CLINICAL OBSERVATIONS. By Ad. Lippe

This Article originally publsihed in THE AMERICAN HOMOEOPATHIC REVIEW., Vol. III. NEW YORK, NOVEMBER, 1862. No. 6.

CLINICAL OBSERVATIONS.

BY AD. LIPPE, M. D., PHILADELPHIA, PA.

After some weeks of varied indisposition and much mental anxiety, Dr. R., aged 35 years, was taken ill on the 22d day of October, 1861. He felt great general prostration; a great heat all over; a strong desire to sleep, with sleeplessness; pain in all his limbs; a want of appetite and aversion to light. He took for these symptoms one dose of Bell.200

The following morning, the 23d, he was visited by Dr. Hering and myself, and the following symptoms were ascertained by our examination: he had not slept the night previous, his mind was too active, but they were always the same ideas which disturbed him; a continued hacking cough, from a tickling in the bronchial tubes, aggravated and excited by motion or talking; he raised at times tough green mucus; the cough causing violent stitches in the head; the head pained all over and felt numb. The tongue was coated white, the edges showing the impression of the teeth; pulse small, empty and frequent, vacillating between 94 and 106; no appetite; very little thirst; utter prostration of strength; very low spirited and taciturn; no passage from the bowels for forty-eight hours; urinating but seldom, and the discharge very scanty. There could be no doubt that a very serious disease was developing itself, and that we had to expect a case of typhoid fever. As the Doctor had taken Belladonna on the previous evening without any result as yet, we concluded to wait until evening before prescribing so that we might be certain that Belladonna was not developing any curative or other symptoms. We met at five, p.m., and found all the symptoms we had observed in the morning aggravated, the tongue was whiter, the edges softer, the cough more frequent, the pulse not as full, the prostration greater. The patient received four pellets of Calcarea carb.200 (Lehrman), and another dose of Calcarea carb. was left with the direction to be given in a solution of water, should there be no improvement in six hours. The next morning it was found that no further medicine except the one dose administered at five, p.m., had been given as the patient had slept soon after taking it. The cough had become less frequent and the head much relieved; the pulse was softer and fuller; the skin moist; an increased expectoration of green phlegm had much relieved him from the incessant tickling cough; the tongue was less coated and clearing off from the edges. He continued to improve from day to day; five days after taking the one dose of Calcarea carb. he was able to sit up, his appetite returned and he has been quite well since.

Calcarea carb. cured this case because it was the only remedy that had similar symptoms among the provings.— The utter sleeplessness from over-activity of the mind, the same ideas always disturbing the patient correspond only with Calcarea carb.; while the tickling, hacking cough aggravated by talking and motion corresponds with Calc. carb., Chin., Phos., Silicea, etc. In this case no aggravation appeared after the exhibition of the medicine, but that invariably beneficial sleep, indicating that the true curative remedy had taken effect, and that an improvement was to be anticipated. The improvement was gradual and steady leaving Dr. R. without the sequel of disease and medicine, and in the possession of full health.

Mrs. L. aged 45 years, had been suffering from diarrhoea for ten days during the hot days of August. The diarrhoea commenced in the following manner, was painless but was relieved only for a short time by Sulph.200, a few days later a watery discharge became more frequent in the evening and caused a great deal of burning for which Phos. was given with but little relief. On the tenth day the following symptoms were present: watery diarrhoea, grey, oftener during the day, worse after eating, the discharge passing with a gush; before the discharge, cutting pains in the upper part of the abdomen, the desire to stool very sudden and after the stool burning and soreness in the anus and rectum which were worse in the evening and during the forepart of the night; after the stool great weakness, sensation of sinking in the lower part of the abdomen and frequent perspiration. One dose of Nat. carb.200 was given in the morning. About ten minutes after taking the medicine a discharge came on very suddenly with not much straining, consisting of green lumps and white mucus; the next discharge was brown and in a few days the normal condition returned.

Nat. carb. has not all the symptoms related very strongly pointed out under the provings, but no other remedy has all the symptoms of the case. The time of the day is not strongly pointed out in the provings, but Nat. carb. has aggravation of diarrhoea after eating. See Hahnemann's Chronic Diseases: symptoms 485 and 486, the violent gushing stool is found,'Ibid 494, and reads  “violent sudden desire to go to stool, followed by a liquid discharge, which passes and gushes with violence from the patient." The burning and soreness in the rectum is Ibid: 413 and 414. The remedy which has next to Natrum carb. the greatest similarity with the symptoms of the disease is Croton tiglium; but Croton tigliutn has more diarrhoea after drinking, and also motion always increases the desire to evacuate; the gushing discharges and the burning after stool in the anus and rectum are characteristic of both remedies.

Lieut. S., aged 24 years, was stationed before Richmond and participated in the battle of the Seven Pines; he was there much exposed to the wet weather, over-fatigued, and having no proper food and very bad water to drink was attacked with violent diarrhoea, for which he took with some benefit Bryonia, China, and Ars. Having only salt meats to eat, and later, when stationed at Harrison's Landing, the water being more impure, he became worse again and came to Philadelphia to be under my care. > On the 16th of August I found the following symptoms:

Stools discharged in a gush, preceeded by some pain in the abdomen; stools consisting of yellow water; motion, eating or drinking caused him at once to go to stool; perfect rest alone gave him relief; after stool a burning in the anus; much emaciation and debility. I gave him one dose of Croton tig.30 (Jenichen). He felt better the next day and under the influence of the one dose of Croton tig. and a proper diet, mutton, rice, okra, tomatoes, Claret and water, he continued to improve. A soreness in the abdomen which prevented him from buckling any thing around his waist, was removed, ten days later, by one dose of Sulph.200 He has resumed his active duties in the field.

In this case no other remedy but Croton tig. could be given; the aggravation of the diarrhoea from eating and drinking as well as from motion have not been observed under any other medicine, while the gushing stools consisting of yellow water are also under Croton tig.

Major M., aged 42 years, who had been stationed at Fortress Monroe and later at Norfolk, came under my care on the 10th of July, 1S62. He had complained of diarrhoea for which Opium had been administered in large doses. When I saw him he had the following symptoms:

Several attacks during the day; frequent desire to go to stool, and when he gave up to this feeling, he passed only discolored and sometimes large lumps of mucus; the continual desire to evacuate became a violent tenesmus; the rectum feeling as if violently contracted; this tenesmus also effected the bladder. Great debility and emaciation followed these attacks, depriving him of sleep, had no appetite and not much thirst.

July 10th. One dose of Nux vom.30 relieved him so far that he passed some faeces, the strangury remaining; on

July 11th. I gave one dose of Caps.30 The strangury ceased, the attacks came -on only once in forty-eight hours, always in the afternoon, he at first passed a large quantity of black and very foetid faeces, and then a quantity of mucus which was followed by frequent violent attacks of fruitless straining, with a sensation as if the rectum was violently constricted.

July 16th. I ordered him Lach.200 (Lehrmann), six pellets dissolved in half a tumbler full of water, one table-spoonful to be taken every four hours for one day. The attacks returned every other afternoon during a fortnight, but each time with less violence and finally ceased without further medicine. The major remains well and is again in the field.

In the year 1855, a married lady, the mother of three children, aged 35 years, came under my care with the following symptoms:

She had periodical attacks beginning with pain in the region of the right kidney, which incommoded her mostly when she moved about or rode in a carriage, the pain was at first a dull indescribable sensation, a heaviness, and finally in the course of ten or more days it became more severe until at length a very severe colic commenced, the pain drawing from the right kidney through the ureter into the bladder, when much blood was discharged with the urine; after this discharge had lasted two or three days she was relieved for a period of three to six weeks. The medicines I administered, at intervals and according to the changes of the collateral symptoms had been, Canth., Puls., Cannabis, Berb., Calc. c, Thuja, Sassap., Lycopod.. Zinc. Zinc. had a better and a longer effect then any of the other medicines, the amelioration only lasting a short time; on the whole the disease became gradually worse. While laboring under the attack, which now lasted much longer than formerly, she tossed about, screaming and vomiting. After passing some blood, there was a sediment like brick-dust to be seen in the urine. I now gave Ocimum canum., according to the few, but characteristic symptoms published by Dr. Mure, I began with the sixth potency which caused at once a violent aggravation, later I gave the thirtieth potency, and since this, 1857, the patient has gradually recovered, her health remaining excellent.

Mrs. O, aged 35 years, mother of four children, the youngest four years of age, had been suffering for more than three years before coming uuder my care, in May, 1862. Mrs. C. is emaciated and of nervous temperament . For more than three years she had not menstruated; she had frequent attacks of violent colic almost always at night, between two and four o'clock, a.m., those attacks came on at irregular intervals from three to ten days and were followed at times by vomiting of food or mucus, and, if this vomiting did not take place, by a severe headache the next morning. The day after such an attack she would feel very weak in body and mind, notable to fix her attention on any subject, and loosing herself in the street because she could not know where she was; when she thus spoke she could not find the right words. The pulse was small and feeble. Mrs. C. had had all sorts of treatment, she had found some palliatives at times, but the disease always returned more violent when the palliatives ceased to relieve.

She took, on the 25th day of May, one dose of Kali carb.30 (Lehrmann). The first night after taking the medicine she had a very severe attack lasting one hour, but she did not suffer so much during the day, the following night she had another attack, less violent then the first night and another still lighter attack came on the following night; all at the same hour, three o'clock, a.m. The repetition of attacks in this manner had never taken place before. The patient improved afterwards, had for some weeks c6nsiderable pain in the small of the back, menstruation returned and she has remained well since.

In the month of April, 1860, the following case came under my care. Mrs. M., married six months and in the fifth month of pregnancy, has been sick for three'days with headache, pain in the limbs and fever. I visited her on the third day; she had taken no medicine, complained of great weakness, severe pains in her head, in all her limbs, but mostly in her back; much worse when moving, no sleep, bitter taste, much nausea, tongue yellow and becoming very dry, moderate thirst, face red, skin hot and dry, pulse 120 beats a minute, full and hard constipation, discharge of urine scanty and dark. Several members of the family had died during the last few years of typhus fever under allopathic treatment. I gave the patient several doses of Bry.200 and found her easier the next day, I omitted the medicine. The following day, the fifth day of the disease, she was much worse, she had vomited frequently during the night, mostly bilious matter; the headache had been much worse, she was now unconscious, delirious, talked incessantly, she passed urine involuntarily, picked the bed clothes, tongue dry and black, face very dark red, eyes wide open, glassy, pupils dilated, when she drank a loud gurgling noise in her throat to the stomach. I gave her Cuprum met.200 (Jenichen) six pellets dissolved in half a tumbler full of water, every two hours one tablespoonful to be given till an improvement was apparent. After the second dose she fell asleep, slept uninterruptedly for ten hours, perspired profusely, and awoke feeling well but very weak. She took no more medicine and was able to take her meals with the family on the twelfth day of her sickness. The pregnancy progressed and at the proper time she was delivered of a healthy child.