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 to 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 Helleborus
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.
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 [Arsenicum album] 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 any, 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 had the enema 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 200C, 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 object 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.