Read at the monthly Clinical Meeting of the Homoeopathic Post- Graduate Association, Bombay, on 29th March 1940.
Dr. J.N. Karande, M.D. (Bom.).
In the practice of obstetrics the medical man is called upon to shoulder the responsibility of the pregnant woman during pregnancy, during labour and after labour. In addition he has to look after the care of the infant. It is not necessary to say that proper and intelligent care of the pregnant woman and appropriate homoeopathic remedy will assure a normal labour with a healthy mother and child.
Importance of antenatal care is now appreciated both by the public and the doctor. It would be a happy day when the doctors realise how by judicious use of a proper homoeopathic remedy the complaints during pregnancy could be cured without the use of injections and nauseating drugs.
I intend to place before you my experience of some homoeopathic drugs in my practice. I shall attempt to give in short the salient features of the individual drug and its application in practice.
Mental symptoms of Aconite are very characteristic. She is anxious and restless; fears of death, predicts death. She is peevish, oversensitive, cannot bear light or noise; will not be touched or uncovered.
She complains of fainting on rising from recumbent position.
During pregnancy this drug has been used by me in patients who were anxious about their labour. Some of them said, “Dr., I am to die during this pregnancy” or “Dr.,” Do you think I shall survive this confinement ?” This anxiety and fear has very often lead to s election of aconite, which worked like a charm, the patients coming to me again with a smile on their face. These patients stood their labour well. Some of these women get symptoms from fright. They date their trouble from a particular incident, e.g., death of a relation, or sight of an accident.
During labour : The mental condition-great distress, moaning and restlessness with each pain, will help the selection of the drug. She fears she will not deliver. The pains may cease owing to the presence of the doctor which serves as fright. The condition is common in primiparas though I had same, in some multiparas too. These patients are covered with hot sweat all over; they are thirsty.
Mrs. K., a primipara, of a short stature, came with labour pains; she had slight dribbling of waters. The proportion between the passage and the passenger was normal. She was like that for two days in the hospital. On the third day the pains came on strongly; the head had descended into the pelvis. The patient was restless and moaning during the pains; her body was covered with hot sweat; she was thirsty.
She resented being examined. Her mother told me that the patient thought that she would not deliver and would die. On the vaginal examination, the cervix was 3/4 dilated; the pulse was 100. Temperature, 99F. I prescribed Aconite, every hour. Two hours later I was surprised to hear that the patient had delivered normally without any tear.
Aconite is serviceable during puerperium for fever provided the symptoms agree.
For infants : I have used it for jaundice, with success. About 3 to 4 doses of Aconite, 30, will clear the jaundice. it is given as a routine to babies if jaundice sets in. Another use of Aconite is in retention of urine in infants. Those who are conducting a maternity home will very often come across such cases of retention of urine and where every other remedy fails. A case of a baby, 14 days old, was referred to me for retention of urine. The family doctor had given everything.
The male child was brought to me for catheterization. I could not pass the smallest catheter. I then referred to Kents Repertory, page 651, under Retention in new born infants, Aconite is given,in bold type. Yinglings Manual gives only Aconite. So it was given in the 30th potency. With the third dose, the urine passed; the parents were very grateful for this magic result. Aconite is also useful for the dark green motions which infants get in early days. More like the meconium.
A womans remedy; want of tonicity of the womb. During labour, when the pains are deficient and patient is exhausted and fretful. Besides, it has a special affinity for the smaller joints. 310.
According to Farrington, the main characteristic is intermittency of pains. They are sharp and crampy, and appear in the bladder, groins and lower extremities. Extreme uterine atony. Exhaustion of the whole system. She can scarcely speak at times, owing to weakness. Nearest specific for false pains, Stops false pains and develops real pains. It is useful for bleeding after labour due to uterine debility. It is a fine remedy for after- pains; thirst is present. Rheumatism, especially of the small joints. Nash mentions a very peculiar symptom which has helped me in the selection of the remedy, viz. internal trembling of the body or extremities though one cannot see it externally.
This drug has saved many patients from Pituitrin injections and also from forceps deliveries. I use the mother tincture or the third potency. I will not omit it from my midwifery bag.
A Doctors wife, a multipara, complained of pain in her left upper extremity. The pain was more marked in the index and middle fingers, shooting upwards. I had treated her some years back for the similar trouble by Hypericum, 6. This time the remedy was tried without effect. I was told next day that she was getting profuse lochia and that the smaller joints of both hands were affected. I gave her Caul. 3, three doses, one every two hours, and the joint trouble and the excessive loss of lochia stopped. No other treatment was given.
It is of great use in cases of severe after-pains.
Is another womans remedy. Mild, yielding, likes sympathy, easily moved to tears, are some of the characteristics. Thirstlessness and desire for open air are prominent symptoms. It is very useful for many complaints of pregnancy. I have used it with benefit for heart-burn which did not yield to allopathic medicines. Another drug for this complaint is Merc. Distention of the abdomen causing breathlessness, worse in the evening, is quickly and effectively treated by pulsatilla. For vague pains in abdomen, false labour pains, pulsatilla is a handy remedy.
Urinary complaints of pregnancy, e.g. pyelitis are promptly cured by pulsatilla, provided the symptoms agree. Painful foetal movements, disturbing sleep, are benefited by pulsatilla. In Kents Repertory Page 554-2, there are Arn.1, Op.1, puls3, Sil.1. Sil. stands prominent and I have used Sil 30, with marvellous effect in a primipara who was not relieved by large doses of sedatives. It may be remembered that Puls. is the acute of Sil. as Acon. is that of Sulph. I have seen a patient with a tumour in the breast who is being treated with Sil., requires Puls. in some intercurrent acute complaints.
I have used Puls. for malpresentation before rupture of membranes with great success. Very recently I had a multipara who was being treated by her doctor on old lines. She was sleepless and had great discomfort in the abdomen; the presentation was breech and the mental condition was typical of Puls. I tried external version without success. She was given Puls. 30. 3 doses, and S.L. powders.
Next time she reported that she slept better and her abdominal discomfort was gone. The foetus was lying in breech position. She had to be given the dose again for recurrence of her complaint. When she confined she had normal vertex presentation with no trouble whatsoever. She stood her labour well and reported that she had never such a trouble-free confinement, before.
Puls. is very useful in labour for weak, vague pains with no progress. The patient is thirstless, wants the windows open and is timid. Puls. will serve these cases and bring on normal labour pains.
Puls. is useful during puerperium for puerperal fever, worse from 2 to 4 P.M. Thirstless, shivering, but does not allow covering for more than a short time. It also serves as a galactogogue or brings on a flow after suppression of milk. It is useful for abnormal lochia milky, scanty, suppressed lochia.
A very common complaint after confinement is retention of urine. Catheter is the last thing to be used in these cases as urinary infection is more likely at this time. I have found Arn. m. and Causticum, of very great use in these cases. I give Arn. as a routine to relieve pain and to counteract the effect of bruising of the soft parts. In these days of war when Ergot is so very costly I would like to draw the attention of the profession to the use of Arn. in puerperium as a substitute for Ergot doses. I think routine use of Ergot is unnecessary and that it could be omitted with no harm to the patient and great benefit to the doctor.
4. Magnesia Phosphorica.
Another complaint during pregnancy is the pain in the valves. The pain is worse at night when the patient is resting. She is free from pain during the day while she is on her legs. The pain is ameliorated by heat. Allopathic treatment very often fails to give relief. I have used Mag. Phos. 6x, gr. 5, T.D.S. with prompt effect.
5. Calcarea Phosphorica.
This reminds me of another case who was complaining of pain in the lower limbs and left sacro-iliac joint. Her gait was like that of a case of Osteomalacia. She was given injections of Calcium, Calcium by mouth and Codliver oil. Analgesics failed to give her relief. In one of the so-called charitable hospitals she was told that she had an abscess in the hip joint and required operation. Mind, she had no fever at all ! I studied the case from homoeopathic point and gave her Cal. phos, 6x, gr. 5, T.D.S., for eight days. The patient got relief from the next day and had an easy delivery. In the second pregnancy the same drug was repeated when the symptoms recurred.
6. Nux Vomica.
Nux vomica is another useful drug. I have used it successfully in cases complaining of indigestion, pain in the abdomen and constipation during pregnancy. It is also useful in urinary troubles of early pregnancy. The patient is chilly, irritable, has to go to stool often without satisfactory result. Usually worse in morning or evening 5 P.M. onwards. During labour the patient feels like passing urine and stool but nothing results. The pains are not helpful to the progress of labour. The patient wants to be covered, wants the windows closed. I shall describe a case of puerperal fever treated successfully with Nux vomica.
A koli woman, primipara, normally confined, no tears, had severe rigor at 4 A.M. which came down with profuse perspiration. The patient did not like the windows open. She wanted to be covered even during the hot stage. She did not like her hand to be taken out of the blanket for the pulse reading. The temperature again shot up in the evening at 5 P.M. Her face was congested and she had headache. I studied the case and gave her Nux vomica 30, 3 doses, with very good results.
Another case which was saved by homoeopathy was a multipara who gave history of profuse post-partum bleeding. She came to me for her fifth baby. She had no P.P.H. this time, so after seeing that she was o.k. I went to bed. Half an hour later I was called to the case. She had vomited 3 kidney-trayful of black coffee- ground stuff. The uterus also was enlarged owing to collection of blood clots.
The patient was nearly pulseless, cold and her eyes were glassy. I still remember her deathly face. Veritol injection was given but without much effect. I studied Kents Repertory. Phos. is the only drug which was prominent and was given in the 30th potency; only 2 doses were given. The patient regained her consciousness and colour and made uneventful recovery.
One can go on giving instances after instances of the marvellous cures with homoeopathy.
I would draw your attention to a very important point, viz., a drug selected for complaints during pregnancy serves to fix the constitutional remedy. A constitutional drug may be indicated by the symptoms and the exhibition of such a drug not only ensures a normal pregnancy and labour but also the health of unborn.
Let Homoeopathy be given a place in the maternity and gynaecological hospitals in Bombay. I am sure, in a short time, the authorities will find a great drop in expenditure and in the number of operative cases, as well as, in the maternal and foetal mortality and morbidity.
DR. P.N. VAIDYA : I read in some magazine that during pregnancy the husbands constitutional remedy be given to the wife. Would this be of any use ?
DR. J.N. KARANDE : I have no experience about it.
DR. K.N. VAIDYA : The jaundice in the new-born infant is a physiological one, due to the destruction of a large number of red-blood-cells. In what way did homoeopathy work in these cases ?.
DR. D.N. KARANDE : Physiological jaundice disappeared earlier under homoeopathic treatment than with the allopathic treatment.
DR. B.G. MARATHE : I had on hand a case of a woman with very painful foetal movements. Two remedies were found to be indicated, viz., Sepia and Psorinum. The patient was also feeling chilly. Gentrys Concordance Repertory” helped me in this case. Two doses of Psorinum were exhibited in the case and the remedy had almost an immediate effect on the painful foetal movements.
DR. A.E. FERNANDES : I would like to know whether it was possible to change the presentation during labour by homoeopathic treatment.
DR. J. N. KARANDE : So far as the presentation is concerned, homoeopathic remedies work so long as the presenting part has not descended in the pelvis, but once the presenting part has descended, it is of no use.
DR. PILLAI : Pulsatilla is a useful remedy in amenorrhoea. So, will Pulsatilla start abortion if used in early cases of Pregnancy ?.
(The answer was in the negative, not unless the remedy was proved on her.).
DR. R.P. MAYENKAR : I used Sepia in a case of pregnancy with prolapse of the uterus. A lady doctor who had seen the case said that abortion was inevitable. The patient was given Sepia in rising potencies going up to 10,000. The patient delivered a full term child.
DR. R.R. PAI: I had a case of a woman, pregnant 7 months, with cough alternating with diarrhoea in the beginning. Later, only the diarrhoea continued. Stools, watery and yellow 6 to 7 times a day, even on a strict diet. After repertorizing the case, I gave her Pulsatilla. Diarrhoea stopped but cough came up again. Puls. was again exhibited and the cough cleared up.
DR. L.D. DHAWALE : With reference to the statement of Dr. J.N. Karande that Sepia should not be given in higher potencies in early pregnancy, I would like to say that Sepia could be given in higher potencies in early pregnancy, if that was the indicated remedy.
In reply to the query of Dr. P.N. Vaidya regarding the exhibition of a constitutional remedy of the husband to the wife during pregnancy, I have to say that I recalled an article, read some months back, by Dr. K.N. Vaidya, from the J.A.I. of Homoeopathy, in tour monthly Journal Meeting. Therein the author advised injection of Husbands blood to the wife as a treatment for vomiting of pregnancy. By analogy it might appear to be possible to help the wife with her husbands constitutional remedy, in her ailments of pregnancy. But above all, the womans constitutional remedy would be the paramount remedy for her ailments of pregnancy.