BY B. C. MACY, M. D., DOBB'S FERRY, N. Y.

The patient in this case was a little girl about ten years old, of scrofulous diathesis, who from early infancy had frequently taxed to the utmost the skill of her physician.

I was called to see her on the 9th of November, 1859, and found her suffering from general anasarca. The abdomen was greatly distended, and the extremities — especially the lower ones — swelled, apparently, to the utmost capacity of the integuments. She could stand, and even walk, but with much difficulty. I learned from her parents that they had first observed the increase in her Size several weeks before, but did not then suppose it to be a matter of any serious importance; recently, however, it had increased so rapidly as to alarm them. No cause could be assigned.

Finding by careful examination the action of the heart to be normal, I suspected the disease to be in the kidneys. On heating a portion of the urine in a glass tube, it was found to contain so large a proportion of albumen as to form a solid mass, retaining the shape of the tube in which it was heated. The addition of Nitric acid to the urine produced a similar result. The secretion was scanty and rather high colored. She complained of vertigo with occasional pain in the head and a good deal of pain in the lower extremities. — Her complexion was sallow and her skin unnaturally dry.

My first prescription was Apis, which was taken at intervals of four hours during three days without benefit.

November 12th. Gave Apoc. can. (Indian hemp) about one drop, in solution, every four hours with slight improvement, continued only two days.

November 14th. Ars. was given and continued about three weeks, in the 3d, 6th, 12th and 200th potencies. During the first fortnight under this remedy the dropsical symptoms almost disappeared but the albuminuria was persistent, though as the urine was more copious, the proportion of albumen was proportionally less. After the second week however, no further benefit was derived from this drug.

December 5th. Prescribed Hell. nig. This like Ars. seemed to control the anasarca but had no apparent effect upon the quality of the urine. Finding after a week or more the dropsy increasing, discontinued the medicine.

December 16th. Again resumed the Ars., but having in the meantime written to Dr. C. Dunham, of Newburgh, describing the case and asking his advice, I again discontinued its use on the receipt of the following letter:

“I have just received your favor of the 14th inst. If you would carefully examine the urine of your patient with the microscope, you would probably detect casts of the tubuli, blood discs, etc., and determine the existence of Bright's disease. In fact, however, I think that the constant presence of albuminuria for a period of several months leaves no room for a doubt of the presence of some form of Bright's disease.

“I should like an opportunity of examining the urine, chemically and microscopically. * * Your statement of the case suggests to me the propriety of giving Turpentine which has rendered to me (and many others) great service in albuminuria, and which seemed homoeopathically indicated in at least some forms of Bright's disease. I would give the third trit. of Terebin. every four hours, and if no effect followed would give a half drop dose of the Oleum terebinth (as practised by Dr. Kidd). If practicable, a warm bath every other day.”

From December 20th to the 30th of January following, the patient took Terebinthina from half-drop doses of Oil of Turpentine to the 200th potency with little or no benefit further then the holding in check the dropsical symptoms. Indeed during the latter portion of this period the quantity of albumen was decidedly increased. In the mean time I had forwarded to Dr. Dunham a vial of the urine and received from him the following reply:

“I received from the station agent at Fishkill a vial of urine sent by yon. On examining it, I found it alkaline. — Heat and nitric acid caused copious deposits of albumen. Boiled with caustic potash no precipitate occurred.

“Under the microscope, fibrinous casts in tolerable abundance, large epithelial scales, one prismatic crystal of triple phosphate.

“There can be no doubt of the existence of some form of Bright's disease.

“It is singular that a few hours after I sent my last letter to you, I was called to a case of very similar character. The urine was so loaded with albumen as to become solid when heated. The dropsy very great indeed. I gave Terebinthina², one grain in a tumbler of water, a tea-spoonful every four hours. Yesterday the swelling had greatly diminished, the quantity of the urine had increased nearly four fold and there was but a trace of albumen in the urine.”

The case had now been under my treatment eighty-two days without any advance toward a cure, for, although the dropsy was held in check by Ars., Terebinth, Hell., etc., the urine was still loaded with albumen, while the strength of the patient had for some time been steadily failing.

I have previously stated that she complained of pain in the lower extremities. This had been a persistent symptom throughout and at times a troublesome one; none of the remedies used had seemed to afford the slightest relief to it. Those familiar with Hering's proving of Kalm. lat, published in Vol. I of the Transactions of the American Institute of Homoeopathy, will remember how prominent was this symptom. Nearly or quite all the provers experienced it, whether the 1st, 2d or 30th potency was used.

January 30th, 1860. Gave Kalmia every four hours.

February 3d. Patient decidedly improved in every respect. The pain in the limbs being relieved for the first time since the commencement of the treatment. For the next five weeks she took Kalm. four times a day, using about a drop of the mother tincture each day. During this period there was a steady improvement from week to week; the dropsy disappeared entirely; the urine on being tested indicated but a small amount of albumen, while the general condition of the patient was very encouraging.

March 8th. Gave Kalmia³ in solution, four times a day. This was continued eleven days. During the latter part of this period the patient complained of a return of her old pains, and there was found to be a marked increase in the quantity of albumen in the urine.

March 19th. From this time forward to the end of the treatment the mother tincture was used as heretofore, about one drop each day.

On the 30th of April, six weeks afterwards, I again and for the last time examined the urine, both by heat and Nitric acid, and found it free from albumen. The health of the patient seemed to be completely restored. Fearful of a relapse however, I continued the use of the medicine — a fractional part of a drop once each day — for weeks afterwards, but as I took no notes of the case after the 30th of April I cannot say when I ceased to give it altogether.

It will be observed that the patient was under treatment almost six months, but nearly half of that time was lost in the use of medicines which failed to have any curative effect. Reckoning from the first exhibition of Kalmia to the last examination of the urine, when no trace of disease was manifest gives just three months as the time occupied by the cure.

More than two and a half years have since elapsed and the patient still continues to enjoy good health, far better indeed than ever before. She complains a little from time to time of pain in the lower extremities, but not more than is usual with children of her age. I do not recollect having to prescribe for her since her recovery.