Homoeopathy in terminal conditions and apparently incurable diseases
by Stuart Close, MD, Brooklyn, NY
(this article contains much useful information, as well as the case where Close “bring the lady back to life from the dead.”–JW)
Is Homoeopathy sufficient in terminal stages of such diseases as Bright’s, diabetes, tuberculosis, cancer or valvular heart disease?
Is Homoeopathy able to cope with such grave emergencies as collapse during severe acute diseases or shock after injuries or surgical operations?
Is it not necessary in such conditions to resort to the stimulants, narcotics, sedatives, diuretics, etc. of “physiological medicine”; to administer drugs in doses sufficient to produce their so-called physiological effects, for palliative purposes?
In other words, – is a homoeopathic physician justified in sticking to his colors in such cases, or should he give up, haul down his colors, confess himself beaten, admit the insufficiency of Homoeopathy in such conditions, and fall back on the routine methods of the dominant school ?
In one form or another, these questions are often asked. Indeed, they present themselves frequently to every one of us. Some answer them one way, some another. Some stand up, manfully, proclaiming that the similar remedy is the best palliative, and all-sufficient for every medical emergency. They affirm that every emergency requiring the use of medicine is best met by administering the similar medicine, in dose or form suited to the nature of the case. In the matter of the dose they are not disposed to dogmatize, but are content to let individual judgment and experience decide. They insist, however, that the effect sought shall always be the medicinal, and not the so-called physiological effect; for it is agreed that the purpose in giving a homoeopathic remedy is not to produce symptoms, but to remove those already present. It is established that the homoeopathic dose is always a sub-physiological dose; i.e., a dose too small to produce symptoms. The nature of its action is curative. In practice it often turns out that the highest potencies do the best work.
There are others in our school, (and they are in the majority) who assert that Homoeopathy is not sufficient; that it has its limitations, even in purely medical cases, and that there comes a time in many such cases when it is necessary, for them at least, to abandon homoeopathic methods and resort to traditional or conventional routine measures for relief. They would be “physicians first, and homoeopathists afterwards”, and they are disposed to criticize those who do not agree with them.
The real question at issue between these two parties is not one of the size or quality of the dose, as it is commonly held to be, but one of principle and policy. One party holds that the true welfare of the patient is best served by adhering to homoeopathic principles and administering remedies for their medicinal, homoeopathic or curative effect irrespective of the stage of the disease. Theirs is the Hahnemannian treatment exclusively by symptom-similarity. The case may have reached the incurable stage and be hopeless so far as ultimate cure is concerned, but the greatest good, they hold, will be accomplished for the patient if similar remedies in medicinal doses only are used, for the action of the homoeopathic remedy is always along the line, or in the direction of cure. It is curative in nature as far as it goes, and it is the highest good we can attain.
On the contrary, drugs administered in physiological doses have a pathogenetic action. They produce symptoms. They create disturbance in organs where, perhaps, there was no disturbance before. They are noxious to the organism, sick or well. They compel a defensive or eliminative reaction which exhausts the already weakened vital energy. The physiological dose is a toxic dose.
To every action there is a corresponding reaction in the opposite direction. The drug which stimulates in its direct or primary action depresses and weakens in its secondary action. If the case be in its terminal stage, life is shortened and the sum total of suffering increased; for the temporary sense of comfort and well-being sometimes experienced after a palliative or stimulant is fleeting and deceptive. It is soon replaced by the weakness and irritability of the secondary action, with increase of suffering and decrease of ability to endure it. The physiological action is never curative but always pathogenetic. Hence, our purists say that we are never justified in giving drugs for their so-called physiological effects, except when it is necessary to make provings in the healthy for the purpose of creating or augmenting the materia medica.
If the physician knows what can really be accomplished with homoeopathic remedies, and if he had the best welfare of the patient at heart, there would seem to be but one answer to the questions under discussion. He will adhere to the use of homoeopathic remedies only, because they are capable of accomplishing more for the comfort and benefit of both curable and incurable medical cases than any other measure whatever – with one possible exception of which I will speak later. The real duty incumbent upon us is to make ourselves proficient in the application of the homoeopathic method.
It may be stated as a general proposition that the Homoeopathician always treats his case as if it were curable. That is to say, he observes and studies its phenomena, and selects his remedy according to the method of symptom-similarity without being influenced by any feeling or opinion as to what the outcome will be. He knows that death comes in time to all men; that some cases are incurable by any means; and that the most that can be done for some cases is to make their condition as tolerable as possible as long as they live. He may know, or think he knows, that a particular case is incurable or about to die; but he also knows that many cases pronounced incurable and hopeless have been saved, or helped, or cured, by one who ignored all such feelings and suppositions and opinions, and settled resolutely down to the task of finding and giving the similar remedy. The sooner our practitioners realize and accept this as a duty to themselves, their patients, and to Homoeopathy the better will it be for all concerned.
There is too much servility to opinion; too much bending the knee to those who parade the authority of place and power; too much easy compliance with the whims or pleadings of patients who, while they suffer, are yet ignorant of what is good or best for them; too much running after the ever-changing medical fads.
The Homoeopathician should know his art, and know the best there is in it; and being thus prepared, should take and hold his true position as a medical director. Upon occasion, he should be a dictator, brooking no opposition, submitting to no influence which would tend to turn him from his plain path of duty. Rather than lower his standards and compromise his principles, he should withdraw from a case. Thus only will he retain his self respect and the respect of all whose consideration is worth having.
If it were true, as it is claimed, that the resort to other than homoeopathic remedies really accomplished anything for either the comfort or welfare of the patient, the case would be different. But it is not true. No one who has ever seen the two methods and their results side by side, and made a fair comparison between them, would hold for one moment that it was true. Who of us has not taken cases from the hands of those who have pursued such methods up to a point where it was admitted that “nothing more could be done”, and seen those came cases, under homoeopathic treatment, either recover, or have life prolonged and suffering greatly ameliorated by homoeopathic remedies alone?
I can conceive a situation where for myself, or for a fellow sufferer, I would welcome, might even demand, the merciful surcease of pain which morphine or chloroform can give, even to “the sleep that knows no waking”. But I cannot conceive how any one who knows and has seen what homoeopathic remedies can do, even in the hands of indifferent prescribers, could turn aside into the tantalizing and deceptive paths of “regular medicine”. “That way madness lies”. The primary effect of certain drugs may simulate Heaven, but their secondary effects give a remarkably good imitation of Hell.
How shall the question be settled? It is easy to reply, “by experience”. But men differ in their interpretation of experience. They differ in their point of view, as much as in their mental ability and technical equipment. They differ in their natures and in their ethical and moral standards. Prejudice must be reckoned with. Most of us see what we want to see, or what it is to our interest to see. Probably all of us are affected in that way more or less. It is encouraging if there be a few who are able to detach themselves sufficiently from their prejudices to be able to see both sides of the question, and discuss it fairly.
There can be no settlement of the controversy until some common ground of consideration, some mutual point of view can be agreed upon. If the welfare and best interest of the patient is paramount, then we are required to either put aside all personal, selfish or mercenary considerations, or else discover how to harmonize the patient’s welfare with out ideals of success and prosperity.
I do not regard that as a hopeless proposition. Human nature is not as bad as it is painted. Most of us would be willing to do better if we could be made to see that it pays, and the desire to be paid, in coin or commendation, is not necessarily an attribute of moral depravity. “The laborer is worthy of his hire”, and the desire for success is a laudable ambition. We may take courage from the thought that some have found that moral, financial and social success in Medicine is not incompatible with fidelity to high ideals in the practice of Homoeopathy.
The idea that only experts in materia medica can succeed in cases of the class we are considering is a fallacious and demoralizing one, which is often made the excuse for shirking a plain duty. It is true that success is usually proportionate to the skill of the prescriber; that the simillimum will accomplish more than the merely similar remedy. But it is also true that the results obtained by even a moderate degree of skill, loyally and consistently exercised, are vastly better than the results of other methods.
It may be that only the master can select the simillimum, but even the tyro can select a similar, if he tries, and accomplish some good. Certainly he will do no harm, as he will if he resorts to other measures. Let him but do the best he can, and strive always to do better, and all will be well. Let him know, also, that to the one who performs his work in this spirit, “inward revelations” are sometimes given, by which he is richly rewarded for his faith and loyalty to principle. The simillimum has sometimes been found by the humblest among us, who make no pretensions to expertness, and marvelous cures have been thereby effected when they were least expected. Such rewards come only to those who are in “The Way”, ready and worthy to receive them.
In the meantime, as a slight contribution toward a basis of agreement, let me briefly set forth some of the qualifications of the practitioner, technical and otherwise, illustrated by a few cases from personal experience.
The practitioner who expects to treat the grave conditions under discussion by homoeopathic methods alone, and with a reasonable degree of success need not be an expert. It is only necessary that he be reasonably competent. Such a degree of competency depends upon the following modest requirements.
He should be thoroughly grounded in the essential principles of Homoeopathy, as laid down in the Organon.
He should have a practical working knowledge of the art of case-taking. This means that he must know what symptoms are from the homoeopathic viewpoint, and how to elicit them.
Knowing this he must make thorough examinations and keep written records of his findings in each case.
He must know the method of finding the similar remedy for every case. This does not mean that he must have the entire materia medica in his head as some pretend to think; but that having the materia medica on his library shelves, (he will have some library shelves, if he is wise, and books to fill ´em) he must know how to find what he needs. He will therefore require at least one good repertory and the ability to use it. With this modest technical equipment, and a modicum of brains, he will be able to do very well.
The only remaining essential is a willingness to work, and to work systematically. A method is of no value unless it is used, and to use it requires work. Homoeopathy is the method of treating individual sick persons by symptom-similarity. Its prescriptions are not ready made and carried in stock. They are exclusively “made to order”, to fit the individual. The Homoeopathic way is not a “primrose path of dalliance”, but the attainment of a moderate degree of success requires no more labor than is necessary to keep its follower in good condition and prevent him from getting flabby.
Let the practitioner, then, be soundly convinced of the truth and sufficiency of Homoeopathy for all medical cases; but above all let him have the courage of his convictions, so as to be able to stand firmly in the face of great temptations to change his course. If his temperament permits him to have or acquire enthusiasm, so much the better, both for his patient and himself. Remember Emerson’s epigram : “Nothing great was ever achieved without enthusiasm”. Enthusiasm is that joyous faith which not only inspires us to our best efforts, but upholds us in the face of seemingly overwhelming odds, and enables us to inspire others. The power for good of this personal, psychical element can hardly be overestimated; for very often success depends upon the ability of the physician to seize and retain a hold upon the patient’s desire and will to live; to inspire him with hope and courage; to call forth an effort to live; to arouse the flagging spirit and recall it to life and action.
This is illustrated in Case I.
A case of uremic coma, gangrene, and apparent death. A woman, age 45, previously healthy, had been ill for over two months – an illness of which I have never been able to form a very clear idea according to accepted pathological standards, – partly because I could never get a clear or satisfactory previous history owing to the ignorance or inattention of the people concerned. Perhaps I was not as scrupulous in my investigation of the history of cases in the early days of my practice, when this case presented, as I subsequently became, and am now. And, besides, the interest of this case for me has never consisted so much in its pathology as in its psychology.
Roughly outlined, the case began as an eczema, affecting principally the lower extremities. In the beginning of treatment by her allopathic family physician, she did not appear to be seriously ill; but as treatment progressed she became more and more ill and weak, and finally was confined to her bed. From this time on there was a steady decline of weight and strength, of loss of interest in life, and of hope, until she became apathetic, and finally comatose. Urinary secretion had become more and more scanty until it ceased, and uremic coma came on. The treatment had been mostly topical — consisting of the application of various ointments and lotions for the eczematous areas, and, as I learned afterward, of the free use of Arsenic internally. In consequence the eczema had been suppressed, and the systemic symptoms developed.
For two days prior to my being called, she had been pronounced to be dying. On the day I was called the physician had called early in the morning and said that the end was very near. About noon he called again, and found her so nearly dead that he said she could not possibly live more than an hour, and that he would not call again.
At this juncture I was appealed to by her daughter, who had been a patient of mine, to come and see if I could do anything. I arrived about one o’clock in the afternoon. As I entered the room, I saw her lying on the bed surrounded by weeping relatives. Someone said : “It’s too late, doctor, she’s gone”.
At first glance it looked that way, but something impelled me to go to her and make an effort to save her. Paying no attention to the relatives, I made a rapid examination. Her limbs were cold and rigid, but the body was still warm. There was no radial pulse, and no visible respiration. With the unaided ear I could detect no heart-beat, but in my haste I had forgotten to bring my stethoscope. Her eyes were fixed, the lids slightly open, and her features had the expression of death. But the thought of death was not in my mind in spite of the evidence.
I drew down her lower lip and shook a few pellets of Arsenic 45m (Fincke) upon the exposed mucous membrane and rubbed her lips against the gum. Then, following a peculiar, but impelling impulse, I seated myself on the edge of the bed, placed my hands upon her head, and called her loudly by name. Addressing the insensible form, I said positively, “You are not going to die. You must come back”. I moved her head slightly from side to side, to loosen the rigidity of the neck muscles. Placing my thumbs on her upper eyelids, and pushing them upward so as to fully open her eyes, I bent down close to her, looking directly into the eyes, and addressed her again with reassuring words. I said, “I am going to help you move. You must try with me”. Several times I opened and closed her eyelids, and rotated her head. Then I said, “Now open your eyes”. There was a moment of hesitation, then the lids trembled and slowly opened. “Now close them”. She obeyed, and repeated the act twice at my command. Then I proceeded to move her stiffened arms and legs, – flexing and extending them several times, and gently manipulating them. Next I moved her body, turning her from her back to one side and then the other, shifting her position in bed. During this time I was speaking to her occasionally in encouraging tones. After thus loosening up the rigid muscles, I resorted for a few moments to very gentle artificial respiration, directing her at the same time to try to breathe herself. After about ten or fifteen minutes of this work (I had very little sense of time) she was breathing regularly, color was coming back into her face and lips, and her hands were becoming warm. Presently she opened her eyes and looked at me as I bent over her, and whispered to me, “I’m coming back”.
In ten minutes more she was talking to me in an audible voice, asking me questions about herself and what had happened. I had continued gentle rubbing and massage of the extremities, under the bedclothes, but in order to act more efficiently, I now uncovered her feet, and to my amazement saw that the toes and plantar surface of the metatarsal region of both feet were gangrenous. Then I felt sure she had been dead! Here was local death, at any rate, plainly visible. But my patient was now plainly alive, and very much interested in what was going on. I had difficulty in keeping her quiet, and preventing her from talking. I directed that she be kept quiet, and that some warm broth be prepared and given to her, that warmth be applied to the feet and legs; and that Arsenic 200 in solution be given at intervals of two hours, until my next call.
In the evening I called again, and found her in a high fever, with flushed face, sparkling eyes, active delirium, recognizing no one, but talking continually in an excited manner, and very restless. Reaction had come on with a vengeance, but the symptoms spelled Belladonna, and salvation. For eight days the fever and delirium continued, but the urinary function was re-established, and a diarrhoea came on. The circulation became active the gangrenous areas on the feet sloughed out, healthy granulations appeared, and healing progressed rapidly. On the ninth day the delirium left her. Her first intelligent words were a request that I be sent for at once. She had something to tell me which she would not reveal to her family. On my arrival she asked me how long she had been sick, and then said that she had sent for me to tell me her experience “while she was dead”. It was all clear in her mind now, and she wanted to tell me before she forgot it.
She said that after lying for several days unconscious of her surroundings, but “alive in her mind” her father and mother (who had been dead many years) came for her to take her away with them. She had left her body and was just about to leave the room with them when she heard me call her to come back. She felt that she could not disobey me, and regretfully left her father and mother and came back. The next she remembered was opening her eyes and seeing me, and talking to me. Then all became blank again, and she had no sense of time or surroundings until the present.
That was her story. She made an uneventful recovery, gradually regaining her strength until she finally resumed her ordinary round of life. She is alive today, a strong, healthy woman. That was over twenty years ago. I meet her occasionally, and she never fails to remind me of “the time when she died and I called her back”.
Was it a case of poisoning by Arsenic and other drugs?
Case No. 2. Collapse after operation.
A man, 66 years of age, naval constructor, had suffered several years from what had been diagnosed and treated by a homoeopathic physician as cystitis with enlarged prostate. He came under my care during an acute exacerbation of his trouble, brought on by taking cold from getting wet. He was much weakened by his long chronic illness, and was in a grave condition when I first saw him. Urine could only be voided by catheterization. Urinary analysis and microscopical examination of the urinary sediment, taken in connection with the symptoms, suggested the existence of a vesical calculus. This was confirmed by the sound, as soon as the acute symptoms had subsided sufficiently under treatment, to permit its use. Rectal exploration did not reveal any extensive enlargement of the prostate. Operation was advised and accepted, and patient was removed to the hospital as soon as he was deemed strong enough. The supra-pubic operation was performed by Dr. John Hubley Schall and myself. A large, rather friable stone, of phosphatic composition, was found, partly embedded in the tissue surrounding the neck of the bladder, which was greatly thickened and indurated. Several small papillomatous growths were also found in the bladder. The stone, and the largest of the growths near the neck of the bladder were removed. The patient bore the operation well, and everything went well until the third day after the operation when the secretion of urine suddenly ceased, paresis of the intestines came on, the abdomen rapidly inflated, and the patient went into collapse.
While awaiting for my arrival the nurse, on her own responsibility, administered a copious hot saline enema and applied heat to the extremities. I found him in extremis; deathlike pallor and expression, pulseless, extremities cold, abdomen enormously distended and tympanitic, almost unconscious.
I was unable to account for the sudden collapse, and there was nothing in the symptoms absolutely characteristic of any one remedy. The ordinary collapse remedies, Camphor, Arsenic, Veratrum, and Carbo veg. ran through my mind, but I was unable to decide which, if either, was needed. I dared not make a random selection. A mistake would be fatal. I vainly questioned the nurse for more symptoms, until I bethought me of asking her “what the enema had brought away from the bowels”. Her answer was illuminating. “The water, with a lot of ragged shreds and strings of white mucous”.
That completed the picture. Persons poisoned by Colchicum have presented identical symptoms. Colchicum 200, in solution, every five minutes, brought about a reaction in about fifteen minutes; circulation was restored, flatus passed freely, consciousness returned, urine began to flow again, and the patient made a rapid and perfect recovery. I was glad that the nurse had given that enema, and noted what came away.
Case No. 3. Diabetes with gangrene of the right foot and leg.
In November, 1911, I was called to take charge of Captain -, married, age 49, master of a ship plying between New York and the tropics.
He was known to have had diabetes for several years, but was, nevertheless, a powerful and rugged man, weighing 260 pounds. He regarded 220 pounds as his normal weight, and attributed his overweight of forty pounds to overeating and lack of exercise. No special attention had been paid to his diet. He was a heavy eater and moderate drinker. As a young man he had had gonorrhoea – suppressed as usual, and his wife had borne him no children in consequence. His other serious illness had been an attack of “Calentura”, (tropical malignant malarial fever, with jaundice) fourteen years ago, and an attack of erysipelas of the feet and legs some seven years ago. (Seven years periodicity?) He also had yellow fever during the Cuban War.
The present attack began during a return voyage to New York about two weeks before, as an infection of the left great toe, from cutting the nail too deeply. After three or four days the toe became inflamed, and the septic inflammation rapidly extended up the foot and leg to the knee. It presented the appearance of a malignant vesicular and phlegmonous erysipelas. The foot and leg were swollen, the leg bluish, and the toes and about half the foot nearly black. Gangrene was evidently in progress, and rapidly spreading from the toes upward. His whole body and face were covered with an itching red tropical rash, with a vesicular eruption on the nose. The first examination of the urine showed a specific gravity of 1033, sugar 1.44%, albumen, and granular and hyaline casts, indicating the existence also of a chronic nephritis. Later the sugar content rose as high as 3.40%, fluctuating for some time between these two extremes. Withal, the Captain did not feel seriously ill, his courage and strength were good, and his spirit cheerful, in spite of the fact that he had been told of the exceeding gravity of his condition and the probability of a fatal ending.
By great good fortune his ship surgeon was a man of excellent judgment and a deeply interested student of Homoeopathy, although he was practicing as an allopathic physician. This young man recognized the futility of ordinary treatment, turned aside from it, and applied himself to the study of the case from the homoeopathic standpoint. He decided that Lachesis was the only remedy which afforded any hope, and having a case of homoeopathic remedies, he began giving the Captain Lachesis 30, applying meanwhile simple aseptic dressings to the foot and leg and modifying his diet. He thus kept the disease somewhat in check during the homeward voyage, and on arriving at New York, turned the case over to me, and returned to duty on the ship.
In order to satisfy friends and relatives who were clamoring for immediate amputation, I called my surgeon, Dr. Schall, and submitted the question of the advisability of operation to him. After getting the history of the case and examining the patient, he advised against operating. To amputate at the knee joint in a diabetic whose gangrene was extending so rapidly, was merely to anticipate the further extension of the gangrene from the flaps up the thigh and a second operation which would inevitably prove fatal, if the patient did not die before it could be performed. Privately, he told me that, in his opinion, the patient would die anyway, and very soon. He had seen a number of such cases in Europe and America, and they had all proved fatal, with operation or without.
Here, then, was a desperate situation, calculated to test the faith and resources of the best-equipped Hahnemannian. The Captain and his good wife were game, however, and when the situation was explained to them, the Captain said, “Well, doctor, I pin my faith to you and Homoeopathy. If I’ve got to die, I will at least make a good fight of it”. Thereupon, being myself encouraged by his plucky stand, and knowing how valuable is such courage and the “will to live” as a therapeutic adjunct, I assured him of my belief that he would not die; and that together, – he, his wife as nurse, and myself – we would bring the case through to a happy issue. And so we entered into a compact of mutual courage, fidelity and patience, and shook hands upon it. If either of us ever faltered, the others never knew it.
I will not go into all the details of the long medicinal treatment of the case, giving indications for the remedies used, as is commonly done. There is not time and that is not the purpose of this paper. I am simply giving my personal testimony to the sufficiency and dependability of pure Homoeopathy in desperate cases, when conditions are right for it; and I am emphasizing the fact that among those conditions, not the least important are the qualities of courage, faith and patience, and loyal co-operation, on the part of patient, nurse and physician.
Suffice to say, that the treatment extended over a period of eight months. Remedies were selected with scrupulous care, and given, with only two or three exceptions, in potencies ranging from the 200th upward. He was kept on a modified, but not a rigidly anti-diabetic diet.
Doses of some remedies were repeated until improvement was evident and then stopped. In other cases, single doses were allowed to act as long as there was improvement.
Necessarily, in a case of such character, many remedies were needed. The case was one of long standing, chronic and complicated in character. Many different phases presented themselves. Two, and possibly three chronic miasms were actively expressing themselves. The case was in its terminal stage, and the termination, according to accepted medical, as well as surgical standards, should have been death.
The key to the situation lay in the recognition of the fundamental miasm expressing itself in the diabetes, of which the gangrene was merely a terminal condition. But neither the gangrene nor the diabetes were the objet of treatment, as such. Unless remedies could be adapted to each phase of the case as it developed, the process of dissolution would go on to the end. Control of the gangrene depended upon control of the diabetes, and both upon the characteristic symptoms of the patient; in other words, upon individualization of both case and remedy under the principle of similia.
For about a week, Lachesis, in the 200th potency, instead of the 30th, was continued. Under this remedy, the erysipelatous condition of the leg began to subside, and the area of livid discoloration to recede downward towards the foot. The gangrenous area of the toes and foot extended upward slightly and a line of demarcation developed dorsally at the base of the third, fourth and fifth toes, extending on the middle plantar surface of the foot, however, well back towards the arch. Sloughing began at the toes, and a little later, on the sole of the foot. One after the other, after sloughing had progressed considerably, I disarticulated and removed the third, fourth and fifth toes at the metatarsal-phalanged articulation. I also made a central longitudinal incision two inches long in the sole of the foot for free drainage, for the sloughing process extended well up into the metatarsal region, and the plantar incision opened into spaces which communicated with the openings at the end where I had disarticulated the toes. Through these openings, pus, blood, fragments of bone, fascia, tendons and ligaments were continually escaping or being removed. The nerves were destroyed, as well as a part of the plantar arch and its branches, which I removed piece-meal, from time to time. There was but little hemorrhage at any time, and that was easily controllable.
The spaces and sinuses were cleansed twice daily by injecting either Dioxygen or Electrozone, and dressing with aseptic gauze. After granulation began, diluted Calendula was used part of the time for injecting in dressing. The discharges gradually diminished, and the spaces began to fill with healthy granulations, until finally, all were closed solid except one very small sinus from which there is still a slight discharge – sufficient to make a spot a quarter of an inch in diameter on the bandage which is still worn. The patient is still under observation.
During all this time the sugar in the urine was steadily diminishing and the patient’s general condition improving. At the end of the fourth month the urine was normal and has since remained so. The patient resumed duty and took charge of his ship in January last, thirteen months after beginning of attack, and is today in perfect health, weighing 220 pounds.
He has a good solid, serviceable foot, minus three lesser toes, and walks without a perceptible limp. The skiagraphic report made October 16th, 1912, before healing was complete, was as follows :
X-Ray findings : -The tarsals present no abnormality of any kind. The first metatarsal and phalanges of the great toe are normal. There has been destruction of the head of the second metatarsal, and of the base of the corresponding proximal phalanx. There is some active disease present in the head of the metatarsal, and a considerable amount of bony detritus in the metatarso-phalangeal articulation. The head of the third metatarsal has been the seat of a necrosis, and there is only a portion of the proximal phalanx present. There is no active disease present in these parts. A similar condition exists about the fourth and fifth metatarso-phalangeal articulation, but in the latter, the remains of the phalanx appears fused to the metatarsal. The arteries of the foot are markedly sclerosed.
Diagnosis : -There is an old necrosis about the second, third, fourth and fifth metatarso-phalangeal articulations with the loss of practically all the third, fourth and fifth toes. arteriosclerosis-sclerosis is present to a marked degree.
The principal remedies prescribed as the symptoms called for a change, were Lachesis (frequently returned to as the principal remedy during the more active stage), Arsenic, China, Secale, Sulphur, Silicea, Thuja, Mercury, Phosphoric Acid, and Lycopodium.
Case No. 4. Sunstroke.
A man aged 82; overcome in the street on one of the hottest days in August; unconscious, pupils dilated, face and scalp hot, temporal and carotid vessels throbbing, respiration and heart action labored, pulse full, rapid, skin dry, temperature 110.
It may be taken for granted that the condition portrayed by these symptoms, existing in a man 82 years of age, is a grave one, closely bordering on dissolution. I have little doubt that the institution of the ordinary modern treatment for such cases, by ice packs and antipyretics would have speedily brought about the catastrophe. But I remembered the spicy wisdom of our old friend Raue in his “Special Therapeutics,” read over twenty-five years ago and never forgotten.
A dose of Glonoine 200 was given. The bath tub was then half filled with cool water (as drawn from the cold water faucet) and the patient’s body was submerged in it, the head and neck being supported. He was kept in the bath about fifteen minutes, water being constantly dipped up from the tub and poured over his head. By this time consciousness began to return and he was lifted from the tub, wrapped in a sheet, and put to bed with a wet towel on his head. A few doses of Glonoine 200 in solution were given. His temperature dropped rapidly, and in about twelve hours was normal. In three days he was going about as usual.
Case No. 5. Entero-Colitis.
At three o’clock in the morning on November 28th, 1907, my telephone rang and a voice said, “This is Dr. H. I am at the house of Dr. B. with three of my colleagues, all in consultation upon the case of Dr. B’s baby. We have been here all night, and at the last conference, a few minutes ago, it was decided that the case was hopeless and the baby dying. I have suggested that you be asked to come over and see if you can do anything to save her, and they have accepted the suggestion. Will you come?”
I replied that I would. The doctor came for me in his motor car, and in a few minutes I was at the bedside of the little sufferer with the five physicians assembled in the room to observe my procedure. They told me that they had exhausted their resources, including the measures advised by an eminent allopathic specialist in the dietetics and treatment of children’s diseases, who had been called in several days before. They placed the case unreservedly in my hands, being themselves hopeless. This is what I observed.
The baby, nine months of age, was lying on her back unconscious; eyes half open, sunken and turned upward; face drawn; head bent backward; fingers clenched upon inturned thumbs; nose cold; breath cold; respiration groaning, 50 to 60; mouth and tongue dry; chewing motion of the mouth; convulsive motions of arms; at times biting the fingers; truly a serious condition, likely to end very shortly in death unless the curative remedy could be found.
I learned that the attack had begun with a diarrhoea ten days before. For four weeks before this, however, there had been no gain in weight, although she had been previously healthy, this being her first illness. There had been from three to six stools daily, at first brown fecal, then yellow, later green. The stools had been undigested, containing lumps of casein. All dietetic and hygienic measures adopted, and all remedies given had failed. Twenty-four hours before, forcible, or projectile vomiting had begun; she became thirsty for cold drinks which were vomited; was restless, pale, weak, refused food, and sank rapidly into the condition in which I found her. Cham., China, Calc. phos., Bry., Cicuta and Helleb. had been given, all in low dilutions, without benefit.
What was to be done? Five able young men, all “up to the minute” in modern dietetics and hygienic methods, and considered fairly good homoeopathic prescribers, reinforced by one eminent allopathic child-specialist, had failed, and frankly acknowledged their failure. Has they sounded the depths of homoeopathic resources? Reviewing the case, I thought not.
With Bonninghausen, and my penciled notes in hand, I worked out the case before them, commenting as I worked. It appeared that the characteristic symptoms, insensibility, coldness, head bent backward, eyes turned upward, desire for cold water, forcible vomiting, respiration groaning, hands clenched, were covered only by Nux vomica, which corresponded also to the general character of the original gastrointestinal disorder.
I called for a glass half full of water and dropped a few pellets of Nux vom. 200 in it. I directed that a teaspoonful of the solution be given every two hours until three doses had been given, and that then I should be informed of the condition of the patient. One of the physicians remarked sotto voce, “She’ll be dead before that”. I reassured them, and went home.
At eight A.M. , four hours after the first dose had been given, my telephone rang again and my friend in a jubilant tone of voice said, “Doctor, you were right! The baby has reacted. She is now warm, and convulsive symptoms have all ceased. She has taken a drink of water without vomiting, and is now sleeping naturally with her eyes closed! It is a miracle!”
From this time on the case was simple. On the third day she was up and dressed. No other medicine was given until the fourth day, when a single dose of Nux vom. 45 m was required to remove a few remaining symptoms, after which she was in perfect health.
W.S. Hatfield: When is it not right to depend upon the homoeopathic remedy?
Stuart Close: I did not specify any particular condition, but I can imagine a condition that might demand relief, or release from suffering, by means of a suitable dose of morphine or chloroform. I can say that only on two occasions have I ever met such a condition. One was a case of uremic convulsions in the terminal stage of chronic interstitial nephritis, immediately preceding inevitable death, and the other was a case of severe traumatism from instrumental delivery of an acephalous monstrosity.
P.E. Krichbaum: I have never found anything better to produce comfort in the dying hours than the homoeopathic remedy. If the patient demands on opiate, they must go elsewhere because I do not use anything but the homoeopathic remedy.
W.S. Hatfield: I believe that the homoeopathic remedy is always equal to the occasion; I have found it to be so. Carbo veg. given in extremis either saves the patient or allows them to die easy.
H.L. Houghton: A year ago last winter I treated a little frail woman for pneumonia; she already had progressive arthritis deformans. Phosphorus was her remedy as it turned out after studying her symptoms a while. She told me a very similar story to that related by Dr. Close, as happening twenty years ago. Does he think that the shouting did it or the Arsenicum?
J.F. Roemer: The adjuvant remedies that were used in the case of the sea captain should be emphasized. I do not believe for a moment that the doctor could have cured him unless he had had the co-operation of the patient and his wife.
E.A. Taylor: In regard to the shouting as to whether it did good or not there need be no trouble. At any rate it did not interfere with the action of the homoeopathic remedy. I was impressed with the point the doctor made when he said that we need not all be experts; we need not be experts, if we know the principles of Homoeopathy and do the best we can, we can do better than by any other known method whether we are experts or not. I was displeased with the circular that our officers sent out to us because it spoke of the members of this society as therapeutics specialists. We are physicians and surgeons. Therapeutics is the most important part of medicine; what do we do most in general practice? Is it not to get the indicated remedy? We are called upon to prescribe for symptoms twenty times as often as we are called on to do surgery. Those who practice Homoeopathy should qualify themselves to practice it. The way for us to do is to go at the problem in a plain sensible way, take the case as well as possible, and then follow the plain directions of Hahnemann; we may not always get the simillimum, but we will get a remedy that will be similar enough to help the patient and will never do any damage such as may be done by some of these new fashioned fads.
G.E. Dienst: The point is, will Homoeopathy do as well for the patient in emergency cases as the old school will? Is the indicated remedy as efficacious in severe hemorrhages, post-partum and others as are the expedients of the old school? In traumatisms? dislocations? fractures? violent vomiting of blood? I simply ask these questions without attempting to answer them.
A.P. Bowie: All who ask such questions as those, should get hold of the recent work by Edmund Carleton, a man who was a surgeon of the first class. He will tell you in that book how his homoeopathic treatment helped him in his surgery. Dr. Carleton has gone, but he has left us a legacy that is worth its weight in gold.
Lawrence M. Stanton: A patient in such a state of collapse that death seems imminent may be said to be an emergency case. Such a case, the heart beats not audible, water rolling into his stomach with audible gurgling as into a paper bag, was given Laurocerasus and made a complete recovery. I think that beats any vaccine.
Julia M. Green: A case of nine got into an extreme condition and it seemed would have died until it dawned upon me that it was a complete picture of Opium which produced a favorable reaction and recovery. I was asked to report it at a meeting and did so. After reading it they all crowded around me and said, that is all right but I could not have done it.
C.M. Boger: it is well not to make up one’s mind as to what Homoeopathy is capable of doing or not doing and always await an extension of its possibilities. Careful and conscientious prescribing does greater and still greater things with our remedies. Our new hospital superintendent found a lot of old uncured cases had been dumped there. Among them a case of syphilis in a woman who had been infected eighteen years before. Some eight months ago she had had an attack of grippe followed by myelitis and contracture of the hamstrings; the lower limbs were firmly flexed on the thighs, hands clenched and she had the argyll-Robertson pupil. She could not even sit up in bed. She now received a daily massage and a single dose of Pulsatilla 1M. In three weeks she was better; in seven weeks she was dressed and sitting at the window, after which complete recovery gradually followed.
G.E. Dienst: I want to say for myself that I asked the question in order to bring out this very discussion. Personally I have had very little trouble with emergency cases. The indicated remedy will do more than all the thousand that are not indicated. A child was sent to me from Wisconsin; the child was losing rapidly. I tried to find symptoms but could not. The weight had fallen from twelve to five pounds. I prescribed as best I could without result, when the family moved to Lockport. They sent for me and told me to bring a death certificate. I found the child nearly gone. It was so weak that when I pulled the eyelid down it could not raise it up. Finally I asked the mother what she ate while she was carrying the child. I found out that she had an inordinate craving for salt. Only one dose of Natrum muriaticum was needed. He is a big boy now.
Geo. G. Starkey: I am emboldened to add a stone to the pile that has been heaped up here from the experience of many. A little boy of five years was the patient. He was in a tremble, uncertain of movement, could not walk straight, staggering, running into the door-frame when trying to go through; easily crying, eyes rolling; some nystagmus; getting rapidly worse. Legs were giving away, yet he wanted to climb things. It looked like Friedreich’s ataxia. Phosphorus caused a slight improvement. Dr. Kent helped me to see that Alumina was indicated and in the 10m after a slight aggravation it helped promptly. In a few weeks, he was a well child.
Stuart Close: I can only endorse Dr. Bowie’s suggestion about the excellence of the posthumous work of Dr. Carleton. I hope that every member of this association will send to Boericke and Tafel for a copy and read it as they would their bibles. It will do more to strengthen Homoeopathy than any other book that has been published within the last twenty-five years. As to Dr. Houghton’s question I may say that I did not “shout”, I merely spoke in an ordinary tone of voice, and it was not at all to sustain my own courage; thought of myself never entered my mind. I never felt more exultant and confident nor have I ever had a keener inward sense of power and efficiency than I had when I entered that room. The course that I pursued was entirely without premeditation although I saw afterward that I had followed physiological lines and dynamical principles in beginning with the smallest muscle in the upper part of the organism, the upper eyelid.
While I understand Dr. Taylor’s and Dr. Houghton’s attitude towards anything that savors of mysticism, I believe that everything I did was necessary to recall that patient and save her from dissolution; it was necessary to relax those rigid muscles, to awaken her attention, and to arouse in some way her desire and will to live. She had died in her mind; the victim of ignorance and error; she had been surrounded by those who thought that she was dying, and said so in her presence. The depressing psychical influence had brought on slowly what is brought on rapidly in those cases of hazing in our colleges, where students are sometimes told that they are being bled to death, and while blindfolded, the arm is scratched and water poured slowly down so that they imagine they feel the blood trickling down. Death from fright has occurred in such cases. My patient was dying because psychical traumatism was an element in her condition as well as physical disease.
Psychical treatment was as necessary as medicine. I used a combination of physical manipulation, psychical control and drug action, and I am certain that she would have passed away never to return if I had omitted any of them.