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be astonished at the rapid and nimble rate at which the child will get over the ground, and at each step, if so it may be called (for the motion is more like vaulting with a pole), coming down to the ground with a shock and jerk of a very pronounced kind.
If hip-joint disease were always treated very early and according to reasonable indications, the success we should meet with would be far greater than it ever yet has been. As an illustration of what I mean the following sad case may be recorded:
Many years since a poor man brought to me his daughter, aet. 10, and stated that she was suffering from an inflammation of the right knee, but it was very evident that there was disease of the hip-joint of the same side. I mentioned the nature of the disease, and prescribed for the child, and requested the father to come to me again in a week, and directed that the limb should be kept in a state of entire rest. I saw nothing further of the man for several months, when he came again, bringing the little girl with him, and expressed his extreme sorrow that he should have listened to other advisers, who confirmed him in his first opinion, that the knee was the principal part affected, if not the only one; there had been suppuration of the joint, and the child was lamed for life.
Soon after this event, another patient, in an early stage of this disease, a boy of nine years, came under treatment in good season, and the parents being intelligent and trustful, the disease entirely subsided in six weeks, Aconite and Belladonna being administered internally, and Belladonna lotion assiduously applied to the joint.
"Unsteadiness of the knees, they totter and give way in walking; tearing of the knees, as with a jerk in the inner side; drawing in the right leg, and the region of the tendo Achillis extending as far as the heel; the legs feel heavy; the legs and feet feel numb, and go to sleep; pain in the tarsal joints, accompanied with despairing thoughts and the dread of death."
BSnninghausen gives "want of power in the hip and knee-joints." The first condition given in the text of our Materia Medica I have never had to treat, except in a man, aet. 26, who had suffered some degree of paralysis of the lower extremities when a child. The attack was believed to be due to severe convulsions when teething was going on in a painful manner; there was also some distortion of the ankle-joints. The poor fellow on one occasion slipped and fell, at the same time the extensor muscles of the thigh contracted so violently that both ligaments of the patellae snapped asunder; nor was there ever after any good repair of these structures. The man was sadly crippled, and could only walk by aid of crutches.
The other symptoms enumerated are met with commonly enough in practice, with the exception of the last, in which, strangely enough, there is found extreme mental depression, with affection of the tarsal joints. There can be little doubt that this combination must have been an accidental one.
"Coldness of the feet, extending as far as the malleoli, with sweat of the toes and soles of the feet. Coldness of the feet, particularly the toes. Sensation in the malleoli as if a bandage were drawn tightly around them early in the morning. Excessive pain in the malleolus, diminished by pressing upon the part."
This passage scarcely demands any remark. The diaphoretic property of Aconite is felt, no doubt, in the extremities. It would seem that the malleoli are especially subject to the influence of our drug. The pathogenesy does not suggest to my mind any clinical experience.
(From the Oest. Zeitschrift.)
"Trembling of the lower extremities. The lower extremities totter. They are in constant motion. Drawing pains in the hip-joint during movement. Drawing pains in the lower extremities, especially in the joints. Drawing in the aponeurosis of the lower extremities. Drawing, tearing pain in the thigh." Trembling and tottering correspond with and confirm the original observation in the Materia Medica, viz. "unsteadiness and tottering of the knees." For this want of power in the lower extremities it is highly probable that Aconite will not be found in practice to be the most useful remedy, and that it will require the help of others, such as Arnica, Belladonna, Laurocerasus, Secale cornutum, &c.
Certainly in rickety, badly-nourished children, and in the weakness of the extremities, as old age approaches, Aconite would be a bad crutch to lean upon; but doubtless there are other conditions resembling the above, and secondary or consecutive to certain morbid states, in which Aconite may be tried with good effect; and the sentence which follows in the text will afford us a fair example of such primary affections as may lead to or be accompanied by marked and distressing debility in the lower extremities. Such pains as are designated drawing or tearing may at least be set down in the category of rheumatic. Class 5th of pains gives in its picture fifteen shades or varieties of such aches, such differentiation marking the various sensations complained of. My conclusion is this: that our drug would be a reliable agent in the primary and secondary states of rheumatic or arthritic disorder.
"Soreness of the thighs when touching them. Cold creeping on the inner side of lower extremities, and drawing, tearing pain in the knee-joint. Tension in the patella, hindering walking. Aching pain in the patella and tendo Achillis; aching, gnawing pain in the patella. Stitches in the left knee. Icy coldness of the knees, alternating with shooting stitches."
The first sentence describes a simile of a very common affection, viz. rheumatism of the skin. The second is analogous to the miserable numbness and lameness felt on the outer side of the extremity in the first onslaught of "cold sciatica," and both of these have their similes also in the Aconite working; and, briefly, the remaining sentences have their disease-reflections most distinctly defined in different stages or degrees of rheumatic distempers.
"Sensation as if the hamstrings were shorter than usual. Pain in the calves as after a cramp. The feet heavy as lead. The toes of the right foot go to sleep while walking. Hot pricking in the toes at night."
These pathogenesies are so like those which have preceded that it is not necessary to do much more than record them. In natural disease as dispart from medicinal disease, the doubles of the above have been over and over again noticed by every physician of experience, and one would have thought that the wonderful correspondence which may be noticed between drug pathogenesies in general and actual diseases, would long ere this have convinced all men of the truth of our law of similia similibus.
Looking at the last sentence from a pathological point of view we may read amongst other things congestions of tendinous sheaths and bursae, and perhaps myalgy from vascular engorgements, and different sensations in the feet characterised by more or less perversion of nervous power.
That Aconite has the capacity in an eminent degree of causing anaesthesia in the organism has been amply proved by experiment, and that it would antagonise such a state of things when caused by natural disease no person, no physician who has escaped from the trammels of prejudice, can possibly entertain the shadow of a doubt.
Sleep. "He feels drowsy, heavy in the limbs, even during a walk, especially in the afternoon and after a meal; frequent yawning and stretching of the limbsi" .
I believe that this drug has some direct influence in procuring sleep, and that its modus operandi renders it infinitely preferable to Opium, but it is to be remembered that its soporific effect is most commonly connected with or rather is the result of its bland and blessed operation in soothing and allaying pains originating from an inflammatory cause. The action of this drug upon the capillary circulation generally is something marvellous, and the rapidity with which it takes effect is not less so. The local effects mentioned in the text are all in keeping with the central torpor, and the passage reads as if the prover was under the full influence of the drug.
Jt is not out of place here to remark how invaluable is Aconite in all cases of an apoplectic character in which extreme drowsiness is a prominent symptom; indeed in the incipient stages of such a grave malady Aconite should be trusted to in preference to Opium. If there is marked somnolency and therewith a full energetic beat of the heart, with throbbing of the carotid and temporal arteries, then indeed we may place the greatest reliance in the working of Aconite.
(To be continued.)
CASE OF COLIC SIMULATING- PAINTER'S COLIC, WITH OPISTHOTONOS AND OTHER CASES.
By Dr. E. C. Holland.
(Read before the British Homoeopathic Society.)
On the 26th of February, 1862, 1 received a very urgent telegram from Mr. Reed, requesting me to come, by first train, to King's Lynn to see a patient in consultation with him. On arriving at Lynn, Mr. Reed met me at the station and detailed to me the particulars of the patient's case, which were dreadful enough; but very far short of the actual condition in which I found the patient. He had been ill two days, suffering from the most frightful abdominal spasms. The abdomen was as hard as a stone, not very tympanitic, but the recti muscles drawn up into knots, nearly as large as my fist. There had been no alvine evacuation for two days, and no urine had been passed for eighteen hours. The countenance was expressive of the greatest anxiety, and the face and forehead bedewed with a cold clammy perspiration; pulse very feeble, but not particularly quick. When the spasms came on, which was about every three minutes, vomiting of a blackish, grumous fluid took place, attended wi^h deadly faintness,