Allow me to thank you for the privilege and opportunity of presenting a paper before such a learned gathering this evening. The subject I have chosen is rather deep and comprehensive one, and my shortcomings are many; so I crave your indulgence freely.
In this paper, as the name implies, it will be my earnest endeavor to discuss briefly the symptomatology of some of the frequently indicated remedies in treating various mental disorders. But before going into the actual subject matter, it would not be out of place, I believe, to mention some of the interesting past events that are intimately connected with homoeopathy and its discoverer, particularly the treatment of mental diseases. From this short history, it will be clearly evident that the homoeopathic method of treatment can claim superiority over other existing therapies in the treatment of psychopathic disturbances.
Until the time of Hahnemann, little was known and less attention was paid to that most interesting branch of medicine –diseases of the mind. The reason for this must lie chiefly in two paths: Firstly: Because of superstition. Those who suffered from these diseases were believed to be infected by demons, and were thus to be shunned. Secondly: All, or nearly all efforts at treatment were met with flat failure. Evidently the treatment of mental diseases was a great problem before Hahnemanns time.
Hahnemann was the first to overcome the superstition mentioned above, and to show the world the wonderful efficacy of homoeopathic remedies in the treatment and cure of mental diseases.
Hahnemanns investigation of this problem came about in a singularly interesting manner. In the year 1792, he went to Georgenthal in the Thuringian forest to take of an asylum for the insane, and to take as a private patient Herr Klockenbring. This asylum had been established by Duke Ernst of Gotha, and Hahnemann was appointed manager by the Duke and opened the institution in August, 1792. Klockenbrings case is one of special interest, and his cure reflects much credit upon Hahnemanns treatment, then a comparatively young physician.
The skill with which he traced the origin of the trouble, his careful study of the case before prescribing, the freedom allowed the patient in the natural expression of the symptoms and the careful regime prescribed by him, leave little doubt that Hahnemann was entire master of the situation from the beginning. This is of particular importance, as the patient, being the Chancellors Private Secretary, had been treated by Dr. Wichmann, the Hanoverian Court Physician, for some time without success.
Hahnemann himself, writing of this asylum, says:.
After having been for several years much occupied with diseases of the most tedious and desperate character in general, and all sorts of venereal maladies, cachexias, hypochondriasis, and insanity in particular, with the assistance of the excellent reigning Duke, I established three years ago a convalescent asylum for patients afflicted with such disorders, in Georgenthal, near Gotha. This institution was described as a model asylum for the treatment, by gentle methods, of the insane of the higher classes of society.
At the time of this incident, the insane were subjected to all sorts of harsh treatment and Hahnemann was among the first to recommend the moral and gentle method of treatment of such unfortunates. Hahnemann, however, was the father of the new school of therapeutics — his was a master mind. He could see that the method of treating maniacs as if they were in reality devils, by teasing, starving, beating, flogging and chaining the unfortunate wretches, was rewarded in every case by a direct augmentation of all their symptoms. Thus excited, patients became raving maniacs — the melancholics became suicidal in the intensity of their depression. While a diseases mind was thus kept in a constant turmoil, how could anyone expect to cure?.
To Hahnemann belongs the glory and thanks of the world for his correction of these baneful methods of dealing with the insane. He is to be honored for his lenient treatment by instituting gentleness, quietness, fearlessness, and indifference which he expressed in the following forceful language in his Lesser Writings:.
I never allowed an insane person to be punished by blows or any other kind of corporeal chastizement, because there is no punishment unless there is responsibility, and because these sufferers deserve only pity and are always rendered worse by such rough treatment, and never improved.
How different it was from the system of treatment which was adopted in many hospitals where the domestics and keepers were permitted to use any violence that the most wanton caprice or the most sanguinary cruelty might dictate!.
It is of historical interest to trace the origin of the humanitarian movement which Hahnemann advocated in the management of the insane. Dr. S. H. Talcott, in his work on Mental Diseases and Their Modern Treatment, has discussed at great length the early history of insanity to its modern treatment by hospitalization of the insane.
What were the distinctive tenets of Hahnemanns psychical management of the insane? From his experience with Klockenbring, he was enabled to formulate a general system of allowing unrestraint, yet reasonable liberty to the ravings of such a patient. By studying Klockenbrings own mental processes (Datura stramonium was prescribed in one of his attacks which was followed by a cure), he was able to proceed to those wider generalizations which characterize his salutary regime.
Homoeopathic physicians have long treated their mental cases from the standpoint of the patient, not from the standpoint of the disease from which he is suffering. For instance, an early contributor to homoeopathic literature, Dr. Dulac (Hahnemannian Monthly, Vol. V, No. 6), thus states the series of cases which he reports: The first case he recounts the cure of the ill effects of grief, with aggravation by consolation by Natrum mur. 1M. The second case of melancholia by Veratrum alb. 2C.
Two cases presenting the peculiar impulse to kill some member of the family with scissors or any sharp instrument by Nux vomica 1M. and 24M. respectively. Another similar case, where the slightest contradiction excited homicidal impulse, by Mercurius vivus. A continued fever in consequence of a reversal of fortune by Ignatia 24M. A case where the patient appeared to possess clairvoyant intelligence, and saw the inside of her head, which she described very accurately, yielded finally to Veratrum, after Ignatia and Rhus tox. had been given.
When we know more thoroughly the relationship of the remedies to each other, we shall walk more firmly and will make the most rapid and splendid cures. At the point at which homoeopathy has arrived at present we should be able to reach our ideal, which is to proceed quickly and with certainty. We need to show to the public and to the medical profession at large the position of our school in these subjects.
When we shall have demonstrated the power of homoeopathy to cope with the severer forms of insanity with greater success, and with a larger percentage of cures than the dominant school of medicine, then we shall be in a position to defend the methods of Hahnemann, and successfully carry out such treatment in practice.
I am afraid of having already taken up too much of your valuable time. I have endeavored up to this time to prove that our Master fully understood insanity in all its forms, its proper method of treatment and its ultimate curability. He has given us all this information in eight and one-half pages in his valuable book, Organon of Medicine, sections 210-230.
Now I shall discuss a few of our most commonly indicated remedies which are often called for in treating these maladies.
This remedy is chiefly useful in acute cases where disease has been caused by over-heating or some violent emotional disturbance as after a great fright, joy or anger, and when with the mental symptoms we find an exalted condition of the general circulation. Almost certainly this remedy should never be given in cases where the sickness or suffering is borne with calmness and patience. On the contrary, if Aconite is to be even thought of, we will find mental uneasiness, worry, or fear, accompanying the most trivial ailment. The more thoroughly this state of mind exists, the more surely Aconite will be indicated.
There is great and uncontrollable anguish, constant excessive anxiety and great fear to go out of the house, of darkness, of a crowd, to cross the street, of approaching death, and being alone; predicts the day, even the hour, of his death; confusion of mind, weakness of memory, unsteadiness of ideas, and disinclination for mental labor, variable humor, at one time gay, at another sad; sleeplessness or sleep disturbed by unpleasant dreams.
Aconite nap. and Veratrum vir. both play an important part in the early stages of mania which marked by such unnatural and exalted excitement. The distinguishing features between Aconite nap. and Veratrum vir.:.
There is a fitful mood changing from one thing to another, now full of mirth and in a few moments disposed to weep and a great mental anxiety. Fearful of the future, terribly apprehensive of approaching death, predicts the day he is to die.
Face is flushed, bright red, or is pale with moderate congestion.
Great thirst and gulps water eagerly.
Muscles are tense, whole mental and physical conditions are those of an instrument strung to the highest pitch. In short, the Aconite patient has mental anxiety with physical tension.
Excessive physical unrest. Depressed but comparatively careless of the future; intense cerebral congestion with a face flushed to a purple hue and hot, or it is cold with a pale bluish cast; has a dry hot mouth, which feels scalded.
Thirst is moderate. Nausea, retches and vomits profusely, muscles relaxed, has muscular twitchings, restless, constantly changes his position.
Patient has a lower grade of mental unrest with physical relaxation.
It is one of our most valued remedies and is especially indicated where the mental condition has been produced by causes which have greatly exhausted and debilitated the patients general condition, as from anxiety, overwork, loss of sleep, and a diseases condition of the mucous membrane generally, and particularly of the stomach, thus preventing the proper digestion and assimilation of food.
The mental symptoms show in the beginning, anxious restlessness and from this a continuation towards delirium and even insanity, with all that it involves. He thinks he must die, even the patient expresses to the physicians that “There is no use of your coming and it useless to take the medicine; I am going to die, you might as well go home; my whole insides are mortifying”; thought of death and incurability of the complaints. Excessive anguish with irresistible desire to commit suicide.
He has fear of death but not like Aconite fear (Acon., inconsolable anguish, fearful and apprehensive that something will happen; predicts day of death; unlike Arsenic, Aconite patient does not refuse to take the medicine, in fact he wants to take it, in spite of the fear and prediction of the day and hour of death), but rather an anxiety, with physical exhaustion and a feeling that it is useless to take medicine, for he is surely going to die; he is incurable. The mental restlessness is as great as the bodily. He has attacks of anxiety that drive him out of bed at night. It makes little differences what the name of the disease is, if this persistent mental anguish, restlessness, attended with great physical weakness and thought of death and incurability of complaints is also present, we should not forget this great remedy.
Probably no remedy in the materia medica possess such a wide range of action or greater power for removing abnormal conditions of the brain than Belladonna. Its symptoms are clear, well defined, unmistakable; its action sharp, vigorous and profound. It is the powerful supplementary ally of Aconite in removing the last vestiges of cerebral congestion and beyond this it subdues like magic the subtler processes of inflammation.
In two forms of insanity, Belladonna has proven itself preeminently curative. Acute mania attended with great excitement, violence, and destructiveness, and accompanied by the characteristic cerebral congestion, and in melancholia, where the mind is extremely dull, stupid, and slow to act, with great heat of head, dilated pupils, congestion of the eyes, full bounding pulse, and persistent sleeplessness. In the former class of cases, the 30th potency were most effectual, while in the latter, frequently repeated doses of the 1st potency have been necessary to achieve the desired result.
Following are a few of its characteristic symptoms on the mind: Its furious delirium, with great rage, biting, striking, and spitting and tearing everything within reach; fear of dogs, wolves, giants, fire, and horrid monsters filling the room; foolish and obscene talking, laughing, dancing, and gesticulating; cerebral exaltation, or confusion of mind with loss of memory; excessive nervous excitability of all the senses; sleeplessness, or sleep disturbed by anxious, frightful dreams, or frequent startings as in a fright; drowsiness, with inability to fall asleep.
This remedy is most efficacious in mania of hysterical females, characterized by excessive talkativeness and inclination to laugh and sing; or puerperal mania with sexual excitement; in cases refusing to eat from fear of poison, it seldom fails to remove the delusion. Although frequently effectual in reducing the sexual excitement of patients inclined to expose themselves, it seldom proves beneficial in masturbation, and time spent in waiting for its action in such cases is simply wasted.
It has insensibility and loss of consciousness, does not recognize those about him; great mental excitement with constant foolish talking, laughing, and singing, or rage with attempts to strike and bite. Sexual excitement with inclination to go about naked; obscene talking, jealousy, great apprehensiveness, fear when alone, with fear of being poisoned or bitten by animals.
The Hyoscyamus patient is very excitable but less frenzied than the Belladonna patient; is very talkative, mostly jolly and good natured, but occasionally has savage outbursts; is inclined to be destructive and obscene with a tendency to expose and handle the genitals. Hyos. is perhaps more often indicated as a remedy for female patients than Bell, the latter being frequently indicated for the male insane.
Rhus and Hyos. relieve the belief of having been poisoned, the former remedy being particularly adapted to low typhoid conditions.
The therapeutic sphere of Stramonium, from its symptomatology and the writings of various authors, we suppose to be in acute mania, characterized by more intense excitement than Hyos. or Bell., and with less cerebral congestion. From the wonderful curative effects assigned to it, we had expected to achieve some marked results, but thus far we have been doomed to disappointment. After many trials, with apparently clear indications for its use, we are forced to admit that we have but few positive results achieved from this drug.
It has fearful delusions of men, ghosts, dogs, cats, rabbits, bugs, and flies springing up around him, with violent endeavors to escape; worse in the dark and when alone; imagines that he has been killed, roasted, and is being eaten; that he is very tall and large, surroundings objects seeming to him too small; hallucinations of hearing music, dancing, and voices; mania with constant incoherent talking, screaming, laughing, or crying; merry exaltation with pride and affectation or furious, almost uncontrollable rage and violence, with desperate attempts to bite, strike, and injure those around; melancholia with crying, fear of death, and despair of salvation.
By way of comparison Stramonium is the most widely loquacious. Hyos. is the most insensibly stupid. Bell. in this respect stands half-way between. Stramonium throws himself about, jerking head pillow. Hyos. twitches, picks, and reaches, otherwise lying pretty still. Bell. starts and jumps when falling into or awaking from sleep. All have times of wanting to escape.
This remedy has a wide range of action in mental disease. It is well reputed in puerperal mania, but especially its effects in mania and melancholia with stupor have been most gratifying. It is especially efficacious in the apparently most hopeless cases where the patient sits in a stupid manner with the head bent forward, taking no apparent notice of anything; answering in monosyllables, or not at all, often eating nothing unless fed, skin cold and blue, pulse weak and intermitting.
With the foregoing symptoms we have occasional fainting spells with temporary unconsciousness and suspension of the hearts action. Under the influence of Veratrum, the depressed vital powers are soon revived and the patient advances to a complete recovery. After a seeming recovery, the patient is liable to a relapse, if the medicine is too soon discontinued, but when once the cure if fully accomplished it remains permanent.
Melancholia, with anxiety as if she had committed an evil deed, sadness, despondency, and grief with involuntary weeping and despair of her salvation. Delusions of being a prince, a hunter, or being deaf and blind, pregnant and in labor; much lascivious and profane talk; wants to escape, can scarcely be held.
It is related that about the year 1500 B. C., a certain Melampus is said to have cured the daughters of Proctus, King of the Argives, who in consequences of remaining unmarried, were seized with an amorous fever and affected by a wandering mania. They were cured chiefly by Verat. alb., given in the milk of goats. Dr. Talcott says that at the asylum they verified the homoeopathicity of Veratrum in amorous fever and in wandering mania, particularly when the symptoms of peculiar excitement are followed by great mental depression, and tendency to collapse.
The Veratrum patient combines the wildest vagaries of the religious enthusiasts, the amorous frenzies of the nymphomaniacs and execrative passions of the infuriated demon. The extremities become cold and blue and the hearts action weak and irregular, the respiration hurried; and all the objective symptoms are those of utter collapse. With such a picture before us, we can scarcely hesitate to select Veratrum album.
This remedy is chiefly indicated in the treatment of women whose mental disturbances have been caused by uterine displacements, and whose general constitution has been sapped by a long standing debilitating leucorrhoea. Although not usually rapid in its action, it is almost certain to restore to health the diseased sexual organs, and with this restoration sound mental health returns.
The patient is nervous, very irritable; indifference toward those she loves best; sensitive to the least noise, sadness; worrying about her health and the future, with frequent attacks of weeping< in the evening and in open air; fits of involuntary laughter or weeping, indisposition for mental work, with weak memory and difficulty in expressing her ideas. Restless sleep, disturbed by anxious dreams, awaking in a fright. Sepia and Lilium tig. find an important place in the treatment of depressed and irritable females.
The troubles of such cases originate largely in the malperformance of duty on the part of the generative organs. Both of them are full of apprehensions and manifest much anxiety for their own welfare. In the Sepia case, however, there is likely to be found more striking and serious changes of the uterine organs, while the Lilium patient presents either functional disturbances or very recent and comparatively superficial organic lesions. Lilium is more applicable to acute cases of melancholia where the uterus and ovaries are involved in moderate or subacute inflammation and when the patient apprehends the presence of a fatal disease which does not in reality exist.
The Lilium patient is sensitive, hyperaesthetical, tending too often to hysteria. She quite readily and speedily recovers, much to her own surprise as well as that of her friends, who have been made to feel by the patient that her case was hopeless. The Sepia patient is sad, despairing, sometimes suicidal and greatly averse to work or exercise. That is, however, oftentimes a good reason for such a patients depression, for too frequently she is the victim of profound organic lesions which can be cured only by long, patient, and persistent endeavor.
Ignatia is another one of the long list of our marvelous remedies. Its peculiar mental symptoms, like those of Aconite, Chamomilla, Nux vomica, and many others, are most characteristic. It has in it a marked element of sadness and disposition to silent grieving; any one suffering from suppressed grief with long-drawn sighs, much sobbing, inclined to smother or hide her grief from others. She desires to be alone with her grief. Another equally characteristic state of mind is changeable mood. No remedy can equal Ignatia for this.
The patient is at one time full of glee and merriment to be followed suddenly with the other extreme of melancholy sadness and tears, and so these states of mind rapidly alternate. Mentally the emotional element is uppermost and coordination of function is interfered with. Hence it is one of the chief remedies for hysteria; ailments arising from bad news, disappointed love, grief, mortification, or jealousy often require Ignatia.
It is one of our best remedies in various mental disorders and is often required for the chronic effects on mind when Ignatia, apparently well indicated but fails to effect a complete cure. Natrum is a chronic of and complimentary to Ignatia in these cases.
Depression of spirits is characteristic of this drug; the patient is sad and weeps much, like Pulsatilla, the difference being that the Pulsatilla patient is soothed and comforted by consolation, while the Natrum mur. patient is aggravated. Consolation aggravates the complaints of Natrum mur. patient, and is fluttering of the heart follows. It affords relief to patients given to much crying; this continuous weeping being of the open kind, while the grief of the Ignatia patient is more passive and concealed. Natrum also has difficulty of thinking, absence of mind, weakness of memory, and will power; fondness for dwelling on unpleasant trifles, is joyless, indifferent and taciturn, hates people who had offended him.