EDITORIAL NOTES AND COMMENTS

Allan D Sutherland

 

Advancing the Cause.- In these United States we now are living in the hectic age of one hundred per centism, boosterism and wild enthusiasm, as manifested at Rotarian, Kiwanian and similar organization meetings. The methods of the three-ringed- circus are in vogue and no medical convention is a success, unless it can be described din the language of the press-agent as “the greatest and most marvelous concatenation of illustrious, celebrated medical and surgical stars ever gathered together under one tent.” Our national homoeopathic organization seems to have succumbed to this spirit of twentieth century hysteria, if we are to judge by the literature with which, at painstakingly regular intervals, we are bombarded.

The 1927 convention of the American Institute of Homoeopathy is to be held aboard ship, during a cruise to the West Indies of some eleven days duration, far away from the distractions of the usual convention city, and we hope and presume sufficiently removed from the Puritanic restrictions of the vast army of Federal Prohibition snoopers, who are eternally engaged in the task of making our lives already dull, still duller. No doubt the cruise will be a glorious one and one long to be remembered; it will reflect great credit upon its originators and sponsors and “among those present” will be all who are entitle d to recognition by their fellow-practicians lesser fame. The press will be kept well informed of the daily activities of the medical -Argonauts and prominent headlines will impress the yokels who are left behind of the marvelous pronouncements of our medical and surgical luminaries. The convention will be a success, spelled with large and brilliantly illuminated letters, and everybody will return radiantly happy, especially since a stop at dear old Havana is contemplated.

But is the this junketing trip likely to do anything for homoeopathy itself? Will the science of homoeopathy be advanced din even the slightest degree? To judge by the history of the past, it seems most unlikely. The organization will be glorified and with it, seems most unlikely. The organization will be glorified and with it, its able and efficient officers, whose efforts are more suitable to the advancement of commercial, rather than professional enterprises. We confess to real admiration of their ability and enthusiasm, even though we regret that their herculean efforts cannot be directed along more truly productive channels. The picture of Rome burning while Nero fiddles, is strongly suggestive of the present state of homoeopathy in America; perhaps a Mussolini is needed to restore a decadent profession to its senses!.

The Treatment of Gonorrhoea in the Female.- In the September number of The Hahnemannian Monthly appears an article under the above heading, by Drs. Joseph H. Fobes and William P.Eckes, both of the Department of Gynecology of the New York Homoeopathic Medical College and Flower Hospital. The initial paragraph states:

“Gonorrhoea in the female, because of its chronicity and the difficulty in eradicating the foci which are the cause of its chronicity, presents a most interesting and difficult problem to the practitioner and gynecologist alike”.

In speaking of the unreliability of smears as an aid to diagnosis, the following statement is conclusively made: (italics ours).

“In our clinic, if a patient presents symptoms, which in our opinion are gonorrhoea, we class the patient as such, regardless as to whether the smear is positive or negative, according to the laboratory report, and the patient is placed on the routine gonorrhoea treatment.

“We find the patient suffering from gonorrhoea very difficult to manage: Difficult to obtain microscopic corroboration of the diagnosis, difficult to persuade to continue treatment until cured, difficult to prove that she is cured. For most certainly when we receive negative reports in cases which are clinically positive, how then are we to place any reliance on negative reports when the case is apparently clinically positive, how then are we to place any reliance on negative reports when the case in case is apparently clinically negative?”.

Under the heading, “As to Methods of Treatment,” the article states:

“There is hardly an antiseptic that has not at some time been advocated and tried in the treatment of this stubborn disease. Chief among these are the silver, salts, plain and colloidal, bichromate of potash and permanganate of potash, compounds of mercury and more recently the analine dye derivatives. Douching with solutions of these antiseptics is advocated and condemned. Both factions having adequate argument for their attitude. Thermal means of many different varieties have been devised and advocated to destroy the gonococcus. Some have attempted to freeze him to death, others have tried to bake him to death, all have produced poor results so far”.

Further along we read: “We have tried vaccines and find that they are or little or no value.” Then followers:

“On our service we have a routine form of treatment which is about as follows: Whenever possible, we place the patient in bed, in the Flower position. Plenty of fluids are given, in fact, water is forced and urotropin in appropriate doses is administered. After a few days, if the acute symptoms have subsided, the patient is given four to six quart douches of a very hot solution of potassium permanganate and a therapeutic baker is applied over the pelvis, beginning with half hour exposures and increasing this up to two hours, if well tolerated by the patient. This is repeated several times during the day.

“After the acute stage has passed and the temperature is normal, the patient is allowed to be up out of bed, but is, however, cautioned that she must take to bed when the menses occur and remain there during this time. This is a very important point and we stress it strongly. Kidd, of England, has recently published a book on the results of treatment of gonorrhoea obtained on his service in which there was a remarkably low incidence of adnexal involvement. He attributes this to the policy of enforced rest in bed of these cases during the catamenia. When the case passes into a subacute stage we combine the foregoing treatment with topical applications of acriflavine and argyrol tampons.

This is done an alternate days and our technique is as follows: A bivalve speculum is introduced and the cervix brought into view. The cervical canal is carefully wiped dry, being careful to go us far as possible up the canal. The canal is then painted with a 2 per cent. solution of acriflavine, going as far up the canal as possible. With a separate applicator impregnated with the same solution, we paint the entire cervix and vagina (by rotating the speculum), the urinary meatus, labia minora, clitoris and inner side of the labia majora. A tampon of argyrol, is inserted and the speculum withdrawn, about a drachm of the same solution of argyrol is then instilled into the urethra and bladder.

“The patient is instructed to remove the tampon next morning and to take a hot permanganate douche. This douche is to be repeated several times during the day. Before retiring the patient is instructed to take a hot sitz bath and to insert a suppository (consisting of 10 per cent. neosilvol in glycerin) in the vagina, being sure that it is placed well up in the vagina. A napkin is worn to prevent soiling of the bed linens. Next morning the patient takes a hot permanganate douche and that day reports to the office for a repetition of the treatment outlined. This treatment takes a long period of time”. And finally, we read :

“If we should eliminate venereal and the accidents of child birth from our general surgical practice, there would not be anywhere near the amount of surgical work that there is being done today. Therefore, it behooves us all to give this question of gonorrheal infection in the female our most serious and constant infection that we may provide for the health of nature generations.

The point to which we wish to draw attention is the fact that frank admission is made of the difficulties of positive diagnosis by means of bacterial smears, the importance of clinical diagnosis, and above all, the insistence upon purely local treatment of gonorrhoea in the female. The authors evidently are at least reasonably satisfied with their own method of treatment, which they designate as routine and which they have adopted after the failure in their hands of other methods advocated by various authorities. There is, incidentally, no misunderstanding of the lack of confidence they have in vaccine therapy.

The question now arises, “What about pure homoeopathy in the treatment of gonorrhoea in the female? Has it no place? Is it evidence of imbecility, or worse, for the physician who follows Hahnemannian principles to apply it? Have Hahnemannians never treated such cases and have their alleged cures been mythical, or cures of simple catarrhal vaginitis only? We doubt it. Our own experience is small, but we have been cases, clinically as well as bacteriologically verified, cured by such remedies as Kreosotum, Pulsatilla, Sepia, Sulphur, etc. Unquestionably many other prescribers have had far greater experience than we ourselves and can present evidence of undoubted cures, made by homoeopathic remedies alone. The authors whose statements have been cited are men of ability and of high surgical attainment and reputation.

It is unfortunate that comparative statistics cannot be obtained by them which will show beyond question of doubt the value or uselessness of pure homoeopathy in the treatment of gonorrhoea in the female. They could present such statistics, obtained from a series of cases in their clinic, were they to associate with themselves a Hahnemannian prescriber of ability and allocate to him a certain number of “control” cases for ultimate comparison. We hope that this plan can be put into operation, for we know that Professor Fobes is genuinely interested, not only in his own surgical work and teaching, but also in the furtherance of the interests of homoeopathy, for which he entertains the highest respect.

Homoeopathy Abroad.- The great revival of interest in homoeopathy in Germany continues; owing to the economic distress of physicians in that country, it is impossible for our homoeopathic colleagues to purchase American works, which they are eager to translate into their own language. We appeal, therefore, to those physicians among us here in the United States, who may be giving up their practices or libraries, to donate such works as Herings Guiding Symptoms, Farringtons Materia Medica, Kents Materia Medica, etc. If these physicians will send their books to the editor of THE HOMOEOPATHIC RECORDER, at 666 Madison Avenue, New York, the editor will be happy to forward such books, free of cost, to Germany.

Between the Devil and the Deep Sea.- In the Deutsche Zeitschrift Homoopathie, June, 1928, appears a criticism by Dr.H.Ritter of Rostock, Germany, of various articles by the editors of THE HOMOEOPATHIC RECORDER, as well as a criticism of one or two or our contributors. DR. Ritter finds fault with our extreme Hahnemannian, or shall we say, Hahnemannians tendency, to write of cases and their cure without giving sufficient differential or other diagnostic evidence in verification of the claims set forth. To a large extent, we plead guilty to his charge, that we are too much inclined to rely upon the fallacious dictum, post hoc, ergo proper hoc. Hahnemannians as a general rule neglect the methods of modern medicine, at least in their case reports, forgetting that their audiences may not be in a sufficiently receptive mood to accept their dicta.

Dr. Ritter points to the well-known American sentimentality, which always strikes the foreigner who comes to our shores, as ludicrous and silly. In this he is right, as the gallery of any American moving picture show will prove. We Americans dislike to be told the naked truth; we love to be soft-soaped and flattered. In time we will get over this, but the moment is not yet there.

However, it is undeniably true, that many of our American Hahnemannians have made wonderful cures, where the latter seemed impossible of accomplishment; unfortunately, they have had to be taken on faith and this the cold scientific mind cannot and will not accept. Rightly so! On the other hand, a large majority of American homoeopaths are long on diagnosis, but short on homoeopathic cure and their case reports too often demonstrate an unholy alliance between the poor little orphan of similia and the cocksure determined villain of O.S. polypharmacy. It is therefore often hard to choose between the two hours of this dilemma.

Our hospitals could, if they chose to do so, correct this state of affairs, but team work on the part of clinicians and materia medicists would have to be employed. Usually, the materia medicist is a poor diagnostician and vice versa. The very nature of the materia medicists work makes it difficult for him to be well up in modern methods of diagnosis. So far as THE HOMOEOPATHIC RECORDER is concerned, we are grateful to Dr.Ritter for his frank strictures upon our weaknesses and, let us hope, we will endeavor to profit by them.

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