DEPARTMENT OF PRACTICAL CASE MANAGEMENT


Patients with a badly damaged heart may manifest a surprising amount of vitality and an eagerness to be up and doing. They may easily persuade members of the family that they are only losing strength through inactivity. It is well for the physician to realize that over exertion proves fatal in many cases.


CONFUSING INDICATIONS

1.

Patients with a badly damaged heart may manifest a surprising amount of vitality and an eagerness to be up and doing. They may easily persuade members of the family that they are only losing strength through inactivity. It is well for the physician to realize that over exertion proves fatal in many cases. The comeback, at best, can only be brought about by means of extremely conservative measures and any exertion beyond the patients individual limit of tolerance may result in further decompensation.

Homoeopathic physicians are liable to be caught off guard in serious cardiac conditions. The indicated remedy so arouses the vitality of the patient that he is soon much stronger than the mechanical aspects of the proposition would seem to warrant.

Some cardiac specialists have studied the mechanism of the failing heart so thoroughly that their conservative management produces slow but excellent results in a fair percentage of cases. This is especially results in a fair percentage of cases. This is especially true of those who have learned to avoid the dangers of routine digitalis therapy and other forms of over- stimulation.

Hahnemannians are fortunate in having the real goods in their medicine bags and if they are expert prescribers they will obtain results that are outstanding and far beyond anything the specialists are able to achieve. But just here lies the danger. Having prescribed the remedy and having observed the reaction to it, do not wreck the works through over-confidence and optimism regarding your patient. Continue to manage the case as you would if you had no remedy on which to depend. Make haste slowly and with extreme caution. It requires time and plenty of it for nature to repair a badly damaged heart.

II.

The apparently indicated dietetic remedy for a weak, empty, hungry, gone feeling between meals would seem to be something “good and nourishing” to eat, but the really homoeopathic meal at such a time would be absolutely nothing or at the most an apple or a glass of fresh orange or grapefruit juice to ease the patients suffering without adding to his future misery.

Those aggravated when the stomach is empty and ameliorated after eating are in a particularly dangerous spot and unless carefully advised are in danger of wrecking their digestive function. The homoeopathic remedy is marvelous in correcting disorders of this kind but its good work will be ultimately brought to nought if unhygienic eating habits are allowed to persist.

The habit factor is a large one in many conditions but especially in cases of digestive dysfunction. The desires and aversions, aggravations and ameliorations in respect to food and drink are of considerable importance in selecting the indicated remedy, but the tolerance and perversions of habit cannot be ignored and this may, at times, prove quite confusing as far as the dietetic management of the case is concerned.

Every homoeopathic physician should realize that his responsibility to his clientele is far more inclusive than the mere prescription of the indicated medicine. The correct remedy will turn things in the right direction but the tout ensemble of the environment may prove the determinant as regards recurrence e or further progression of the constitutional disorder.

III.

Excessive thirst may be a misleading symptom at times. It is often present in patients needing Aconite, Arsenicum, Mercurius, Natrum mur., Phosphorus or Sulphur, but persistent dietetic faults can produce an unnatural thirst. Over-indulgence in sweets, starches, meat, fish and seasonings tends to create a chronic thirst for anything from water to whisky. On the other hand, a well balanced diet of wholesome, natural foods including liberal quantities of raw fruits and vegetables will do much toward normalizing the appetite in every way.

The idea of forcing liquids in both acute and chronic cases is almost a fad with many physicians. In our opinion the prescription of water above the thirst requirements of the individual is generally inadvisable.

The excessive intake of liquids may:

1. Increase the pulmonary infiltration and exudation in pneumonia.

2. Increase the risk of hypostatic pneumonia in senile subjects or following serious trauma.

3. Add to the danger of pulmonary oedema in cardiac emergencies.

4. Deplete the blood and tissues of their saline constituents.

5. Aggravate an already existing anaemia. KLEPTOMANIA. A woman reported that since her boy, then about twelve, was injured, he was impelled to steal. She promised to bring him, but did not, but we looked up the remedies, and this case seemed to point to Kali bi. Kent mentions Abs., Ars., Art.v., Bry., Caust., Cur., Kali c., Lyc., Nux v., Puls., Sep., Staph., Stram., TARENT. Steals dainties, Mag.m., Nat.c. Steals money, CALC. We were wondering how big a dose would be necessary to stop these politicians! ! -V.M. JOHNSON, M.D.

Eugene Underhill