Page images
PDF
EPUB

dilution, three times a day, one drop in a tablespoonful of water. Under this treatment, within three days the sensitiveness of the buboes had diminished considerably, but the swelling not at all. I now had the poultice covered with a compress bandage, acting at first very lightly; this consisted of a double-sided fracturebandage without hip-spring, which the patient bore very well, as all such patients do; if it be applied at the right time, and sufficiently slack to begin with, within two or three days at furthest, during which the bandage has to be gradually tightened a little, such patients find a very material alleviation, and gain an advantage not to be undervalued, viz., that they can now move without pain, and are soon able to walk without any inconvenience. And such was the case with our patient, whose appetite began to revive, and sleep was much improved after this treatment, and the further use for two days of the Nitric acid. Of course the cold compress, covered with dry lint, was regularly continued, and its application was very easily managed by a little lifting of the bandage on one side; and afterwards with a little practice the heated compress that had served its turn was drawn out over the bandage, and the fresh cold one slipped in, without requiring the bandage to be slackened, but only the abdomen to be slightly drawn in. After five days' treatment I allowed him to leave his bed, whereupon in consequence of weakness he at first always experienced vertigo and was soon obliged to sit down; yet this disappeared entirely in three or four days; after which he gradually took stronger nourishment and also some beer, by which the perspiration was considerably diminished. And what of the buboes? They were flattened, quite painless, and only a little reddened where the bandage had pressed them; yet even those places could be touched and even strongly pressed without his complaining of the slightest pain. Patient could also attend to his studies again all day long. And now he put the question to me quite timidly,—whether I believed that in nine days he would not be physically capable of going up for his public examination, for which he thought he was quite prepared, and it would be very disagreeable to him to have to apply for a postponement of it. In consideration of the striking improvement already attained in the general health of the patient, and of the very favourable change observable in the local ailment, since the inflammation was all gone, so that there was no longer any fear of the suppuration which was once imminent (and besides, there seemed to be fairly in process an absorption of the infiltration), I thought I could reply to his question in the affirmative; yet I put in the remark that, up to this point, the cure was not yet by any means complete, and that he would have to go on for at least fourteen days with the cold compress (only not to be changed so often), to keep the bandage on, and continue taking the medicine, as there would probably be at least so long to wait before the local curative process would be thoroughly completed. Five days before going up for his public examination I allowed him at first to drive out for an hour or two, and then to take a walk without the least distress, either from walking, sitting, or rising up. He looked better from day to day; and after getting well through the examination, there was nothing more to desire. The glandular swellings were entirely levelled, and considerably less; yet there was, on the right side, a very scanty discharge of fluid resembling pus (without pain), through an orifice no larger than a pin's head; which however soon dried up, and was scarcely perceptible.

In the fifth week of homoeopathic treatment the cure of these buboes was completed. I cannot say whether they were more sympathetic or more mercurial; they were, at any rate, called into existence by the skill of the great healer.

But one would be doing shameful injustice to these specialist gentlemen if one should fancy that they are only capable of producing buboes; their skill is by no means so narrowly limited, it extends still further, as we may perceive from the following case:

A gentleman, married six years, had taken a business journey, and was obliged to stay some time in Vienna. Here, one evening after the business of the day was concluded, he forgot his marriage vows, and a few days after made the very unwelcome discovery that he had contracted gonorrhoea. Great, very great was his perplexity, for in ten to twelve days at latest he had to return home. So he soon resolved to betake himself to the leading practitioner for " secret cases," and besought him earnestly to give speedy relief. This he obtained, in part, for in six days the gonorrhoea was removed by several injections; but a surprise again awaited him at home, for the first lawful coitus brought the gonorrhoea once more to view. Now he had recourse to one of the most renowned specialists in Prague, whose earnest exertions had again the success of considerably diminishing the gonorrhoea, but at the same time brought on an exquisite, acute, and excessively painful catarrh of the bladder, accompanied with feverish excitement. This disorder also was, chiefly by local anodyne meal poultices, and tepid sitz bath, so far alleviated that the violent pains gradually abated, and the only remaining subjective symptoms were a frequent urgency to pass water, and a burning sensation in the urethra; but to this a new objective one was added, viz., that mucous masses, becoming day by day more considerable, accumulated at the bottom of the utensil, and accordingly the acute catarrh had passed into a chronic one; which, after it had obstinately resisted allopathic treatment for three months, I was asked to cure.

From all the history of the case reported to me as above it was perfectly clear that in consequence of highly inappropriate medical treatment the original inflammatory excitement of the mucous lining of the urethra had been transferred to that of the bladder, and that incorrect management of the acute catarrh of that organ had only rendered it chronic. The urine exhibited to me in a tolerably tall glass of about nine centimetres diameter was for two thirds of its depth pretty clear and light yellow; still, at the bottom of the glass was seen a thick, yellowish-white collection of mucus, which, after slowly emptying the contents, rolled out in lumps, whilst the remainder drew out into ropes. The fact that he complained of violent burning when he passed water (always in a thin stream) rendered it advisable to examine the passage with a bougie, by which the absence of stricture was ascertained. Tet during this examination a remarkable tenderness, probably indicating erosion of the mucous membrane at the vesical opening of the urethra, could not escape notice. I began treatment with Pulsatilla 6, and as he was compelled to remain at home the greater part of the day owing to frequent urgency to urinate, he took it in water, two teaspoonfuls every three hours. When I repeated my visit in two days, I learnt that the said urgency was less frequent, and no longer so cruelly violent; yet the burning pain of urination remained as before, and the same was true of the quantity of mucus deposited in the urine glass. Just the same story was told after taking Pulsatilla for several

VOL. XXXII, NO. CXXVIII. APRIL, 1874). A A

days, and the burning (nay, sometimes cutting) pain in the urethra was particularly marked. Now came Cantharides, Nux vomica, and Sulphur in succession, yet the pains remained constantly the same, till at last I lighted on Kali bichrom., after which, within two days, the pain was strikingly diminished, and had nearly disappeared in a week after; but the deposit of mucus all the time underwent no diminution, and now an accurate testing of the condition of the urine showed that it was when first passed turbid, as if intimately mixed with the mucus, and not until the second or third hour did the thick masses settle to the bottom. Red test-paper was coloured blue, and also the smell of the urine was sharply ammoniacal, a phenomenon to be explained by the fact that the copious mucus of the bladder was decomposing the elements of the urine. In succession now Dulcamara, Galcarea carbon., and Natrum carbon, were given, from the two last of which, and especially Calc. carb., a favourable effect, viz. manifest diminution of the mucous secretion, could be observed. The observation of this determined me to give the patient a wineglass of the Wildung Spa water, which is so extremely rich in Carbonate of Lime, every night and morning. The essential service rendered by this calcareous spa was soon manifested; and that not only in the visible diminution of mucus (and thus too in the abatement of ammoniacal odour), but also in the complete disappearance of the burning pain. After taking the Wildung water for barely four weeks, the patient was at last perfectly cured.

CLINICAL RECORD.

Thlaspi bursa pastoris in Metrorrhagia.
By Dr. Rafinesqtje.*

Last year I received a letter from England, sent by one of my patients, a young widow, whose state of health caused her great alarm. She informed me that three months previously she had had an attack of icterus of no great severity, and that for two months sbe had suffered from a continual discharge which came on after the menses.

* Bull, de la Soc. Med. Bom. de France.

She had been treated without success for this discharge by several medical men, who had given her among other remedies Cocculus, Sulphur, and Gonium, They had also strongly recommended the use of generous wines, but not being accustomed to them she felt all the worse for them. She suffered much from pain in the region of the right ovary extending to the knee; her stomach and bowels were frequently deranged, she lost her strength, and fell off visibly. She desired to return to France, but feared she might not be able to stand the journey but be laid up somewhere on the road.

Judging that the climate, the treatment, and the regimen she was subjected to were unsuitable for her, I encouraged her to undertake the journey. She accomplished it happily, but the catamenia appeared as soon as she arrived, and did not leave off until the sixth day. I then gave Ferr. met. 24, three globules in half a tumbler of water, to be taken until the following day.

The effect was favourable, no loss, only some pinchings in the abdomen and small of the back. I continued the Ferr. met.

The third day there occurred pains in the stomach and two bilious motions ; the liver was tender, pulse 84. I gave internally Ars. 12, but as the pains in the stomach went off whilst the diarrhoea increased, I had recourse to Verat., and the symptoms subsided, the pulse falling to 72.

Then, that is to say, six days after the cessation of the catamenia, not two days as formerly, what the patient called a loss of blood, such as had occurred in England, recommenced. It was in reality a very profuse leucorrhoea, to which the name was very inappropriate, as it was of a chocolate-brown colour and very fetid.

Examination with the speculum showed the neck of the uterus swollen, but not ulcerated; 1 could only detect slight granulations and the presence of some viscid clots of a dark colour.

This case required a methodical and long-continued treatment; I reckoned that three months at least would be required, as well as great patience and perseverance on the part of patient and doctor.

I shall not go into details of the daily treatment, which lasted in fact three months and ended in complete cure. I will briefly

« PreviousContinue »