quickness and speed with which the disease is alleviated is remarkable, almost overnight. I saw this in particular in my office with Lycopodium. A child vomited all over the floor about eleven oclock at night. I took a culture, because they are very particular about that in my town, and put it in the incubator. That night I gave Lycopodium CM. The next morning the culture came back negative.
In another case of laryngeal diphtheria, I used Kali bichromicum. The case was sent to the hospital for incubation but before it got there it was relieved by the use of Kali bichromicum 10M.
DR. D. T. PULFORD: I have seen only two membranes in my short career. One was in a young Mexican, typical case, white and pearly, looked almost like feathers in his throat, and the second case looked nothing like a membrane. My heart fell into my stomach and my stomach got sick, but I prescribed Rhus tox. and it cleared up very nicely. The membrane in that throat I dont know whether you have looked over the side of a boat when the water is real inky but that is what it looked like. The Rhus tox. mellowed the whole thing out in very short order.
