By Wm. Gallupe, M.D., Bangor, ME.

I wish to report, through the pages of your Review, a few cases showing the value of Rhus toxicodendron in the treatment of inflammation of ligamentous and cartilaginous textures and synovial membranes resulting from strains and injuries about joints, dislocations, etc.

Case 1. Miss H -, a servant girl, about twenty-six years old, of strong athletic form, sanguine temperament, received a severe strain of the right wrist. It soon became painful and tender, when used at all, and sensitive even to slight movement or use of the joint, or to pressure from handling it. After receiving prescriptions and attendance for three months, from one of our prominent physicians of the allopathic practice, with but very little if any relief, she sought the advice of another, and one who prides himself much upon his surgical skill and ability to manage obstinate cases. She followed his advice and prescriptions for three months more, but without any perceptible benefit, except the concentration of the pain and tenderness in the inner parts of the joint; not being able to use the hand without suffering acutely from it at the joint, with heat, pain, swelling and soreness, lasting from one to four days. She then stopped all medical advice, except to make use of a few articles urgently recommended by her friends, which were represented as sure remedies, but did not enable her to use her wrist or hand. She then desisted from all remedies whatever for about one year. After the expiration of this time she came to me for advice respecting the wrist, being healthy and well in other respects.

She could not use that hand except with the greatest care and caution. It caused pain, soreness, and swelling about the joint. The external appearance of the wrist was about natural. On pulling steadily by that hand, in the direction of the forearm, no unpleasant sensation was produced, but to push the surfaces of the joint together was quite painful. Taking hold of the forearm near the wrist, and shaking the hand back and forth, produced much pain and irritation at the central portion and about the joint. Again, on pressing with the thumb and fingers at opposite sides, and over the central portion of the joint, it was quite tender and irritable, causing it to be painful for a short time. Afterward she could not use the hand in any sidewise motion, nor lift any weight, not even the hand, by the direct action of the wrist. It required much care and caution to use that hand, even for very light work.

It was evident to me that there was a decided inflammation of the cartilaginous surfaces of the whole joint and, probably, to a greater or less extent, of the synovial membrane of the joint. I prescribed Rhus toxicodendron³⁰ five powders, each to be taken in two doses, by dissolving one in six spoonfuls of water, taking a part of it at evening, and the remainder in the morning, also to repeat a powder twice a week until she could take hold of the arm above the wrist, and shake the hand back and forth without causing pain at the wrist. I did not see her again for six weeks. She reported that, after taking the third powder, and when it became time to take the fourth, she found she could shake the wrist freely without causing uneasiness; but as the next day was her time for washing, she thought she would take one more powder; and the next day, before she was aware of it, found she was using that hand with much ease and freedom, and without any uneasiness about the wrist. Next day no soreness was observed from it, and she used the flat-irons with that hand for the first time in twenty months. The next week she did her washing in the forenoon, and her ironing in the afternoon, for the family of five, and did not feel any inconvenience from it. Thus was the effect of a severe strain, which had withstood all her best directed efforts, with allopathic advice and prescriptions for over nineteen months, causing her much affliction and suffering, radically cured with about twelve small pellets, in the short space of two weeks time. About one year afterward she again strained that same wrist in handling some heavy articles. It was quite sore and painful, and she was unable to use the hand without much pain. She called on me for medicine, and I gave her three powders, the same as before, and with the same directions. After two weeks she reported that two powders cured her entirely, and she had no further trouble from the wrist.

Case 2. A strong, athletic man, of sanguine temperament, with large, hard, muscular frame, was crushed by a gravel bank caving in upon him and injuring the right hip. A physician, of considerable note and practice as a surgeon, was soon called, and decided that it was only a severe strain about the hips and across the back, with neither fracture nor dislocation. He was in considerable pain, and unable to use his right leg or turn himself. Liniments and cooling applications were applied about the parts, and anodyne powders given him to relieve his severe distress. A painful, sleepless night was passed and the doses were increased the next day, but without relief or even a momentary mitigation. The second and third nights were passed without much if any sleep, from the constant pain and distress, the physician having visited him three times.

On the fourth day I was called to him at three, p. m. I found him suffering from severe pain, and constantly groaning in anguish. It was stated that he had not slept any apparently since the accident. He was lying partly on his left side, with his legs diverging and partly flexed. The right limb appeared longer, from one to two inches, as well as I could ascertain, as he could not bear even a slight movement of it without great suffering. On examining the hip I found an erysipelatous redness, of a circle of eight inches diameter, over the region of the great trochanter, the parts considerably swollen, and such exquisite tenderness as scarcely to admit of handling it; the least movement of the thigh upon the pelvis was excruciating to him. I felt no hesitation in saying it was dislocated at the hip, or possibly fractured. But what could be done? In the existing high state of inflammation of the part, he could not endure any manipulation with it. I prepared a solution of ten or twelve pellets of Rhus., tox. ³⁰, in a tumbler of water, one-third full. I added to it (as I happened to have it with me) some granulated Sac. lac. which had been medicated with Rhus. tox.¹², as much in bulk as that of the pellets, and gave him two-teaspoonful doses, to repeat in two hours, and again in three to five hours, as I felt he needed quietness and sleep, also to bathe the part frequently with cool water. On visiting him the next day, at eleven, a. m., he reported decided good effects after the second dose, mitigation of pain, and he slept quietly after the third; he had taken four doses. I could examine the limb, and move it somewhat with comparative ease to the patient, and I was thus able to confirm my suspicions of the previous day of a dislocation into the foramen ovale. There was some soreness of the muscles of the limb when moved, though but little tenderness to gentle pressure about the hip. I gave a solution of pellets of Arnica³⁰ in a cup half full of water, to take two spoonfuls, and repeat in two hours, then again in four hours, and, after passing over six hours, to return to Rhus. again, and repeat it in two hours. I visited him next day, at two, p. m.; he had had a quiet night; there was very little soreness of the muscles on movement of the limb. I could examine the parts freely with comparative ease to the patient. I made preparations, and adjusted the bone to the proper place with as little suffering to the patient, perhaps less than usual, when this is done soon after the accident.

This case I think shows a decided power in potentised medicine to control the effects of injuries of parts about the joints, a matter which has hitherto been considered beyond the control of medicine, internally administered, by all classes of physicians, until the law of similarity became known. But even now how strongly do we see it contended against by nearly all of the old school of physicians. I feel quite sure, from observations since, that the solution of the pellets of thirtieth potency would have been amply sufficient. I added some of the powder of the twelfth, which I happened to have with me, as it was for an athletic, vigorous looking patient.

We find, in the pathogenetic symptoms of Rhus tox - Pain, as if sprained in the joints; painful sensation of the joints on rising from one's seat;“ and in the enumeration of its general symptoms. - “Affections of the ligaments, tendons and synovial membranes.” Thus its pathogenetic symptoms and the law of similarity are verified by its curative action.