[Report to the Hom. Med. Society of the County of Cayuga, N. Y., June 23d, 1864.]

BY C. W. Boyce, M.D., Auburn, N. Y.

The Committee, having in charge the subject of Catarrh, finds itself, at the end of the second year, in the same condition as at the close of the first - able only to report progress. During the two years of its continuance, it has presented six written reports, four of which have passed into the literature of our school; in addition, several verbal reports have been made. These have comprised all parts of the body liable to catarrhal diseases, except the vesico-genital organs of the male. The committee, far from having exhausted the subject in these reports, feels that it has only made a beginning, the completion of which must be left to abler minds. By catarrh, or by this term, we express the idea of an inflammatory disease of the mucous membrane, generally caused by exposure to changes of temperature. Lately, however, the term has been more restricted, and perhaps justly, being used to convey the idea of an inflammation of the mucous membrane of the nasal passages, larynx and chest.

How common this inflammation is may be inferred from what Watson says: “There is scarcely one in a thousand who passes a winter without an attack.” Such being the frequency of the disease, we may be pardoned if we trespass on your time by further consideration of it.

Let us review. Catarrh of the air passages is an inflammation of the mucous membrane, which is prone to pass, crysipelas-like, to other portions of the same, and which often implicates the whole of it. Strictly, the primary condition is one of decreased secretion. The membrane is dry and thick, even impeding respiration by lessening the size of the passages. The secondary condition is one of increased secretion, which is not, however, followed necessarily by relief; for the first flow is generally thin and acrid, poisoning all the parts over which it passes. Following this is a bland, thick mucus; which marks the period of improvement. The first of these periods is marked by fever, with its common accompaniments. This continues a longer or shorter time in proportion to the severity of the case and its extent; with the decline of the fever generally appears the increased secretion. We will pass over the treatment of the primary stage, as this, in the experience of the committee, is not generally difficult; but when the primary condition has not been cured, and the disease has passed into the secondary, uninfluenced by treatment, we have a condition which requires careful investigation.

The inflammation, from being acute, is now sub-acute with tendency to continue indefinitely; there is pain and soreness manifested on sneezing and coughing. All the sufferings are generally increased in the afternoon and fore part of the night, when the secretion is lessened, and the membrane becomes dry and thickened. The latter part of the night, and through the morning, all the sufferings are lighter, and there is a more or less free discharge of comparatively thick, yellowish mucus. Without comparing the symptoms and the pathogenesis of Pulsatilla, side by side, let us assume that the condition described and the effect of Puls. on the healthy are nearly the same; so much so, that perhaps no remedy in the materia medica is so often prescribed for it a Pus. According to our law, Puls. ought to cure the totality of the symptoms, but in many cases, and perhaps in the majority, it fails to do so; nor have we any remedy in common use which has all the symptoms nearly as fully as Puls., Sulph., Calc., Hepar, Carb. veg., etc., in many things resemble the case under consideration, but none so well as Puls. One case of this kind·, from practice, will bear detailing, and perhaps serve to express the view of the committee better than in any other way.

Mrs. Smith, fifty years old, had for years been subject to catarrhal attacks which came on early in the fall, upon the first change from warm to cold weather. These lasted until warm weather came again next summer. Any exposure, even the slightest, aggravated the condition severely. The result was that the lady was sick all winter; there was soreness and pain of the whole chest, worse at the superior portion; cough was more or less constant, but increased when lying or during exercise. There was shortness of breath; the cough was almost constant in the morning, attended by expectoration of slime and yellowish mucus of a salt taste. The cough was spasmodic and attended with retching and inclination to vomit; there was discharge from the nose of thick, yellow mucus.

This case was prescribed for repeatedly every year, and she got Puls., Sulph., Calc., Hepar. and several other remedies, with no decided benefit. The symptoms were palliated by Calc., but not cured. This was the history for years. The patient came to feel that there was no help for her, and that the end of her disease was consumption.

In searching for the curative, after many hours a remedy was found whose pathogenesis contains the following: “Scraping and dry feeling in the larynx, increased toward evening, and accompanied by hacking cough and hawking; cough which wakes him at six a. m., having remissions of a minute. It is at first dry, clear and barking; subsequently some thick mucus is detached, and the effort of doing this desire to vomit, accompanied by an excoriated feeling in the throat, and pressive headache. Easy expectoration in the morning; expectoration of a yellow mucus of an acrid taste.” These symptoms are found in the pathogenesis of Coccus cacti. Two grains of the Cochineal of the shops were triturated up to the third Two powders of one grain each were given, one to be taken every evening. The first dose aggravated the case; consequently the second was not taken. After a few hours there was amelioration, followed by entire relief in two days. Mrs. S. has had no return of the catarrh for two winters.

Cases similar to the above have been common with us, and Coccus cacti has seldom failed to cure in the same prompt manner.

On the authority of Dr. Lippe, of Philadelphia, we recommend this remedy in the troublesome coughs of drunkards.

Another form of catarrh, which is new to the committee, has been observed during the past winter and spring. The symptoms defy classification, and appear without order or regulation. There would be excessive dryness of the mucous membrane lining the nose and soft palate; deglutition difficult from a feeling as if the soft palate were stiff like leather. Occasionally, with great effort, a piece of dried, hardened mucus would be discharged, looking like a scab. After this mucus was dislodged, the stiffness was somewhat less, but for a short time. The feeling of dryness became painful toward evening and at night; generally by morning the distress was little. The patient would feel nearly well, yet before night his complaints would be more than ever. Sometimes these spells of dryness and distress alternated with periods of entire relief several times a day. This peculiar type seems inclined to become chronic. No remedy seemed to be of decide benefit until Sticta pul. was used; this had a powerful effect, and in some cases immediate relief followed its administration. The first account of its use was in the North American Journal of Homoeopathy. This was copied into the London Homoeopathic Review.

Mention of it was also made in the American Homoeopathic Review. Some western physicians have used it, and given the results in the Investigator or Observer. It is undoubtedly a remedy of very great value in catarrhal difficulties. The committee desire to call your attention especially to this remedy, and to urge members of the society to prove it on themselves and others. Dr. Robinson has had some very pleasing results from its use, and perhaps by proper solicitation he might be induced to give the results of his valuable experience.

Another remedy of special importance in catarrh is Kali. hyd. Dr. Robinson, Jr. being the special champion of this valuable medicine, we shall only point you to him as a source of information on which you can draw at sight, and the draft will not be dishonored.