A CONSTITUTIONAL DIAGNOSIS AND PRESCRIPTION

PHILIP RICE, M.D.

 

Some months ago a chiropractor asked me to go with him to see an osteopathic physician confined to his bed with acute arthritis. A mixture of schools of thought, sure enough. But there was one thing on which we were all agreed, namely, that medicine had its place, and that the only system worthy to be called scientific was the homoeopathic. In this fact lay the reason for my being called in consultation.

The patient, a man of sixty-four, a scholar, a writer, and a scientist, had been confined to his bed for some weeks with arthritis affecting chiefly his right hand and feet. Other parts were involved but in a lesser degree. I was asked to prescribe.

As I sat by the bedside I made a mental survey of the patient while he and the chiropractor discussed the question of vitamins, calories and diet in general. As the characteristics of his constitutional make-up stuck out all over him, reaching a fairly clear idea of what lay in the background was not difficult. However, while this was the case, no notice had apparently ever been taken of them, they had never been deemed worthy of serious attention, al-thought he had at various times and for various reasons been treated by osteopaths, homoeopaths and allopaths.

Finally I was asked by the patient what I thought the homoeopathic remedy could accomplish in such a condition as his. I asked whether for the immediate acute symptoms or for the root cause in the background. This led to a discussion of what was the root cause and what a real cure. Offering the opinion that no condition could be considered cured unless the cause of the predisposition was removed, I was asked what I thought this was in his case. My answer was, rickets which had never been cured.

Coupling the idea of rickets with arthritis afflicting a man of sixty-four struck both men as a bit funny. While I had made no examination other than mental, yet I felt perfectly sure of my ground. I admitted he showed none of the classical signs of rickets as we observe them in children, but I said, “You had your full share of them in your childhood. Examine your xiphoid cartilage, and tell me if it is not abnormally large.”.

“I dont have to examine it, I can tell you now that it is.”.

“Now run your fingers over the ends of your ribs and tell me if they are not nodular, irregular and thick.” He did so and reported that they were.

“And isnt it a fact that your thorax has somewhat the shape of a bell, and that it flares out at the bottom?” “Another bulls eye, by Jove.”.

“Now put your hand over the region of the anterior fontanelle, and tell me what you find.” “A flat spot, or a depression.”.

“You probably dont remember much about your teething experience, but I”ll venture to say you well remember that your teeth decayed early in life.” “Say, I can hardly remember when I didnt have store teeth. My father spent a small fortune on my teeth and those of my sister when we were children.”.

In other words from his birth, and likely before, he had been a victim of faulty calcium metabolism. But while most obvious, the fact had never been deemed worthy of attention, as I have said before. Whatever the immediate condition for which he sought relief, this was made the object of treatment. The folly of this was no more realized than was the root cause of his difficulties. After making clear the real condition he recalled a number of experiences in his life which he had never been able to explain but which now explained themselves.

Morphologically, or constitutionally, if you prefer, two things stood out in bold relief. One was a very well developed vegetative system, and the other a highly developed cerebrospinal system. The former, unless understood and wisely controlled, creates a disposition toward a primitive type of organization, one in which lymphatism and obesity are conspicuously shown. The latter is evidence of an advanced stage of evolution, dispose the individual to seek and lead a studious and sedentary mode of life, and in turn predisposes to neurotic manifestations of one kind and another according to other factors in the internal and external environments.

In the early stages of the morbid process and up to a certain point little or no evidence of pathology is discernible. But after that things tend to go from bad to worse, and anything may happen, depending upon habits and vicissitudes of life. Gout, arthritis, and rheumatism are probably the most frequent conditions to give trouble. Lymphatism and obesity, while always in evidence, not being acute or causing great distress, usually are treated with indifference or ignored altogether.

With no more than these facts, what is the remedy? Shall it be based on the acute symptoms, distressing as they were, or shall it be based on the constitutional condition in the background? Undoubtedly Belladonna, if given, would afford some relief. But could it be considered the true similimum ? NOt according to my way of thinking. When the matter was put to the patient he said, “Get the confounded thing out by the roots.”.

Calcarea carb. struck me as being the appropriate remedy, the constitutional or morphological similimum. It was therefore given in the 30th potency. But at the end of two weeks no change had taken place. The 200th was then given. But this likewise failed to give relief. Nothing of a striking change was expected, of course. It was not a condition in which such thing happen. But something should have occurred to show that the remedy was at work. We decided then to give a lower potency and repeat more frequently. The 12th was prescribed, three tablets three times a day for a few days, followed by an interval of at least a week when nothing was to be taken. At the end of this time a very noticeable change for the better was shown.

By following this method over a period of six or eight weeks we now find the patient up and about, quite able, in fact, to live a very normal life. All the swelling is gone, though the joints are still large, as they have really been for a number of years.

A rather curious thing occurred as the pains lessened, namely, an intense and uncontrollable restlessness at night. The harder he tried to control it the worse it got. Tarentula 200 put an end to it. It was strikingly similar to the restlessness of Zincum.

It seems to me that in the past we have not given sufficient thought to the question of the constitutional feature in the symptom complex, the why of the subjective symptoms and their root-cause and peculiar mode of manifestation in the individual; in other words, that we have dwelt with too much emphasis on aches and pains and modalities. There is a cause for every effect, and there is a special or unique mode of unfoldment of a process in every individual. That both are as much a part of the totality as the effect, even as the grossest pathology, seems to me cannot possibly be denied; and as it cannot be denied then it cannot be ignored without danger of failing to cure curable conditions.

This proposition is based on the fundamental conception that as an organization is the indispensable prerequisite for function, symptoms of a morbid process alone are logically inadequate to account for all that is involved, and in a proving inadequate to account for mode of development of the reactions or to definite the limits of the drugs action. LOS ANGELES, CALIF.

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