REPERTORY STUDY FROM A THESIS PRESENTED IN COMPETITION FOR THE DARNELL PRIZE


Still this does not disturb our choice. To understand the scope of our treatment we must be able to discriminate between disease as a morbific process within the organ and the material results or products in which this process terminates. Homoeopathy has to do with the former and is not essentially concerned with the latter. The application of Chelidonium in this case will not result, primarily, in the return of normal activity of the uterus.


CASE II.

Mrs. L.P., aged 50, married. No children, never pregnant. Complains of a soreness over the region of the liver, a burning, referred to the right scapular region and from thence downward. Frequent headache, preceded by blindness of the right eye, with nausea but no vomiting. Has no modalities. Is an aspirin fiend. Generally she feels better lying down. Most of her attacks begin in the morning. She has a sweetish taste in her mouth. She is fair and stout, has many gold teeth and has a chronic nasopharyngeal catarrh. She may be said to be of the lymphatic constitution. Her bowels are regular but there is a frequency of urination.

Some years ago she was subject to eczema. She is sore to touch in the region of the gall-bladder and clothes annoy her here. She is better in the open air. She has periodic nosebleeds. Ten years age she was operated upon for polypi of the nose. On several occasion she has had a cessation of menses which returned after some months with a severe uterine haemorrhage. Examination of the uterus shows it to be large and baggy, adnexa normal. There is a small, red teat in the cervical orifice. She was advised against operation and a drug was given. This produced a haemorrhage of dark, watery fluid from the uterus, old stagnant blood, and the teat from the cervix proved to be a polypus. She remains well to date.

PHILOSOPHICAL DISCUSSION.

Throughout this thesis the reader will constantly be confronted with psora and its secondary manifestations. Underlying the disease process in this patient, we are able to ferret out this universal disturbed, and gradually we come to realize that perhaps Hahnemann was not far off when he stated that this was a prime factor in eighty per cent of all chronic diseases, the remaining twenty per cent being traceable to syphilis or sycosis. It might be well to further broaden our knowledge of this prominent factor in disease. What is it? Where did it originate? How is it spread?.

Psora, as defined by Hahnemann, is a morbific process within the human organism which, in its active form following its primary skin manifestation as the itch-pustule, distorts the normal function of the body and predisposes t visible symptom- manifestation of this dysfunction. Its end products we call disease. Its latent form is found when the vital resistance and the morbid process counterbalance each other.

The origin counterbalance is by no means distinct. Psora or its analogue in mentioned throughout the Bible about the time of Moses. At that time and for centuries following it was marked by cutaneous eruptions. Since then the transmission of the ancient miasm through countless numbers of organisms in the course of hundreds of generations has brought about a distortion of the original manifestations so that today the condition is marked by not one but a multiplicity of complaints. Suppression has played a prominent part in this distortion and the resultant secondary manifestations are tabulated over thirty pages in Hahnemanns Chronic Diseases.

Association and contact, according to Hahnemann, caused its spread. Its universality today is the result of its distortion. When the lesions were prominent upon the skin people avoided the afflicted and did not become similarly affected but since the lesion has been suppressed many unsuspected exposures and contacts have been made.

But it was noted that frequently secondary manifestations of psora appeared in which there could not be elicited any history of the initial lesion. Admitting of the unreliability of he patients word, many cases continued to crop up where the above explanation did not seem to apply.

Charles Julius Hempel, M.D., noted this and attempted an explanation. He contended that the presence of the psora within the body antedated its cutaneous manifestations and further stated that any abuse of the organism which has a deleterious effect upon the normal vital process should be considered a causative factor of the miasmatic process. He wrote:.

Man is ignorant of the true laws of life; he eats improper food.. inhabits smoky, dark rooms.. is deprived of fresh air, is without cleanliness, is doomed to hard and enervating labor.. inhaling the same death-harboring stench (with his fellow men); bellowing, roaring, sweating, together, in the same horrible discord; it is to such influences that we must trace the first immediate or proximate cause of disease, and not to the suppression of the cutaneous symptoms of a miasm that was itself a result of mans primitive deviation from the divine laws of life.

Lastly, there came th theory of inherited taint and predisposition to morbific processes, one of its advocates being J.H. Allen.

Taken as a whole we have before us a picture of distorted life processes and a plausible explanation of the foundation of disease. We are at liberty to accept them for what they are worthy and by observation confirm them, or we are at liberty to reject them and continue without any semblance of an idea of what disease is all about.

Once the miasmatic process is incorporated into the body it never dies out of its own accord. In the words of Hahnemann “it is more aggravated from year to year, through a transmission into other and more serious symptoms until the end of mans life, like every other chronic miasmatic sickness”.

The connection between this paragraph and the case before us is obvious. Reading the history we are able to point out the early manifestation of the psora. Though married, the patient has never been pregnant. This could hardly be called the result of normal functioning (although we must remember also the possibilities of sterility of the husband). The history further states that some years ago she was subject to eczema. This might be the first external manifestation of the internal disorder.

There is no mention of maltreatment of this condition but then that is not essential. Hahnemann has said that the external eruption may not only be driven in by faulty practice but unfortunately it not infrequently of its own accord withdraws from the skin. The after effects in either case are the same. The psoric process continued its activity within the body and the distortion of normal function results so that we are confronted today with a patient having a multiplicity and complicacy of complaints.

One thing we must remember about this case. When the history is taken all symptoms are noted but we must learn to recognize the symptoms dependent upon the disease process per se and those resulting from the effects of the condition. Primarily homoeopathy has nothing to do with the tangible or physical products of disease. Effects of disease and the associated dysfunction will remain after the cause has been removed in most cases. Indirectly, the homoeopathy remedies many exert a favorable influence upon the products of disease by restoration of the normal vital function and resistance.

This thought is to be kept in mind when we note the presence of the uterine polypus and also when we consider that the age of this patient makes highly probable the deduction that not a few of the symptoms of uterine dysfunction might be the result of an impending menopause.

CHOICE OF SYMPTOMS FOR ANALYSIS.

Repeated attempts to organize a group of symptoms which would give us satisfactory results has met with only continued failure. Fortunately several general symptoms were found in the case. They consisted of, first, amelioration or general feeling of betterment in the open air; second, a morning aggravation; and, third, better lying down. Of the integrity of the first two symptoms there seem to be no misgivings but the third choice still leaves us with a feeling that the point could be brought out more clearly if we were questioning the patient personally.

From her we fell we would be able to elicit information which would bring out whether the act of lying down was really necessary for the amelioration of her complaints or whether the truth was that motion aggravated her symptoms. There is a difference. Further there may be a general debility or lethargy which might prompt her to lie down. The way the point is expressed “generally she feels better lying down” seems to indicate that the latter conclusion is the more probable. We do not feel that under the circumstances we would be justified inn readjusting the symptoms to fit our opinion so we will repertorize the symptom as it stands.

From the mass of Particulars we next attempted to build up our totality. We are inclined to the opinion that the seat of the trouble is the liver. the headache and the uterine symptoms are easily explained from this point of view. Consider an hepatic inflammation, catarrhal congestion or diffuse hepatitis with engorgement and enlargement of the liver, and the bogginess of the uterus is explainable upon a basis of portal congestion and venous stasis. The polypus is a natural sequence and its appearance would aggravated and perpetuate the condition.

Likewise the nasal polypus is explainable upon a basis of chronic irritation from a chronic nasal catarrh (most frequently from an anterior ethmoidal sinusitis). The age of the patient and the realization that she most likely is passing through her change of life might be partially the cause of the menstrual irregularities and the peculiar concomitants thereof. The headache gives us an extremely peculiar symptom, a headache preceded by blindness of the right eye, and is to be remembered.

Frederick A. Riemann