The Old School tells us we take too many chances with appendicitis. What if it should burst? Well, I am not so sure but that we could handle that too. We have several good remedies that cover all the pathology attendant upon a burst appendix; to name a few, I will list Lachesis, Pyrogen and other good septic remedies. However, do not get me wrong. This is the last possible thing I could ever think to let happen to my cases of appendicitis.
If the case at hands seems not too violent and there appears to be time to wait on the medical treatment, I carefully work out a remedy; send them home to bed with an ice cap; allow no food or drink for the first 12 hours, then cracked ice by mouth; give a couple of high warm soap water enemas; order a tablespoonful of olive oil night and morning. By the second day they are getting plenty of water and some fruit juices; then follows the full liquid diet for a couple days; then the soft diet and gradual return to their regular food. Usually by the second or third day i hear no more about it.
If the case is questionable at all to its seriousness, I immediately put it in the hospital for observation and especially follow the white count. Sometimes I may call a surgeon in consultation. Usually with the above medical management in the meantime, the case quiets down and the surgeon himself admits that there is no use to go in.
Now to mention a few remedies and their indications. Of course, many of you may other ones that have served you equally well, given on each one’s indications.
Bryonia where the pain is better from pressure and lying on the painful side. The patients is usually walking bent over to the right side and holding himself in that region. Just remember, Bryonia may play out here; then follow with Psorinum and you’ve got it.
Belladonna is nice where the patients gets relief from lying on the opposite side.
Lachesis where the pain starts in the general abdomen and localizes over the appendix region. This is a sure fire one. Lycopodium may be considered where there is much flatus and the pain goes from right to left.
Lastly I do want to mention a “honey” of a combination tablet, although I am not in the habit of using shot gun prescriptions. In septic bowel cases, where other remedies do not do as much good as one would like. I have gotten brilliant results with Luyties tablet No. 199 which contains:
Merc. Cor. 3x
Bellad. 2x
Echinacea. H.
I would also like to refer to Calcarea fluorica at time of operation to prevent adhesions.
I feel this paper would not be complete if I did not say a word or two about the miserable cases that have come to me late, long years after an appendectomy has been performed. Now adhesions are dogging them. For such cases I leave with you one good suggestions in Thiosinamine 2x to CM. In fact, I do not believe a chronic case of any nature can be cured without first taking care of this obstacle, be the adhesions from appendectomy or panhysterectomy or cholecystectomy.
Phosphorus worked wonders in a case of stomach pain with vomiting green. Desire for ice cold water which is vomited as soon as warm in the stomach. Very tender over McBurney’s point. GREENSFORK, INDIANA.
DISCUSSION.
DR. A.H. GRIMMER [Chicago, Illinois]: Dr. Bond has selected a very controversial subject. A great many of our good prescribers think that an appendix is strictly surgical. I believe in taking the middle ground. I think there are some cases that are surgical, at least when we see them. I have seen such cases in my practice.
I remember very distinctly a case that another doctor brought to me in Chicago, which had been treated with remedies. The remedies were good and the treatment was good, but the diagnosis as bowel obstruction. The patient had a burst appendix with a generalized peritonitis. The patient had vomited incessantly for three or four days.
I said, “Doctor, we have a peritonitis here, and probably a ruptured appendix. The only thing to do is to operate. I don’t think even that will do any good”.
In those days they didn’t do as they did later. This patient was taken to the hospital. The abdomen was opened and great quantities of pus were drained off. The appendix was removed. The patient died within twenty-four hours.
Nowadays I have seen some similar types of cases opened, and just drained and left alone, as you would open a boil. Those patients recover very nicely, especially with the help of Pyrogen and some of our other remedies.
When you get a case that is constantly relapsing, or case
that remedy will help for a little while and then it requires another remedy, then you have a case that is mechanical, and you had better take care of it surgically.
Give your remedies, as Dr. Bond mentioned, but I think you will avoid a lot of trouble if you watch those cases. We have a place for surgery here. I think a lot of this surgery is unnecessary. In many acute cases the patients will respond to the remedies mentioned. Any remedy may be indicated. Dr. Bond has given us a few highlights of the remedies that are of value, but I have seen cases in which Bryonia has done the work as well as Belladonna. Bryonia is very much like Belladonna.
Dr. Bond mentioned Echinacea, which we know is one of the remedies in blood changes. Pyrogen is one of the very best we can use when pus is forming. It gives the same symptom that Phosphorus gives-vomiting water as soon as the water is warmed in the stomach. Don’t rule out Pyrogen entirely.
I remember in Chicago one time we had a doctor who brought in a patient who was vomiting incessantly. He had given the patient Phosphorus for two days. He called me in and said, “What would you suggest?”.
I replied, “Well, that is good prescribing, but I think Pyrogen is better because this man has pus”.
The doctor did not want to give up the prescription, but the intern had heard what I had said, I remarked, “If you don’t make the change, the man won’t live”.
The patient had a Pyrogen pulse; the temperature then was subnormal and the pulse was very rapid. One of the keynotes of Pyrogen is any disproportion of the ratio between pulse and temperature. After we had felt (I had left a powder of the CM with the doctor’ s consent, to be given in four or five hours) the intern gave the remedy to the patient. The next morning the patient was sitting up in bed, asking for breakfast. Subsequently he was operated and they drained of a quart of pus. He made a good recovery.
DR. ALLAN D. SUTHERLAND [Brattleboro, Vermont]: Mr. Chairman, I have read somewhere a warning concerning the use of Echinacea, which drug has many symptoms of acute appendicitis. The warning is that one must be cautious in its use because it tends to further the formation of pus, and its use in acute appendicitis may produce a rupture of that organ and cause the formation of pus.
A word about Thiosinamine, which Dr. Bond mentioned in connection with adhesions following surgical work in the abdomen: I have an elderly woman patient who, we felt, needed operation several years ago. We opened the abdomen, and it was such a mass of adhesions that we could not operate. You could not even make out the divisions of the large intestine. I had never seen anything like it, and neither had the surgeon.
In attempting to break up some of the adhesions, the surgeon perforated the bowel and decided he had done enough. This woman received Thiosinamine, 3x, and the only thing it did for her was to make her so dizzy that she could not walk on the street, it
had no effect on the adhesions at all. Perhaps the adhesions were too greatly distributed or to great in amount to allow Thiosinamine to work.
I wonder whether actually it does work in adhesions.
DR. A. DWIGHT SMITH [Glendale, California]: I admire Dr. Bond’s courage. I am afraid I would not have the courage to let every case of appendicitis go. We always watch them very closely. If they do not respond we have them operated on.
I have found that if a case clears up once and then recurs it is usually wisest to have it operated. I don’t care to take the chances that Dr. Bond is willing to take. Probably he has a surgeon who cooperates more with him. We have no good homoeopathic surgeons, and we don’t have any sympathy homoeopathically. We would be severely criticized if we did not have them operated on.
DR. BOND: I think there are some other good remedies for adhesions that I did not mention. I would like to hear the experience of this group.
DR. GRIMMER: Graphites.
DR. CHARLES A. DIXON [Akron, Ohio]: I am inclined to speak on this topic myself.
When I was discharged from the First World War, I came home and found my brother desperately sick. He had a fulminating case of appendicitis. That was in March of 1919. I was in communication with a surgeon in less than fifteen minutes; in half an hour my brother was in the hospital, and in twelve hours he wad dead.
That was the last case of appendicitis I ever lost, until a year ago, when I was called to the home a patient I had not seen for several years. Not a symptom was present, as far as I knew, indicating involvement of the appendix. The trouble all seemed to be up in the region of the liver, I prescribed my remedies and she got no better. Finally, I took her to a hospital and had a blood count taken, and found she had 17,000 white cells. We opened her immediately. She already had a burst appendix.
