The patient, a kindly old lady of eighty years, has been bed-ridden for the past six months. Slowly but surely she is losing out. Several years ago she sustained severe internal injuries in an automobile accident. Two years ago she fell and fractured her hip. A malignant abdominal neoplasm has resulted in ascites, oedema of the extremities and a profound cachexia. The remedy picture for some time has been Arsenicum (beginning in October, 1939, with the 30th potency, later the 200th and now the 1M.). Under the action of this wonderful polychrest the anxiety, restlessness and night aggravation have all subsided and, except for repeatedly insisting that she has lived too long, there have been practically no complaints.
The dietetic factor in this case was difficult for a while but a mono-diet routine has solved the problem and has helped to relieve the distress and burning previously experienced after eating. By a mono-diet is meant one kind of food at a meal or a very simple combination such as a thin corn meal gruel with cream and sugar. Under this plan of feeding a different kind of nutriment is given each time in order to insure a fairly well balanced diet.
In extreme and practically hopeless cases, such as this, the patients desires, aversions, aggravations and ameliorations in regard to food and drink should be particularly respected and the diet regulated accordingly. This patients appetite has been capricious at times as has often been observed in terminal conditions and as often happens a few mouthfuls of the coveted dish have generally proven disappointing. These symptoms have been clinically noted under Arsenicum (Kents Repertory, 4th edition, page 476).
True also to the modalities of the remedy hot foods and drinks are preferred and seem to ameliorate.
Fearing nutritional deficiency, two teaspoonfuls of plain cod liver oil have been given daily with apparently good effect and without aggravation of any kind.
Bed sores have threatened but have thus far been averted by:.
1. The remedy (Arsenicum in this case).
2. Cleanliness and occasional use of corn starch as a dusting powder.
3. Relief of pressure and frequent change of position.
4. Avoidance of friction against the skin while moving patient.
5. Gentle massage around but not over bony structures.
6. Daily exposure of the back and limbs to the air and to radiant heat and light. For this purpose an ordinary 200 watt lamp is used when direct sunlight is not available.
Light general massage has afforded conspicuous relief of some of the nervous symptoms. There is a standing order to employ it whenever necessary.
The bowels have not been much of a problem but occasional constipation has been relieved by a meal consisting of nothing but fresh spinach cooked only five minutes.
Special powders (Sac. lac.) have been prescribed for use when the patient is especially restless and a few capsules filled with pulverized sugar of milk are kept on hand as a precautionary measure to be given only if ordered.
Before leaving the case we sat down and thought it over. Was there more or less suffering than one would anticipate under the circumstances? Would any new measures, medicinal or otherwise, afford greater relief? The indications were definitely in favor of leaving the prescription alone and for continuing with all the other measures in respect to diet and nursing care. However, not knowing when an unfavorable turn might occur, a higher potency of Arsenicum (a single dose of the 10M.) was left with instructions to give it only if ordered.
Homoeopathic medication and conservative and constructive case management may be far from profitable as far as the drug houses are concerned, but why add to the patients discomfort and torture by trying this or that or these and those when everything is progressing peacefully and as satisfactorily as can possibly be expected? “The physicians high and only mission is to cure the sick” when possible and to relieve suffering according to the indications observed in each individual case. The best prescription in the world for incurable patients is the similimum. Nothing else can give as much real relief and comfort to the sufferer.