SURGERY VS PHYSIOTHERAPY



In conclusion I wish to make the suggestion that even a homoeopathic physician could increase his armamentarium and curative facilities if he would be willing to investigate and study the technique and therapeutic value of some of our simpler physical treatments. Most of us do not appreciate what we could do with our hands and the therapeutic value they possess.

We may smile at osteopathy; we may ridicule and condemn chiropractic, and we many think that massage and medical gymnastics have no real value except that of a little “soothing rubbing”; but in maintaining such an attitude we may not only lose a great many patients but fail to make use of all the good useful and harmless means that a good conscientious and all- around physician should have at his disposal.

Of course, in this society of the I.H.A. there may be some who are such perfect masters of homoeopathic prescribing that they do not need the assistance of any other means in treating and curing their patients; but the great rank and file of honest and hard working homoeopathic physicians may not always be able to find the absolute similar remedy and they would be greatly assisted by adding a few physiotherapy apparatus to their office equipment.

NEW YORK, N.Y.

DISCUSSION.

DR. BRYANT: The reason I was particularly anxious to have Dr. Almfelt prepare a paper was due to some articles I had read by Kovac. Kovac probably has the best book on physiotherapy on the market today. He made the statement that you are not treating disease locally as such, but that these treatments had a specific effect upon the autonomic nervous system and did a great deal to create a balance in the autonomic nervous system, which I think is quite evident from Dr. Almfelt’s paper.

DR. KAPLOWE: Dr. Almfelt has very well presented a more or less difficult subject–difficult when we view it in the light that it is sometimes hard to reconcile homoeopathy and physiotherapy and, I might even say, other therapy.

Even though Dr. Almfelt considers himself a physiotherapist, the typical physiotherapist looking upon himself more or less as a treater of disease by mechanics, Dr. Almfelt goes further than that and realizes that even though the human body functions as a mechanical apparatus, it nevertheless is governed by a dynamic or vital force which rules supreme, in the words of Hahnemann. When a physiotherapist has that conception, he cannot go wrong.

Dr. Almfelt, what remedies have you used mainly in cases where there is gangrenous appendicitis with local peritonitis?.

DR. ALMFELT: I haven’t had any such cases for a good many years. I do not think I would attempt to treat them. I would turn them over to the surgeon. They would be a little bit too dangerous. The remedy would be whatever the symptoms would indicate.

I am basically a homoeopathic physician; please don’t forget that, gentlemen. I am not trying to be a physiotherapist, I only use it as an adjunct in a practice that deals largely with chronic disease.

DR. WAFFENSMITH: Looking back, I think we will agree that had the medical profession take cognizance of homoeopathy, also the various forms of physical therapy, and incorporated them in the college curriculum, many difficulties would have been avoided, which may lead to the ultimate disruption of the medical profession as we understand it today.

I must admit through all the years of my practice I have devoted myself to the exclusive use of homoeopathy. So far it has fully met my needs. On the other hand, I am ready to further admit it may not meet the needs of others, but it is my opinion were medicine broad and thoughtful enough, these questions would ultimately be solved by the individual, both of the profession and the lay public.

It is my opinion one cannot make a successful homoeopathic specialist, neither a physiotherapeutic or surgical specialist.

Each person has aptitude, something or other tends to predominate. Therefore, it becomes a matter of desire, training and experience.

I commend the paper because it dovetails with the use of homoeopathic remedy.

DR. PULFORD: I am very much opposed to my friend Waffensmith. I am a firm believer in surgery, with Hahnemann, when all other methods fail and the condition jeopardizes human life.

DR. GOBAR: About the use of homoeopathic remedies in severe cases of appendicitis. Just before I came here I had a very interesting case, a man who has kept me in hot water for some years. He started out about four or five years ago with a gastric ulcer. By hard work I kept him away from surgery and he got along very nicely and has done extremely well.

About six months ago he got bronchopneumonia. We got him into the hospital, treated him, and his stomach went back to him.

I finally got that straightened out and got him out of the hospital in pretty good shape. He was doing very nicely. He lives on the windiest street in San Francisco, and he got another congestion. I got him to the hospital, and he developed an excruciating pain over McBurney’s point. It was extremely tense, and it looked very much as if he would have to go to surgery. He had a double hernia and was a very bad risk. I did not know what to do. I fooled around with him a while, and finally put him on Iris tenax. It was really surprising how that cleared up. There is no doubt that eventually he will have to have surgery. He has this double hernia.

I got him out of the hospital just before I left. The appendiceal trouble cleared up,and he was entirely free from tenderness and pain, was up and around outside the hospital, and doing very nicely. That is the third or fourth case that has responded very well under Iris tenax.

DR. JACKSON: Regarding the use of surgery, I think a great deal depends on whether the physician is a surgeon and a homoeopath or whether he is a homoeopathic surgeon. There is quite a little difference there.

Another thing, a great deal depends on whether the surgery is emergency or whether it is premedicated. In emergency surgery you do not have the opportunity of using homoeopathic premedication. You can use your homoeopathic treatment subsequent to surgery. But if it is premeditated, in other words, if you know in advance that you are going to do surgery, then premedication homoeopathically is certainly going to make a lot of difference in the way that patient gets along during the necessary surgery.

Surgery does have a place in homoeopathic medicine as well as in allopathic medicine. Physiotherapy and diet control, of course, have their fields also. The physician, regardless of his school, who fails to recognize all of those things in failing in the real practice of medicine. In fact, he is failing in the

real practice of homoeopathic medicine. He may not do surgery himself, but there are certain cases, as has been said, where it is very necessary to have surgery.

Regarding appendicitis, the thing that has to be considered primarily is whether there is an obstruction which prevents that organ from emptying. If it is, as you might say, corked up with infection, you are going to have a ruptured appendix, if you don’t do something about it. Surgery is absolutely necessary under those conditions.

I have taken care of many cases, where I was confident there was no obstruction, with homoeopathic medication and the patients have gone for many years without a subsequent attack. That is something that the physician has to determine in the individual case.

DR. UNDERHILL: Theoretically, it is fine for a man to be both a homoeopathic physician and a surgeon but, practically it does not work out so well because most of those who combine the two, are about 99.44 per cent surgeon and the rest homoeopath.

DR. BOGER-SHATTUCK: As I was the victim of a ruptured appendix myself, after the best homoeopathic prescribing that Boston has, I would really like to know just how Dr. Almfelt got at all those cases.

I myself, since my own experience, have stuck pretty close to the blood count. I want to know just what Dr. Almfelt does about the blood count and just how it is controlled, other than entirely symptomatically, because symptoms, I know, will sometimes fail as they did in my case.

DR. MOORE: I want to thank Dr. Almfelt for his classification of surgery. It is one of the best I have ever heard. I have some surgical friends who don’t realize that there is such a thing as destructive surgery. I am going to tell them about that.

DR. ALMFELT: Of course, there are many things to consider even in the treatment of appendicitis. You see, I do not have a so-called homoeopathic practice. In fact, I have no regular patients. They come to me for certain reasons, because I use diet and physical treatment. Hence, before these people come to me, they usually have had a diagnosis made by some other school man. So I do not always go into the blood count or such things. If you have the time to do it, it is all right to do it.

Even in ruptured appendices, surgery is not always needed. It depends upon where the rupture takes place. If it ruptures into the intestinal tract, it is safe to leave it alone, without surgery, and treat it mechanically. Of course, if it ruptures into the peritoneal cavity, the safest way in surgery.

Gustavus A. Almfelt
Gustavus A. Almfelt, MD