On what does the success of a surgeon depend? What are the essentials for a successful operation?.
First, surely, if possible, a correct diagnosis of the conditions present, be it a fracture or dislocation due to some accident, the presence of an abnormal growth or the need of some repair work; second, putting the patient in as good physical condition as possible to meet the strain of the operative treatment; third, speed and deftness in the reduction and dressing of the fracture or the performance of the necessary operation; and fourth, the use of means to promote healing of the living tissues at the seat of the operation.
It is of the last point that I would speak especially. Whatever tends to increase the general bodily welfare will aid in healing the tissues; so warmth, suitable food, absolute rest or some passive exercise as indicated should all be given careful attention and the patient should be kept as calm and happy in mind as possible. All these means will tend to stimulate the natural processes of growth and they are used by both schools of medicine alike. The homoeopath, however, has the advantage of possessing remedies which are especially helpful in stimulating healing, in encouraging tissue growth and in relieving the suffering due to injuries or to the operation itself.
When intense pain is present, the Old-School have little to offer except opiates or coal-tar derivatives, both of which are dangerous and depressing in effect. If the case is one of fracture with intense pain shooting along the nerves, or hard throbbing, Hypericum perforatum will almost surely make the patient comfortable. This remedy is especially good for the effects of a fall on the coccyx or for the injury of some part rich in sentient nerves, as the ends of fingers or toes.
If the case is one of operation, there is a wide choice of remedies, according to the part affected and the direct cause of the pain.
If the operation has been one which involved stretching of tissues, Staphisagria is almost surely the remedy. Gas pains after an abdominal operation may call for Nux vomica, Pulsatilla, Arsenicum, or perhaps Chamomilla. We are very thankful for Magnesium phos. when the pain is paroxysmal and much relieved by heat.
Let us return for a moment to the subject of fractures and see what our remedies can do beside relieve pain.
There are two-and perhaps more-which have proved themselves valuable aids in bone healing, favoring the production of callous. Calcarea phos. is believed especially helpful for young people and Symphytum for older ones. Symphytum, too, has a reputation for relieving the pricking pain during or after the healing of bones and the soreness of the periosteum remaining after an injury. It is also most useful in removing the pain from the eye after it has been struck by something hard.
Of course, Arnica is very often the remedy to give first after an injury, on account of the great soreness and bruised feeling. Rhus tox. comes in later for straining of tissues or stiffness and lameness.
Ruta graveolens helps injuries to bone, tendons or cartilages. That remedy and Rhus are almost always worse in wet weather.
Part of a patients preparation for an operation may often be the giving of a remedy to quite the mind or to prevent nausea. Aconite is wonderful in its power to remove fear and it also relieves tendency to shock after an operation. Often a dose of the patients constitutional remedy is his best preparation for the ordeal.
Phosphorus is said to antidote the effect of chloroform and to relieve the nausea due to it. If it is given before an operation where ether is the anaesthetic, there is much less apt to be nausea and vomiting.
I am always sorry for the Old School that they dont know Calendula-one of our most successful surgical remedies. In cuts or lacerated wounds, it helps marvelously to secure union by first intention; and even where suppuration has developed, it can clear up the condition. It may be used both internally and externally at the same time. Externally is should replace the popular iodine or mercurochrome as an application in case of a cut or laceration.
H.C. Allen says, “It is similar to Hypericum in injuries to parts rich in sentient nerves where pain is excessive and out of all proportion to the injury.
Kent, in one of his lectures, calls attention to Strontium carb. as a remedy that may prove a life-saver in a condition of shock following operation. He says, Where there has been much cutting, there may follow a state of prostration, coldness, oozing of blood, and almost cold breath. Strontium carb. will relieve the congestion and the patient will get warm. Strontium carb. is the Carbo veg. of the surgeon.
I have suggested only a very few of the remedies that may prove useful. Each physician will find them for his own cases. But patients, physicians and surgeons will all be thankful that homoeopathic remedies do serve mankind so well. NORTHAMPTON, MASS.
DR. STEARNS: Raphanus for your gas remedies; that is the black radish. China, also. Calendula is a specific for infected wounds of the scalp. The first case I ever had that I learned that on was a case at that same hospital that Dr. McLaren talks bout. This fellow came in; he had been on a drunk, and he had been sewed up at the clinic. We left him sewed up and put him to bed. A night or two before I went to the hospital as an intern, that case had been found bleeding, and the intern had opened up this wound, slit back, and the scalp folded down over his head.
I had that case to dress. I dressed it for several weeks. I tried everything I could think of that was supposed to be done for those things. You know it is passed down from intern to intern what to do. They have their stock of things. I didnt like that very well, but that was all I had to do. I went over to see Edmund Carleton one day, and I asked, “What can we do for these cases of scalp wounds that are suppurative?.
He said, “Give them Calendula”.
So I went back and ran up a potency of Calendula to an 8th and I started giving it to him. By that time I had established the principle of using no dressing except sterile. I had my instruments for the dressings always in the sterilizer and took them out as I used them, and tried to keep things as clean as I could. I gave him Calendula 8th. I think I gave it every two or slimy and thick and white and clear. I didnt know any better than just leave that for a while longer. Before I woke up to what was happening, that thing had healed with the flap down over the ear. I had to start in and keep sliding it up. As it was, I left about an inch-wide scar. It was a remarkable recovery.
After that any case that came in got Calendula, and I never bothered to sew them up; they all healed.
DR. GREEN: I want to give testimony to the use of Hypericum after operation for the prevention of surgical shock, very much as we have been used to using Arnica, I dont know how many others have done it, but I had to decide at the age of 92. Of course the operation meant opening up the abdomen and handling the whole swollen intestine its whole length to find out the site of the obstruction, which was found to be in the sigmoid, and then putting the bowel and sewing her up.
I reasoned that the shock would come more from handling the intestine than it would any bruising of other tissues, and I chose Hypericum, with the result that surgical shock was reduced to such a minimum that one could hardly find it in a woman of that age.
DR. HUTCHINSON: In surgical cases I should say for the last twenty I have tried to differentiate between drugs that I after shock or from injury of any kind in this way: I always think to Arnica for bruise or strained muscles, especially with discoloration. I usually think of rhus tox. for straining of muscles or tendons or spraining, without much discoloration. I always think of Ledum in punctured conditions, and as Dr. Green has said about Hypericum, it is good. She prevented, with her Hypericum, a great deal of shock and trouble, that might come from the injuring of the sympathetic nerves around the bowel, and that is where Hypericum comes in, or in injuries to the spine or brain, or laceration of the nerves in any place.
DR. DIXON: One point that the essayist has not brought out in her excellent paper that I feel we should stress is after amputation, when that troublesome symptom remains that the patient feels the amputated member is still present, Ledum. I could tell an interesting story about a boy that lost his leg in the late war. Of course he is on compensation because he is permanently disabled. For about five years he was a nervous wreck because that foot was always bruised and injured.
It was amputated above the knee, and he had been an inmate of half a dozen different hospitals, I imagine; anyway, they had shipped him all over the state of Ohio. The boy was skeptical that anything could be done. Through the family that he married into, I was consulted about it. He didnt think anything could be done about that, but I assured him that I could, and a few doses of Ledum has made a different man of him. He is just as robust and hardly as anyone crippled can be, but he has never dared to tell them at headquarters that he isnt suffering any more because he would lose his dollar 80 a month.
DR. STEVENS: I am grateful for the suggestions. I meant to have spoken of one thing. Dr. Stearns said to me yesterday, I think, that as a routine thing he had Arnica prescribed after every operation, that he preferred it to Aconite because it not only relieved the shock, but it helped the injured tissues in every case.
As far as Hypericum is concerned, I am very glad to know of the case that Dr. Green speak of. I have used it in several cases of fracture of the hip, where the pain was intense, and I think it helped greatly, and in one case of woman 75 years of age, who had a fracture of the hip, I gave Symphytum. She was a woman in very delicate health. The surgeon really resented keenly, I think, my insistence on having her put into a cast, because he thought she would die anyway. she is walking now, with her leg just as long as the other leg, and it was a most marvelous recovery. I am sure Symphytum helped her very much.
Speaking of Ledum, in some cases we have that symptom of great aggravation from heat had relief from cold. I remember this comparatively mild case, but a friend of mine had gotten a blister on her heel from walking. I was called to see her about two oclock in the morning, because she was suffering such intense pain from that blister. I started to bandage it with some sort of dressing, and she pulled it off. She couldnt endure the heat of the dressing. Ledum relieved her in a very few minutes.