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.
The doctor had handled the case perfectly, as for as he has gone. He is playing the game of watchful waiting. It is necessary in these classes of cases, It is not homoeopathic, but in as way an adjunct to homoeopathy. It is in such cases as these that our electronic reactions come to help us very extensively and materially.
I have recognized for a long time, and you all have, that we have been up against this very thing that the old masters didnt have to such an extent. The drugs we use today are killers; that is all. They just submerge everything and that is why we have our difficulties, and that is why the new system of drug selection by the electronic method is truly a help and we find sometimes a drug will only run a few days when the reactions will indicate, long before symptomatic changes will indicate, the need of another remedy.
After a time we will get order and remedies will hold longer and more nearly approach the homoeopathic ideal and methods. As soon as we get remedies that do work, we let them work.
It is a fine paper for this very reason.
DR.ALFRED PULFORD: I should like to ask Dr.Dixon what his definition is of an intelligent patient. The statement has been made that there are plenty of learned people but very few educated people, and the educated people are in the minority, and lots of these people I have often thought when they come into the office that a college education is a detriment to them. They didnt know anything. I have lots of people who come in who never had an education of any kind, who could express themselves and you could get a definite idea of them and I have people come in with all kinds of degrees tacked on the end of their names and they dont know-well, you know what I was going to say.
DR.HARVEY FARRINGTON:It seems to me that this case of the doctors is one for Bogers Materia Medica, some book where you can get the peculiar group of symptoms. When you have a case like this it always seems to me just like a lawyer who has failed in examining his opponents witness.
DR.OVERPECK: I just want to say this reminds me of a case I have of shingles, without eruptions. The eruption might have been suppressed a long time ago. The same remedy was used.
DR.K.A.MCLAREN: I think it is very unkind f DR.Dixon to get up and ask why. I am so sick of hearing people ask why all the time. If they want to know why they are sick, I ask them why they were born. I tell them I dont know way.
A patient can tell me the symptoms. We dont know what happened twenty years ago in that patients life. He may have had shingles twenty years ago and the eruption may not have come out. Who is going to be able to prove that he had it or hadnt it? We dont know why, and if you start spending too much time on the why, you will forget about the now, and your selection of your remedy.
Your patients always want to know because they have been reading in the periodicals so much about health lately. They have been taught there is a cause for everything and we must know the cause for everything, and that is why they come at us with the everlasting why all the time. That is not essential. All we have to have are the symptoms and then it is up to us to pick up the remedy. We have enough to worry about without answering all their whys and it is a good thing to put them off and tell them the why part of it isnt important.
DR.HEIMBACH: I dont very much whether it was a case of shingles from the beginning. From what I know of shingles. the pain is fixed in that certain nerve and it doesnt change, and when you have once had shingles, I dont think you will ever get them again.
I wrote a paper on that subject some years ago and went into it as much as I could in all the literature I could possibly find, and that was my findings. You get a case of shingles, and you dont get them again, and the case is always one nerve-I dont care where it is, in the chest, or wherever else it is, so I doubt whether it was a case of shingles.
Of course, we know if there is effect, there must be cause, by sometimes we simply cant find the cause no matter how much we search, and it is wise, if you can find the cause-it will help you, because by removing the cause you can help the case, and if you can remove it, you oftentimes dont need even a homoeopathic remedy.
DR.DAYTON T. PULFORD: There is one peculiar condition there, the alternation between the chest and the abdomen, and I wonder in connection with the cramping if h has used Conium. I think that is the only remedy that gives alternation between the chest and the abdomen.
