It is difficult to find good spleen remedies, because the spleen, as compared with the liver, is seldom painfully affected in its substance. When it pains, the pain is most commonly at the margin of the epigastric and left hypochondriac region rather than in the hypochondrium itself. But, alas! just at this very spot liver affections also often express themselves, so this symptom is uncertain. The comfortable lying on the left side, and the impossibility of lying without distress on the right side, certainly speaks for a spleen affection provided always that the left lung be not affected. So it is very well to pay attention to this symptom, it is an uncertain one. People whose spleen is much affected like to lie on their backs, just as do those who have the right lobe of the liver much enlarged, and neither can lie comfortably on their sides. When we further bear in mind that the spleen (so far as we know at present) is neither an excretory nor a secretory organ, it follows that we cannot have any symptoms indicating a disturbance of such-like functions. When we further consider that the gall ducts are sometimes sympathetically affected in spleen complaints, with the urine discolored as in gall affections-that, in fact, the menstrua digestion is in general are qualitatively altered; and that to fill the cup of difficulties to overfilling, abdominal plethora will simulate painful spleen disease; it is easy to see that the findings of good spleen medicines is, indeed, a very difficult affair.
The states and symptoms that, during my medical career, I have known to arise more or less frequently from spleen affections are the following:
Pain in the stomach (often).
Cough, and that oft, violent, and suffocative.
Bellyache (at times).
Chronic diarrhoea, and rather more frequently.
Disturbed renal functions and their consequent dropsy.
And with regard to such dropsies, in so far as they are not due to organismic affections, I ascribe, according to a rough calculation, about one-third to the spleen.
In women the spleen affects the womb and the vagina, causing emansion, or excess of the flow, and leucorrhoea. (This I (Burnett) have myself observed very frequently, and also a very distinct sympathy between the male urethra and the spleen, which Rademacher does not appear to have noticed, since which Rademacher does not appear to have noticed, since probably peccant urethrorrhoeae were not very common in a place like Goch.)
Not a few acute fevers of a secondary nature (consensueller Art-synorganismie) and agues are the mere concomitants of spleen disease. When abdominal affections are prevalent, we at times meet with splenic fever. But in this one year differs from another. At one time, when liver affections were prevailing. I have not to treat a single case of spleen fever in a whole year, and at other times, liver affections still prevailing, I have had here and there an intercurrent case or two of spleen fever.
Brain affections, such as mania and melancholia, eye disease such as diplopia, amblyopia, chronic inflammation, I have seen arise from the liver, but thus far not from the spleen. If I had ever witnessed an epidemic of spleen affections, I should know more about the organ. As it is, what I have to say about spleen medicines can only be imperfect.
Rademacher speaks of the difficulty of really diagnosing a primary spleen disorder, and then says:
Continuous asthma, worse at night, is not a common complaint. It may be, like the cough, of a synorganic (consensueller) nature, and depending upon a spleen affection. Not long since I witnessed an instructive case of the kind. A man who, in his youth, had had a moist eruption all over his body, which eruption was fruitlessly treated with medicines, but went away of itself in adult life, but left behind an ugly fishskin- like epidermis, began to complaint of tension in the left hypochondrium, becoming at times a little painful. He did not, however, consult me for this, but for shortness of breath. I soon ascertained that he had had the tension in the hypochondrium much longer than the asthma, and so thought he was suffering from a disease of the spleen, and which I thought the more likely, as he had never had the least the matter with his lungs. Well, I did not give this man Carbo, but another remedy, and the complaint got visibly better. When it had reached a certain stage of improvement, he was hard hit by a then prevailing liver fever which in his case implicated the chest. This chest affection, however, did not consist in the previous asthmatic attacks, but in pain in the side, with cough and bloody expectoration. He got well, but hardly was he able to be up all day when the old asthma came back worse than ever. Thinking the liver complaint might not be quite cured, I gave him a good hepatic, but the asthma remained. Here I gave him the spleen remedy-the splenic-which had done him so much good before the acute affection came on. The man asked for it himself, but it did no good at all. Asthma and cough remained, and instead of picking up after his acute disease with good nights’ rest, the asthma drove him every night out of bed. I now gave him Carbo, which soon altered the face of things. Cough and asthma lessened; the latter soon disappeared altogether, so that the man was able to make the hour and a half walk home to his friends, who had given him up.
But not every case of asthma, due to the spleen, will yield to Carbo. These stomach pains, that, as they pass off, lose themselves in the left hypochondrium, and which I put down to the spleen, I have at times cured with Carbo; more frequently, however, with other spleen remedies.
Kidney affections, with dropsy due to primary spleen disease, I have never tried to cure with Carbo, because I thus far have managed to cure them with other remedies, and I do not hold it to be right to try experiments from mere curiosity.
In my youth I used Scilla, like so many other physicians, as a pectoral and diuretic. But findings it thus used so little helpful, I gave it up in contempt. During the last twenty years, in which I have taken more interest in the affections of single organs, I came to recognize the necessity of findings out good and reliable remedies proper to the various organs, and as I had indeed such a very poor stock of spleen medicines, I read one day in an old Galenic author (I really don’t remember now in which) that Scilla was a very good splenic. Dioscorides also reckons it to the spleen medicines, but he has put down so many drugs remedies that one`s whole life would not suffice to try half of them. All things considered, I thought the old Galenic`s idea not a bad one, and from that time on I have used Scilla as a spleen remedy, and I have never given it up since.
Although I may be in some doubt as to whether Carbo veg. really acts healingly upon a diseased spleen, I am, on the contrary, very sure about Scilla. I have found it quickly and surely helpful in such painful spleen diseases-affections painful and beyond any doubt in and of the spleen.
In those dull pains on the border of the left hypochondriac and epigastric regions, there being no signs of any liver affection (a rather uncertain and negative), I have used Scilla as a remedy with advantage.
I have also used Scilla with very striking results in those so-called stomach pains that are made so much better by lying on the left-side, and which in all probability depend upon a primary affection of the spleen.
Finally, I have used it with good results in one case of continuous asthma from a spleen affections, with nocturnal exacerbation, and in which Carbo has been used in vain, but in this case the spleen engorgment was of such long standing that I hardly believe in its being radically cured.
As to the dropsy that depends upon a diseased I no doubt gave it in former years in such also, for I dare say I gave Squilla to nearly all my dropsical patients; and that may account for my having found it so useful in dropsy, but I am not so very sure. But since I have had the habit of trying to find out in all diseases the primarily affected organ (provided the to be-cured diseases be not a primary one of the whole economy) I have not used it, for the very sufficient reason that I have not needed it, but of which more anon.
The preparation I prefer is the tincture 15 to 30 drops five times a day. In case where it caused diarrhoea in these does, I have had to come down to 5 drops three times a day.
AQUA VEL TINCT. GLADIUM QUERCUS
I became acquainted with this remedy in a wonderful way. Many years ago (I do not remember the exact time) a working carpenter, who had previously lived in Credfeld, came to seek my advice for his bellyache; which was of long standing. According to his own statement, he had long been under Sanitary Councillor Schneider in Credfeld, who was not able to help him, and sent him to professor Gunther in Duisberg. Ten journeys thither were likewise in vain.
I tried my usual remedies for seemingly such cases, but to no good; and as I noticed he was a good cabinet maker, and dabbled a bit in upholstery, I told him it would be a good plan if he were to hire himself out to a country squire as joiner, thinking that the food of the servants’ hall would suit his sick stomach better than the beans, black bread, and potatoes of the master carpenter. The good fellow followed my advice, and lived with a squire for many years; and I heard nothing more about him. Finally, he married the parlor maid, and settled here in this town as a joiner. One day when visiting his sick wife I remembered the old story of his bellyache, and wanted to know how it then was. “All right,” said he, “I have not had it for years” It seem that a local surgeon, being one day at the squire`s told him to get some acorns, and scrape them with a knife, and then put the scrapings into brandy, and leave them to draw for a day, and then to drink a small glass of this spirit several times a day. He did as he was advised, and was forthwith relieved, and very soon entirely freed from his old trouble.
From what I knew of the surgeon, I was very sure he could not give me any intelligent reason for his prescription. I should only have heard that acorn scrapings in brandy were good for the bellyache, or, at the most, I may have ascertained from what doctor, or peasant, or old wife he had got the tip.
But this would have done me but poor service; and as I had in the meantime become much more cunning. I questioned the joiner himself afresh as to the kind of his old pain, particularly as to the part of the belly were the pain was last felt when he had had a bad attack. He was in no doubt about it, but at once pointed to the part of the belly nearest the left hypochondrium. So I very shrewdly suspected that the abdominal pains were really owing to a primary affection of the spleen, in which notion I was strengthened by remembering that the best pain-killing hepatic and enteric remedies had done him no good.
To get as soon as possible to the bottom of the thing, I set about preparing a tincture if acorns, and gave a teaspoonful five times a day in water to an old brandy drunkard, who was sick unto death, and of whom I knew that he had suffered from the spleen for a very long time, the spleen being from time to time painful. He had likewise ascites, and his legs were dropsical as far as the knees. It occurred to me that if the acorn tincture were to act curatively on the spleen the consensual kidney affection and its dependent dropsy would mend. I soon saw that I had reckoned rightly. The urinary secretion was at once augmented, but the patient complained that each time after taking the medicine he felt a constriction of the chest. I ascribed this to the astringent matter of the acorns, and thinking the really curative principle thereof would most likely be volatile, I caused the tincture to be distilled. This acorn spirit caused no further constriction, and the urinary secretion was still more markedly increased, the tension in the precordia became less and less, and this hopelessly incurable drunkard got quite well, much to the surprise of all who knew him, and, honestly speaking, much to my own surprise also. Having thus put the spirit of acorns to such a severe test, and that in a case that I already knew so well, in which it was impossible to make a mistake as to the primary affection, I went further, and used it by degrees in all sorts of spleen affections, and that not only in painful ones, but in painless once, in the evident ones, and in those of a more problematical kind. Gradually I became convinced that it is a remedy, the place of which no other can take. More particularly is it of great, nay of inestimable value in spleen dropsy. Later on, I found that the volatile curative principle of acorns may be still better extracted with water with the addition of alcohol. (The aqua glandium is thus prepared:- One pound of peeled and crushed acorns to the pound of destillate.) Perhaps water alone might extract the healing principle, but it would thus not keep, and so the cures would be uncertain, not to mention the fact that such- like decaying medicines are a great trouble to the chemists. The dose of the spirituous acorn-water (the only preparation I have used of late years) is half a table-spoonful in water four times a day. It has not much taste; some would even say it has none, but the doubter may make a solution of alcohol and water in the same proportions, and he will soon find that it has quite a taste of its own.
I must make mention of two of its peculiar effects. Certain few people feel, as soon as they have taken it, a peculiar sensation in the head, lasting hardly a minute or two, which they say is like being drunk.
With a few people, particularly with those who have suffered from old spleen engorgments, diarrhoea sets in after using it for two or three weeks that makes them feel better. It seldom lasts more than a day, and it is not weakening, but moderate. Hence it is not needful either to stop the acorn-water, or to lessen the dose.
I could add many instructive cases of spleen-dropsies and other spleen affections, in which the volatile principle of acorns proved curative, but as I have so much more to say on other subjects, I dare not be too discursive on this one point; besides, what I have already said will suffice for commonsense physicians. Still I cannot for bear noticing a few bagatelles. For instance, I have found that the acute spleen fevers that occur intercurrently with epidemic liver fevers, are best cured with aqua glandium-at least that is my experience.
Furthermore, I of am opinion that the three splenics of which I have made mention are curative of three different morbid states of the spleen, and I know well from my own experience that acorns are indicated in the most common spleen affections; and, finally, I am acquainted with any positive signs whereby those three separate morbid states of spleen can with certainty be differentiated from one another.
There are other spleen remedies to which I must allow a curative action in diseases of the spleen, but I have not used them so often as those, because the morbid states of which they have been more particularly curative have not occurred so often to me.
Those I have tried are-Galiopsis grandiflora, a celebrated spleen remedy of the old time, and not to be despised; and Rubia tinctoria, which is also undoubtedly justly credited with being a splenic, but I have not used it often enough myself to be able to say anything satisfactory about it.
These berries are a good spleen medicine which I have often ordered for the poor, and sometimes with good effect. The berries must be crushed, and a handful left a long time to draw in four cupfuls of boiling water if you want to see any effect from them. I do not think it is the aethereal oil, but a non- volatile principle of the berries, that acts as a splenic.
OLEUM SUCCINI NON RECTIFICATUM
This is a good spleen remedy. It must be given in small doses, and as people often make a mess of the dropping, it is best to give it in some other fluid. I order it in acorn-water and formerly in acorn-spirit. To six ounces of acorn-water I add half a scruple or a whole scruple of the oil. They do not mix chemically, but if the mixture be well shaken our object is attained; the patient does not get more into his stomach than we intend. The giving them together contains no virtue; at least I have no reason to think so. The Oleum Succini does good service in painful spleen affections wherewith there are convulsive attacks, such as the hysterical and hypochondriacal often have. Only once did I observe its small cause hysterical convulsions in a woman, but that is a very rare exception to the rule.
Oswald Crollius lays great stress on the importance of rectifying the oil of amber, but what he says therein is not true. The rectified oil is nothing like so serviceable as the unrectified. In general Crollius is the most honourable and the most straight-forward of all the jatro-chemists. But a man of but small understanding.
The late Professor Gunther, of Duisberg. used to give for, chronic cough a powder composed of one grain of Conium and ten grains or a scruple of oak-mistletoe. He had once cured an old gentleman with it. A colleague of mine, an out-and-out sceptic, who had in vain patched away at the old gentleman, did not deny the cure, but ascribed it to chance, to the particular faith the patient had in Gunther, and not to the action of the powder. But I could in no wise agree with his opinion, for although I had at the time but very little experience of Conium, still I knew Gunther was a sensible physician, who wrote simple prescriptions, and so must have understood the curative action of his medicines. I once met Gunther over a patient, about whom there was little to say, as he was evidently dying. In the course of our conversation, I begged him to tell me what he thought about Conium. He was willing, but being interrupted by the anxious friends of the patient, only gathered that he set great store by it. I had several times easily cured patients of his of liver coughs, and to whom he had in vain given Conium, as I saw from the prescriptions of his that they brought with them; from which I concluded that it was not a sure liver remedy. I had before fruitlessly used Conium in painful spleen affections, and hence too hastily concluded, because I was still stupid, that it was not a spleen remedy. Now that I had become wiser, and understood that nature could produce different sorts of spleen affections, I began also to see that while Conium might be quiet useless in one kind of spleen affections, it might nevertheless be remarkably curative in another kind of spleen disease. Thus I once used it in a case of consensual cough arising from a primary spleen disease. This is hard to cure; all the lung medicines do no good. Of the belly medicines, the only one that would occasionally be of any service was the Semina cordui. I now put Conium to a very severe test, that is to say, I gave it in cases in which the Cardui Marioe semina failed me, and lo! and behold! I saw the most beautiful and most astonishing curative action from it. Since then I have never given it up, and as I make no unreasonable demands upon it, it has never disappointed me. I stated earlier on that Gunther gave it in combination with oak mistletoe, but there is nothing in that; I have found it just as active with sugar of milk or sweetwood, as when triturated with oak mistletoe.
My readers will not much care to learn how I became acquainted with this remedy. So I may just say that I neither stole it from a brother brush, nor did one very kindly communicate it to me, neither did I find it in a book. Still it is manifestly a remedy with which a spleen affection may be ousted. I confess, however, that I knew nothing of it till four years ago, and from want of opportunity, have not used it much. But as I have got rid of painful spleen disease with its aid, and that such as would not obey other remedies, I am bound to conclude that there must be a spleen affection in nature which is peculiarly subject to the healing power of this remedy. It does not follow that because this particular disease has come comparatively seldom under my observation that this will necessarily be the case in the future.
I have not yet given this remedy in those spleen diseases that are evidenced by consecutive cough or dropsy, for the very good reason that other and twice better known remedies sufficed. I never try experiments with new remedies until the old ones leave me in the lurch. The average dose of the remedy is one scruple four or five times a day. In this dose it has no laxative action. Should one, however, meet with very sensitive bowels, whose movement are increased by this dose,less must be given, for I have observed that the laxative action does not hasten the healing. Rademacher also favourably mentions Cicuta and Acidum pyroligneosum as topic splenics.
There is not much to be learned in any English works that I have read on spleen medicines. I personally, know nothing of
Moore (Diseases of India, 2nd edition, p. 527) narrates that Dr. Dickinson (Bengal Service) had some years ago recommended the Bindoai Rerula, or Luffa echinata, an indigenous plant of the N.O. Cucurbitaceae, as a remedy in spleen disease, and says that he himself had used it in dispensary practice with apparently good results.
I may now refer to a little of my own clinical experience with Rademacher`s spleen remedies, and particularly as to the Oleum Succinatum non rectificatum, which has rendered me brilliant service, as my readers will see.
CHRONIC ENLARGEMENT OF THE SPLEEN WITH HEMIHYPERAESTHESIA, CEPHALALGIA, DYSPNOEA, ORTHOPNOEA, CONVULSIONS.
A more remarkable case of its kind I never observed. Subject: A young lady towards the end of her teens, of good family, and at a finishing school in London had been treated at home for hysteria of a severe type both homoeopathically and hydropathically, the latter consisting of the cold douche when a convulsive attack was on. The cold douche was only once applied, and nearly killed the patient. Many months after it was applied, when the patient was in a state of what seemed to be approaching death from exhaustion with violent delirium, she literally yelled at what she imagined was some one approaching the bed to throw water on her. It would fill a little book to give a complete history of her case: so I will summarize it as briefly as may be.
At first and for a year or two, I treated her for attacks. Said “attacks” I had never seen, but I put them down as a form of epileptoid seizure, though it was distinctly stated that the convulsions were mostly left-sided. Sometimes violent palpitation of the heart was essentially the attack; at other times dyspnoea, orthopnoea; and always a pain in the left side under the ribs, going up and down; and patient, no matter how violent the attacks, was never quite unconscious, I was not able to see an attack, and could never get a really clear description of them. “Dreadful fighting for breath” coming on in attacks, with pain in the left side, was the essence of all the descriptions given to me. I treated the case, but without doing any real good, and finally she was seized with an attack so violent that the parents telegraphed from the country to me to know to do, and I felt it too serious a case to be treated by me at a distance, and so I wired back that I resigned the case to their family physician, himself an eminent homoeopathic practitioner, who also had formerly tried his hand at the case, but in vain.
Many months elapsed, and I heard only indirectly about the case; and then the friends, in sheer despair and disgust at the obstinacy of the attacks of what their family physician said was a severe form of hysteria that would not go away for good, but ever and anon came like a domestic explosion, creating unrest and tension, brought her to reside near me in the neighbourhood of London, and this was at the beginning of the winter of 1886-’87. The attacks soon came, and I had the opportunity of observing them. On entering the room I thought I heard steam coming out in short, sharp “whists” from a kettle-spout. but I found it was patient`s expiratory efforts. The dyspnoea was very great, and the convulsions most violent, being always confined to one side- the left-but varying as to position on the trunk, being at times in the nape, then on a level with the nipple, then in the lumbar region, sometimes so bad that the body would be bent like a hoop, and the movement very often sent patient flying either against the bedstead, over on to the next bed, or on to the floor; and hence we had to pad all hard objects/ Some of the convulsive contortions were awful to behold, and most of her friends devoutly hoped and prayed that she might die. For some weeks I was the only one who believed recovery possible, so long, so violent, and so exhausting were the convulsive attacks. Myself, I only lost heart once, and that was after a series of attacks of convulsions lasting for hours, and leaving only short intervals. Her friends several times fetched me, in the night, believing patient to be dying.