If a case of cholecystitis presents for treatment, whether acute or subacute, or whether simple or complicated by the presence of lithiasis, do not wait until search for a similimum has yielded fruit, but empty the whole man by means of the drastic saline purge, flood the tract with fresh fruit juices, but no other food, empty the colon completely by means of the high colonic irrigation followed by daily enema of plain tepid or cool water. Meantime search for the proper remedy, of course, but do not waste the first day or two of a chance to cut short the whole inflammation surely and always harmlessly by such simple means as the purge and the emptying of the colon.
Afterward restrict the use of animal fats to a daily maximum of two ounces of butter fat, though the same restriction need not apply to the fats of vegetable origin, which do not deposit a cholesterine or cholesterol during metabolism.
I often wonder at the evident reasoning of the surgeon who is content with drainage or removal of a diseased gallbladder. Operation is merely fussing with an end result, shutting the surgical eye to the causes underneath. To drain a gallbladder, to remove concretions, to extirpate the sac, cannot by any possible stretch of even the usual surgical imagination be considered constructive treatment.
To give present relief from pain and discomfort without insuring against a repetition of the cause is a childish objective, and if diseased states of the gallbladder originate in the character of the colon contents then surely any means that will not change the contents of this sewer cannot be considered as anything but temporarily expedient.
The same rates of the colon that caused the disease originally will cause its return, and if the gallbladder is not present to register the resulting disease this will show in other evidences of intoxication, and perhaps of much more serious character.
One of the most difficult cases of lithiasis it was ever my misfortune to attend was in a physician in the late forties who had suffered much from gallstones, finally had the thing drained surgically, in two years was in the same condition, lost his gallbladder, and two years later had a severe type of obstructive jaundice with intense pain, a stone lodged in the common duct, where it had evidently formed gradually for two years.
Obstruction was not complete, else he would not have lived three months, as he had done in great pain. A very bad morphine habit had been picked up through the years of pain, and the eradication of this was even harder to accomplish than the involution of the stone. He was constipated but relied on laxatives for relief, so deepening the atonic state of the colon continually, through frequent false stimulation and its resultant enervation.
He had abjured the enema as something habit-forming, not realizing that of all the means used for emptying the colon the enema alone is not habit-forming. Therefore the cause of his cholecystitis and later his lithiasis was continually operative.
Sterilization of the colon and correct dietary habit corrected the entire condition, but he was warned to used animal fats sparingly as long as he lived.
The usual type of gallstones is merely inspissated bile, though admixture of many chemicals difficult of solution is frequent, calcium perhaps predominating. The former are easy to remove through disintegration, the latter much harder and requiring a longer time. But a reversal of the chemical processes that caused the evolution of the stone will just as surely guarantee its involution, if the colon is kept up to the twenty-four hour schedule by means of the enema, and if the food is chiefly of the base-forming varieties, with considerable reduction in the usual fat ration of the food.
The so-called bilious temperament is merely an evidence of intoxication, chiefly of colonic origin, and in little children who in their first few years develop the frequent so-called acidosis attacks, the correction of the daily dietary and also the complete emptying of the colon every day will so completely change the picture that the parents will be able to say that the child has evidently not inherited the bilious temperament of either side of the house. After all, the type of treatment here suggested is merely a removal of evident cause, and not a specific treatment of cholecystitis or “torpid liver”. STROUDSBURG, PENNA.
DISCUSSION.
DR. STEVENS: I would like to ask what the members feel about the use of saline cathartics. It is something I almost never use except in a few cases, and I have had a very bad heart reaction following it, as something very weakening indeed. I would like to know what the other members feel about it.
DR. BRYANT: I have been through much of what this paper describes.
I was in San Francisco in 1928, on my way to Europe with a homoeopathic professor when I came down with a very severe attack of gallbladder trouble, accompanied by infection. I did not have to have saline laxatives, nor did I have to have any enemas, except on occasional postoperative. The remedy that finally relieved me and gave me lasting benefit was Lachesis.
It was a surprise prescription. I went south to Los Angeles and from there to Coronado, and was suddenly taken with a chill.
Dr. Polhemus, whom I think some of you know, in San Diego, came to see me. By the time he got there, this chill had become so violent that I asked somebody to please hold me. Even then they couldnt control that horrible shaking and I said , “If somebody would sit on me, I think I would get relief.” They piled on me all the covers they could find and surrounded me with hot water bottles. Dr. Polhemus said, “What a wonderful thing for you to stay. There is one of the keynotes for Lachesis. Patients with violent chills beg to be held down by sheets and even put in straitjackets.”.
I made an immediate recovery, and Lachesis has proved to control that condition completely. I left for home shortly after that, and then saw a patient with puerperal infection, and was able to verify that symptom on that patient. She had exactly the same condition and begged somebody to hold her, and asked her husband to please sit on her abdomen. Lachesis cleared that up very quickly.
That is a further evidence of what we all see, these modalities we must depend upon and find so valuable, and the new book of Dr. James W. Ward is going to bring us so much quicker to those. We have had to search so long. I had Gentrys old Concordance Repertory that I never really feel entirely confident about. I didnt feel it was sufficiently proven, but I have an entirely different feeling about Dr. Ward and I think most of you who see his book will realize what a masterpiece he has created for us.
A dark haired widow, aged forty-six years, stenographer, has had a cough with wheezing in the trachea for several years.
Aggravation from lying on either side, from laughing, from speaking.
Expectoration greenish, with salty taste.
Chest feels weak and empty after coughing.
Rawness and tickling in the larynx.
Awakes in the morning in profuse sweat, weak and exhausted.
1913, March 29. One powder Stannum 1M. B. & T.
May 18. Her cough is gone and strength is returning rapidly. New symptoms have appeared:.
Faint gnawing sensation in the stomach at 11 a. m.
Constipation with ineffectual effort to stool.
One powder Sulphur 1M. B. & T. completed the cure.
Clinical Experiences, ERASTUS E. CASE, M.D.
