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of 1882 Dr. H. C. Clapp resigns the sole editorship of this journal, but continues to be one of "an association of physicians" who henceforth conduct it.
May, 1882.—The following cases illustrate some of the actions of a potent but little-understood remedy.
Clinical Cases. By J. H. Cabmichael, M.D., Worcester, Mass.
I. Sanguinaria Canadensis 6x in Delaying Menses.
First. Miss S—, a?t. 16, complains of faintness, palpitation of the heart, weakness, and neuralgia in left chest. Cannot give any cause for these symptoms. Menstruates every five or six weeks, occasionally skipping to second month; has a slight dry cough; has been growing worse during the past year, and is now quite emaciated. Puis. 3x and Ferrum. phos. lx trit. for three months did very little if any good. Sang. 6x three doses daily caused decided improvement in a short time, and in three months she was well.
Second. Miss G—, set. 17, commenced to menstruate at the age of fourteen. Was regular about a year; since then she has been irregular. Often goes three months without menstruating; emmenagogues help but little; has chills and flushing of face, a trifling cough, which causes anxiety as her father died of consumption. Has frequent neuralgic headache on right side. Puis. 6x helped the case for three months, but she again relapsed. Sang. 6x caused an improvement at once, and she remained well over two years, when she got her feet wet at the time she was menstruating and skipped the following month; but a renewal of the medicine set things right again.
Third. Miss S—, set. 19, called me especially for pain in right internal condyle of femur. Upon examination I found the pain was not constant, but appeared at the time when she ought to have her menses, continuing day and night until she commenced to flow, gradually disappearing from that time. Her menses appeared every five weeks. I tried Aconite, Oimicifuga, Caustictvm, and Pulsatilla, all to no avail, in as many months. I then gave Sang. 6x, which regulated the menses and cured the sympathetic pain after the second month.
Fourth. Mrs. B—, at. 24; married two years; is subject to periodic neuralgic headaches, which are always worse at monthly period. Has always been regular until the last year. Menstruates every five weeks or thereabouts. When menstruating has palpitation of the heart, severe neuralgic headaches, chills alternating with heat, nausea, and violent vomiting, which is persistent. For two or three days various drugs such as Verat. vir., Puis., Amnion, carb., &c, were tried, but without material benefit until Sang. 6x was given, which proved to be the remedy.
Mfth. Mrs. W—, set. 38; always has been well and regular except when pregnant. Has given birth to two children. Now has passed her proper time seven days. Has pain with bearing down as though she was about to commence to flow. Polyuria, transient cramps of stomach, pale, anxious face. G-ave Aconite 3x followed by Puis. 3x for four or five days without benefit. She became wakeful, extremely nervous, grew worse and had to take her bed. , All the bad symptoms continued, with pain extending down her thighs, nausea with burning of throat extending downward. I gave Caulophyllum lx followed by Macrotin lx without relief. Sang, lx ten grains was dissolved in three tablespoonfuls of water, and a teaspoonful given every two hours. In twelve hours there was a perceptible improvement; in twenty-four she commenced to flow, and with its continuance she made a good recovery. Next month the same thing commenced, but was promptly dispersed by the Sang., and by its continuance for two months she was herself again. Three years later, from some unaccountable cause, she was taken in the same way.; was not within reach of me, and after suffering three weeks, during which time she took homoeopathic and allopathic drugs in succession without relief, I was sent for, and Sang, was given with the same relief as formerly.
With these illustrations we will give what may be considered as its characteristics in such cases; chilliness, followed by flashes of heat; rush of blood to head and face; irregular action of heart, with occasional palpitation ; faintness, vertigo, nausea, or violent vomiting; burning in oesophagus; neuralgia, more especially in right temple, left chest, in region of left mamma, and lower extremities; occasionally hacking cough and gastralgia are noticed; menses delayed with above symptoms appearing in place of menBes. You will find it a useful remedy in phthisical cases, with above symptoms, alternated on alternate weeks with Senecvn 3x and re-enforced by the hypophosphites. Again, in cases with foregoing symptoms, where patients are amenorrhoeic, and their mucous membranes show an exsanguinated spansemic condition, it will be a good remedy with Citrate of iron and quinine 2x as an auxiliary. As a practical hint worth remembering, never give Iron or Quinine in material doses to patients who flow profusely or have premature menses. Such cases cannot take Iron with impunity, except in the higher attenuations, thirtieth or above, and then upon my authority you may discard all in its favour.
II. Sanguinaria can.00 in Flooding at Climacteric.
First. Mrs. B—, est. 47. Is very much emaciated and ansemic; has not been regular for nearly two years; has attacks of flooding every two or three months, so severe that Bhe faints at times, and does not recover her strength under three or four weeks. As she was flowing profusely at the time I was called, I gave Trillin lx, ten grains in three tablespoonfuls of water, a teaspoonful of this solution every fifteen minutes until better; also ordered vaginal injections of hot water. She shortly improved, and was able to sit up in three or four days. China 3x was given for a few weeks, when in a measure she gained her lost strength. Two months later she was again as bad as ever with another attack. The same treatment was resorted to, followed by Sulphuric acid dilute three drops, at meals, with China 3x morning and evening. She improved temporarily, but, although the treatment was followed for three months, Bhe again had nearly as severe an attack as before. Trillin lx arrested the profuse hemmorrhage, and China restored her strength. At the end of the fourth week I gave the patient a two-drachm vial of pellets saturated with Sang. 200, and since then she has never had a return of the flooding. She menstruated irregularly for nearly two years later before it entirely ceased. Before taking the Sang." she weighed from ninety-one to ninety-three pounds, but immediately after she commenced to improve in health, strength, and spirits, and now weighs about one hundred and forty-five pounds.
Second. Mrs. F—, set. 49, has alternate chills and flashes of heat; palpitation of heart; gastralgia; profuse menses, and for the past year has had flooding every two or three months. At the time, by direction of her physician, she took Ergot fluid extract in teaapoonful doses every six hours for two or three days. During the intervals Sulphuric acid and Quinine thrice daily. This case I gave Sang.cc to be taken twice daily. She did not read the directions, and misunderstanding me, took no medicine until she was again having an attack of flooding, when she took the pellets every two hours. I did not -see her until after the second attack, when she came to my office to get another bottle of those pills. Upon inquiry I found the facts substantially as above. I said, "These pills could not check your flooding at the time, and only would benefit you when taken during the interval." She said I was entirely mistaken, and that they were more powerful than the Ergot. "Well," I said, "take them now as I wish you to, and perhaps there will be no more flooding." She did as directed and took the pills for the following four months, once daily, after the first month, and passed the climacteric safely and happily.
Third. Mrs. J—, set. 42, has had a profuse menorrhagia and flooding for four yeara. It followed an abortion. She has been attended by six different M.D.s, members of both schools, and came to me through the recommendation of a friend (who was restored to health while under my care), saying, " Doctor, if you can cure me as quickly as Mrs. P—, I shall be only too happy to have your services." My answer was, " I have yet to find what ails you, at which time I may be able to tell something about the case." A day was appointed for an examination, which showed the following condition: Uterus enlarged to nearly four times its natural size. Probe entered six and a half inches, followed by considerable hemorrhage after being used with the utmost care. Cervix congested and granulated; projecting from cervix two small mucous polypi which I removed by torsion and applied Pulv. Sang. Just inside of cervix was another, scarcely larger than a pea, which was also removed. The internal os was , dilated so that my wire curette passed it readily, and I found the endometrium studded with fungous growths, and by gently scraping the cavity I removed as much as one third of a teacupful of these abnormal growths. I applied freely compound tincture of iodine and ordered my patient to bed for four days. I now gave her fifteen-drop doses of Viscum alb. every two hours alternately with Arnica 3x.
Next day felt weak and exhausted, with some pain; not much hemorrhage. Applied a tampon saturated with one drachm of Sang, tinct. to one ounce of Glycerine containing the remedies. In two or three days she was up, and did not flow for five weeks, when she had a natural menstrual period. She was taking the Viscum alb., fifteen drops three times daily, which was given to get a contraction of the uterine fibres. She was troubled with alternate chills and hot flashes, also a faint, gone sensation at stomach. So I gave Sang,K every twelve hours. She gradually improved, but at the end of the fifth month she again had a severe attack of flowing. Examination after the hemorrhage had been mainly controlled by hot vaginal injections showed that one of the polypi had returned. It was removed and the curette applied, removing a quantity of the fungous growth. Applied Sang, tinct. direct to endometrium by injection, and ordered patient to bed for the succeeding four days. She did well, and on the fifth day I made another application of the Tinct. of Sang. These applications were made at intervals of five or six days for the greater portion of two months, and Sang." continued internally. During this time Bhe did not menstruate, and gradually improved. Probe entered the womb four inches. Cervix looked well and natural, but the body of the womb was yet enlarged. At this time I left the patient with Sang.'*, one dose daily. At the end of another month she menstruated normally, which was continued regularly for the six succeeding months, when they entirely disappeared, and for a year she has been well and grown fleshy, so that we can give it as our opinion that she has safely passed the "grand climacteric." This last case was one that Sang." would not have cured unaided by surgery, although it would have most assuredly helped. These cases are sufficient to illustrate its action. Although we have many useful remedies during this grave period for women, none can supplant this. It will also be useful for the neuralgia occurring at this time in many cases. Aconite, Gelsemiwm, Verat. vir., Digitalis, Lackesis, and many others have useful places, and must not be forgotten. Again, conservative surgery has its proper sphere, and one who does without it must not expect to be the peer of the modern gynsecologist.