Oct. 13, 1815 : M. T, aged forty-six, of nervous sanguineous temperament, with light hair and eyes, married, and the mother of ten children, has been affected with an eczematous eruption for the last seven months. She attributes its origin to the frequent use of soda in washing. Her general health is very indifferent, and she has suffered for years from a chronic catarrhal asthma. She has made use of various lotions without any benefit. Her diet is very simple; bread and butter, and milk in general ; meat and fish occasionally.
Her present state is as follows :
There is an eczematous eruption on the fore-arms occupying both aspects, worse anteriorly, and covering the whole surface, from the bend of the elbow to the wrist. It first comes out in innumerable small vesicles, which cause intolerable itching and burning, with pricking sensation, and affects both arms in nearly the same degree. The eruptive surface becomes red and inflamed, and a thin serous exudation ensues.
Appetite indifferent ; digestion laborious , bowels rather confined.
Catamenia regular, but scanty. Has been affected for some time with thin albuminous leucorrhoea ; not, however, in a distressing degree. She is, moreover, constantly subject to a harassing husky cough ; at first very dry, and attended with argent dyspnoea ; but it is soon succeeded by abundant expectoration of light coloured mucus, with frothy albuminous matter, which affords relief. Her sleep is frequently interrupted by the cough and dyspnoea, which are generally more urgent at night. At all times, the breath is short. Mucous, wheezing, and sibilant rales are heard all over the chest. Pulse 84, regular.
Spirits much depressed in general ; temper even.
Prescription : Sulphur, two drops, fifth dilution, in solution, a sixth part, thrice a day; and, after an interval of three days, Sulphur, three globules, thirtieth dilution, dry. No change in her ordinary diet.
Clinical comments: In this case, as there were no errors in diet to be remedied, and no particular symptomatic group of importance indicating an apsoric medicine, Sulphur was exhibited at once. This medicine was calculated to promote the eruptive efforts of the skin, to act upon the digestive organs and uterine system, and to favour the bronchial secretions. It was prescribed in a low dilution; first, because the eruption manifested a tendency to put on an acute form; and secondly, because experience proves that it will often be advantageous to begin the treatment of such affections by saturating the system, as it were, with a more material dilution previous to the exhibition of the more highly dynamized potencies (as is done in pathogenetic experiment), by which the effects of the latter are certainly increased.
In the inflammatory stages of cutaneous, as of all other affections, Acon, may be had recourse to. Sulph. is principally indicated in the sub-acute and chronic stages, where the eruption, no matter of what kind (whether suppurative or dry), is accompanied with intense itching (the characteristic sensation produced by this medicine), as in this case. It also favours the suppurative process, whether connected with the internal or external tissues.
Arsenicum in similar cases, where there is much heat and burning, with serous exudations.
Graphites is of great use in the desquamatory stages, when the epidermis begins to fall off in scales, as well as in the squamous varieties of skin diseases generally.
In the treatment of uterine affections, when they are attended with eumenorrhea or scanty menstruation, together with albuminous leucorrhoea, Sulphur will be the best antipsoric ; when, however, the catamenia are too profuse, with thick, yellow, corrosive leucorrhea during the intervals, Cede. Curb, and Aurum will be preferable.
Oct. 24. Feels better in every respect, morally and physically. The eruption is much diminished on the anterior surfaces of the forearms, and there is less itching and redness. Cough looser, and the expectoration more free. Bowels regular. The leucorrhea has ceased entirely.
Prescription : Arsenicum Alb., three globules, thirtieth dilution, after an interval of eight days.
Clin. Comments : Arsenicum was exhibited to favour the exudation from the skin, and also the secretion and elimination of the frothy mucous fluids from the bronchial membrane.
Nov. 13. Has been very much better. The eruption had altogether disappeared; but within the last few days it has again made its appearance, only, however, to a very slight extent, and attended with very little irritation. She sleeps well and is seldom awoke by the cough and dyspnoea; both of which arc much relieved. Pulse 78.
Prescription: Sulph. three globules, thirtieth dilution, at once.
Dec. 21. The arms are much improved, and there is now scarcely a trace of the eruption. The cough has been rather troublesome; expectoration difficult, chiefly of frothy mucus. General health otherwise pretty good.
Prescription : Arsenicum Alb., three globules, thirtieth dilution, at once.
Jan. 20, 1846. Considers herself sufficiently well to leave off the treatment. She sleeps well, and is in good spirits. The digestive functions are normal; the eruption has entirely subsided, and the bronchial symptoms are much relieved.
When last heard of, eight or nine months afterwards, the eruption had not returned.
From: Hints for the Practical Study of the Homoeopathic Method In The Absence of Oral Instruction; Cases for Clinical Comment, Illustrative of the Mechanism Of Disease, And Of The Treatment.
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