REPERTORY STUDY FROM A THESIS PRESENTED IN COMPETITION FOR THE DARNELL PRIZE


William Boericke recommends Causticum as an antidote for paralysis resulting from lead poisoning. Gross also expresses this thought when he mentions Causticum in ailments from abuse of Lead of Cinchona, etc., as compared with Phosphorus where the ailments are more frequently the result of abuse of Iodine or Natrum muriaticum.


The Darnell prize is a small reward offered each year at Hahnemann College, Philadelphia, Pa., for the purpose of stimulating interest in homoeopathic materia medica and therapeutics. The prize this year was won by Frederick A. Riemann, Jr. and the following case analysis forms part of this thesis. The first part of this thesis gives an excellent analysis of the interpretation of symptoms, a description of the books referred to, and a short description of repertory analysis.

We are giving the first of three cases exactly as analyzed in he thesis. this is followed by criticism and analysis by Dr. H.A. Roberts according to the boenninghausen method, and by Dr. Elizabeth Wright-Hubbard according to the Kent method. The other two cases in this series will be presented in the next two issue of The Recorder. This thesis is an excellent piece of work. We congratulate Dr. Frederick A. Riemann, Jr. and with him success in his homoeopathic endeavors. ED.

Mr. E.W., aged 60, complains of a burning heat in the right thigh, which seems to be located in the skin, and which, during the past 15 years, has spread to the right arm and hand and foot. It is present during sleep as well as in the daytime. There is an almost complete paralysis of his entire right side. He is slow and deliberate in his speech, of good intellect and in good spirits although not a little suspicious, especially so of all doctors.

Some 15 years ago he developed a series of ulcers on the groin, from one of which a sequestrum of bone discharged. He treated himself by a home remedy of chewed lead and this he prepared himself. Eighteen years ago he had typhoid but remembers no other disease. He denies venereal infection. He has no children and has been separated from his wife for more than ten years. He has a lack of facial expression but no Argyrl Pupil or Rhomberg, although the reflexes in the right extremities are lacking. He cannot repeat the words “Methodist Episcopal,” etc. There is very little atrophy of the muscles although his strength on this side is gone. He has to eat with his left hand, and has a shuffling gait.

PHILOSOPHICAL DISCUSSION.

To discuss a given case from the standpoint of homoeopathic philosophy means to attempt to correlate the medical aspect of the patient with the philosophical interpretation of the disease process, its origin, causation, and development, and in this manner attempt to explain the present picture. The value of this work lies in the more complete understanding of the disease as it relates to distortions of the vital force in the human organism and, as a result of this improved viewpoint, a more effective therapy follows since it is based upon a more thoroughly understood disturbance which the physician is attempting to subdue.

We must first attempt to formulate a theory which will explain the beginning of this patients condition. Until eighteen years ago this patient states he had suffered from no illnesses. Further, he denies venereal infection, a statement which the physician must regard with skepticism until confirmed.

There is the most remote possibility that this patient was an example of the perfect organism, devoid of all acquired and inherited taint until the onset of the typhoid fever. We are more inclined to consider the patient as one of the vast majority who harbor within themselves one of the three universal miasms, termed by Hahnemann psora, sycosis and syphilis. Although we are unable to name the miasmatic process underlying the beginning of the disturbance, we are, at the same time, able to trace its progress and the path traversed in the organism.

Hahnemann, in his work The Chronic Diseases, emphasizes the fact that the miasm may exist in a latent state unknown to the patient, partially bound down to the organism by the robust constitution of the individual, his mode of living and his habits (moral and physical). The ability of the organism to counter- balance the abnormal process does not, however, permit of its overcoming it to the extent that it is able to cast it off. Instead for years of a lifetime, this balancing of vital force and morbific process may continue until the balance is upset by proper medication in favor of the life force to the exclusion of the miasm, or, on the other hand, upset by the invasion of a more active disease process to the detriment of the vital resistance.

It is this condition of balanced serenity that we believe existed in this patient. the onset of the acute attack of typhoid taxed the resistance of the organism to the extent that its control over the miasm was weakened. With the subsidence of the acute invasion, the released latent process gradually became accelerated, and working from within outward eventually became accelerated, and working from within outward eventually manifested itself upon the skin in the form of ulcers.

The long delay in the appearance of the ulcers is not unusual when we consider that this patient has been able to boast to this time of what he states has been perfect health. The morbid process released within him him had to bore its way to the surface, figuratively speaking. The sequestrum of bone discharged might be taken as indicative of the depth of the disease. All this is in harmony with Herings law of the centrifugal action of disease which is so important yet so little understood.

When the condition appeared upon the skin it showed itself in its simplest and least complicated form so that active homoeopathic treatment at this point would have quickly and efficiently released the organism from its hold (Hahnemann). Instead, local suppression was resorted to, and the disease process, no longer subject to modification by the vital forces, is hurled back into the organism where it continues its never- ending destruction in its efforts to relieve its intrinsic tension by symptom manifestation and discharge.

Its course from this point might be taken as a confirmation of the reasoning of James Tyler Kent as brought out in his discussion of the correspondence of organs and the direction of cure, all of which is based upon Herings Law of Symptoms. A complete understanding of this philosophy is necessary for an accurate estimation of the progress of a case under homoeopathic therapy.

The subject in its entirety is worthy of a thesis of itself and we must confine ourselves to a mere scratching of the surface as fits the needs of this case. Briefly it has to do with the course taken by morbific processes within the body, the course under proper treatment being shown by the appearance of characteristic symptoms in specific organs (this being the path of cure); conversely, the path under improper medication, homoeopathic et al, or the path that the process if forced to assume from other causes may be traced in the opposite direction.

In this case the gastro-enteric tract is the fulcrum. We may assume that the miasmatic process released here in conjunction with the typhoid attack, of its own accord and by natures law worked itself in the proper direction, to the skin. The suppression of the condition at this point caused a pronounced reversal so that its path is inward and eventually it strikes at the innermost part of the organism, the brain and central nervous system.

It may go still further, destroying eventually the innermost factor in this, the innermost organ in man, namely, the intellectual faculties with the appearance of an insidious insanity. In this case the path taken by the morbid process is well marked and unmistakable. Gradually burrowing inward, it manifests itself by prodromal signs of distorted sensation. unmolested it continued until we are confronted with frank paralytic weakness and now we find our patient is suspicious, and early manifestation of impending intellectual impairment.

With the commencement of active homoeopathic treatment two results may be obtained. Under improper prescribing this case will be precipitated into a frank mental case; if the remedy chosen is correct we may expect to see disappear first, all the mental symptoms; this will be followed by a decline of the paralytic manifestations (or there may be at the beginning a slight intensification followed immediately by the decline) with the appearance of marked intestinal symptoms, as spasms, diarrhoea, etc. Finally the skin may be resorted to as the final outlet for the miasmatic process if necessary. One other possibility, the process may taken a more rapid exit, going directly from the cerebro-spinal tract to the skin.

The extent of recovery, naturally, is modified by the extent of the organic destruction of the nervous tissue, if any be present.

CHOICE OF SYMPTOMS FOR ANALYSIS.

Before selecting our symptoms let us consider the task before us. We are about to review the various complaints and evidences of a disease process in our patient. From the symptoms we receive we will attempt to construct, logical, a picture of his condition which will identify and simulate a similar drug group picture. Our symptoms, when chosen and logically arranged, will give us our totality, the integrity of which will be reflected in the integrity of the remedy chosen.

Frederick A. Riemann