I wish to submit a report of two cases of meningitis that came under my service at the Childrens Department of the Womens Homoeopathic Hospital of Philadelphia. I will give the history and complete laboratory reports copied from the charts and records at the hospital. I feel it is necessary to present the original laboratory reports and chart history to help to confirm the diagnosis of a serious case when a cure is made with a high potency of a homoeopathic remedy.
There are various clinical forms of meningitis, as you possibly know. These are classified according to the different organisms found in the spinal fluid and blood. The first case discussed here has a confirmed diagnosis of influenzal meningitis. This child was admitted to the Childrens building through the Dispensary, on January 9, 1935. A colored girl, age 6 years; her chart history is as follows:.
FAMILY HISTORY:Mother living and well. Two other children living and well. No history of cardio-renal disease, epilepsy or diabetes. Father died recently of tuberculosis.
PAST PERSONAL HISTORY: No childhood diseases, no operations, no history of injuries; patient well until present illness.
PRESENT ILLNESS: One week ago, patient began to complain of cough, coryza, and became very feverish. There was marked prostration; several times she vomited, which was projectile in character. She developed severe convulsions and was taken to the Hospital. The provisional diagnosis made by the interne was bronchopneumonia.
PHYSICAL EXAMINATION:Black female child in convulsions,m semiconscious, apparently very toxic. Pupils react sluggishly to light and accommodation; marked convergent strabismus in left eye. Chest; increased area of bronchovesicular breathing; increased tactile fremitus; dullness, particularly over right mammary region. Subcrepitant rales scattered over both sides of chest. Respirations very labored and rapid.
Marked dyspnoea. Frequent short, tight, apparently painful cough, Heart: Fair myocardial tone, no audible murmurs. Neurological examination: Marked retraction of head with rigidity of neck, giving a positive Brudzinskis sign. Pupils dilated; convergent squint. Positive Kernig sign more marked on left side. Positive Babinski, knee jerks increased, general hyperaesthesia.
I did a cisternal tap and collected 40 mill. of cloudy fluid under marked pressure.
LABORATORY REPORT:Spinal Fluid-Cloudy fluid, turbid. 30 c.c. examined. Globulin present, 2 plus. Sugar negative. Cell count 180. M.E. Pus, 4 plus. Culture of the spinal fluid showed a distinct strain of influenzal bacilli.
(Signed), GEORGE HOPP, M.D., Pathologist X-RAY OF CHEST. Report: Examination of the chest shows bronchopneumonia involving both lungs. No evidence of pleural effusion or encysted fluid.
LABORATORY REPORT: Blood: The complete blood analysis will not be given here. All counts were done by the Shilling method. The hemogram revealed: January 10, 1935: Degenerative shift to the left. Prognosis grave. January 11, 1935: Degenerative shift to the left. Prognosis fatal.
These are the reprints of the history of the case and the laboratory diagnostics.
The symptoms for the selection of the remedy were entirely objective as this young child was unable to furnish us with any reliable subjective symptoms. On admission, the temperature was 104 plus respiration 50, pulse 160. On the signs and symptoms related, the interne prescribed Belladonna which was allowed to act for three days, with only a slight amelioration of temperature.
When the patient developed opisthotonos, marked squint, became practically unconscious, with all the former neurological findings increased, I said another cisternal drainage, and took some of the fluid and potentized it according to the Fincke method, and began giving it January 12. Within 48 hours, we began to notice a most spectacular change in the patient. The temperature began to drop, respirations became easier, the child regained consciousness, and the pulse improved in quality.
Within four days, her temperature was normal. At the end of a week, the spinal fluid showed very little pus, the cell count was greatly reduced, and by January 21, the neurological findings cleared up. The strabismus had cleared up, were the cervical opisthotonos had disappeared, and there were no Babinski or Kernig sings.
The case came to a standstill for about a week, when Sulphur was given. Another spinal tap gave a perfectly clear fluid, normal cell count, with no pus or organisms present. There now remained no symptoms except anorexia, extreme emaciation, which had been rapid and pronounced, a few rales in the chest which had not cleared up, and an occasional cough. Arsenic iod. was prescribed here.
The child soon began to eat well, gained in weight, got out of bed, and was fully recovered and discharged from the Hospital, February 3, 1935. The outstanding features in this case to my mind, was the effect of the potency made from the influenzal spinal fluid which promptly cleared up the pneumococcic process, reducing the meningeal inflammation, removing the opisthotonos, strabismus, rigidity of the neck, rapidly changing the character if the spinal fluid, and practically removing all pathology within one week from the first dose of medicine administered in the higher potencies.
This case is reported to show the value of a nosode in a desperate case, full of pathology, with the rapid and complete amelioration of all symptoms and the clearing up of all serious symptoms in less than the orthodox clinical time.
The second case of meningitis was referred to our wards through the courtesy iod Dr. Leslie Fry.
A white male child, 22 years old, with the history of having been ill at home for two weeks.
FAMILY HISTORY:Mother living and well. Father crippled. History of tuberculosis in mothers family.
PAST PERSONAL HISTORY: No childhood disease, no operations, no injuries. Child always regarded as delicate, but no specific disease.
PRESENT ILLNESS: Child took sick February 20, 1935, when he vomited several times. Later he complained of being chilly, became dull, lethargic, constipated, and, according to the family physician, developed nervous symptoms. He had a mild convulsions and was removed, to the hospital on march.
PHYSICAL EXAMINATION: A white male child, age 22 years, markedly toxic, opisthotonos present, chest negative to pneumonia, heart negative to any definite pathology. Eyes: Strabismus (Convergent), pupils dilated; did not react to light or accommodation. Marked opisthotonos, almost “gun-hammer” position. Occasionally a severe, conclusive seizure. There were positive Kernig signs on both sides. Also, Brudzinski, patellar reflexes exaggerated, and positive bilateral Babinski, The urine showed acetone, hyaline and granular casts and pus cell. The blood showed a marked secondary anaemia and a marked leucocytosis.
The Manteaux tuberculin skin test was positive in 1/100, 1/1000, 1/10,000, in 48 hours. The spinal fluid was all taken through the cisternal route, clear fluid, 30 mil. under pressure. Cell count of 200. Sugar negative. Delicate web-like coagulum on standing. Globulin, trace. This was done on March 8, 1935. Repeated taps were made. The X-ray examination of the chest showed a moderate enlargement of the thymus gland, with a small, diffuse mottling throughout both lungs, suggestive of early pulmonary tuberculosis.
Having made a thorough physical examination and laboratory diagnosis of this case, the next step was to find the curative remedy, if any. The child had received Cicuta virosa by the attending physician. When first seen by me, the general aspect of the case was entirely different. The child lay in a stupor, I should say completely unconscious. He rested on his back, eyes partly open, pupils dilated, eyes lustreless, staring into space, rolling of the head from side to side occasionally, some occasional muttering delirium sometimes interrupted by a sharp scream. The left side was apparently paralysed, and there were some automatic motions in the right side. The urine was scanty, involuntary, and very dark in color.
One these symptoms, and on account of the progressive type of stupor due to effusion into the ventricles of the brain, I prescribed Hellebore. There was marked amelioration for a few days, when the symptoms returned. The child again developed a marked opisthotonos, a convergent squint, convulsive twitchings, complete unconsciousness, rolling of the head, occasional grinding of the teeth, and to all indications was apparently dying.
After a careful comparison and analysis of the symptoms, Zincum metallicum was prescribed in the 200th potency, with a prompt amelioration of the symptoms, but it did not hold the patient; even repetitions with higher potencies had no effect. Hope was now well nigh abandoned. This was completely unconscious dying child with automatic convulsive twitchings on one side, paralysis of the other, with abolition of all reflexes, extremities cold and occasionally clammy, pupils insensible to light and dilated.
