CLINICAL CASE


A man came limping into my office, saying, “Doctor, can you do anything for my limb? It distresses me so when I sit down that I cannot rest in that position at all” This was a case of rheumatism of two years duration. I asked him, “What is the feeling in your limb that prevents your resting in that position more than any other?”.


Dec.6, 1933. Patient, a physician, age 47. Teaches in regular school college 5. 59″, weight 165.

Duration of trouble twenty years. History in exact language of patient.

Only previous history is appendectomy in 104. Present trouble started as pain in left chest under lower border of chest extending laterally from clavicle to costal margins involving all intercostal spaces. Unable to lie down. Breathing quick and shallow. Lasted two days, then subsided. Similar attacks followed two or three times a year. Never any elevation of temperature.

After five years of the above had severe pain in abdomen. Colic-like, twisting, intestinal, involving entire abdominal cavity. Sometimes constipation preceded attacks, sometimes not.

Similar attacks came every two or three months but no intercostal attacks. The attacks became more frequent, monthly, then every two weeks. Now attacks occur every week or ten days.

Two or three years ago intercostal attacks returned alternating weekly with abdominal attacks. Then came a series of abdominal attacks. The abdominal pains start deep as intestinal then seem to be in the abdominal muscles. Can hardly bear pressure of clothes. The attack disappears and he is perfectly well. There is no ache or pain during the interim. During the attack he is completely exhausted and helpless. Pain is so exquisite he has to be undressed and helped into bed and propped up on pillows.

Abdomen is < jar during the attack and after. Patient must lie perfectly still; during attacks his teeth chatter and he is chilly. Pain is so intense he cries out.

He is irritable during an attack and aggravated by consolation. Face is pale and drawn when ill. He is chilly and sensitive to draft when attack is impending. Sclera of one eye becomes injected one day before attacks. Nose is dry.

He desires air. He is not fond of sweets but everything tastes sweet during the attack and for a day or so afterward.

Attacks occur from 4 to 8 p.m.

Patient has had all laboratory tests for blood, spinal fluid, urine, faeces, etc., all negative. X-rays of gastrointestinal tract, gallbladder, pyelograms, etc., all negative.

He spite of every facility for diagnosis, no pathology has every been found.

What can homoeopathy offer?

REPERTORY RUBRICS (Kents).

1.Pain chest 4-8 p.m.

2.Pain chest < pressure.

3.Pain chest < Motion.

4.Pain chest < Walking.

5.Soreness chest to touch.

6.Pain chest < lying down.

7.Periodic pain, abdomen.

8.Abdominal pain
9.Pain abdomen, cramping, grinding.

10.Pain abdomen < walking.

11.Abdomen soreness to jar.

12.Abdomen soreness walking.

13.Hyperaesthesia abdomen.

14.Pain abdomen < motion.

15.Chill with pain.

16.Periodicity pain.

17.Averse sweets.

18.Sweet taste.

19.Irritable < consolation during attack.

20.Pain chest alternating with pain in abdomen.

REPERTORY RESULTS

Bryonia 8/16 Phos. 9/17

Calc.c.9/19 Ran., bulb. 14/27

Natrum mur 9/17 Sulphur 13/23

Nux vom.13/27

Dec. 10, 1933. R. Nux vom. 200. No change.

Jan.15, 1924. R. Nux vom. IM. No change.

Feb 11. R. Ran.bulb. IM. Improvement. No pain for eight weeks.

“April 90. R. Ran. bulb. IM. Little improvement. Alternating chest and abdominal attacks. Lessened in severity, however.

May 16. R. Ran. bulb., 10M. Free from attacks up to June

19. BOSTON, MASS.

DISCUSSION.

DR.DIXON:It seems as though there is always a criticism due when we dont get any more history than that from an intelligent patient.

I rise to my feet to try to give relief which perhaps he has already covered in the field without developing anything. Why did this man start having attacks in twenty years? Was it some change in his life or change in his occupation, or has Dr.Spalding never talked with him about that, or has the patient never given thought to it? That might might be the keynote of everything.

There might be something there that would lead us to Ranunculus. I hope Ranunculus clears it up. It is mighty hard to get good symptoms, and it is often in the intelligent patient you cannot get anything by particulars; the general are just not there.

DR.GRIMMER:This paper is a striking illustration of what the homoeopaths are up against today. The doctor told us that this man has had everything in the way of opiates and analgesics and whatnot, and I presume a liberal supply of coal tar derivatives and sedatives. We all know what they do to the reactive forces of the body. They simply repress them and suppress them so that there is no possibility of reaction to curative drugs for some time afterwards. Until you can get the effects of these drugs antidoted, you cant do much, and it sometimes takes a series of remedies.

Ray W. Spalding