There is intense itching on the top of the feet and ankles, < scratching, from the warmth of the bed, and > from bathing in cold water.
All conditions in Ledum are > by bathing in cold water; but there is also a sensation as if cold water were poured over the parts. The coldness of the patient is manifest on touching the body, but there is not necessarily subjective coldness.
In Ledum the warmth of the bed becomes intolerable because of the heat and burning throughout the whole limbs, whereas the heat and burning of sulphur are confined mostly to the feet and soles.
The burning of Ledum is distinctive in that it is > by cold water bathing and < by the heat of the bed, especially the legs and feet, so they must be uncovered.
Its aptitude to ligamentous tissue, its gouty manifestations, its alternating habits of rheumatic and chest symptoms in phthisical subjects, in haemoptysis; the pains going from below upward; the bloody and exhausting emissions; the suffocative breathing in whooping cough before the cough begins; the sensation as if something was live in the chest; sensation as if vermin were crawling in various parts of the body; the marked ecchymosis from contusions; the marked adaptability to the effects of punctured wounds; all these characteristic symptoms make a picture not infrequently indicated. A careful study of Ledum will convince us that it is a very valuable addition to our resources, especially in dealing with emergencies and chronic conditions.
DERBY, CONN.
DISCUSSIONS.
DR.GRIMMER: This is a beautiful picture of Ledum conditions and if we study it, we shall have no trouble in recognizing the Ledum patient.
There is one experience I should like to recount, of a tubercular case, to illustrate the doctors statement about the effect on tuberculous conditions of the lungs. I had a man who was probably in his secondary stage of tuberculosis. He was coughing a little bloody expectoration and was up and around and able to get about and be fairly comfortable, but he had a strong indication for Ledum, which I gave him in the CM potency. This remedy was given along about one oclock in the afternoon. At seven oclock that evening I was called hastily to come to the house, which was some distance away, to see the man, as he was having a severe pulmonary haemorrhage.
By the time I got there, he was dead, and the room in which he lay was like a slaughterhouse, he had bled so heavily.
Now, I think I made a mistake in giving Ledum too high. Of course, that is only one case, but we have had many warnings about some of our remedies, in our literature, about Phosphorus and Lachesis, especially, in tuberculosis, and the danger of giving these remedies too high, and I think Ledum falls into that group, from this one experience.
I wonder if other have had the same experience.
DR.CHARLES A.DIXON: I expected to hear Dr.Roberts say something about the pains in the wrist, which is so characteristic of Ledum. I want to add to it. It will often guide me to the remedy.
DR.COLEMAN:I was connected with the Metropolitan Hospital when it was the largest tuberculosis hospital in the world, consequently, I have had some experience in prescribing for tuberculous cases and I have never been able to see that Phosphorus, or any other remedy, even if it were not indicted and given wrongly, or given in any potency whatsoever, has had any bad effect on those cases.
I know that is a popular belief that Phosphorus or some of these other remedies should not be given to tuberculous, I havent personally found that to be the case.
DR.K.A.MCLAREN: I should like to ask Dr.Roberts a question. In my own practice, very, very frequently I am called upon to prescribe for children with pains in the legs at night. Nearly all these children kick off the covers and get their legs out, and then wake up crying. I frequently have given Rhus and sometimes Pulsatilla to these cases, with varying success, and I should like to ask Dr.Roberts whether he thinks that Ledum would possibly fit the bill.
DR.FARRINGTON:The value of Dr.Roberts study of Ledum is shown in the fact that he gives definite modalities and characteristics symptoms by which he can determine whether he is to give Rhus tox., Pulsatilla, Phos, acid, or whatever it may be, for any given ailment as, for instance, the so-called bone pains in children.
To my mind, this is one of the easier remedies to prescribe, because it belongs to that small group which, although having considerable coldness in some of them, as Ledum, a lack of vital heat, nevertheless, are made worse by warmth and better cold applications.
In gouty and rheumatic conditions we frequently see Lac caninum indicated not only but its well known alternation of symptoms from side to side, but because its pains are relieved by cold. The other two remedies which belong to this group are Secale and Pulsatilla.
Many years ago, when I was living in Kents Dispensary, my associate there, Dr.George Cooper, was taken ill with arthritis of the ankles and knees. Dr.Kent was called and prescribed for him, but he didnt improve. For several days, or perhaps a week, that poor fellow suffered intense agony with the pains in his ankles and his feet, and the only relief he got was by keeping his feet in a basin with ice water in it and ice floating around.
Dr.Kent was a little bit loath to confess the two or three different remedies he gave. He gave Pulsatilla for one, but there was a peculiar alternation; sometimes the pains were more pronounced in the right foot and sometimes they were in the left, and then they would jump back to the right foot again.
After a while our great prescriber and teacher of materia medica woke up to the fact that he had found a new clinical symptom, and gave Lac caninum and brought the boy out, but his heart was damaged so in later years he finally succumbed to an endocarditis.
Now, this matter of giving certain remedies in tuberculosis and other serious cases bobs up every now and then. The former speaker has said here he has treated many cases of tuberculosis and given remedies in all sorts of potencies and never found any ill effects, whether they were indicated or not. The experience of one man does not prove anything, conclusive at least.
I know of a number of instances where remedies in too high potency, especially in lung troubles, with the extensive pathology, have undoubtedly done harm and put the patient in danger, and perhaps threatened the patients life.
Now, in that same dispensary we had a number of tubercular cases, and I remember one time going to see a colored girl about ten years of age. She had all the symptoms of extensive tubercular involvement of the lungs. I had a great idea of high potencies. We used them right along and hardly ever have anything below the 50,000 in those days. I gave her a dose of Sulphur 55,000. Her temperature hot up to 103 and she began to cough great gobs of pus, and I was scared to death, I thought I had killed her.
While figuring and trying to find what I might give as an antidote, how ever, the temperature began to drop. The girl made a perfect recovery and I was saved the trouble if signing a death certificate.
Now, that is one instance, but I have seen others with other remedies and in totally different conditions. A woman of about sixty-eight years of age had all the symptoms of Agaricus, especially the pains and tingling and crawling down the spine. I had a good old potency marked 59,000, and I gave her a dose of it and she nearly died. I told Kent about it afterwards. He was rather proud of his pupils. He said, “Farrington, prescribe just as well, but dont give such a potency as that or you are going to kill somebody.”.
DR.EDWARDS: Speaking of killing people, when Dr.Cooper was laid up with that attack of rheumatism, he sent me out early in the afternoon to see a man whom he prescribed for. I went down at eleven oclock, never asked what he gave, nor ever took a record, but it was a wonderful picture of Thuja, and I gave him Thuja and went back and told Cooper what a wonderful case I had made out of this. I had just gone into the Dispensary after graduating. I heard a knock at the door about half-past twelve, and they told me to come down. I told Cooper What I had done and that I had given a dose of Thuja 10M, and he said, “You have killed him,” and when I got there he was very much worse and died about half an hour afterwards.
My mother had cancer. I brought her down to see Kent. It look three days to go over her case and he gave her Graphites 35,000. She wasnt in very bad condition when she came down, but we walked up Twentieth Street, and by the time we reached Arch, she almost fell down. I brought her down in September and died on the 28th of October, and Dr.Kent said that the remedy at that time was Thuja, and if he could have had that case at the beginning, he hadnt any doubt that Graphites would have been her remedy, about ten years before.
So, I think sometimes in these cases when they have a remedy and then have an aggravation we dont always recognize it and give a higher potency and get a very severe aggravation.
