[Read before the Bureau of Materia Medica, I.H.A., June 21, 1951.].
ELIZABETH WRIGHT HUBBARD, M.D.
Why is it that the world is to the chilly? If one person in a room minds the draft the other ninety-nine must swelter. Similarly what a dither there is about hypertension and how few really pay attention to the low blood pressure cases.
What are the symptoms of low blood pressure? Exhaustion, easy fatiguability, fainting, dizziness, feeling of being weak in the knees, numbness, pallor, chilliness, inability to concentrate.
What does usual medicine offer for this oft-neglected complaint? Vitamins, tonics, liver in various forms, salt, coffee and stimulants, food, especially meat. Even strychnine, or adrenal extract.
Differential diagnosis including laboratory work is essential. Has the patient Addisons disease, is he anaemic, has the heart trouble, is he diabetic, has she directed herself into a decline, is the pre-tubercular, has she thyroid or liver disturbance? is some psychic or human relations factor at the bottom of it? Has she been depleted by long loss of vital fluids?.
Common sense and wholesome regimen will solve a certain per cent of such difficulties. Rest, hydrotherapy, diet, exercise, you all use.
The most powerful stimulation to the human body, however, is that exact but puissant imponderable the similimum. Take the hypotensives “chronic case” and give him the indicated constitutional remedy. Unfortunately many of these patients show few distinctive symptoms, but mainly common ones. However, the persistent use of the two most valuable words in homoeopathy “what else?” will elicit some salient trifles.
A few grand remedies will deal with many of these cases: Lycopodium when the patient is irritable; of a uric acid diathesis; with a liverish hue or discolored brownish patches on the skin; with craving for sweets; rumbling flatulence; four to six p.m. or a.m aggravation; relief from motion; a mental giant who is slipping into innocuous desuetude. Natrum muriaticum: if she eats salt out of the salt-cellar; faints in the hot sun; keeps everything in; weeps in secret; has headaches at 10 a.m. China; where there are dizziness; fainting; skipping heart; everything eaten turns to gas which will not go up or down; finicky appetite; noises in the ears; history of loss of vital fluids. Sepia; when there is a yellowish tint with dark circles under the eyes; general dragged down feeling; pulsation throughout the body; desire for sours; relief from violent exercise to their own surprise; empty, all-gone feeling in the epigastrium before lunch; liver spots; indifference to life and loved ones.
Of the nosodes. Tuberculinum and Psorinum are the most helpful. Calcarea phos. in exhausted, fast-growing young people, or Kali phos. in neurotic older women. Picric acid, or indeed many of the acids when indicated. Stannum, if there be catarrh and neuralgias with midday aggravation. Even our frequent friend Gelsemium or its rival Cocculus, or Causticum, despite being an ammonium, may serve.
Study the blood chemistry of your low tension patients. Often their chlorides will be out, their cholesterols low, their nitrogen metabolism may be disturbed, country to what one might have supposed.
At all events, in a field where little is known or done, the homoeopathic remedy can vitalize the patient to a remarkable degree and fit him to lose, more or less joyously, another button in lifes wringer!
NEW YORK, NEW YORK.
DR. A.H. GRIMMER [Chicago, III.]: This is a most excellent paper. Dr. Hubbard has a way of making homoeopathy so easy. You can see the remedy right there, and that is why we should picture our remedies as living entities of sick people. There is one to add to the magnificent list she gave, one she did not mention, Carbo veg. That not only has lowered pressure and depleted vitality in the extreme, but it is one of the great remedies for its antidotal power over the coal tar drugs.
I may be a crank on that, but I have seen so many people who were sick, whose reactive forces were almost destroyed by excessive use of coal tar drugs, not necessarily given by old school doctors, but taken by the patients themselves. They can go to any drugstore or any place, almost, that you might mention, and get a supply of some one of these numerous things that we hear about over the radio twenty-four hours a day-about their virtues and what they will do for a little pain or a little headache, and then, if you dont get relief, they pass the back and tell you to go and see the doctor.
The question is: What is it doing to the race?.
Carbo veg. will help you out lots of times if you can find out-and always find out-what they have taken and how much they have taken of it. You will be surprised what it will do for you.
DR. ARTHUR WELLER [Orange, N.J.]: We have heard something about a disease that doesnt exist, in my opinion. Hypotension is not a disease; it is only a symptom. For many years I have studied these cases and I have found that it is the worst thing you can do to tell the patient he has hypertension or he has hypotension, because there is no such disease.
Some years ago I was talking to our Medical Society, and some agreed and some did not, but I find that they are not carrying it out because patients come to my office whom I have never seen before, and they say, “I hypotension. My doctor in Brooklyn told me so”.
“And what did he say you would have to do?”.
“Build myself up. I am run down. I have to be stimulated”.
Now, two years ago, if you men noticed, in the Lahey Clinic Bulletin, Rut-ledge made this statement: “The worst thing you can do is tell a patient he has hypotension, because there is no such thing as a disease entity”.
I have found that to be true. Hypotension simply depends on something else, and to tell a patient you are treating him for hypotension and giving him stimulating drugs, is the worst possible thing you can do. Many of our good clinicians will say not to tell your patients they have hypertension or hypotension. They worry about it too much.
I think hypotension should be mentioned only to be forgotten. It is nothing, and it is a disease entity I depends entirely upon other conditions, and I think we should remember that.
DR. WILLIAM P. MOWRY [Detroit, Mich.]: I should like to ask Dr. Hubbard one question: In these cases have you found they had a low blood sugar?.
DR. F.K. BELLOKOSSY [Detroit, Mich.]: A proof that hypotension is not a disease is the fact that some of such cases are not exhausted or weak at all; they can be very energetic and work all day long, physically or mentally; therefore, those who are exhausted are exhausted not on account of the hypotension but on account of some other symptoms they may have.
DR. ELIZABETH WRIGHT HUBBARD [New York, N.Y.]: That last remark of Dr. Bellokossys interested me because I am supposed to have too much pep for the worlds good, and I carry 110 right along always.
DR. BELLOKOSSY: One hundred and ten is normal.
DR. HUBBARD: It seems to be creeping down, because I used to be told it was 100 plus your age.
DR. BELLOKOSSY: Well, 115/80, and most of my patients have 110/80, and I consider that completely normal, and if I treat a hypertension case, it goes down to 115/80, and the statement that the blood pressure should be as many millimeters above a hundred as your age, is completely wrong in every case, without exception. It is 115/80, in my observation, if it is normal.
DR. HARRY R. SACKETT [St. Petersburg. Fla.]: Where do you get it?.
DR. BELLOKOSSY: Every case I treat is 115/80.
DR. GRIMMER: Does that hold for age?.
DR. BELLOKOSSY: Unless you are not too young. Some homoeopath in Africa found that in the African woods they have 115/80, and he says, “When I cure a case, it always goes down to 115/80.”.
DR. WELLER: What instrument are you using, Doctor?.
DR. BELLOKOSSY: The same thing as you are.
DR. WELLER: Mercury?.
DR. BELLOKOSSY: It is.
DR. SACKETT: I should like to know how many of those here have it as low as 115. I take 100 per cent exception. You cant tell me 115 is normal in a man of seventy-five or eighty.
DR. BELLOKOSSY: I watch these cases year in and year out and, if you can keep a reasonable balance between your high and low, and keep your low as high as 80, you are in a reasonable position.
DR. SACKETT: But I was under strain last winter, and my pressure stool at 165/80.
DR. HUBBARD (closing): While these gentlemen park their guns, I want to answer Dr. Mowrys question because he has asked a very pertinent as well as a polite question. He asked what about their blood sugars. I purposely did not mention it because I have been somewhat surprised that their blood sugars are not by any means or even preponderantly low, when their blood pressure is.
I have had some very low blood sugars in connection with dieting, where they have attained almost pre-insulin shockage, and I have taken the blood pressure and they were not down, and blood sugars were 67, or something like that, and low blood pressure people with systolic pressure from 60 to 85, and their blood sugars were not low; so that is all I know.