The duty of the physician to avail himself of all possible helps to success in his practical duties, attaches no less to Homoeopathists than to the members of other schools of practice. Whatever can add to his knowledge of diseased conditions, or of the means by which these can be successfully removed, is to be the object of his diligent endeavors to obtain. He can neglect nothing as insignificant, nor reject ought because of its difficulty, if it can in any way be made to assist in crowning these endeavors with success. Among the helps to successful practice, the microscope should have a prominent place in the estimate of the practitioner who would be thoroughly furnished for the discharge of all his duties, and for the following reasons:
1. It furnishes certain knowledge in many cases, not to be obtained by other means, and on this we are able to found positive judgments, in cases where, but for this help, there would of necessity be more or less uncertainty. And who is not constantly meeting cases where uncertainty as to the condition of his patient is a pain to himself and all concerned. In many of these, the disclosures of the microscope enable the physician to say, I know, and the uncertainty is at an end. Among all the helps to our judgments there is none so sure. In cases of suspected tubercular affection of the lungs, auscultation and percussion are helps to a right understanding of the case which no one may despise and yet how many, even the most skilful in their practice, have they deceived. A proximate certainty is the utmost they can furnish to the physician or patient. It is quite different when the microscope has presented to our view the particles of broken tubercle in the expectoration. We have seen them and we know it. There is no longer any possible uncertainty in the matter. If, after such a disclosure, the patient recovers, the physician knows what has been cured. In the absence of this knowledge, those cases of recovery from conditions which, from their symptoms, have been supposed to have a basis of tubercle, must be open to the suspicion that they were something less important, from the fact that the patients recovered, which tubercular cases so seldom do, And yet even these do sometimes. And how our courage for the future dealing with this fearful enemy would be increased if we could say of any given case or cases, it was tubercle, I saw it!
So of another class of cases no. less to be dreaded. If, in the reported cures of cancer, it could be stated that the microscope had revealed the fearful cancer cell in the secretions, or in the removed mass, where this has been excised, with what difference of confidence these could be received. In the absence of this knowledge such cases must always be the subjects of more or less doubt.
It happened to the writer, a few years ago, before he was owner of this instrument, to be applied to by a gentleman of wealth from a neighboring State, for the treatment of an open sore on his under lip of more than a year standing. It had all the appearances of a cancerous ulceration, and such it had been declared to be by the best surgeons of our large cities. He came to New York for the purpose of having that part of his lip removed by the knife. He met a friend who suggested that perhaps it might be cured without cutting, and by the advice of his friend he called to enquire if it could be done. The case looked unpromising. But the thought that if the treatment failed it could be cut as well afterwards, decided the patient to make the trial. It was perfectly successful, and this success will always suggest a doubt of the malignant nature of the sore. If the microscope had been used, an accurate report of the case might have been made an increase of our positive knowledge of the curability of cancer. As it is, all we know is a sore on the lip of this man, called a cancer by men of eminence and skill, was cured in a few weeks, by a few powders, and that to this time, now more than six years, there has been no return of the sore. This is all we ever can know.
2. The instrument is of the greatest service in another class of cases. In illustration take the following: A clergyman who had been for some months performing exhausting labors, while at the same time, from circumstances he could not control, he had been subject to great anxieties, till he was at last compelled to retire from his pulpit, in great depression of body and mind. A violent pain in the loins had convinced him that his kidneys were seriously if not fatally diseased. To be sure, the ordinary inspection of the urine found no evidence to confirm this impression, but this did not relieve the apprehensions of the good man, and his depression of spirits, and of the vital forces, were much increased by them. An inspection by the microscope demonstrated the falsehood of his impression, and this serious obstacle to his recovery was at once taken out of the way. It was thus made possible to say to this man, we know positively that your kidneys are not diseased, and these are the reasons for this assurance. These he could be made to comprehend, and his convalescence was no longer a difficulty. Every physician will at once appreciate the comfort and advantage of this assurance to both the patient and prescriber.
The microscope sometimes reveals a danger before it can be perceived by ordinary methods of investigation, and its removal is possible, or even easy, when, if not so early recognized and met with proper remedies, this might have been more difficult or impossible. In illustration: The writer was called on to prescribe for a little girl who had, as represented by the mother, the same symptoms as her brother who died of hydrocephalus. There was vomiting, pain in the head, intolerance of light, constant sleeping when not disturbed, peevish temper, slight fever, etc. The patient was prescribed for, and seen next morning, when she was found with the skin of a bright orange color, slight fever, loss of appetite, listlessness, wants to lie down, urine of dark brown color when undisturbed, when shaken the color on the sides of the vessel was a bright yellow, the feces were scanty and clay colored, in short, the little patient showed the ordinary symptoms of acute jaundice. It was a good opportunity for the young gentlemen in my office to study the microscopic appearances of bile in the urine. With this in view a specimen was taken to them and examined. The results were surprising. In addition to the bile found in the urine of jaundiced patients, there was abundant evidence of serious affection of the kidneys, which had not been at all suspected, no symptom of the case having in the least suggested these organs as suffering in the slightest degree. There were tube casts, epithelial scales and blood discs in abundance. Here was positive evidence of a serious lesion, which had been entirely masked, and wholly unsuspected. By this timely revelation of the evil it was possible to effect its entire and speedy removal. It might have been quite otherwise, and certainly more difficult, if the renal affection had been unrecognized till the more complete development of the malady which these microscopic appearances disclosed.
These instances may suffice to indicate the kind of help the microscope can bring to our practice, and to indicate the class of cases in which its employment is more useful and necessary. The number might easily be increased, to an almost unlimited extent, and the field of its usefulness be shown to be even far greater than these few instances may indicate, but the object of the present paper is rather to suggest the importance of this help to the physician, than to attempt an elaborate exposition of the sphere of its usefulness. If this suggestion be so impressed on our readers as to call their attention to the advantages they may gain from the use of the microscope, the end for which these observations are made is secured.
“But,” it has often been asked, “can the microscope be made to point out the true remedy in a given case of disease?” After reading the above remarks it can hardly be necessary to reply, of course not. In this it stands on the same ground as the other helps — auscultation, percussion, etc. In this connection, however, it may not be wholly unprofitable to remember that the “finding of the right remedy,” however important this may be, and it is not in any wise to be lightly estimated, does not include the whole duty of the physician. He has other and most important functions to discharge as well, and without which, sometimes, there is no “right remedy to be found.” In the case of the clergyman it will be doubted whether any drug could have effected a curative impression, however carefully selected, till his unfounded and withering apprehension could be removed, and for this no mere didactic expressions of judgment could suffice. The demonstration was required, and to this he yielded. It is submitted that the satisfaction derived from the results of even a few such cases will amply repay any physician for the outlay of the cost of his microscope, and of the labor and trouble of acquiring the skill requisite to its ready use.
|The American Homoeopathic Review Vol. 04 No. 05, 1863, page 193-197
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