A WORD ABOUT PRESCRIBING IN OBSTETRICS

[ Read before the Bureau of Obstetrics and Gynecology, I.H.A., June 26, 1947].

ROYAL E.S. HAYES, M.D.

 

If there is one book more than another than in years past has saved time and energy and provided real satisfaction in practice, it is Yinglings “Accouchers Emergency Manual.” Yet, to my knowledge not a word has been said or printed about it for many years. As this potentially most valuable book is out of print and liable to become obsolete it seems almost a duty of record that there was such a one in its time and that it was most gracious help to homoeopathic patients and their physicians in time of obstetric trouble.

Strange does it seem that such an art as the homoeopathic management of obstetric difficulties should be allowed to dissolve away. Yet it is the very effectiveness and demand for homoeopathic practice, a field in which there is no competition, that allows such an anomalous condition to exist. For as soon as the young homoeopath has acquired competence in using our remedies, he soars off into the practical mysticism of constitutional medicine, leaving his obstetric patients in the dumps. It is sad to relegate these young petitioners to the rigors of conventional methods, modern as they are in technique but antiquated in serviceability, or worse.

As to this book, excluding the possibility of irreducible malformations, were I restricted to one medium of aiding the puerperal woman Yingling would be the choice. Every word of it is rare coin and the repertory is the most dependable one of its size that I know. This work sustains unadulterated homoeopathic artistry throughout. As theoretic proof, let me quote a few dicta from the Introduction: “The patient in hand must be treated (exclusively) and the symptoms alone must point to the curative remedy. This rule must hold good in obstetrical practice as in any other: Give that remedy the pathogenesis of which entirely covers the symptoms of the patient, even though it may never have been used or even thought of in connection with such a case or condition.”.

Yet the same Yingling who says cover the symptoms entirely” taught me (in a written article) that there is such a thing as a totality within the totality, meaning essential symptoms which are the presiding genius of the condition and of the remedy. His contradiction is only apparent. For it will be safer for a while for the newcomer to homoeopathic art entirely to cover the symptoms of the patient.

But with time, a persisting ideal of perfection and patients, he will inevitably recognize the prominent and indispensable features in the foreground, adumbrated on a background of controlling “generalities,” Yingling recognizes this when he writes farther on: “In the Generalities we endeavor to give a birds eye view of each remedy so as to enable the prescriber to decide definitely in case of doubt.” In this way he gave the working part of the book also its own essentials and totality. He advises part of the book also its own essentials and totality. He advises study of the book before times, not waiting for actual case of present themselves.

He makes a wise remark of page 12: “Back of the (abnormal) condition, back of the state of the parts is the nervous system, the vital force, and the cause of the derangement, either of which is reached and controlled by the homoeopathic remedy. It is wonderful, magical indeed, to observe the rapid action of the similimum in obstetrical practice.”.

Also:.

By the use of pure homoeopathy the vast majority of cases resulting in loss of life or in excruciating suffering from the supposed irregularity of the parts would terminate happily and easily. All that is needed is confidence and knowledge on the part of the attending physician.. The people have more confidence in the powers of homoeopathy than many are willing to allow.

They follow implicitly the advice of their homoeopathic attendant.. if he (will) manifest confidence in his system of medicine and insist upon obedience, with the positive result of a most favorable consummation; so favorable that the glad tidings (will) go from woman to woman with the celebrity of happy news, resulting in the rapid spread of.. homoeopathy. It I am an enthusiast on this subject it results from what I have seen with my own eyes, and the result of the course I have herein advocated and advised.”.

How many times have I also seen this with my own eyes!.

Speaking of haemorrhage he says, “The physician should be prepared to select the remedy speedily, but time will be saved to carefully get all the symptoms, and as carefully to select the remedy.” How many times I have verified this in various crises, and noted what a calming effect it has on the distressed people around, making them feel that time is not so mortally important after all.

Furthermore: “The more danger to life the more speedily will the homoeopathic remedy act. This is a fact corroborated by the experience of the best prescribers.” There are other gems of truth in this Introduction, especially his remarks on eclampsia, inspiring indeed; but time and space are a consideration.

I might mention that each presentation of a remedy is divided into seven sections. viz; Labor, Abortion, Haemorrhage, Retained Placenta, Convulsions, After Pains and Generalities. Gratitude to my starry fate is hereby acknowledged for the very best of assistance by way of this book with all of these conditions and complications.

Three swallows make but a small summer but I will relate three recent cases of personal interest, the patients being near relatives, such being regretfully the only engagements permitted for many years.

Mrs. T., primipara, first stage of labor, pains five minutes apart, in lumbo-sacral region and worse on the left side, radiating to the front and down the hips and thighs, better bending forward, had to stop while walking. We waited for better indications and especially because she had had Pulsatilla four days previously for griping in front and low backache. This was at noon. At seven p.m. pains harder, writhing when in bed, ameliorated by slow motion, worse in the sacral region. Wept once. Heat, sweat. Pulsatilla, 10M Sk. Pain lessened rapidly but contractions stronger, became absolutely painless. The patient laughed, joked, said she would have six “if this is all there is to it,” final expulsion absolutely painless and no complications. Marvels to this day at the wonderful change made by “that powder.”.

Same patient two years later. First stage pains with red face during them. Pain is in the sacrum and rectum radiating down the outer thighs. Discharged dark, coppery blood with the first pains. Felt too weak to walk and had to lie down. She had had glycosuria with both pregnancies, cleared each time with that remedy most frequently needed for it, Helonias dioica. Ferrum met. rendered the labor absolutely painless. But there was a complication. The baby being slow to start breathing the mother became frantic and shaking violently with fright, which she could not control even after she knew the baby was alright. But Aconite 1M did.

Mrs. W., primipara; forenoon; griping pains in the hypogastrium better when up and about, of sudden onset with one or two little jabs, then easing gradually (Puls.). Loses bloody fluid while lying, each time preceded by pressure in the forehead. Apathetic mentally but with a restless, hurried sensation, must talk to someone or she “would weep it off.”.

As with the other patient, I waited before prescribing because of a prescription of Pulsatilla 5000. two weeks previously and thinking to secure a better end result after more positive symptoms should develop. In a few hours pains were more troublesome but easier to endure lying, four to five minutes apart, extending to the rectum. Nausea at times. Heat and sweat worse during the pains. Pulsatilla, 10M K. was given. Contractions became stronger at once, painless, with a little difficulty with the perineum but not severe enough to extort a cry. No further complications or treatment. WATERBURY, CONN.

DISCUSSION.

DR. ELIZABETH WRIGHT HUBBARD: Madam Chairman, I should like to ask Dr. Hayes a question, in my simplicity, whether he gave these ladies any anesthetic or not.

DR. HAYES: No, no, never. I never gave an anesthetic after I followed homoeopathy.

DR. HUBBARD: You really get away with it without too much pain?.

DR. HAYES FARRINGTON: I cant let this wonderful paper go by without saying a few words, I dont want to talk too much and I always have to say that long ago I ceased giving a record of my somewhat over forty years experience in obstetrics, because the fellows looked down their noses and said, “Farrington must have practiced in the country where they had no germs.”.

Now, I have had positively eight cases of absolutely painless labor. I have had many cases, to the number of seven hundred, where the mothers labor was not severe, and I have seen remedies work, just as Dr. Hayes has told us, and in one of these cases the mother had six children, and four of them were absolutely painless. The first one was a breech, and they had to hold it back because I was in Philadelphia and I had to take a train, and I can still see that tall six-foot father waving his arms like a windmill at the head of the hill, and I went up in a hurry, and it was most unusual. Constitutional treatment over a period of several years got her into good health, though even when I first started she was well, as most people would think.

On a bright summer day when it was about time for the baby to come, this young lady said to her folks, “I am going to the hospital.”.

“What? You havens got any pains.”.

“I feel as though my baby was going to come. I am going to the hospital.”.

So she walked three or four blocks to the hospital, took the elevator and went up and the interns and nurses made fun of her. “You are very silly.”.

“Get me ready now. I am going to have my baby.”.

They finally acceded to her wishes and took her to the room, scrubbed her up, and did the usual things that are done for preparing the patient, but before they were through, that little head was coming down in there, and they had to hurry to the operating room, and the baby was born, with absolutely no pain, and from the time she left her house until they baby was born, was two and a half hours.

I have had them where the baby came so fast, it was horn in an automobile. One was born on some church steps. I dont know whether that had any significance or not. One remarkable case was twins, but, as I say, I ceased long ago to tell my record, but I know I will have a sympathetic ear in this audience. This girl had all the signs that were supposed to be the dangerous signals. I spoke to a surgeon in my office about the case, and he said, “Take her to the hospital and take that baby. She is going to have convulsions.”.

What I would have done in a case of convulsions in labor I dont know, because I never have had any. I had had quite a number of cases where it was possible.

In regard to the action of medicines, Chamomilla was mentioned, and with that keynote, the woman seemed to be beside herself. She says she cant stand the pain any longer. Then you have to look little further to find that Chamomilla is the indicated remedy.

This was my case but taken care of by a specialist and when I came to the hospital, because I wanted to be there of this occasion, she was lying on a cot in the hallway crying and groaning, and writhing on the little bed, and the nurse said, “she needs Nux.”.

“No, Chamomilla.”.

In five minutes they had hurried her to the operating room.

I could go on and tell about a number of others. I wanted, when I was coming here, to have an opportunity to tell you, though, of one case where Pulsatilla did its usual stunt in changing the position of the fetus. A niece of mine wrote and told me that her doctor said that the baby was crosswise, and it was rather dangerous. I knew her case very well, and I knew that in a general way she was a Pulsatilla, and I sent a dose, and in less than two hours that baby turned around and got its head into the pelvis, and in a few days, when she came to term, was in labor, it was practically painless labor, although it was her first child.

DR. WILBUR K BOND.: I should like to ask Dr. Hayes the remedies he prefers when there is deficient milk supply in the flow of milk.

DR. J.B. GREGG CUSTIS: I have never been able to accomplish painless labor, but I saw one once in a young primipara. She hadnt had any labor at all nor any difficulty at any time. She had an absolutely painless labor. I had never been able to do it with primiparas.

I feel that convulsions in ninety-nine cases out of a hundred are neglected during the time the woman was pregnant. If a woman is carefully prescribed for and seen often enough, her diet probably adjusted, and she is given the right remedy, she won;t have convulsions.

Unfortunately, I have had to use forceps and I have had to do caesareans. One caesarean I did last year I reported to the institute. It was due to a septum down the center of the uterus which extended over a third of the way from the fundus down to the cervix. The baby was breech. The head was in the left side, to the left of the septum, the breech to the right of the septum. I dont believe any remedy in the world would have brought that baby through. That is a mechanical thing.

Of course most caesareans are usually from mechanical things, and we do have those mechanical things.

There is another reason for forceps and that is the so-called vertex labor, which I thick is a most pernicious practice, resulting in a good many infant deaths. I cant, I am afraid, give a record of no forceps and no caesareans, but i do feel very strongly about this convulsion business.

My practice is to see the patient once in three weeks, from the first time she sees me up to the seventh months, every two weeks during the seventh month, and every week during the eighth and ninth months. I feel that with that kind of care and with careful homoeopathic prescribing, we should not have convulsions, and I have seen many case where blood pressures have crept up, not only systolic but also diastolic, and albumin in the urine, and sugar, which would have gone through perfectly all right, without the homoeopathic remedy, of course.

DR. THOMAS K.MOORE: There is one circumstance I am interested in. Hardly any young women ever nurse their babies any more. We see it so rarely out our way. It is exceptional and here are two cases not having had narcotics or anesthetics or anything of the sort. It would be interesting to know if they nursed their own babies. I have a feeling that there is a relation there.

DR. V. TABER CARR: Having cases that we know are painless under homoeopathic remedy, I raise the question, Did nature intend to have normally painless birth?.

DR. FARRINGTON: Not according to Scripture.

DR. MOORE. Not according to The Readers Digest!.

DR. ROYAL E.S. HAYES [Closing discussion]: In answer to Dr. Bond, I havent any preferred remedies that I know of, but it is possible that Calcarea has been more frequently used than others in the past.

In answer of Dr. Moore, both these women nursed their babies.

There is one point which was rather obscures. I hoped somebody would notice it, and that is that I didnt prescribe when there was not very much need for it, but I waited for an urge for a remedy, and then it acted well.

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