EXTERNAL COMPLICATIONS


The family readily told me that at noon each day the osteopath had been in, readjusted the spine, vigorously massaged an old indurated area around a large carbuncle scar on the back of the neck and generally worked the patient over. So this was the complication.


Have you ever muttered in your beard and stayed awake nights thinking?.

I was called into counsel at 3:45 p.m. on April 12, 1944, by an osteopathic physician. The patient gave the following history:.

Patient, male, age 43, had been working long hours and under a severe mental strain and was physically tired, yet he was compelled by superior forces to make a business trip to the various industrial metropolises of the middle west. While he was in Detroit, Sunday, April 2, he ran into rain and snow. Being in and out of heated factory buildings, he felt chilly, achy, had a severe headache, but kept to his work all day. He took 15 grains of aspirin, had a good nights sleep; consequently felt better Monday, but complained of being generally tired. While in Chicago, Tuesday, April 4 had an out and out severe chill.

However, a trip to the midwest was most important since business back home depended upon the success of the trip. As soon as his conference were finished, he would rush back to the hotel, fill up with aspirin, take a hot bath and go to bed to “sweat it out.” He was able, by sheer force of will, to struggle through the week. He arrived home Saturday, April 8, feeling general miserable but had developed a soreness in the ribs of the lower left chest. he thought that possibly he had strained himself himself carrying luggage on his trip so he called his osteopathic physician, who had given him many an “adjustment.”.

The osteopath cared for the patient until April 12 when he asked me to see the case with him. First glance showed a tall middle-aged man, ashen gray in color, cyanotic, obviously in distress, breathing very rapidly and shallowly. Physical examination showed complete consolidation of the lower left lobe. Temperature 102.8, pulse 110, respiration 34.

His symptoms were a heavy oppressed feeling across the chest, as if a heavy weight lay there. He was excessively thirsty for cold things, but had been unable to keep anything down. The sputum was white and flecked with bright blood. He complained of a burning sensation from the throat into the left chest and a feeling as if the last four ribs on the left side were dislocated. I prescribed Phosphorus 200x., one dose in water, and small sips of water every fifteen minutes, and left two Sac. lac. powders to be mixed in water and doled out every two hours.

Thursday morning, April 13, there was marked improvement. He had been restless during the night, but had slept about four hours, kept all of the sips of water down. Temperature 99, pulse 90. I thought he was one of those miracle cases, for the chest was clearer and he seemed brighter. Blood count 19,000 with 84 percent polymorphonuclear cells. Sputum not obtained.

Thursday evening the family called and said he was much worse. Reexamination showed temperature 104, pulse 120, respiration 44, shallow, labored. The symptoms had not changed from the previous night. He began to throw up the water, but not the Sac. lac. The prescription then was more Sac. lac. and water less frequent intervals.

Friday morning the report was that he had slept only in short naps but he was obviously better. Temperature 99, pulse 96, respiration 20. So fruit juices were added to the water diet. Sac lac. continued.

Friday evening came and came a frantic call that he was much worse. Examination showed temperature 104.6, pulse 130, respiration 36. He was obviously much worse and recapitulation of the remedy gave Kali carb. symptoms, so the 1M. was given, one dose dry on the tongue and more Sac. lac and water.

Saturday morning. Had slept a few hours, coughed hard and raised orange mucus. Was much worse from 3 to 4 a.m., when the family thought he should die. Examination showed temperature 99.4, pulse 99, respiration 24. Sac. lac. continued and reassurrance given. I could find no evidence of an abscess or empyema, although the thought was a constant source of worry. Blood count showed 14, 000 white cells and 87 percent polys. Blood culture report was negative.

Saturday afternoon another call by excited family. Temperature 105, pulse 130 respiration 40. Again obviously worse. I felt, then, surely, I had missed a complication.

Physical examination showed no spreading of the process nor evidence of abscess or empyema. I began to think of tuberculosis and yet the left lower lobe had stayed solid, the sputum was orange, there was a stitching or sharp jabbing pain in the lower left chest extending through to the back and severe backache. Kali carb. seemed still the remedy, and was repeated in the 1M., one dose.

I had not been seeing the case with the osteopath for he and the family had agreed to let an M.D. in on the case, so I thought I was completely to blame for no more rapid progress. However, the thought struck me to ask about the osteopath.

The family readily told me that at noon each day the osteopath had been in, readjusted the spine, vigorously massaged an old indurated area around a large carbuncle scar on the back of the neck and generally worked the patient over. So this was the complication.

Sunday was a better day for the patient. I visited with the osteopath. And of course, the “daily dozen” was obviated. The temperature rose only to 100 at 8 p.m. and never got that high again. Recovery, then, was rapid and complete and the man was discharged May 12 with no further complications.

The osteopath said that he was sure I would give one of the sulfa drugs and his treatments would not interfere in any way. But I had a few anxious moments, for I felt responsible for the case as I was giving the medicine. DERBY, CONN.

Donald A. Davis