Non-lactose fermenting bacilli have long been observed as inhabitants of the intestine, but, in bacteriological work, no particular significance has been assigned to them, nor importance given to their pathogenic effects on man. the late Doctor Dishington of England conceived the idea of having the autogenous vaccines of patients potentized from a collecting of autogenous vaccines to make a provings. From the clinical symptoms thus obtained, these vaccines made from abnormal bacilli of the intestines are, of course, true nosodes.
I am going to discuss the clinical place in Pediatrics of two of these nosodes. (1) Dysenteriae comp. is the name given to the nosode prepared from the cultures of the bacillus dysenteriae. (2) Gaertner comp. from the bacillus enteritidis, or bacillus GAERTNER, also originally called the bacillus of the intestine.
DYSENTERIAE COMP. In presenting to you a brief summary of the proving of the non-lactose organism of the intestine in relation to disease of children, it is peculiarly fitting to open with a nosode prepared from the cultures of bacillus dysenteriae. It has a particular application to the main theme-diseases of children. For this nosode Doctor Paterson has suggested a keynote, “nerve tension,” which is of a peculiar type best described as anticipatory, since it is a sense of nerve tension which a child might feel immediately prior to facing an examination.
Throughout the clinical provings, we must search for this identifying factor and it will help us to understand the pathogenesis of the symptoms. The Dysenteriae comp. child is of a hypersensitive nature which expresses itself as shyness or timidity. You cannot fail to note this in the typical facies of the child. When strangers are present, the whole attitude of the child expresses nerve tension within, and you will observe the tenseness of the facial expression which is not altogether an expression of fear, but more an expression of alertness.
For example: If you address the child or make a complimentary remark, there will appear almost immediately a hyperaemia of the surface capillaries of the cheeks and a blushing of the skin, which is more noticeable because of the peculiarly white background of the rest of the skin area. The instability of the capillary relationship under influence of the sympathetic nervous system is a characteristic you must remember in the clinical proving of the Dysenteriae comp. If you continue your observation-that is, keep the child under tension-you may note the fibrillary muscular twitching of the face or limbs, which would suggest to your mind the symptom complex so common in children, namely, chorea. Mental uneasiness shows itself by physical restlessness-the child cannot keep still, fidgets.
In the clinical proving of this nosode, as indeed in the proving of many remedies, a selective tissue action is to be noted. The Dysenteriae comp. seems to have a specific relation to the duodenum. Has this pathological fact any application in the treatment of the infant? In the newly born infant, I have, on several occasions, completely cured spasms of the pylorus. This is in line with the accepted opinion that “nerve tension” plays an important part in the pathogenesis of pyloric spasms. Likewise, in the pathogenesis of duodenal ulcer.
Dysenteriae comp. also has a selective action on the cardiac muscle; functional disturbances of the heart action associated with “nerve tension.” You will recall the muscular twitching of chorea, which is a feature of Dysenteriae comp., and is also a rheumatic manifestation and associated with valvular heart disease.
I shall now exemplify the clinical action of Dysenteriae comp. by giving you a short picture of two clinical cases treated at the Womens Homoeopathic Hospital of Philadelphia in 1941.
CASE 1. Mary B., a white child, was admitted and her case was diagnosed as chorea of four weeks duration. This child came of neuropathic parents, both of whom had all the common symptoms of chorea. This is a typical neurosis characterized by the presence of irregular, purposeless, involuntary muscular contractions in various parts of the body. clinical examination also revealed a gallop rhythm and mild systolic roughening over the mitral area. This child had been treated with bromides, Fowlers solution, luminol, etc. Also several homoeopathic remedies had been prescribed in the hospital, with practically no sustained beneficial effects.
As it was the first of the month, I came on service. I observed this patient as having a white skin, showing marked nervous tension mentally easy blushing and, mentally, quite alert. Because of the failure of all the former therapeutic measures and the orthodox homoeopathic remedies, I decided to try my Dysenteriae comp. I gave Dysenteriae comp. in the 30th potency three time a day, and within two weeks the irregular movements had practically ceased, and at the end of four weeks the heart lesion had cleared up and the child was discharged from the hospital, apparently cured. This case demonstrated the value of the keynote, “nerve tension,” and the effect of the Dysenteriae comp. on the heart muscle. I consider this a clean and prompt cure with the indicated remedy.
CASE 2. A female infant, born in the maternity, came to my service at the age of six weeks. Past personal history: the child had a normal birth, but continued attacks of vomiting since the first week. All formulas were promptly vomited, mostly of the projectile type. The stools finally reached the starvation type, scanty and seldom.
I lavaged this infants stomach and elicited some reverse peristaltic movement. I put this child on heavy feeding, commonly known as the Sauer formula, with very little relief. Nux vomica, the 30th, produced some amelioration. At the end of the ninth week, the child was reduced almost to birth weight. Doctor John Wertz examined several stools for me and finally isolated the bacillus dysenteriae. I immediately prescribed Dysenteriae comp. in the 30th potency and within four days the vomiting ceased, the child began to have normal fecal stools, and there was no recurrence of the pyloric spasms. She was discharged in very condition and has remained so.
GAERTNER (Bach). I consider the Gaertner comp. the Childrens nosode, because in the clinical picture you will find something of practically all the nutritional disorders so common to the child. doctor Patersons keynote for this nosode is “Malnutrition,” and, as this would imply, it is the nosode applicable for the treatment of many of the diseases of childhood. To me, marked emaciation may be taken as an indication for the use Gaertner nosode. In the child, the first point to which I would call your attention is the very poorly developed musculature of the body and limbs. You will observe this the moment you commence the clinical examination. You will never think of Gaertner comp. as a remedy where you find a well- nourished physical body.
The second point is hypersensitiveness, mental and physical. It is easy to understand how these ketone by-products are produced which result in attacks of vomiting. The effect is cumulative, so that attacks occur in cycles at various times. Gaertner (Bach) has been demonstrated in the stools of infants who have inability to absorb fats. The great importance of investigating fully the pathogenesis all nutritional errors is seen to advantage in this study of Gaertner (Bach) and the clinical picture presented by the nosode. You will find this nosode, Gaertner comp., of great value in the treatment of these diseases in children. I associated Gaertner with two remedies, Silica and Phosphorus. Silica will remind you of the underdeveloped musculature system, and Phosphorus of the overactive nervous system.
I hope this short discourse will give you a fair clinical picture of Gaertner (Bach). I have had a large number of cases which appeared to me to indicated. In some cases, no other remedy was required, and in others, clear cut symptoms came out that guided to the similimum.
If I may digress for a moment, both of my pathologists have found Gaertner (Bach) associated with that specific constitutional nidus that breeds malignancy. These constitutional facts are all important to the homoeopathist.