DEPARTMENT OF PRACTICAL CASE MANAGEMENT


Natrum sulph. is often indicated when some acute illness develops a complication or where some unfavorable sequelae follow pneumonia, hepatitis or Neisserian infection. This remedy acts especially on the occiput, the lower lobe of the left lung, on the liver and in the pelvic tract.


HOMOEOPATHIC TREATMENT OF GONORRHOEA.

Three remarkable remedies stand out as antisycotics of the highest rank. These are Medorrhinum, Natrum sulph. and Thuja. All are frequently indicated medicines for deeply disordered states of the constitution. They are not so often needed in acute conditions.

MEDORRHINUM.

In children especially a group of “strange, rare and peculiar” (characteristic) symptoms call for Medorrhinum:.

1. The knee-chest posture (with face perhaps half buried in the pillow).

2. Inordinate craving for sweets.

3. Fear of the dark.

4. Pungent body odor.

5. Amelioration of all complaints at seashore.

The same symptoms hold for all ages although in adults the knee-chest posture generally gives place to the prone position and Medorrhinum is one of the relatively few remedies that is ameliorated by lying on the abdomen.

This nosode is suited to many congenital or inherited troubles in children. Pre-adolescent individuals who are subject to asthma will generally require this remedy, if the symptoms are definitely ameliorated at the seashore. (Aggravated, Natrum sulph.).

Women who begin to fail in health after marriage and who become forgetful, nervous and hurried and especially if the symptoms are worse with each menstrual cycle may require Medorrhinum. There is often a preference for the left ovarian region as in Thuja.

Sometimes the mental and nervous symptoms rather resemble those of Pulsatilla-changeable mood, often tearful and ameliorated in the open air, aggravated in a close room. However, the mental picture of Medorrhinum is less well defined, less individually characteristic, than in many remedies.

In some cases a daytime aggravation (sunrise to sunset) has been observed, but this is not nearly as sharply defined as the night aggravation (darkness to daylight) of Syphilinum.

Puffiness above the eyes, between the brow and the upper lid, is a good objective key-note for this remedy as it is for Kali carb.

Painful heels and tender soles of the feet without callous formation is as characteristic of Medorrhinum as a monoarthritis affecting the knee joint is characteristic of Thuja. In both there is usually the history of Neisserian infection.

It is seldom that Medorrhinum is indicated in acute or recent cases of gonorrhoea, but when it is the discharge is profuse, acrid and of a pungent odor and causes annoying itching. When a gonorrhoeal discharge has been suppressed in a tuberculous individual or one in whose family history there is a strong tuberculous diathesis Medorrhinum will very frequently become indicated. It has saved many a young person from acute pulmonary tuberculosis.

Psorinum frequently becomes indicated following Medorrhinum (sycosis engrafted upon a deeply psoric constitution).

NATRUM SULPH.

Like Medorrhinum this remedy is suited to congenital or inherited conditions arising from a sycotic taint in the constitution. Unlike the nosode, Natrum sulph. is definitely aggravated at the seashore and from dampness in general. Asthma in children which is ameliorated by the sea air will nearly always respond to Medorrhinum, but the cases which are aggravated are likely to require Natrum sulph., Sepia, and a few other remedies.

Natrum sulph. is another of the great warty remedies like Nitric acid, Sepia and Thuja. In this respect it also differs from the nosode, which seldom exhibits a warty state.

More than any other drug in the materia medica Natrum sulph. is the remedy par excellent for the lasting effects of head injuries, particularly injuries to the occiput. Suicidal impulses following severe head injury will nearly always require Natrum sulph. All the remedies in the Natrum series are sad and mentally depressed. Sadness and depressed states following Neisserian infection or head injury with sensitiveness to music and aggravation from dampness and wet weather. Averse to conversation. Face pale and sickly with a “gloomy aspect.” “Cheerful after stool” is a key-note.

Natrum sulph. is often indicated when some acute illness develops a complication or where some unfavorable sequelae follow pneumonia, hepatitis or Neisserian infection. This remedy acts especially on the occiput, the lower lobe of the left lung, on the liver and in the pelvic tract. In pneumonia there is a loose but violent cough and the patient holds his sides with his hands (Bryonia). There is often a salty taste in the mouth and yellow- green expectoration. Very frequently indicated in unresolved pneumonias involving the lower left portion of the lungs. (Right lower, Kali carb.).

In the digestive sphere Natrum sulph. exhibits a “dirty brown or greenish-yellow, thick pasty tongue and a bitter or salty taste.” The remedy affects the liver and biliary function, the pancreas, ileocaecal region and the descending colon. There is much flatulence, rumbling and gurgling in the abdomen. The stool in these cases is “gushing, noisy and spluttery” and the diarrhoea is apt to come on immediately after rising in the morning although sometimes it drives the patient out of bed.

When a gonorrhoeal discharge is suppressed by local treatment and invades the constitution we have the condition known to homoeopathists as sycosis. It then depends upon the type of constitution and past medical history as to what is likely to happen. It would appear that children born of sycotic parents are more likely to require Natrum sulph. than are the parents themselves. Thuja, on the other hand, is seldom indicated in children until their latent sycosis is aroused to activity by vaccination.

The type of urethral discharge under Natrum sulph. is characteristically either yellow or watery or more often, thick yellow-green pus.

Natrum sulph. is sometimes the indicated remedy in meningitis following gonorrhoeal suppression and especially in the meningitis of sycotic children providing the symptom totality corresponds.

THUJA.

We now come to a consideration of Hahnemanns leading antisycotic. His chief remedy for the fig-wart disease, as he termed it, was Thuja. While frequently indicated in modern practice for the constitutional effects of gonorrhoea it is probably less often needed for patients suffering from gonorrhoeal warts than was the case a century and a half ago.

Modern habits of bathing, dress and general living conditions have caused the genital warts to appear with much less frequency. To a large extent the warty tendency is now passed on to the succeeding generation. Cases of congenital sycosis with warts as a conspicuous symptom will more likely require Natrum sulph., Nitric acid or some other antisycotic. However, when warts arise following vaccination in sycotic individuals Thuja will often cover the symptoms.

This is one of the remedies having a rather characteristic appearance of the face. A waxy transparency about describes it. Marked pallor but only slight puffiness like a beginning edema of the face.

The Thuja patient is often the victim of fixed ideas which are difficult to dislodge from the mind. During the menopause especially the delusion of pregnancy is common and Thuja is often indicated in these cases. This imaginary pregnancy originates from sensations in the abdomen as of something alive and closely resembles the movements of a fetus. Spastic states of the intestine and colon with the formation of gas pockets cause most of these sensations.

A peculiar and well verified Thuja sensation is that of brittleness of the fingers and toes and of the arms and legs even to the point that it seems as if they would break under any strain.

Women who suffer with severe left-sided ovarian pain each month or every other month are frequently the victims either of sycosis to the vaccine poison or both. For this type of trouble Thuja is quite likely to be the remedy.

An annual periodicity is many times observed as it is in Arsenicum and a few other medicines.

Monoarthritis involving the knee joint in patients with a Neisserian history requires Thuja more often than any other remedy. Visible swelling as observed together with the characteristic sensations of numbness, stiffness and brittleness. Another distinguishing feature is pain localized in small spots as in kali bi. Where the knee is involved the entire area may be stiff and numb but one spot as indicated by the patient is exceedingly sensitive and painful. At times the modalities of Rhus tox. appear to be present, but if the case is of sycotic origin it will only palliate. Neither Arsenicum nor Rhus tox. are related to sycosis.

Monoarthritis affecting especially the large joints nearly always has a Neisserian base and Thuja frequently comes into the picture, although its favorite point of attack is the knee joint as noted above.

Recurrence of the symptoms following exhibition of the homoeopathic remedy is a problem to be considered. Homoeopathy produces as brilliant results in both acute and chronic disease as can be found anywhere in the therapeutic field. In fact it outdistances all other types of therapy, but in chronic conditions there seems to be a residuum which is untouched, a focal point which never entirely clears. From this nidus, sooner or later, the old disease arises anew. Only with nearly perfect patient cooperation during and following treatment can the physician hope to cure cases of chronic disease.

Eugene Underhill