In these days of frustration and lowered spiritual quality the message to the doctor telling of acute illness is often delayed until the illness has become well advanced. Otitis is one of these critical conditions and often is not seen until suppuration and spontaneous drainage has become effected or even an extension to the mastoid has resulted. This provides more opportunity for the study of these critical conditions.
With middle ear abscess the question of paracentesis will often be presented. In the absence of that degree of certainty which homoeopathic practice confers and when the suppurative focus has become fairly well developed, paracentesis may well be adopted. But the homoeopathic remedy is certain in its effects, at least more certain than anything else; it is the most important factor in most cases, the most decisive influence in the turn towards recovery.
“Spontaneous” drainage when aided or directed by the remedy is less destructive, there is less tendency to premature closure, extension is intercepted and the period of recovery in general is much shorter. Of paracentesis before a reasonable degree of suppurative development has been effected nothing good has come to my notice. Certainly it makes recovery slower and relapses and chronicity are more likely to ensue.
In the mastoid area a similar condition pertains. Here again, with the exception of some atypical cases and the positive exception of certain advanced conditions the homoeopathic remedy should, it seems to me, be the determining factor; to be given at least twenty-four hours in which to develop vital power; and twenty-four is usually enough. Even when the tympanum has not ruptured the abscess may resolve with free discharge through the nose or by sleeping into the throat; or if already ruptured there may be increased evacuation through the ear.
These terms are affirmed without being unmindful of the always difficult anatomy, of the possibility of individual anatomical peculiarity and consequent precarious pathology that may result.
With exceptions dictated by these factors and rarely by some inherent personal quality or by exceptional virulence of the infecting agent itself, the homoeopathic remedy is the best coup. Even should operation be unavoidable and the urgency extreme, the homoeopathic remedy will offer the indispensable stratagem in the game to save life.
I report an ordinary case of mastoiditis although at critical stage in which the homoeopathic remedy was the sole reliance:
Alice A., aet. 11, had had earache four days, the left first then both. Both tympani had ruptured, there was swelling and redness about the them and there was free discharge of bloody, brownish soreness; relieved by warmth; shrinking from being touched about the ears. At first the pain had wakened her frequently but during the latter twelve hours or so there had been only soreness and dull headache.
The girl had evidently became more ill, however, and there was an especially sore spot on the mastoid at a level with the orifice. She felt quite weak, as if unable to sit up. She was rather darkly flushed, dull heavy countenance, dull mentally, dozing much, the head heavy, dizziness. Noise in ears like trolley cars. Photophobia. Chilliness and heat. Thirst for cold day and night. Restless moving from midnight until morning. Sleeplessness. Temperature 102.8, pulse not recorded but I think it was relatively slow.
Lachesis 1000 was given and the child had a good night, was quite bright next morning and the discharge from both ears was considerably increased. No local treatment was used. After two weeks recovery was perfected.
DR. STEVENS: There is nothing I dread more than a case of middle-ear involvement, but the right remedy can work wonders. Puls. is apt to help early in the game. Sil. often is the remedy when there is real suppuration, but always one must differentiate.
I agree with Dr. Hayes that too early paracentesis is a great mistake. The given case is fine.
DR. BROWN: We all get these cases, sometimes after they have been very bunglingly handled by those who believe differently than we do and possibly I have bungled it myself for in no case does pure homoeopathy show its superior value and sterling worth than in mastoiditis.
DR. WOODBURY: It would be hard to improve this prescription; it was not Arsenicum, nor did it seem like Rhus. Lachesis is a remarkable remedy, taken all in all. I have been fortunate in never having an ear drum punctured, though have had them rupture spontaneously. I have had but one mastoid operated upon; that one followed a severe attack of scarlet fever. Hepar and Silica have served me greatly in healing the suppurations of otitis media. It takes courage, finesse, and persistence to win in these cases; but win homoeopathy will, when properly applied.
DR. BELLOKOSSY: I like his paper, but cannot understand what the terms; “difficult anatomy, possibility of individual anatomical peculiarity and precarious a pathology” mean. Is not the homoeopathic remedy always the best coup? I have seen several mastoiditis cases after operation and they had to be treated as if they never had been operated. We should not forget the operations– while they may save life in some cases–in other cases endanger life. The audacity and mendacity of the operating gamblers should not impress us any longer!.
DR. POMPE: Some 20 years ago I was called to see a child of 2 or 3 years 9 miles from town who had been crying without any apparent reason for several days. I could not determine whether there are any ear trouble but on that crying symptom I gave her Caps. 1M. and very soon the crying stopped, so apparently there had been ear trouble. Several years later I was called to see the same child then 70 miles up the Columbia River and reached the patient at 10 p.m. She was then asleep but she had complained of pain in one of her ears for some days, so I parted her lips gently and dropped in a few 1 2 5 pellets medicated with Caps. 1M. as I remembered that I had give her this remedy before. I was able to leave on the 6 a.m. train next morning, for there was no further complaint. Homoeopathy can sure score remarkable triumphs in ear troubles as in all other sick conditions.
DR. A. PULFORD: Another of Hayes excellently handled cases. Dr. Hayes has illustrated just what a real homoeopath should, and can do, if he cares to.
Perhaps I never had a case of mastoiditis, and perhaps would not know a case if I should run across one. Perhaps also it is my dense ignorance that gives me such implicit faith in the indicated drug when properly applied.
I have had quite a number of ear cases of all kinds, but my faith in the indicated drug never faltered, and for some unaccountable reason my patients neither died nor were they compelled to visit the surgeon.
I well recall the case of a 4 year old child, who already had had four delicate mastoid operations. At 11 p.m. I was called to the bedside of that child. The mother told me that every attack had commenced that identical way, and the child had been tortured unmercifully, and she was sick and tired of allopathic treatment. Here is what I found: The child woke suddenly, screamed and said someone had stabbed her in the ear. Raging fever, skin burning hot leaving a burning sense to my fingers, and of a bright scarlet color.
Eyes bright and glistening, pupils fully dilated giving a wild look. Carotids throbbing violently. Throat scarlet red and dry. Every jar, especially of the bed increased the pain in the ear intolerably. Who could possibly have missed Bell.? She received a single dose of the 30x. In fifteen minutes she was sound asleep. Woke in the morning with a watery discharge. The drug was not repeated, neither we any other remedy given. It is now over 20 years and there has been return.
DR. D. T. PULFORD: This paper has interested me very much as I, like all others, have had a few ear cases in my short time, all treated without the knife and some after the ardent specialist had left his usual mess. One I fell down on miserably because the child, a spoiled one, yelled so long as so loud that the parents wanted to drum lanced and she had it and later repeated the performances. The specialist had told the fond parents that she had unusually small canals and that cutting was imperative. One lady quite deaf from the “usual scientific treatment” regained her hearing under Sulphur.
The only mastoid I had was last June. This little girl, about the same age as Dr. Hayes little patient, had had an otitis media which had not been progressing so very satisfactorily. She had always been frail. She was thin, had an awful muddy color, to her face particularly. Just one of those “one damn thing after another” cases. It struck me that Tub. bov. might not be a bad thing for her and I gave her a dose. It set up the fireworks just the day after we left for the I.H.A. meeting. Upon my return was called out to see her at once. The protruding ear told the whole story.
As in my custom, the first two prescriptions went wide of the mark until I found that she perspired only on uncovered parts. Thuj. in the 1M. and later 10M. drew the ear back and the whole thing cleared up along with a great improvement in her general health. A low potency man called in my absence refused to even see the case. A child specialist hung yards of crepe and an ear man, the relatives, friends, hospital attaches, etc. etc., damned the mother and myself but we stood our ground and homoeopathy came through in great style. The gratitude of the parents was in indirect ration to the way they paid their bills as I am still trying to collect. A peculiar thing was that the ear cleared up without a bit of discharge.
DR. JOHN HUTCHINSON: Mastoiditis by Dr. Hayes evidences on all points the merit of homoeopathy. The paper aroused all my fears on first reading by its pathology. Can skill and remedies correct all this disorder so delicately involving not only structures but their vital organism? And then we see that whether the case is incipient, severe, advanced, or whatever, the remedy for it when well chosen brings cure.
For some years now I have avoided, at an annual banquet, sitting next a surgeon whom I like personally because we always have got into a warm discussion of mastoiditis. That is his specialty, and he is operating hospital and other cases continually. Of course with a consummate absence of tact I have hitherto got involved with both feet; I must know that often he is right and so far at least I have been wrong. Yet I am perfectly sure that he considers me wrong in all counts. This is worth considering since surgery of the ear cases having mastoid involvement seems to be without exception the dominant practice.
As a matter of fact I have never referred a case of mastoiditis to a surgeon. It has not seemed to be the thing to do, while I have had some pretty bad cases. Those which have not been badly treated at the outset have invariably yielded kindly to the indicated remedy. That remedy has oftenest been, in my experience, Capsicum, which as far as I can see loves to resolve mastoid inflammation.
Some years ago a fellow practitioner called my attention to Capsicum, otherwise I might never have discovered it. But Dr. Hayes has demonstrated that it is not the only specific (if one is to use that much abused word).
DR. SLOAN: Some twenty years ago, the eight-months old daughter of my “Digitalis & Ethers” patient had an otitis media. She had been yelling for nearly twenty four hours and the father had given all the dope he dared, without relief. He asked me for help. The drum was congested but no bulging. Puls. 1M., 1 dose, put her to sleep. No ruptured drum and a perfect recovery. However, it took him twenty years to take homoeopathy seriously.
Some years ago I had a mastoid case which cleared up under Capsicum. There was a high temperature and the woman was very sick.
I can conceive of cases with free pus in the mastoid cells, which should be drained. We must remember that cavernous sinus, which leads to the brain (?).
DR. HAYES: It was worth the trouble of writing the paper to have elicited Dr. D. T. Pulfords report of his Thuja mastoid case. I begin to think that one does not have to use the same remedy for the same nominative!.
Never yet, Dr. Hutchinson, have I ever recognized a Capsicum similarity for mastoiditis. On what does it popular reputation hang? I see little of significance in the text under the ear section. Are there important concomitants? them? I could never rest comfortably merely on double black marks based on location and pathology.
May I ask Dr. Woodbury what result was obtained with the operated mastoid following scarlet fever? From the little observation that has come my way I would expect certain death.
To Dr. Bellokossy: I should not have used such doubtful language. I meant simply that some mastoids are more self draining than others and the formation of some limits extension and destructive pressure more than others. And some mastoids have larger cells, which facilities spread thus diminishing the liability of damage to the plates. Also the plates may vary in thickness and in distance between them.
If any should be interested in the answers to my questions and will say so I will send the paper around a third time.
DR. WOODBURY: The scarlet case recovered after the operation, but during the operation there was injury to the facial nerve which resulted in a one-sided facial paralysis, and, of course deafness. It was in my first year of practice, and there seemed to be nothing else I could do, as the patient was in a very serious condition previous to the operation. The sinus healed under simple sterile dressings, and remedies. I believe the surgeon used a little campho-phenique, till I took her dressings over. The other day I was called to see a child who had been sent home from school by the school nurse, with a diagnosis of mastoiditis. The story was that the boy had been hit by a snowball, just over the mastoid process, which resulted in hard, reddened swelling. Arnica cleared it up, and the mastoiditis vanished. I am convinced I cured one case of threatened invasion by Capsicum.
DR. FARRINGTON: Dr. Hayes always seems to pick out subjects of especial interest and, as in this case, involving questions at issue in the profession at large.
Few who call themselves homoeopaths have the courage to treat mastoiditis medicinally. Like some of the rest of the group my experience in this ailment is limited. I have had four cases in nearly forty years–actually diagnosed. One, a boy of 18 or 19 following an otitis caused by his going in swimming too soon after measles. Hepar was quiet sufficient. Another with distinct redness of the mastoid was cured with Capsicum. A third, the wife of a physician, I didnt help with my first remedy. Her husband called in Dr. Edgar J. George of Chicago, one of the few O. O. & L. specialists who prescribed homoeopathically and he cured her with Gels. 6x. The last was the sneaky kind, coming on with few symptoms. little local soreness–marked insomnia.
I didnt recognize it and her husband, also an M,D., took her to the hospital. Of course, Ive had hundreds of otitis media; in many the drum ruptured “spontaneously” and then the trouble cleared up with remedies. There is a point to be considered here. If your remedy is not going to absorb the pus or open the Eustachian tube and the drum is about to rupture, I think paracentesis is in order. When skillfully done there is a clean incision instead of an irregular tear and it heals without much damage to the drum.
Yet I have had only two such instances. From one I learned a lesson. A boy of twenty, agonizing pains; no relief from heat, cold, etc. or the remedy. The drum was punctured and serum and pure blood shot out. Recovery was rapid. Several years later an identical case. The patient was walking the floor in agony. Drum bulging, red; face red; some temperature. They were getting ready to operate but the specialist was too slow in getting there. I said I could fit it; gave Ferr. phos. 200, 3 powders; relief came in a few minutes and no rupture. The Lach. case; D. T.s Thuja case were fine prescriptions–just two more confirmations or rather illustrations of the fact that the similimum–no matter what the name of the ailment–does the business!.
DR. D. T. PULFORD: Let us have a third round!.