DEPARTMENT OF PRACTICAL CASE MANAGEMENT


Do not think for one minute that these remedies are all that might be indicated, for there are many that may be called for. Opium has a most profound effect on the very character of an addict, affecting as it does the mental, nervous and physical system of the patient.


CASE REPORTS.

CASE I. Male, age 57, married, 3 children; occupation: garage business; weight 144 lbs. Chief complaints: loss of appetite, chronic indigestion and constipation; duration twelve years. Has tried all sorts of treatment and diets without relief. Becoming increasingly weak and emaciated.

His wife was informed by at least one physician that her husbands trouble was undoubtedly cancer.

Patient was thin and anemic in appearance, bordering on cachexia. Mentally very irritable and brooding much over his condition. Complained of feeling dazed and confused in his mind. Unable to decide matters pertaining to his business. Compelled to lie down and rest several times a day. Unable to be actively engaged in his work and reaching a point where he could no longer give his business adequate supervision. Rumbling, gurgling noises in the abdomen were frequent and annoying.

Chronic constipation for many years. Much ineffectual urging, the stool being variable, sometimes hard, sometimes soft, often nodular and lumpy. Dryness of mouth with a metallic taste has been a persistent symptom, also dryness of the skin with annoying itching. A feeling of weakness and uncertainty in the back and legs has been increasingly complained of with easy fatigue on walking.

Phantom tumor of the abdomen has appeared from time to time in various locations probably due to incarcerated flatus.

Pending selection of the remedy suitable dietary correction was instituted but without relief. Study of the case resulted in the selection of Alumina as the indicated remedy. This selection raised a question as to whether the patient needed potentized Alumina or whether he was being poisoned by the metal. Upon inquiry it was discovered that aluminum utensils were used at home in the preparation of food but in order for this to be etiologic significant the patient would have to be allergic to aluminum.

As a precautionary measure the discontinuance of the use of such utensils was advised. Fortunately in marking a re- examination a discovery was made that had been overlooked the first time. The patient worse an upper denture the base of which had a bright metallic appearance. Upon inquiry the patient stated that the denture was mounted in aluminum. How long had he worn this plate? Twelve or thirteen years. How long had he been suffering? About twelve years.

Instead of prescribing Alumina the immediate discarding of the aluminum denture was advised. This proved to be the turning point in the case and a rapid and uneventful recovery has resulted. Improvement began in less than two weeks after the aluminum poisoning was stopped. Now after several months everyone says that the patient seems better than he has for years. He no longer suffers from indigestion; the bowels are regular and he is looking after his business every day.

We were doubtless more fortunate than wise in discovering the true etiology of this case. The unusual appearance of the denture had escaped us at a previous examination. This serves to emphasize the importance of a careful physical examination as a routine procedure in every case.

CASE II. The only possible excuse for this case was that it occurred many years ago. A man who had enjoyed shad for dinner complained of a fish bone sticking in the roof of the mouth. Examination with a good light disclosed nothing and the patient was informed that the sensation might persist for a while after the fish bone was gone. In a short time he returned with the same complaint in the same spot on the palate. Again no fish bone was discovered even by means of a digital examination.

Just why he returned the third time will always remain a mystery. He should have been hunting for another doctor. “Its still there, Doc,” he said, “right there”, pointing to a spot on the hard palate. “I can feel it every time I rub my tongue over it”.

Luck was with us for when he mentioned the word tongue it actually did occur to us to examine the tongue and sure enough there was the fish bone as plain as day.

QUESTION AND ANSWER DEPARTMENT.

[ SEnd questions to Dr. Eugene Underhill, Jr. 2010 Chestnut Street, Philadelphia, Penna].

Question: WHAT IS THE MOST EFFECTIVE REMEDY IN HOMOEOPATHY FOR WEANING AN OPIUM ADDICT? DR. A. S. RAJAH, SINGAPORE.

Answer: Probably the most effective remedy for weaning an opium addict is Nux vom. high, and next, Opium high. Sometimes Ipecac comes in and occasionally Lycopodium, with the emaciation from above downward that so often occurs in these patients.

The most effective remedy is, of course, the most similar, and each individual personality must be taken into consideration, and the reaction of that patient under the narcotic itself. Dr. H.A. ROBERTS, DERBY, CONN.

Question: IS THERE ANY SPECIAL HOMOEOPATHIC TREATMENT FOR OPIUM SMOKERS? DR. A.S. RAJAH, SINGAPORE.

Answer 1: The treatment for opium smokers would naturally be first antidotal and then constitutional-in other words, first the treatment for an acute condition to be followed by the chronic remedy-and the remedy may be the same of different. In the constitutional treatment the above statements would hold as well as for weaning the patient. In the excitable stages have particularly in mind Belladonna and Hyoscyamus, with their clear indications: Lachesis and some of the snake venoms in the more subtle cases, especially Naja with its nervous reactions. In the acute states of wakeful excitement Coffea. In the exceedingly childish states of irritability Chamomilla. In the downright sulky ugliness Nux vom.

Do not think for one minute that these remedies are all that might be indicated, for there are many that may be called for. Opium has a most profound effect on the very character of an addict, affecting as it does the mental, nervous and physical system of the patient. DR. H.A. ROBERTS, DERBY, CONN.

Answer 2: Pulsatilla and Muriatic Acid for the diarrhoea, Chamomilla for nervous states.

After the first remedies Calcarea sulph. and Kali phos. help build up the nervous system. Any of the five may be needed for the condition, depending upon individual symptoms. In my own experience Calcarea sulph. has been my best remedy. DR. A.H.GRIMMER, CHICAGO, ILL.

Eugene Underhill