Typhus

[Eugene Beauharnais Nash]

This is one place where the homœopathic treatment is superior to the old methods, for we may treat the patient before the disease may be certainly pronounced a confirmed case of typhoid or some such unwelcome diagnosis.

I know we are sometimes charged with treating such cases and claiming to have "broken up" a fever, and it is not impossible that mistakes along that line have been made but I submit that an old practitioner of abundant experience treating cases during a prevailing epidemic of the disease, would have to be given credit for knowing something of the case he was treating before it had reached the point where all the most serious diagnostic indications were developed, and be reasonably sure he had "aborted" a case, which some, claim to be impossible. Those who claim to treat disease by name, with diagnosis fully established, must, to be consistent, wait until the time for preventing the disease is past. No wonder they claim that typhoid cannot be aborted. Such proceeding would be criminal with the homœopathist.

In our indications for remedies we will follow out our own experience in the treatment of the disease, prodroma and all. Forty years ago if asked from our knowledge of remedies what were the remedies most likely to be needed in this (the prodromic) stage, we would have answered

Bry. Nux-v. Rhus-t. Puls. and Bell. It is different now, for there are two remedies that are oftener indicated than any of those named and which must be added, viz. Gelsemium and Baptisia.

Bry.: Great lassitude or weakness. Pains in head, back and limbs, agg. on moving white-coated tongue, dry parched lips and mouth, without or with thirst for water in large quantities at a time loss of appetite, empty eructations

and constipation with restless sleep, which is accompanied by dreams of business, tiring him out, and particularly when the patient does not want to move, as all his bad feelings are greatly aggravated by it. One very characteristic symptom often but no always present is that the patient gets sick and faint when rising up from lying down.

Gels.: Extreme muscular and nervous prostration, with general trembling as a consequence. Wants to lie down, feels so weak. If he attempts to walk the legs tremble, or the hands tremble if he attempts to lift them the tongue

trembles when he attempts to protrude it the pulse becomes weak and slow, but is accelerated on the least motion there is some chilliness, hands and feet cool, while there is crimson flushing of the face inclination to drowsiness, or sleeps frequently, with incoherent muttering head feels "big as a bushel," with vertigo and dimness of vision tongue slightly coated, or not at all speech thick, because the tongue, like all the rest of the muscles, "refuses to obey the will" from sheer inability, or from weakness, to do so. There is generally little or no thirst, no constipation or diarrhœa, and at this early stage, no stomach or bowel symptoms, unless it be, in some cases,

the same sense of weakness (sometimes expressed as goneness) which is felt in general. Drooping of the eyelids is very characteristic and in keeping with the general prostration.

Bapt.: Great prostration and soreness as if bruised in whatever position the patient lies the parts rested upon feel sore and bruised. (Arnica.) Stupor falls asleep while being spoken to, or in the midst of his answer face flushed, dusky, dark red, with a stupid, besotted, drunken expression. Tongue coated with a well-defined streak down the middle, at first white, but very soon turns brown, with red edges. Sometimes the tongue is large and flabby, with a red dry tip, but not distinctly triangular like Rhus-t. Exhalations and discharges early become fetid, and offensive breath, stool, urine and perspiration. Nervous, cannot get to sleep because she cannot get herself together feels scattered about, tosses around to get herself together.

A picture of a rapidly advancing case of abdominal typhoid. The diarrhœa and decomposition of fluids set in early and progress rapidly, and if not speedily checked by Baptisia will come to the stage of Ars., Carb-v. Mur-ac.

DD.:

Psor.: profuse perspirations remain after typhus fever.

Then it is necessary that we understand them thoroughly, so as to apply them correctly, for a mistake at this stage is not easily corrected later, and may prove fatal. Let us compare a little. All three remedies have muscular soreness and prostration but if the soreness is most prominent Baptisia leads if the prostration, Gelsemium. Gelsemium and Baptisia are both drowsy with red face, but with Baptisia the mind is very clouded, with Gelsemium not nearly so much so. Gelsemium and Bryonia want to lie still, and dread motion - Gelsemium because he is so weak, Bryonia because his pains (especially in the head) are greatly aggravated. Bryonia is constipated, Baptisia diarrhœic, Gelsemium neither. With all three the face is red. Baptisia most so "besotted," Gelsemium next. Bryonia least, and turns pale on rising or sitting up. Tendency to decomposition comes early with Baptisia, not so with the others. The delirium of Bryonia is about the business of the day, Baptisia cannot get himself together. Gelsemium not characteristic. The tongue of Bryonia is white, with parched lips and thirst. With Gelsemium the tongue is thinly coated or not at all, there is no thirst, and the tongue trembles when attempting to protrude it while Baptisia is the only one that turns dark in a well defined streak through the middle in this stage. The urine with Bryonia is scanty and high colored, if changed at all, with Gelsemium may be profuse, and with Baptisia is scanty, dark and offensive. Other diagnostic differences between these remedies might be added, but enough is done to show that there is no reason for confusing them or difficulty in choosing between them.

NO ROUTINISM.

Now let one, because I have taken pains to set forth the indications of these three remedies, so as to make them easily and quickly available, accuse me of a spirit of routinism and let it not for a moment be supposed that I mean to convey that any other remedy indicated by the symptoms must be ignored, because there are other remedies that may in some individual case rule all these three out. For instance, if I should find a case in which the excessive soreness and bruised feeling, complaining of hardness of bed and prostration, and even coupled with a dark streak through the middle of the tongue, so strongly indicating Baptisia as above described, and the history of the case should show that the patient had come to this state through the strain of overwork and fatigue, I should consider and compare Arnica, notwithstanding this remedy is not generally useful until later in the course of ordinary fevers. Rhus toxicodendron also will come strongly to mind in cases arising from similar causes.

In other cases in which those who, during an epidemic of fevers, had come down after a long strain of night watching and broken rest in taking care of the sick, no remedy so helps them as Cocculus Cuprum stands next.

PULSATILLA AND NUX VOMICA.

Pulsatilla. If there is much chilliness yet the patient cannot bear to be in a close room, it oppresses her white tongue without thirst bad taste in the mouth sour eructation, and especially if the menses retard,

or are suppressed very greatly discouraged, or gloomy and lachrymose.

Nux vomica. In the case of sedentary men who come down with severe headache and constipation, with frequent desire for stools, which do not satisfy, or ineffectual efforts at stool, and especially if with very high fever and bright red face there is constant desire to be covered, for he is chilly if he moves or is uncovered in the least. The patient is very nervous, sensitive and easily affected by external impressions.

I put these two remedies here together because I think they belong here. The Nux vomica picture is predominantly found among men Pulsatilla in women. If some should object that these are not typhoid fever remedies, because they do not create or cause the pathological changes that characterise a fully developed case of this disease, I answer that any remedy having the symptoms of the patient, even though they be only subjective symptoms, is homœopathic to the case, and that if applied when and where it belongs the pathological changes so characteristic may be averted. To meet and defeat in this way disease at the very outset is one of the chief excellencies of our art as compared with the old school of medicine. The "practice of medicine made easy" by prescribing the one remedy for all cases of one (nominal) disease, without regard to the individual, or peculiar, symptoms in the case, is simply in the line of the old mistake of Quinine for malarious affections, Mercury for syphilis, etc., etc. We know the result.

It is not possible to tell what exceptional remedy will be the indicated one in the first, or, indeed, in any stage of typhoid fever.

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