Clinical Cases

A Day From My Practice

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The author presents a case of peritonitis in a woman of 37.

(author unknown)

Excerpted from The Homoeopathic Recorder Vol IX, 1894

It was a case of most intense peritonitis in a woman aged 37.  The attack was manifestly caused by a violent cold, and began with a considerable chill, which was soon followed by pains in the abdomen, increasing in severity from hour to hour, exacerbation resulted from the least touch or movement, or from attempting to take a deep breath.

While the patient complained of internal heat and burning thirst, the limbs and cheeks were cold to the touch. The face was pale and sunken, and its expression denoted the most intense pains, almost driving to distraction. The sunken eyes had dark rings, and from time to time pitiful outcries forced by the intense pains were followed by lamentations over a terrible nausea, which at times culminated in vomiting of a greenish mucous liquid. On the second day of the attack the tense and tympanitic abdomen denoted extensive exudations which was verified by cautious attempts at percussion. Diarrhoea came on, greatly exhausting patient. Pulse was small, weak and hurried.

I had given during the first two days Belladonna, Bryonia then Mercurius, Veratrum, without success, and could only alleviate the condition by persistent applications of compresses of cold water, carefully covered, and the frequent change of the same gave at least momentary relief. Then on the evening of the third day I concluded to give Colocynth 3, four drops in half a glass of water, 2 teaspoonfuls every two hours. Early in the morning of the day (the 20th of January) I hastened to the house and met the daughter, who with beaming face reported that her mother noted a decided decrease of the pains before midnight, and then slept quietly from 1till 5 o’clock, and that she felt very much relieved. The patient herself soon reiterated the good news, and her whole appearance denoted the decided change for the better. Light and of short duration were the spells of pain that followed, and the sensitiveness of the abdomen was remarkably diminished, so that a more precise percussion could be effected disclosing the presence of a widespread exudation, in consequence of which the abdomen was tense and bloated. Nausea, had ceased entirely, and the heretofore cold tongue had normal temperature. A similar change was observable in the temperature of the skin, of the limbs and face. The pulse was nearly normal, and the harrassing thirst had ceased.

Within a few days, with continuing improvement, undoubted signs of the beginning resorption of the exudation become manifest. Secretion of urine was increased, as also the activity of the skin. After the complete cessation of all inflammatory symptoms, Bryonia 3 was again given with an occasional dose of Sulphur 15, and within less than three weeks, the process of resorption was happily brought to a close.

In the course of last winter I had to treat a similar case of peritonitis, but not so violent, but on account of a copious, watery diarrhoea I resorted to Veratrum album, 3d, and after the diarrhoea ceased I gave also Bryonia, with an occasional dose of Sulphur, which speedily brought about resorption.

I would here remark that I regard the simultaneous application of cold compresses as imperative, and this is borne out by my whole extensive previous experience. These well-covered cold compresses afford at least temporarily instant relief, and should be persisted in until the sensitiveness of the abdomen has ceasedentirely, and the gradually slower warming of the same will indubitably point to a less frequent change, until they can be left off altogether. Even in peritonitis puerperalis I invariably made use of these cold applications, so grateful to the patient, and I have to see the first case wherein it had a bad effect; on the contrary I always saw the lochia re-established under its use.

Published by Boericke & Tafel, Philadelphia – Translated for the Homeopathic Recorder

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