Mrs. C. presented herself for treatment when her first child was two years old. She had never been well since the birth of the baby, having suffered during the entire pregnancy with nausea and vomiting, being able to retain so little food that the consequent exhaustion and anaemia were so alarming that an induced labor at seven months was very seriously considered. At the first consultation she complained of great exhaustion, especially at the time of menses, lack of vital heat, cold feet, which were apt to be damp, and a recurrent rectal fissure which had been operated on four years previously without permanent relief.
She looked frail and pale, the least effort “played her out”. She received Silica 5M, which made a new woman of her. Her color improved, she lost the constant chilliness, her endurance doubled, the rectal fissure healed. Three months later she became pregnant, she knew it even before the next menstruation was due, as she was beginning with the same symptoms which troubled her during her first pregnancy. She had nausea all day which was only relieved by eating; there was a faint, empty, gone sensation in the pit of the stomach; she could often stave off the vomiting by eating; the vomited matter was thick and yellow and so acid that it scalded her throat.
Nausea was markedly aggravated by the thought of food, when she was on her feet, and by the least exertion. Sepia 1200 brought prompt relief, “the only medicine which ever relieved that terrible nausea”. For two months I did not see Mrs. C., when she did appear she had a sorry story to tell. She had been free from symptoms for several weeks after the Sepia then she became worse and her family objected to the “sugar pills” and insisted upon having the latest “scientific treatment”. This was so unsuccessful that the doctor said, “There is nothing which will help your condition, you will have to bear this nausea and vomiting.”
So she “took the law in her own hands” and came back to me. The symptoms were all intensified, the most pronounced aggravation being after her evening meal, one or two hours after eating her dinner she would vomit huge quantities of undigested food, and thick green acid masses. She would vomit small quantities during the day, but generally by eating little and often she could retain her food until after dinner. She carried crackers with her wherever she went in order to have something to eat when the terrible nausea came on. She was extremely weak and there was great fatigue from the least exertion.
Kreosote 1M produced a prompt change for the better, all the symptoms disappeared. Kreosote repeated at intervals carried her through the remaining months of her pregnancy in comfort. Under Kreosote we find: Dares not remain fasting, < while fasting (And yet this patient was not aggravated by fasting in the morning). Vomiting in the evening of all food eaten during the day. Continuous vomiting and straining to vomit. Vomiting of undigested food. Weariness, prostration, fatigue on least exertion. Chilliness. Cold feet.
Mrs. H. complained of nausea and vomiting which commenced about the time of the expected menstruation, violent retching and forcible vomiting after the evening meal, did not have any trouble in the morning unless she took orange juice, which she could not retain. Lump in the throat and general abdominal bloating and rumbling commenced about 3 p.m., became especially marked between 4 and 5 p.m., and was not relieved until she vomited her evening meal. This was followed by great exhaustion. Cold water aggravated, could keep warm drinks down better. Felt utterly miserable, irritable and depressed, sighing, nervous, twitching. Constipated, with ineffectual urging and stool composed of hard, dry balls.
SEveral remedies were given without result, then Nux vom. 2M brought an immediate relief of all symptoms. The confusing feature about this case was the evening aggravation which commenced about 3 p.m., Nux vom. having as its cardinal symptom aggravation in the morning, as well as 3 a.m., patient wakens with many complaints at 3 a.m., ideas crowd upon him at 3 a.m., nausea and vomiting at 3 a.m. Also in The Guiding Symptoms is recorded the following: “For many years spasms of stomach, about 3 p.m., has pressure and a pressing together, at same time a trembling of whole body and debility and formication in the limbs.” The prescription was finally made on the aggravation from cold water, the condition of the bowels, the marked and unusual irritability, the sensation of a lump in the throat.
DR. C.M. BOGER: There is not much to say about that paper. The only thing that struck me especially was this; She said that the vomiting came on several hours after eating. On page 7 of the General Analysis you will see three, five, eight, twelve remedies, which have aggravation long after eating, and while most of us are accustomed to think of Phosphorus in those cases – that is, Phosphorus comes to us as the first thought in those cases – I just want to remind you that there are eleven other remedies which have the same symptoms and, after all, the cure of our cases depends upon the coincidence of the symptoms, and that is where most people fall down.
It is the coincidence of the symptoms that counts. As I said several hours ago, it is the ensemble symptoms that count. This thing of giving a man something for his heart, or his kidneys, or his headache, is the worst kind of prescribing. It looks right attractive and it is attractive to some minds to prescribe for what is the matter. A patient wants something for what is the matter with him. That is not the question. If you want to do quick and good work, your work is to find the coincident symptoms and sum those up and see what is indicated, and then you will get something that will give relief.
Take the combinations of diseases an sufferings that go from one family to another, that are handed down form one generation to another until cancerous affections, tuberculous affections, and growths of various kinds are developed. Now the physician must recognize is beginning the treatment of a case like that, that in our provings we have not produced tumors, we have not produced tuberculosis, and we have not produced these changes noted in morbid anatomy; we have not produced sensations, and changes of sensation; yet all the essentials of disease.
Hence it is that the record of symptoms derived from cases of poisoning are the poorest kind of evidence to record for the homoeopathic materia medica; they are useful only as collateral information, while the finer sensations produced by the slow process of provings with small doses give us sensations, like unto the conditions observed in the sick room, that guide us to the curative remedy. The symptoms derived from poisoning cases in prescribing for the sick come to us like pathological anatomy; we do not find our guide in poisoning symptoms; we do not find our guide in pathological changes. – JAMES TYLER KENT, M.D., 1889.