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long a time, that symptoms of impotency and infecundity are beginning to be quite alarming. Hence, far from endeavoring to increase the evil, a few workers, among whom Dr. T. F. Allen is the most honored and conspicuous, have thus far endeavored to save our materia medica from becoming unproductive in the not distant future. But no good will come of praising a worker and his work, and at once condemning it with a phrase which, though its sound is worse than its meaning, misleads the young, and the older ones also, to whom a figure of speech is equivalent to an idea.
Denn eben wo Begriffe fehlen,
Da stellt ein Wort zur rechten Zeit sich ein. The fear of losing what Dr. Hughes terms “concomitants," or what Dr. Drysdale terms "contingents,” is groundless and unfounded, as any one who will take the pains to analyze a single proving, will easily discover. After the most searching process of this kind there are always more than enough of such contingents left over. The position most easily defended, in fact impregnable in its self-evidence, is that, while we do not wish to get rid of these contingent symptoms, we have to demand that they, like the main symptoms, should agree, or at least exhibit that degree of concordance which would vouch for their therapeutic value. As it is, the fear of losing such a symptom amounts almost to a morbid state on the part of homæopathic doctors, while a little study would convince them that, far from losing anything, the materia medica would gain by the elimination of many “concomitants” and “contingents," so called, obscuring the real and positive pathogenesis of the provioing.
This morbid fear of purification tempts the writer strongly to raise a storm by proposing the omission of a “contingent " from the "symptoms" of ambra; the one recorded as “anthropophobia before defecation,” condensed, by Jahr, from Hahnemann's words, “a frequent urgency to evacuate which makes her anxious, and the presence of persons intolerable.” (Symptom 185.) No body else had it, so away with just so much waste of paper and ink.
"Hold thy hand, oh Vandal,” the defenders of the faith are heard to say. “Emasculate not the provings of ambra, for who knows how many lives that symptom has saved or may yet save!” Profound veneration of the esthetic prevents the completion of the picture and drops the curtain at a point where vulgar laughter might mar the solemnity of the scene — a prover in agony !
It is not difficult to disprove the argument brought forward by Dr. Cowperthwaite in favor of symptomatological and in op
position to pathological effects, by reminding the reader that a symptom of disease to be a symptom, must be of diseased, that is, in modern parlance, of pathological origin.
An unpathological symptom of disease it is impossible to conceive in mind. Hence, those symptoms which are to be retained in the materia medica shall not be imaginary, but actual to the best of our knowledge, no more ; and they should agree in pathological sense. If they do not, they are useless for therapeutic purposes; and the only test of their possible utility is to be sought for in a reasonable degree of agree. ment between the provers who furnished them. Dr. Cowperthwaite avers that "you can't cure anything with pathology." Correct; but you can cure with a well-established pathological symptom while you will fail with a non-pathological "contingent," or by mistaking for symptoms those interminable lists of sensations recorded by healthy provers, who have taken no drug.
Such are the thoughts the writer would have had, and possibly might have uttered, had he been present at the Convention.
SOME SYMPTOMS PERTAINING TO THE SKIN, GLEANED FROM
THE CYCLOPÆDIA OF DRUG PATHOGENESY;
WITH OCCASIONAL REMARKS THEREON.
BY JOHN L. COFFIN, M. D., BOSTON, MASS.
Prover No. 3 b. 90 drops in 6 doses. — Same day, in evening, complained of incessant irritation of the skin, which she described as “furious.” It lasted till she went to sleep, extending even to the toes. Took no more medicine, but had return of irritation, now and then, next day, and for four following nights.
Prover No. 4. Cardol painted on skin. — Painted on the sound skin it dries in rapidly, and in a few minutes causes a slight burning and itching, gradually followed by redness and swelling. In about twelve hours epidermis rises in wheals, firm and solid, like urticaria tuberosa. In course of time this exudation is saturated and softened by an effusion of serum and breaks down into a sero-purulent fluid, converting wheals into vesicles, at first pea-like and flat, but soon coalescing to form large flat bullæ, which open and discharge a turbid, purulent fluid ; cuticle then falls off, leaving the exposed cutis swollen and congested, and suppurating profusely.
Prover No. 5. – On the morning of February 16, Dr. Reil rubbed on back of the hand (space size of sixpence) a small quantity of the brown, slimy fluid found between the shell and kernel of an anacardium bean. In the evening the skin was slightly reddened. On the 17th, 18th and 19th nothing was noticed, only the redness seemed to increase in the warmth, and the skin became shrivelled somewhat. On the 20th, 21st and 22nd itching was felt; the place that had been rubbed with the juice was elevated above the rest of the skin ; the skin, which was black in the furrows, seemed as though it would burst. The itching increased, and the epidermis desquamated in small pieces, but the new skin beneath it was not smooth but uneven and shining. On the 27th the whole place was clear of the old epidermis, and presented the appearance of an inflamed cutaneous surface, covered with small miliary pustules ; the itching was considerable, especially during the night and in the heat. The elevation of the circumscribed spot, as well as of the surrounding skin, was increased, and was from a quarter to a half line high.
Each pustule exuded from its apex a fluid which dried into a yellow crust. In the night of the 27th the itching was quite intolerable, and he must have scratched in his sleep, for the exudation the next morning was greater, and round about the place the skin was studded with red, inflamed spots; the whole back of the hand was swollen and hot. On the first of March the state was the same, and that, by the friction of the glove, apparently, the small spots surrounding the central spot swelled for some hours into wheals, and then disappeared ; itching considerable. On the 2nd and 3rd the burning was less, as also the exudation and crust formation. The whole space had the appearance of an hypertrophy of the skin ; the surrounding red spots only became more distinct by scratching. On the 3rd, in the evening, there was desquamation. During the following days this went from the periphery to the center, and was repeated several times till the 7th ; but in proportion as the spot on which the juice had been rubbed became regenerated the surrounding inflammation increased, producing a surface covered with papules and wheals which did not exude, but on the slightest excitation became bright red and as if indurated, so that the movement of the wrist, over which towards the forearm the wheals extended, was hindered by formation of thick folds. During the subsequent days a bran-like desquamation occurred here also, which nearly ceased by the uth, when the natural appearance of the skin was almost quite restored.
Poisoning No. 2 a. Nut hung about neck by string. — In eight days there came an itching on the chest, aggravated by warmth and exercise, and compelling constant scratching ; a few days
later the itching spread over the abdomen and axilla. It was attended by an eruption of larger and smaller, red, inflamed and elevated wheals. The itching increased ; was disagreeable by day, and kept him awake at night; he got feverish, lost his appetite, and was constipated. When examined, his chest, axilla, upper arms, belly, scrotum and thighs were not only found to be covered with wheals, exuding a viscid, yellow fluid, but some of them had turned into warty excrescences, with thickened epidermis. All the intermediate skin was of erythematous redness, and the itching frightful. Scratching brought no relief; on the contrary, increase of pain and discharge, so that many places were covered with yellow crusts.
Poisoning No. 3. While bruising seeds some juice spurted into face. - In the evening there occurred violent burning on the chin, and later small vesicles, which, being rubbed, exuded a quantity of fluid. Next morning the left side of face was much swollen and covered with a quantity of small pock-like vesicles. In the forenoon violent burning, which went off towards evening, after two drachms of rhus 2. At night slept well, but next morning the swelling was much greater; not only was the left eyelid quite swelled up, but small vesicles appeared on the backs of both hands. About noon the swelling of the eyelid abated somewhat, and some of the vesicles burst and discharged yellowish, transparent fluid, which hardened in the air into a transparent, yellow mass. Towards evening the burning increased. On the fourth day the disease underwent a change. Instead of the burning a very painful itching came on, combined with a shooting sensation like a gnat bite; could not sleep at night for itching. Whole lasted about ten days.
Poisoning No. 4. Juice painted on the arm. — In a week the arm became red, and a number of small pimples appeared. In night face became swollen and red, as also abdomen and thighs, on which arms rested. Next day arm and hand bright red, and swollen as in erysipelas. Painted spot was abraded. Over rest of forearm many vesicles, of various sizes and shapes, with minute pustules ; on back of right hand and on front of wrist, also on right cheek, a few raised red spots, sharply defined, surmounted by minute white pustules. Redness and swelling of the face was chiefly about the eyes, left eye being quite closed. On chin a yellow crust resembling that of eczema. On inner side of each thigh, at the upper part, was a large, red, ill-defined patch, with one of two transparent vesicles on lower abdomen ; a few spots on right hand. Eruption caused considerable itching
Poisoning No. 5. Some juice got into a crack on left wrist. — After twelve hours wound itched, and scratching increased the irritation. In the afternoon of next day vesicles appeared around wound and higher up arm toward elbow. At first not much itching, but on second day this was considerable, and so much worse at night as to hinder sleep. On the evening of second day scrotum became inflamed, without vesication ; also face, eyelids and upper right cheek, presenting erysipelatous appearance, and feeling hot, stiff and burning. There was also a red patch at bend of right arm and on right hand. After five days, though rhus i x had been taken, arm was more swollen and tense, redness deeper and more uniformly diffused ; color disappearing on pressure and reappearing directly it is removed.
Although as a general thing I do not consider the immediate local manifestations, arising from the application of a drug to the skin, as the best guides in determining its therapeutic value, I should make exception in the case of anacardium, for the reason that its eruption does not appear till after some considerable time has elapsed, and it appears on many other parts of the body than that with which it came in contact.
The symptoms recorded above present very remarkable pictures, it seems to me, of two distinct diseases; that of urticaria and eczema.
In the former the size of the wheal, its degeneration into bullæ, sometimes filled with pus, shows its homeopathicity to those rare forms of this disease known as urticaria tuberosa and urticaria bullosum. In the latter its sphere is evidently in the most acute form of eczema, when the swelling, redness and vesiculation come on with extreme rapidity and virulence, and accompanied with itching even more intolerable than usual. Case number five, second series, was accompanied with such constitutional symptoms as would lead to its trial in some cases of acute, superficial erysipelas of the face.
The other symptoms of this drug would show that it is especially indicated in the above-mentioned diseases, when the cause is supposed to be neurotic.
ANTIMONIUM CRUDUM. Prover No. 3 a.
49 grs. — (Had been proving the medicine some time, taking from 1 to 4 grains every day.) Deep sleep with perspiration ; itching on the skin, especially about the genitals and inside of the thighs; sometimes twitched strongly towards morning; thereafter slight redness, and during day there appeared a pustular dry?) eruption. Next day took 6 grs., and the itching and eruption, on scrotum, spread towards perineum. After two days he took 10 grs.. On both inner surfaces of thighs there came dry pustules, which itched and felt tense, and when walking the whole thigh was painful. These pustules