COMPLICATING FACTORS IN CHRONIC PRESCRIBING


COMPLICATING FACTORS IN CHRONIC PRESCRIBING. Some of these drugs are causing disease, others are helping to complicate and perpetuate various diseases and still others are most certainly antidoting, to some extent at least, the action of the most carefully selected remedy. Moreover, the mere presence of these drug substances in the system helps to cloud and obscure the symptoms of the patient, thereby confusing the physician in his analysis of the case.


A seventeen-year-old girl had suffered from chronic eczema for years. The family physician had predicted relief with the establishment of the menstrual function but it got worse instead of better. Medorrhinum 200th was prescribed on an unusually clear remedy picture and with excellent results. The eruption disappeared entirely within six weeks. Improvement in the general health level was remarked by all. The remedy held all summer and fall until early in January and then the eczema began to return. The symptoms again called for Medorrhinum and the remedy was repeated.

The reaction this time was much less dramatic and the eruption failed to clear. The 1000th potency was equally disappointing. The health was good but the eruption refused to budge. A review of the case resulted in the selection of Psorinum which was prescribed in the 30th potency. After a mild aggravation, the eczema began slowly to recede. By the middle of August, at the time of the patients nineteenth birthday, there was every reason for encouragement. Two weeks later the picture changed abruptly and the eruption came back with a bang. A dermatologist was consulted by the family and took charge of the case.

Two years later the young lady and her father stopped in the office to show us that the dermatologist had done for her– not a blemish on the skin, every evidence of good health and no relapses in the two-year period. The far the remarked that the experience had taught him a good lesson, a specialist should have been consulted in the first place, for “after all,” he said, “every man to his trade.” After hating the father and the dermatologist, we finally decided to call the latter on the phone and take a chance of learning something.

The doctor was most cordial and said that he made it a rule to prohibit the use of chocolate in all forms in all cases of chronic skin eruption. Unless the patient promised at the first interview to discontinue chocolate absolutely and without exception, he would not be willing to take charge of the case. He secured this promise from our former patient. “Otherwise the treatment was purely symptomatic,” he said, “an occasional laxative or vitamin or an aspirin if necessary, a little skin oil to be used sparingly on any particularly irritated area but no regular medication”.

In looking over our record on this case, we noted what we had failed to observe before. The worst aggravation had always corresponded with some holiday season or a birthday which of course spelled candy and plenty of it, probably mostly chocolate. This concentrated, irritating and highly acid-forming sweet was evidently the chief offender, the outstanding allergy in the entire case.

This experience has paid off many times over in our results in chronic skin lesions, particularly eczema in young individuals. It all comes back to Hahnemanns priceless advice, the physician “is at the same time a preserved of health when he knows the causes that disturb health, that produce and maintain disease, and when he knows how to remove them from healthy persons”.

The following appeared in Pageant, May 1951, page 146, “Most Americans are malnourished to some degree because excess sugar consumption crowds essential foods out of the diet. Sugar provides about 18percent of the calories in the average diet. It should supply no more than 10 percent.” But it is not just sugar; excesses of all kinds, dietetic or otherwise, are bound to crowd something worthwhile out of ones life.

There are innumerable factors complicating chronic prescribing and these in many instances interfere with the action of the homoeopathic remedy to an extent that our therapeutic results are dragged down to the level of mediocrity. Consider for a moment of almost countless number of substances of a chemical nature which are being consumed by the public with a degree of faith that is truly amazing. The emotional appeal in advertising is paying off in hundreds of millions of dollars and at an ever increasing ratio every year.

Some of these drugs are causing disease, others are helping to complicate and perpetuate various diseases and still others are most certainly antidoting, to some extent at least, the action of the most carefully selected remedy. Moreover, the mere presence of these drug substances in the system helps to cloud and obscure the symptoms of the patient, thereby confusing the physician in his analysis of the case.

A graduate nurse presented such a clear picture of Asafoetida that we anticipated pleasure in prescribing the remedy for her. However, an inquiry into the matter of previous medication revealed the fact that for the past several months she had been taking Asafoetida tablets with considerable regularity. Suspecting that it was a proving, the drug was discontinued and placebo given in its place. The symptoms subsided promptly. Later, simple dietary correction overcame the flatulence which had caused her to resort to self-medication.

The case illustrated above was easy but it would not have been had we not inquired as to previous medication, nor might it have been so easy if the patient had been taking multiple vitamins plus other medicinal junk.

Some will say that the exactly correct remedy can overcome all medicinal interference, that the process of potentization puts the drug on an entirely different plane of action where crude drug substances cannot touch it. This we are prepared to admit with reservations. The prolonged use of mineral oil has produced many a case of mucous colitis. Would anyone advise its continuance while attempting to cure the patient? No to insist upon the total discontinuance of all possible obstacles to recovery is to court failure in homoeopathic prescribing.

One of the unanswered questions in homoeopathic practice is why it so often happens that the very first prescription in a chronic case acts in a manner far superior to any repetition or change of potency of the same remedy and is apparently more effective than any other remedy that may later become indicated. In the eczema case detailed above we may find a hint as to the possible answer.

The cause, or at least one of the causes of the disorder, was allowed to continue in operation after the remedy was given. May this not have resulted in a tolerance build-up to homoeopathic remedial action, thereby weakening the reactive response of the organism? If this is true, then it becomes supremely important to stop disease causation before attempting to prescribe for the patient, a large order if there ever was one.

Not only should all previously used drugs be discontinued before giving the remedy but all dietary excesses and apparent deficiencies should be investigated and corrected when discovered. A woman of sixty used an amazing amount of salt and had been doing so for years. She was thin, nervous and suffered from gastric hyperacidity. There was also much burning after urination. She was given placebo and placed on a salt free diet. In a months time the digestion had improved, the irritation from the urine had cleared and a gain of three pounds in weight was noted, the first weight increase for many years.

This was another case of a partial drug proving, although the symptom totality of Natrum muriaticum was far from complete. Months later the symptoms of Phosphorus emerged and cleared up the balance of the case. This was one of the few cases where patient cooperation was almost 100 percent. The result of the treatment proved gratifying to both patient and physician.

Coming now to emotional factors in chronic cases, the trend recently has been to stress and often overstress emotional maladjustments.

All directional trends have a tendency to swing too far and this one is no exception. After all one cannot fire the boss, either at home or at the office, nor should the physician feel called upon to find a parking place for the mother-in-law so that the young folks may live happily ever after. Life has to be lived and often of necessity the old, the sick and the helpless must be included within the family circle. If an adjustment to circumstances cannot be made, the individual is either suffering from an impairment of health or from emotional immaturity.

Philosophy has shown us that the even is of far less importance than ones reaction to the event. It is the reaction that is symptomatic of the individuals mental and physical health. Sound psychiatric advice may help one to make proper adjustments, but let us not forget the power of the completely similar remedy in achieving the same and often a more lasting result. Homoeopathy enables people to live at peace with others more than anything else yet discovered in the line of therapy.

PHILADELPHIA, PENNSYLVANIA.

DR. ALLAN SUTHERLAND [Brattleboro, Vt.]: This is a very interesting paper in many aspects. I often wonder if it would not be advisable and helpful in these many cases of eczema which we homoeopaths see to have all of them skin-tested for possible allergy. I am doing that myself more and more, and I find that the information obtained is extremely useful, and I might say not only in eczema but also in other chronic states.

For instance, an infant of seven months was brought to me last summer–incidentally, I had delivered the child–who had a well-marked eczema of the face, hands and body, but was apparently a perfectly healthy baby otherwise. The remedy worked out was Sepia, which did not seem to do any good at all. Of course, I felt that my stupidity might have been responsible for that, but still the record seemed to show that Sepia was the remedy, so, as a matter of interest, I had some skin tests done and found his youngster was sensitive to feathers, eggwhite, chicken, and a few things of that sort.

I felt that perhaps the feathers were particularly the offending substance, so we managed to get pillows and other things covered up and kept the youngster away from feathers, and after that she began to improve, and I saw her two weeks before I came down here, and she has no evidence to eczema at all and is very much better in her general health.

Something to which an individual is extremely allergic constitutes the hindrance to cure which Hahnemann asked us to recognize, and remove, in his third paragraph of The Organon.

Another instance is a young man with an extremely marked hay fever. When I first say him–he asked me to call at his place of business–the first thing I noticed before I even spoke to him, was the fact that he was working over a table and just streaming.

He used a box or two of Kleenex daily at his work, because of this profuse nasal discharge.

Well, to make a long story short, the remedy worked out by Boenninghausen was Sulphur. I think we used thirty-one rubrics, all of which Sulphur covered. That is a rather unusual thing, but Sulphur covered the complete picture, and this man got some benefit from Sulphur, but not enough. We then had him skin-tested and found he was sensitive to feathers 4-plus, house dust 4-plus, and a few other substances such as tuna fish, and crabmeat, and rabbit fur, and beef. By process of elimination we determined that the feathers were the chief offender and, with plastic pillow covers, his hay fever immediately began to improve, and since November he has had none. I believe that the removing of the feathers from his environment, as much as we could, gave the indicated remedy a chance to work; otherwise we would have gotten nowhere with him at all.

DR. EDWARD C. WHITMONT [NEW York, N. Y.]: I wish to apologize because I am going to take issue with that statement. I think we have to differentiate here between two things, palliation, because we are physicians, and curing, because we are homoeopaths. It is undoubtedly true that hypersensitivity to such substances will bring about disturbing symptoms and gain relief by removing the substances, but we have not dealt with an obstacle to cure because a patient is cured; as long as an ordinary mortal cannot stand feathers, he is not a normal human being in our sense. Our job and our possibility with homoeopathy lies in removing the allergy per se, in just making him so that he can stand feathers and dust.

How are you going to remove dust?.

I think it was at the meeting in Swampscott I reported the case of hairdresser with eczema who was sensitive to hair dyes. I have followed up this case over four or five years, and this man was skin-tested and sensitized, and he is continuing to use hair dyes and he is free, and his remedy also was a typical Sulphur remedy, for a Sulphur case, and the remedy was Tuberculinum.

Now, as to that particular case mentioned, in my own limited experience I have never seen Sulphur cure a hay fever case. In all Sulphur cases with hay fever you need a nosode, and it is usually Psorinum or Tuberculinum, and I would suggest, quite humbly, if you give Tuberculinum to your patient, he may be able to stand the feathers afterwards.

The same thing is true with children with eczema. Undoubtedly you can remove food items and get rid of the eczemas, but the child is not a normal child after that. He is still psoric, and he may not have eczema but he will develop abnormal conditions in later life because his allergic state has not been removed, though he is free of symptoms.

Again I may state that in order to get a breathing spell for the moment, we have to do it. It is a removal of an obstacle to cure, but just not a cure.

DR. ELIZABETH WRIGHT HUBBARD [New York, N. Y.]: I was just going to point out that the interesting thing is to make people able to cope with what they could not cope with before; for instance, I have a child in my practice who was skin-tested before she came to me and found to be terrifically sensitive to milk, and she was a very skinny little child, who should have had milk, and had not been able to take it for years.

Remembering what our President once said, a year or two ago, that Tuberculinum was practically specific for allergy against milk, I looked into the background of this childs family and found there was plenty of tuberculosis a couple of generations back, and I gave the child ascending potencies of Tuberculinum, and she now drinks a quart of milk, at least, a day, with gusto. We sent her back to the allergy specialist who tested her for milk, and he said there must have been some error because she is not sensitive to milk any more, and there is no cure for that allergy.

DR. ROGER A. SCHMIDT [San Francisco, Calif.]: If you will bear with me, I should like to bring up a point. I think Dr. Whitmont hit the nail on the head and I agree with him 100 per cent. For a long time now I have not sent my patients to specialists for skin testing because I notice that one year you send them and they will send a list of five, six, seven, or eight allergens, and the next year you send them and they have another list of ten or twelve. The allergies change from one thing to another. You have to go to the constitutional remedy to really do good work.

It is also true that nosodes are essential, but there is another angle brought out in the first case mentioned by Dr. Underhill, which has been very valuable to me, and I should like to pass the tip on if you are interested. This was at least twenty or twenty-five years ago when I was in Paris. I heard a very famous clinician, an allopathic man, by the way (and they give you some very good ideas sometimes).

He was a specialist in asthma, and he had found out in his work in Paris that in all cases of allergies, whether hay fever, asthma, colitis, or any part of the body where those allergies may be manifest, you also have an accompanying hypercholesteremia, and if you give those patients low cholesterol diet, you will get much quicker results and give them a great deal of relief, given the time and the chance for the homoeopathic remedy to do its work.

Of course, among the most noted item of foods of high cholesterol content is chocolate, and it is a policy of mine in every case of skin or hay fever allergy– or no matter what the allergy is –to stop the chocolate immediately, and also eggs, and also butter, and animal fats in a general way, things like sardines and salmon, things that are rich in animal fats,and invariably I have gotten some very, very good results from that until they overcome their difficulties.

DR. SUTHERLAND: I do not like to be put in the position of apparently not realizing the implications in a chronic case. I have spent quite a lot of time fiddling around with this stuff called homoeopathy and there is a lot of interesting material in it. I, too, fully believe, and am quite convinced, that an allergy is an expression of a very deep-seated, chronic constitutional disturbance, and I do not mean to say that if one avoids feathers, one is going to be cured of that–oh, no, but if you want to cure an addiction to morphine, you dont let the addict have morphine.

You have to withdraw it. It is an obstacle to cure. If a man is addicted to feathers, you have to remove the feathers. Then the homoeopathic remedy has a chance to operate and will then correct the underlying constitutional difficulty and eventually the man will be nonallergic.

That is the point I tried to get over, but in my stupidity I apparently did not.

DR. R. C. WOODHAMS [Mombasa, Belgian Congo]: The question of chocolate is interesting. I was surprised to find out that a nursing mothers eating chocolate affected the baby. I arrived in Iowa to visit my daughter and three grandchildren, whom I had not seen before, and, naturally, I took along a box of chocolates, but my daughter wouldnt touch them. She had discovered the week before when she had eaten a small piece of chocolate that the baby at once had pain, as well as a slight eruption; so my box of chocolates was popular with the rest of the family but not with my daughter!.

DR. T. K. MOORE [Sharon Center, Ohio]: It looks as though the eczemas respond to nosodes of one sort or another, I think I have already mentioned a case of ten years duration in an eleven-year-old boy, persistent and very disturbing to the eye and to the patient, from itching, and I didnt get anywhere with our regular procedure, but I found out that the mother had had the “flu.” She had it very severely a year and a half before the baby came, and Influenzin cleared the case.

DR. F. K. BELLOKOSSY [Denver, Colo.]: I completely agree with Dr. Whitmont and Dr. Schmidt, but nevertheless, they are not completely right, that is, they have not completely reached the bottom of the problem. What makes these allergies? People get allergic because they eat wrong, and they eat wrong when they eat sugar, devitalized sugar, and when they cook things, boiled milk, or boiled butter, boiled cream. Nothing gives more cholesterol in blood than boiled or cooked cream, cooked butter, cooked milk, and surely cooked meat also. If those things are eliminated from the diet, the patient will immediately get better and his allergies will diminish.

In Europe where people eat a very modest and primitive diet, usually not so rich and so complicated as in America, they have no allergies except in big cities. In small towns, in villages, you will never find any hay fever or any other allergy. This is because their diet is so much simpler. They eat plenty of vegetables. You can eat cooked and raw vegetables, but cooked animal foods are not good. Animal foods must be raw armed up, but not really cooked. As soon as you eat cooked animal food, you will develop allergies.

DR. WHITMONT: I do not care to open now a battle about eating, but I think there is a danger if we nail ourselves to a panacea approach. I fully agree with the dangers of wrong eating and I do also say many of the things we eat are not fit for human consumption, and I am in the bad graces of my patients, because I am supposed to be a devil on diet, but lets not put all the human ills just on eating.

May I point out that the diet of the European farmer is notoriously low in vegetables.

DR. BELLOKOSSY: In some countries. In Hungary they eat too much meat, but in other countries it is not so.

DR. WHITMONT: I havent met a farmer yet in Europe who didnt eat potatoes and meat, who had a miserable diet and miserable teeth, yet they are also meat-eating farmers. Their diet is notoriously bad. DR. BELLOKOSSY: They are not allergic. DR. WHITMONT: They have allergies.

DR. BELLOKOSSY: They do not.

DR. WHITMONT: You just cant put everything on sugar and potatoes and meat.

Eugene Underhill