The exophthalmos when present for some months may never completely disappear and is more long-lasting in cases where the gland is much enlarged and pressure has taken place. This is true for cases treated by surgery or by medication.
The slight cases of hypertrophy usually have two or three of the classic symptoms only. It is common to have somewhat nervous patients with rapid heart action, slight tremor, and aversion to heat and warm rooms consult us for relief. They have not lost weight nor do they have any sign of exophthalmos. A very large percent of these are afraid of thunder storms, afraid to be alone at night, their heart rate slows while you use the stethoscope but accelerates when the pulse rate is counted. They may not have lost weight but dislike hot rooms and hot weather. There are a raft of these cases all can be helped back to their own normal health, and Natrum mur. is often the remedy to do it for you.
In the next class we have those with a slight tremor, hot flushes, rapid heart, smothery feeling, tight or oppressive feeling in the chest and lower throat. They awake from sleep with palpitation and hot feeling, throw off the covers and lie in fear of the heart’s rapid action. They have to have the head elevated. In these patients the heart rate is more constantly accelerated and they keep putting their hand to the throat. Here Lachesis is indicated and will do wonderful service. These two remedies will help a great many incipient and slight cases without bed rest.
Where the disease is full-blown, absolute quiet and bed rest are imperative and surgery is the quickest way out. But, as said before, not all patients are willing, so in such a situation good homoeopathic prescribing is indicated.
If such a patient goes to a surgeon, and for some reason or other operation is deemed inadvisable, they will be kept in bed in hospital and given one of the new drugs such as Thiouracil. Blood specimens should be taken at least twice a week and urine specimens every other day in order to check on possible ill- effects in kidneys or blood. Such a case will be under treatment about six months.
If, then, you put your patient on bed rest and prescribe homoeopathically, you have from three to six months in which to either return him, or her, to normal, or to decide that surgery is necessary as a last resort.
The most violent of these patients will frequently need Belladonna. The flushed face, dilated pupils, rapid soft pulse, hot face and cold feet with the pulsation, tremor and exophthalmos, are classic symptoms for this remedy.
The next most frequently needed remedy is Ferrum met. The flushed face alternating with pallor, the nightly aggravation, muscular weakness with tremor, possible epistaxis, or history of anemia and epistaxis, exhausting sweats, protruding eyes and excessive nervousness all point to this remedy.
Iodium: This patient is thin but eats heartily; has palpable, hard cervical glands, goitre soft, great heat or flushes of heat with rapid pulse-most frequently indicated in dark-haired, tall, thin people with rapid loss of weight.
Bromium: Huge swelling of the thyroid, exophthalmos, violent palpitation, easy profuse perspiration, cannot lie on right side because of palpitation, usually indicated in blond patients.
Spongia: Huge goitre with suffocation attacks, has to sit up to breathe, eyes protruding, very violent visible palpitation, worse after midnight. The voice may be affected and the cough dry and croupy in sound.
All the above remedies will act and act well in the higher potencies. There is one other sheet anchor which can render good service in the tincture and low potencies. This is Lycopus virginicus. This remedy produces an every other day aggravation much like Natrum mur. There is a pressing full feeling in the frontal area which is often worse at eight A.M. The eyes protrude with a pressing out feeling in the eye-balls and supraorbital region, worse at eight A.M.
These patients belch, have colic-like pains in the abdomen and profuse and forcible diarrhoea. This feeling of diarrhoea being imminent can b e controlled perfectly, which is the reverse of Aloes.
The heart exhibits sticking pains, constrictive pains and tumultuous beating, heart murmurs (mitral regurgitation), palpitation from nervous upsets; many heart beats do not reach the wrist because of weakness and irregularity.
This heart condition may be present in rheumatic fever, or in old rheumatic heart cases which have been overworked. The heart is enlarged and the heart sounds may be heard better to the right of the sternum. Rheumatic pains in the back, in the hip, knee, etc., are generally worse in the morning and more pronounced upon the left side. In severe cases there is hacking cough the nights are restless and full of troubled dreams. This is, of course, a frequent accompaniment of failing heart.
Where the patient fears death, with anxious, restless tossing about and tumultuous heart action, do not forget Aconite, frequently repeated.
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