A Case Solved by a Single Symptom
D. P. MADDUX, M.D.
From: The Hahnemannian Monthly 1917
The very great majority of the members of our school of medicine do not place any possible value upon the therapeutic efficiency of a remedy prescribed alone upon a single symptom. The dominant school does not give any credit whatever to any remedy based alone upon symptomatic prescribing.
It impresses me that the report of the following case would warrant one in thinking that if the symptom for which the drug was prescribed was a typical, characteristic, peculiar and individual symptom of the drug, that drug might be efficient, even though the ordinary symptoms usually associated with that drug’s activity were lacking.
My intimate professional friends call me a therapeutic nihilist. I confess that the special attention I have given to surgery unfits me to pose as a therapeutic critic. But some of the training of Farrington still lingers. I cannot but feel that if some very dominating, indicated symptom gives the call for the use of the homoeopathic remedy peculiar to that drug alone, nature will respond in a curative fashion.
Let the case I now cite speak for itself.
I first saw W. B. when he was brought to the Crozer Hospital with a compound, comminuted fracture, involving the left frontal bone, the roof of the orbit and the frontal sinus. The duramater was ruptured and considerable brain substance was oozing out.
I gave him the indicated surgical attention, from which he rallied well. His surgical condition was at all times ideal. The third day after the operation he developed an intermittent delirium. This delirium usually became worse about midnight. It was preceded and initiated by explosive and abusive profanity. This profanity was not of the abstract variety, but was directed against the nurse or person who was present.
The periods of the delirium became progressively more frequent and protracted. The character of his profanity more noisy, explosive and personal. I was compelled to substitute a male nurse, and soon two male nurses, as during his delirious periods a female nurse could not restrain him, nor did I care to subject her to the character of profane abuse she would have been compelled to listen to. I was soon compelled to remove him from the floor containing private patients, so that they would not be disturbed by his outcries. Homoeopathically, Belladonna and Hyoscyamus seemed indicated and these were given alone and in various potencies, but they were impotent as were the bromides in large doses.
The only temporary respite was from hypodermic injections of morphia, but even with this, restraining apparatus was frequently needed.
During this entire period his surgical condition remained entirely satisfactory. The wound appearance was ideal. The temperature even during the delirious periods, never rose but a fraction of a degree above normal. The blood count and other laboratory tests were absolutely negative. Nothing suggesting a toxemia or a meningitis was present.
During over half of the time he was a quiet, gentle, considerate young man. I would repeatedly ask him in a perfectly lucid period, why he had acted so badly the night before. He said it was a blank to him. He had no recollection of saying or doing anything.
On the morning of the eleventh day following the operation, I received the report that he had been especially violent and noisy during the previous night. I think the following is a verbatim interview that led, or, I should say, forced me to prescribe upon the “Single Symptom”:
“Walter, why is it, when people are trying so hard to be good and kind to you, that you make so much fuss and trouble?”
He replied, in a quiet and composed voice, “Well, Doctor, if people were trying to take your arms and legs apart, wouldn’t you make a fuss?” “Does it feel like anyone was trying to do that?” I replied. “Feel?” He he answered in excited tones. “If they put your arms on the bureau and your legs on the wardrobe, you would make a fuss and a racket, wouldn’t you?” “Do you really think anyone is trying to do that?” I said to him. “Think!” he said in indignant tone and an outburst of explosive profanity. “I know they are. Guess I am the one that suffers. There would not be any think about it, with you if they were taking your arms and legs apart, would it?”
I assured him with much emphasis that if I had known anything like that had happened I would have had it stopped and severely punish anyone that treated him that way.
It is needless to say that I prescribed Baptisia tinctora. I had ten drops of the 3x placed in a half glass of water and a tea-spoonful given every two hours. I gave instruction that his usual dose of morphia was only to be given if absolutely necessary.
He was much quieter during the rest of the day and, upon visit the following morning, I learned that he had passed a rational and comparatively quiet night. The delirium never returned. His subsequent improvement was rapid, uneventful and uninterrupted. In a short time he resumed his former occupation in comparatively good health.
Call this a coincidence; call it the effect of psychological suggestion, or call it any name you wish, but personally it would be difficult to convince me that the abrupt turn towards health was not caused by the administration of the wild indigo. This medicine was administered from an indication of the use of a drug that rested entirely upon a single, subjective, I may say, psychic symptom.
Homoeopathic training has associated the use of Baptisia as most or only applicable, in the profoundly depressed and toxic state, the best example being in typhoid fever. Homoeopathic training in the use of this drug has taught that the symptom of feeling that the different parts of the body were being separated and taken apart, was more distinctive and personal to Baptisia than any other remedy. You may take any man who has received a single year of training in any homoeopathic college and ask him what remedy is indicated by that special symptom, and I do not think that you could flunk one.
I am making this contribution as a clinical confirmation of the efficiency of a drug when employed in unusual conditions, but in which the most characteristic, typical, I may say like Farrington the “personal” indications for its use, were unusually strongly emphasized.
The facts in this case do not rest alone upon my personal observations and memory. Several other members of the staff are quite familiar with the conditions as above stated. Almost everyone in the hospital at that time knows how he disturbed the entire institution for a portion of ten nights. It is a matter of record how he improved following the administration of a remedy based alone upon the “Single Symptom.”