Some thirty-five years past, after having practiced in a large and cultured city of the middle east, I unfurled the banner of homoeopathy to engage in general practice in Rio Arriba Country, New Mexico. Some twenty-five years I have been too busy otherwise to follow the interesting practice of obstetrics. I say this with all sincerity, for with homoeopathy it becomes a most satisfactory form of practice.
Homoeopathy listens attentively to the unerring voice of nature, grows in the ability to interpret, and walks with it in faithful obedience. In no other branch of medical practice do we find the characteristic symptoms so clear cut, accentuated, and undiluted with residual symptoms.
Hospitalization in those days was unknown ; neither the inclination or the economic ability tended in that direction. In fact, where today it is difficult with group plans of hospitalization to secure a room, at that time it was next to impossible to have the room taken.
Fate had placed me in the saddle with a set of the old hand-made Boericke & Tafel potencies, two hundredth centesimal, carefully packed away in my saddle-bags. I was in the wilderness, on the range, among pioneer folks. Life went on, reproduced itself, sometimes in the cabin, sometimes on the trail, at other times in the camp, always surviving to a fair degree. No long obstetrical preparation, no urinary tests, no instrumental measurements, but the frequent quick request to get down to business and deliver the woman from the pains and distress of childbirth.
The native midwife had been there before you were called from the quiet and peaceful meditation of nature while travelling along the winding trail or cow-path.
Dark and sombre implications came in rapid succession past the mental horizon when one after another the many difficult experiences of the past were recalled. There was not much time to take the case, no library or opportunity for repertorial refreshment. There had been days of uterine inertia, depletion of the vital force, evidence of dread infection, and the heart- rending cry of the patient for relief. Under the great emotional pressure personality changes were in the making, and it was here where a knowledge of the psychic symptoms of our materia medica came to great advantage. There were no drug toxemias to complicate, no consultations, no asepsis, but brutal nature in the raw on a rampage in the delivery of a new life, and the battle to save it.
It is under such circumstances one feels an unusual appreciation for the genius of Hahnemann, for those who carried down the knowledge to us. In the fearsome darkness, broken by the faint glimmer of a flickering candle or kerosene lamp, the anxiety and panic of the patient, the apprehension of the family, all add to the phantasma of weirdness. Under such circumstances, one realizes the superb value of the concentrated dynamis of our potencies. I know of no other way or establish internal order from chaos and prepare the way to get down to the necessary mechanical work of the occasion.
Who among you does not recall the anger and quarrelsomeness, the irregular contractions, quickly allayed by Chamomilla, and the woman attending to the business of delivery in a normal manner. I have been accused of using an unusual and potent dose of morphia.
Those days are gone, and few among us realize what the indicated remedy offered under the primitive trying conditions. We did not have the modern refined methods of suppression and palliation. How vastly superior our time-tested therapeutics are in comparison to the innumerable number of panaceas that have appeared upon the medical stage since I began to travel the tortuous road of general practice. They have passed into the limbo of broken idols.
On the other hand our homoeopathic luminaries such as Arsenicum, Carbo veg., Lachesis and the host of others grow in stability in action and range of usefulness, whether they be used in primitive application or under stream-lined tempo. Under modern conditions, in my opinion, homoeopathic therapeutics in obstetrical practice offers a splendid field for the young graduate. Especially is this the case when one considers the difficulties of the past.
I recall a patient who had been under extended constitutional treatment, and late in married life became pregnant. It is surprising how often under correct homoeopathic treatment these women react in the reproductive cycle. Being a primipara, the best obstetrical specialist in one of the large hospitals of New York City was engaged, with the agreement that she be placed in the hospital and that I do the internal prescribing before and during the time of the delivery. A careful and complete examination resulted in the decision that a Cesarean section was needed and would be done in due time.
When the climax of the episode came, unable to get away from my past, homoeopathic habit pleaded for more time to permit nature to paint the remedy picture, which I contended would be beneficial to the patient. The thrill which comes with seeing the beauty of a desert or mountain flower, the stately forest, the bright plumage of the tropical flamingo, or any other natural beauty, is not surpassed by that which comes from the rounded symptom picture of the indicated remedy. I have never seen a more perfect picture of Kali carb. in labor. Although my plea for further time was treated with disdain the patient, under the action of the remedy, did have an early delivery without the operation. There was no tear and a rapid convalescence.
Today there is the opportunity of months of therapeutic preparation of the expectant mother, the practical means to educate the family along homoeopathic lines.
In proportion as we grow in the wisdom of our treasured are do we realize the great potential possibilities involved therein. This applies to the important field of obstetrics.
HAMDEN, NEW HAVEN, CONN.
DR. GRIMMER : This paper is true, every bit of it. What the old homoeopaths did under dreadful handicaps, under conditions not always, or rarely, we might say, aseptic, still there were none or very few of the severe eclampsias and septicaemias and things that often did follow ; now they are not following so much with the refinements and care that they get in hospitals ; but in the olden times, when men had to go into the farm houses and homes and with whatever help was at hand, many times a servant or a husband, and make these deliveries, even forcep deliveries, yet with remedies like our Arnica and others these patients made marvelous recoveries.
The plea that the doctor makes is very appropriate, in that the homoeopath instead of having less opportunity has more opportunities these days to really help the pregnant woman and the coming into the world of a new life with homoeopathic prescribing.
DR. ROBERTS : I want to call attention to a little book that is our of print, Yinglings Accoucheurs Emergency Manual. It is a wonderful help. It has helped me out in many a place because it has a good repertory of all those conditions that we may meet with, and there is a section also for the remedies and good clear indications for their use. If one is doing obstetrics and can get a second-hand copy it will be worth many times what it costs.
DR. SMITH : That books has been remedy reprinted in India.
DR. SCHWARTZ : The great advantage of the homoeopathic remedy is in its simplicity, and one can get wonderful results from the indicated remedy. Today we have the refinements but we also have the complications of our so-called civilization, with the coal- tar remedies and the effects of radio advertising, because we do not always get homoeopathic patients. They come to us with all kinds of drug in their systems.
DR. CUSTIS : I also want to speak of Yinglings book, and the old Guernsey book of Diseases of Childhood, which has given me great help during my practice. I feel that homoeopathic remedy has only one limitation in obstetrics, and that is actual mechanical obstacles. We must always remember the possibility of actual mechanical obstacles. For instance, I remember one case I had of a woman with a double uterus. The non-pregnant side of the uterus was down at the lower side of the pelvis and absolutely blocked the entrance to the pelvis. Homoeopathic remedies would do that case no good because they could not change the anatomical position of the non-pregnant side of the uterus.
I remember another case with a fibroid tumor in the lower uterine segment blocking off the pelvis. The homoeopathic remedy could do that case no good for the same reason.
Also, we must remember that there are cases of things like fibroids in the wall of the uterus which, after delivery, stop the proper contraction of the uterus. It is necessary in the practice of obstetrics, it seems to me, more than in any other branch of medicine, to make a proper diagnosis, and that diagnosis must include the possibility of mechanical obstacles to delivery.
There is no excuse on earth for a homoeopathic patient having eclampsia if the patient comes to you early in pregnancy, because, certainly, if there is one thing we can control, it is the toxaemia of pregnancy if we get it in time to do it.
There is no reason why a woman with a proper size pelvis and a proper size baby should not have that baby fairly normally, if you dont mess the case up, and by messing it up I mean doing a lot of these things that a great many obstetricians think are proper to do, and which we are under pressure to do, because of the propaganda spread by the drug houses-barbiturates, opiates, paraldehyde and all the other things to keep the woman from having pain in labor. Think the Lord, the pendulum is beginning to swing the other way, and the best men of the “old school” have finally learned that it gives them awfully bad babies. Perhaps from now on we wont have as much trouble keeping our patients away from those things.
DR. SCHWARTZ : Twilight sleep !.
DR. CUSTIS : Luminal, morphine, codeine, paraldehyde, scorporalamine,all that list of things which has become popular.I have turned more than one patient down because they came to me saying they wanted that kind of labor. I say, “If you want that kind of labor, go somewhere else. I cant do it ; I dont know enough”.
But we must remember in obstetrics there are cases where the placenta is in front of the baby, where you have a real placenta praevia. Your patient is in real danger. The safest thing to do in that case is something different than to give the homoeopathic remedies. Except for mechanical things-and that is a mechanical thing because of a malposition of the afterbirth-we are pretty poor if we dont keep away from a lot of the complications of both pregnancy and labor.
DR. SCHWARTZ : Speaking of mechanical obstructions, I recall when I was over at Womens and Childrens Hospital for four months, a woman coming in to be delivered. She was about forty- five years of age, the wife of a coachman for a wealthy family who wanted a doctor who is considered a very good surgeon and a fine obstetrician. She did not see the patient until shortly before she was in labor. This was the fifth pregnancy.
As intern there, I was in the operating room. The patient had quite a bit of bleeding. The baby was delivered all right but the woman was losing considerable blood. Her pulse was very rapid. The doctor thought she had controlled the haemorrhage. By the time the woman got back to bed and the doctor had just got black to her home, I called her up again because I noticed the oozing and the bleeding. We all thought the uterus was fully contracted. By the time the doctor got back to the hospital and made an examination, she found what she had thought was the contracted uterus was an enormous fibroid, where the uterus should be, making pressure on the uterus. That is where the bleeding came from.
Of course when the condition was recognized the haemorrhage was controlled with secondary treatment, but there was this fibroid blocking the passage, the size of a babys head and hard as bone.