The articles on Lachesis in the June and July number of this REVIEW, by Drs. Lippe and Dunham, should not fail to call forth the dormant interest of Homoeopathists regarding the important questions involved in the “to be or not to be” of Lachesis as a remedy in disease. There are numerous points of controversy yet earnestly engaging the argumentative faculties of the adherents of Homoeopathy. The study of the relation of curative agents to disease, the endeavors to discover the true nature of curative actions, and the contest existing between the advocates of low, high and highest potencies, continue with unabated zeal as of old.
In bringing up Lachesis for discussion, some new questions arise as yet but little commented upon. We have not yet decided where low potencies end and where high ones begin; we have not yet determined at which point and in which scale of potentization, medicines are most efficacious or absolutely preferable, and now in the midst of these gigantic problems comes another; can a poison obtained and offered for use as a medicine thirty years ago, and not since renewed, still retain its full efficacy? An animal poison, which if introduced into the skin produces immediate fatal results, but which, taken into the stomach, has been and still is believed by many to be Harmless.
It appears that the difficulty of solving this question theoretically has led many practitioners to reject Lachesis as a remedy altogether, while, on the other hand, numerous drugs, scarcely proved and known only in connection with certain names of diseases, are daily pressed into service.
For my part I have used Lach. like any other well-proved remedy, whenever it appeared to possess a homoeopathic relation to the disease. I naturally shared with others the doubts arid misgivings so often expressed regarding Lachesis, but since its name was intimately associated with my earliest knowledge of Homoeopathy, I continue to use it in order that it should speak for itself. The following cases treated with Lachesis, considered alone and unsupported by the experience of others, may prove nothing to those who reject every thing as impossible to which they can not apply a theory. But I have no doubt that if the beginning is once made, others may add new experiences and finally counteract theoretical opposition.
The Lachesis used by me was obtained from the original solution of a portion of the third trituration of Lachesis poison, given by Dr. C. Hering to my uncle, the late Dr. William Wesselhoeft, of Boston. From a drop of this solution I prepared the thirtieth dilution, which I have now used exclusively for six years. I am far from recommending the Lachesis on account of its age, for L should infinitely have preferred a fresh preparation.
CASE I. January 19th, 1859, I was called to visit Carrie P., a child 5 years old, dark straight hair and blue eyes, who was afflicted in her second year with caries of the dorsal vertebrae, resulting in great distortion of the spinal column and thorax, in a manner rendering the development of the respiratory organs very imperfect, leaving the patient feeble though of bright intellect. She had been much petted and indulged in every respect, but enjoyed tolerable health for a year past. Since two weeks previous to above date, she had paralysis of both legs, losing entire control of them, being unable to stand or move the legs with the exception of an occasional involuntary drawing up of the toes. I could not account for this condition satisfactorily, since it did not appear dependent on a further vertebral distortion, but attributed it to the effect of exposure during the very inclement weather. Her parents were in the habit of taking her to ride in all weathers, on one of which occasions she became chilled. The patient coughed during the day, but particularly at night on going to bed; but sleeps well otherwise; appetite good; much thirst, during meals, and drinks much at a time. Complains of pain in the spine, and lies only on her back at night.
Up to February 2d I bad made use of Rhus, Cocculus, Sulphur and Bryonia, giving one remedy at a time in one or two doses at long intervals, but without any decided benefit; all the symptoms remaining the same up to the above-named date, when I was summoned to prescribe for the following conditions:
The cough, hitherto slight, had become severe, and was accompanied by much wheezing and rattling of mucus in the air passages. This had begun in the night accompanied by febrile excitement and thirst. Respiration was feeble and difficult, with blueness of the face; each coughing turn produced perspiration; expectoration was impossible and sleep at night much interrupted.
Up to the 6th of February I made use of Ipecac., Ars., Merc. viv. without any perceptible benefit to the child. The parents were discouraged and I saw little prospect of success before me, when I considered the deplorable physical conformation of the patient. Having been driven to resort to remedies in rapid succession, and cramped in time, I hastily reviewed the leading symptoms, such as the cyanotic appearance of the face with difficult respiration and inability to expectorate; the thirst and the paralysis of the legs which continued as before. Imperfect as the indications were for Lachesis, I prescribed that remedy in two doses of the thirtieth dilution, one to be given in the morning and the other at night.
February 8th. I found a marked improvement; cough sill continued but almost without dyspnea. The thirst for cold water I found to my surprise almost abated; sleep at night was little disturbed; at the same time the girl was able to move her legs quite freely and complained of pain in the feet, which I hailed as a rather favorable sign. I gave no more medicine but visited her on the 10th of February, when I was assured that she was as well now as usual, with the exception of muscular weakness. The parents of the patient proposed to start at once on a journey South, against which I protested without effect, but which subsequently proved to have been of much benefit.
CASE II. Mr. W., a wealthy farmer of this neighborhood, came to me on the 23d of April, 1860, saying that he had been told that my medicine “was good for bilious headache,” having relieved a friend of his, on the strength of which fact, he wanted “some of the same stuff to cure his bilious headache.” For sometime I nearly gave up the hope of eliciting any proper information from the man, who persisted in the assertion that he was bilious, and did not see why I wanted to know more, supposing it the simplest thing under the sun for me to hand him a “a parcel of stuff good for biliousness.” At length I gained the following history from this indurated specimen of allopathic conservatism, on whom old school physicians had repeatedly tried their skill without success.
The patient was at that time 60 years old, measuring six feet in height, of straight athletic frame, with blue eyes, a broad full chest and stentorian voice. He labored on his farm from morning till night, and could endure more fatigue than many a younger man, except when his headache came on, besides which he never had any sickness. This headache had troubled him ever since he was six years old, appearing every eight or ten days. The pain habitually began toward evening in the back of his head, at first dull and gradually concentrating with an acute boring sensation behind the left ear, apparently at the juncture of the temporal, parietal and occipital bones. When the boring pain reached its height, generally toward morning, vomiting of food and slime supervened, accompanied by stitches in the chest, which, lasting for some hours, generally ended the attack, whereupon ho felt sleepy and exhausted. Sound sleep and quiet through the rest of the day restored him to his normal condition. In all other respects the man was perfectly well. His diet was nutritious and his habits regular. As far as I could ascertain he used no liquor, but indulged in, a number of poor cigars daily, took coffee in the morning and tea at night.
I could give my friend but little encouragement in a complaint of such long duration; but finding him in earnest, I concluded to satisfy him by prescribing something. I gave Lachesis30, four doses in globules, one dose to be taken every other day, followed by Sacch. lact. to last him some time. I purposely made no change in his diet.
July 30th. Up to this date the patient had not reported to me. I was much pleased and astonished to find him quite enthusiastic on account of the improvement in his health. Since taking the first set of powders he had no vomiting at all, and feels that his headache has changed its character entirely, coming in the morning instead of the evening at intervals of two or three weeks, and lasting only through the forenoon without interfering with his work, the exercise of which makes him feel better; while formerly he was obliged to keep in bed and rest for nearly twenty-four hours before he could attend to his business again.
September 11th, 1861. I made the following memorandum: Patient had no headache nor vomiting all summer, until yesterday (September 10th), when he was obliged to Stand in the water up to his knees for three hours while getting in his salt hay from the marsh, exerting himself in an unusual degree for a man of his age; whereupon he had an attack of the old pain and vomiting during the night. Though Rhus and Calcarea were strongly indicated, I gave one dose of Lachesis.
November 2d. Patient reports that since the day he last called, he had suffered repeatedly from headache coming on at night and lasting till morning; but vomiting occurred only two or three times for the last two months. Prescribed Lachesis200 (Lehrmann's preparation) one dose.
March 11th, 1862. The patient came to say that he felt considerably better; that he still had occasional returns of pain of a dull rheumatic kind, but that the real sick headache had not returned since taking the last medicine. The result of the treatment was quite satisfactory, since he had not expected so much benefit. In his own words he considered himself “two-thirds cured.” The attacks of pain now occurred only at long intervals, sometimes not for several months, when he would be troubled for a few days with slight occipital pain in the morning, lasting until after breakfast, when it left him well all the rest of the day. Prescribed Nux vom200 in two doses, to be taken for two successive nights, which was the last medicine I gave him.
September 9th, 1863. I called on Mr. L. to enquire it any change had taken place. He says he had no sick headache at all since he took the last medicine. As he grows older, he cannot endure the exposure of his occupation as well as formerly. Making hay on the salt marshes late in the season, and driving an open wagon in all weathers, produces occasional rheumatic pains in his joints, particularly the elbows after pitching off heavy loads of hay. Sometimes these pains extend to the back of his head, where he feels them mostly in the morning, but leaving him entirely after break-fast, when he begins active work.
CASE III. May 17th, 1861, I was called to attend David E., a boy 16 years old, son of parents in affluent circumstances, naturally strong and active, red hair, dark eyes, freckled complexion. I found him in bed, complaining since the day previous of acute cutting, stinging pains, radiating from the navel over the upper portion of the abdomen, rendered excruciating by the slightest touch, as well as by motion, with tympanitic distension of abdomen. There was headache, particularly on moving the head; much thirst, dry heat of the skin, constipation, pulse hard, though not remarkably frequent; the entire symptoms indicating a marked case of peritonitis. I prescribed Aconite'30 in water, a teaspoonful to be given every three hours.
At my visit that evening, I found the patient in much the same condition as the morning and complaining of pain on deep inspiration. I left Bryonia 30 to be used instead of Aconite, in case there should be no improvement during the night.
May 19th. Abdominal pain more severe than yesterday; the patient lies on his back only, and describes it as cutting and gnawing, but has some appetite and much thirst. Tongue is dry with brown coating in the centre; constipation continues; the aggravation of the pain and general discomfort takes place in the afternoon and evening. The pain is increased by every motion of the body. Lachesis30 in water, a teaspoonful every three hours.
May 20th. Patient says that his pain lessened in the night, allowing: tranquil sleep, followed by decided improvement in the morning; he feels no pain when keeping quiet, neither does motion cause its return; still there is considerable sensitiveness on being touched. Continued Lachesis every four hours.
May 21st Pain still less than on the previous day, and now very slight; patient can bear considerable pressure upon abdomen by the hand, and can change his position and move in bed without any pain, while just previous to the exhibition of Lachesis the mere approach of the hand toward his abdomen caused him to shrink. Nevertheless there was rather more hardness and tympanitic distention (Lachesis aggravation across the epigastrium). I hesitated to prescribe another remedy, since the patient was evidently out of danger and quite cheerful; but finally decided to give Belladonna in water, every four hours.
May 22d. I found the tympanitic distention reduced to a slight degree and, what remained of slight pain, limited to a small spot near the navel. The costiveness, indicating a participation of the intestines in the inflammation, still remained. For this I prescribed two doses of Nux vom.30, after which no more medicine was needed, the bowels moving soon afterwards, and on the 28th the boy was well enough to go about out of the doors.
CASE IV. On the 20th of August, 1862, I was called to attend Mrs. P., a lady about 30 years of age, who after three abortions had now reached the eighth month of pregnancy, during which time he had enjoyed much better health than for years before. She is of stature rather below medium height, of dark complexion, straight black hair, and, like other members of the family, subject to swelling of the glands and inclined to morbid discharges from the mucous membranes. I found her suffering from a pustular eruption of the back, legs and particularly about the ankles, consisting of isolated pustules, rapidly filled with sero-purulent matter and surrounded by an inflamed halo. The pustules varied from the size of a pea to that of a five cent piece; these soon dried into dark hard scabs, which were easily knocked off by accidental friction or scratching, leaving red moist surfaces extremely sensitive to contact with the atmosphere or bed-clothes. The itching was intense, almost driving the patient to distraction, mostly during the night and also by paroxysms in the day time; often changing into a severe burning stinging sensation, so that she could not refrain from tearing her skin with the finger nails. Aside from these symptoms the legs and feet were so painful that standing or walking was out of the question; at the same time she found it impossible to keep the limbs quiet in the warmth of the bed. The pustules continued to come in small crops, so the skin was dotted at the same time with incipient pustules, numerous old scabs and denuded ulcerating spots. Many of the scabs were encircled by a rim of detached cuticle, enclosing a quantity of purulent serum.
I was at first undecided whether to class this affection as Rupia (or Rhypia) or Ecthyma, to which latter form, however, I thought it to have most resemblance, since I could not distinguish any bullae, said to characterize the former species. The pustules, in this case, were rather conical in shape, and difficult to observe owing to their rapid degeneration into scabs and ulcers. Little importance, however, should be attached to names of these diseases, since they do hardly more than to point to large classes of remedies, which, after all, can only be selected according to the most prominent subjective and objective symptoms.
From the 20th of August to the 30th of September, I used Lachesis, Rhus, Thuja and Arsen., without permanent benefit. Rhus, administered on the 27th of August, was followed by a perceptible improvement, lasting only about two days. Arsen.30 failed to have any effect, while the tenth dilution of the same remedy produced so much improvement that the patient was able to stand, walk without pain and to take a drive. For nearly a week I considered the case as cured, but my hopes proved to be unfounded, the eruption having gradually increased again up to the 20th of September, when I found it present in full force in spite of a repetition of Arsen.10 I found the patient complaining much; some new pustules had appeared; at the same time many of the older ulcers and scabs were surrounded by a blue halo. The veins of the legs, much enlarged in consequence of the existing pregnancy, appeared usually blue and knotty, giving to numerous sore places almost the appearance of incipient gangrene. Itching, burning and stinging pains had also set in again with their former severity. Lachesis30, in three doses, to be taken morning and night.
September 24th. There is a decided improvement, exceeding that of any previous occasion. During the past four days the eruption was almost entirely dried up, and was now leaving the skin to assume a healthy appearance. The patient now enjoyed her nights' rest, could move her limbs and bear her weight upon her feet without any suffering, though subjected to the severest test, occasioned by the illness of one of the children at this time with inflammatory rheumatism, requiring constant watching and physical exertion on the part of the mother, who continued quite well and equal to her task. On the 15th of October, she gave birth to a healthy well developed child.
Though the description of this case might properly be concluded at this point as tar as Lachesis is concerned, there is still a sequel worthy of a few remarks. Visiting the patient on the 31st of October, I learned that she had suffered repeated attacks of a popular, itching eruption, which was now so troublesome that it became necessary to rid her of it by medicine, since it evinced no disposition to depart of its own accord. Examining the humour carefully, I found it to consist of numerous elevated nodules of a whitish appearance, surrounded by a red halo; these were scattered over the whole body and itched intolerably, subsiding somewhat in the day time but reappearing at night, disturbing sleep. These symptoms I found corresponding to Antim. crud., of which I gave three doses of the thirtieth dilution, a dose to be taken every night and morning. The result was an almost immediate relief; the eruption disappeared after taking the second dose, and did not appear again, the patient enjoying comfortable sleep every subsequent night.
The variety of forms assumed by the disease, led me to consider it worthy of a minute description. I claim for Lachesis the cure of the ecthyma with as much justice as relief can be attributed to the use of any remedy ever applied in disease. The subsequent appearance of the popular eruption, popularly known as nettle-rash, proves the protean character of skin diseases. It appears that a severe variety of skin diseases may pass into a milder form before finally leaving the organism in a healthy condition; but the transition was in this instance undoubtedly achieved by the specific influence of Lachesis.
CASE V. On the 27th of October, 1862, Mr. Alfred T. came to consult me on account of chronic irritability of the faces. The patient is of medium height, 25 years of age, of a healthy family; of fair complexion, muscular and accustomed to out-door exercise and horse-back riding; hair dark, eyes blue. This young man had been afflicted for nearly a year with an irritable condition of the faces of which he took but little notice for several months, but the disease gradually increased to such a state that its effects became very apparent to his friends, who advised him to consult a physician. Upon examination I found the uvula elongated to such an extent that in its most contracted state it would touch the tongue. The mucous membrane covering the uvula, appeared hypertrophied into an elongation, extending about a quarter of an inch beyond the muscular structure, creating a constant inclination to hawk and scrape the throat, thereby exciting the mucous Secretion, which in its turn increased the efforts to clear the throat. The faces appeared redder than in health, or rather of a purplish hue; the tonsils were but slightly enlarged. The patient, whom I had known well for several years, had become visibly emaciated, his countenance was pale and wore an anxious haggard expression; night sleeps was interrupted, appetite and strength were impaired, all of which he attributed to the constant hacking and coughing produced by the irritability of the faces, now extending to the larynx and trachea. Besides this I could not discover any disease of the respiratory organs. In addition to the above symptoms there was a feeling as if the parts were swollen, some soreness on swallowing, and a frequent sensation as if a small crumb had got lodged in the throat, which it was impossible to remove by coughing. Prescribed Lachesis20 three doses of a few pellets each, one to be taken every night and moraine.
I saw the patient again ten days after he had taken the medicine. Upon examination I found the throat almost well; the purple hue had nearly disappeared; the uvula no longer touched the tongue, nor adhered to the sides of the tonsils as before; the hacking cough had subsided. I prescribed two more doses of Lach., soon after which the patient recovered completely and has continued so up to the present time.
CASE VI. Mr. C. H. consulted me on the 20th of May, 1863. The patient is 22 years old, married, of very fair complexion, with light hair, blue eyes and excellent teeth. He had served as adjutant during fourteen months in one of the volunteer regiments sent from this State, but was obliged to leave the service on account of ill health. At the time of his first interview with me, he complained of certain throat and chest symptoms, such as hoarseness and soreness of the chest, which he had contracted while camping in the open air during wet and cold nights. I prescribed Carbo veg. and subsequently Phos., after which he improved somewhat; but on the 17th of June, certain aggravations occurred leading to the following disclosures: In the autumn of last year, this patient had contracted a chancre on the penis, which was promptly suppressed by repeated doses of calomel. Though his health was not good after this scientific treatment, he continued in the military service for some time longer before given up fairly; but the secondary symptoms of the suppressed venereal disease soon began to appear. For months previous to seeing me, he had observed upon his fore-arms a brownish red exanthematous eruption, consisting of numerous nodules and blotches, slightly itching and rather painful to the touch. More recently his legs, from the knees downward, began to be covered with purplish and blueish-black circular spots, varying from the size of a pea to that of a five cent piece; very painful to the touch, at the same time the entire lower portion of the legs pained him as if they were severely bruised.
Up to the above date he had been able to attend to his business in the city, riding there and back in the horse-cars; but soon the increased severity of his disease obliged him to stay at home. He feels pretty well until ten, a.m., then his head becomes hot, and perspiration breaks out after the least exertion; there is but little thirst; after a short paroxysm of chills the pulse rises to 112 beats per minute; appetite ceases after the first mouthful of food; complains of febrile heat, with restlessness all night, abating about three o'clock in the morning. Dull rheumatic pains in the right knee and the calves of the legs, rendering standing and walking very difficult; the pain ceases for a time while sitting but soon returns. Since the eruption appeared, he suffers less with headache than formerly. There is considerable pain in the faces during deglutition; talking causes his throat to ache; the left parotid gland is enlarged. Ocular inspection of the throat reveals only slight vascular redness of the faces and some enlargement of the tonsils; there is expectoration of yellow mucus without cough, particularly in the morning, accompanied by dyspnea. The patient is so feeble that the least exercise produces complete exhaustion, causing him to lie down most of the time. Prescribed Bryonia30 in a glass of water, to be taken four times a day.
On the 21st of June, the patient reports relief. The chills and heat do not set in until four o'clock, p.m., lasting until seven, after which he sleeps comfortably; the pain in the knees is gone, but continues unabated in the calves of the legs. For two days he has been troubled with frequent micturition, urine limped and pale. The head is hot, while the hands and feet are cold; little thirst. Prescribed China20 in water, every three hours for two days.
June 23d. The fever which Bryonia had moderated, was completely subdued by the China, the frequency of pulse and temperature of the skin were normal, but the red nodular eruption on the arms, and the blue spots on the legs were more apparent than ever. The pain was excruciating in the knees and calves, the latter feeling quite hard to the touch; an attempt to bend one of the knees caused the patient to cry out; by a great effort he could just hobble over the floor with the aid of a cane. His perspiration emitted an odor like that of putrescent urine, his breath was likewise very offensive; sleeps all night but is restless; prostration after slight exertion and desire to lie down are prominent symptoms.
There is no doubt in my mind that this was a syphilitic exanthema. The fact that the eruption on the arms differed in appearance from that on the legs, rather corroborates the supposition. I have every reason to believe that the patient during his illness while in the army had been treated liberally to Quinine, besides the Mercury, which produced this peculiar variety of syphilitic affection. The febrile symptoms undoubtedly were connected with the skin disease, but hardly constituted an eruptive fever, since the nodules and spots had been present for months without any febrile aggravation to my knowledge. I prescribed Lachesis in three doses, one to be taken every night and morning.
It was during the warm fine weather, with an unusual degree of moisture in the atmosphere; the previous abuse of Mercury, the peculiarity of the rheumatic pains, with prostration and easy perspiration, and the nodules on the forearms all pointed to Lachesis, as well as the peculiar or blueish black color of the spots on the legs, which had served as a chief indication in the case of ecthyma above narrated.
June 26th. I find only this brief notice in my memorandum book; The patient is much better in every respect; has very little pain in the legs, walks briskly across the room without lameness; erythematous spots on arms and legs are vanishing; appetite much improved; his countenance looks fresh and animated. No medicine.
July 1st. Patient has no more pain; spots have entirely vanished: feels very well indeed, and is anxious to go about his business as a clerk in a Government office. Almost three months have elapsed since that time, and the patient has been perfectly well ever since and is anxious to join the army again.
CASE VII. Mrs. P., the same patient whom I had treated for ecthyma, as described in case four, was delivered on the 15th of October, 1862, of a healthy female child, after a natural labor of short duration. She had borne four children previously at the full period of gestation, but had suffered three miscarriages at about the third month of pregnancy, previous to her last confinement. She had scarcely been able to nurse any of her children owing to the want of milk, the secretion of which generally subsided completely after the second or third week; whereupon she was obliged to resort to the nursing bottle. Attributing this deficiency of milk to the habit of her former Allopathic physician and nurses of deluging her for weeks with odious concoctions, very properly known as slops, of which, she was urged to imbibe huge bowl-fulls, including quantities of tea, for the purpose of “making milk.” I substituted a more nutritious diet at the end of ten days or so after her confinement, passing gradually from light gruel to bread and butter and light cocoa, good beef and mutton broth, and eventually tender roasted meats with vegetables, allowing cold well water, and only two or three cups daily of warm infusion of the roasted and cracked cocoa beans. By these means and the occasional use of Puls. or Calcarea carb. the patient was enabled to nurse her child for six months, after which time the milk, though still secreted in moderate quantity, became thin and did not afford sufficient nourishment for the vigorous child, which was then weaned and accustomed to pure cow's milk.
On the 17th of June, 1863, the mother consulted me on account of the following symptoms: The menses had not returned although the child had been weaned for nearly three months; severe aching in the small of the back; every two or three days she had acute colicky pains low in the abdomen, resembling labor pains, attacking her unexpectedly at various times of the day. These had been her chief complaints from the time of her confinement, and were apt to be produced by eating; (nearly five months ago these pains were relieved completely by Phos.200 and did not return until she weaned her child). Besides these cramp-like-cutting pains in the bowels, there was a hard aching pain, distinctly referable to the uterus, which was not the case with the other distress. Appetite very variable, either strong or wanting; frequent sinking, fluttering feeling in the epigastrium. The bowels were moved every day, but the stools were quite loose. For a number of weeks she complained of great sleepiness, the ordinary amount of sleep did not satisfy her, so that she felt a constant inclination to lie down. Sleep in the day time aggravated the abdominal pains. I gave Lachesis, a few pellets to be taken for two successive nights.
June 24th. Since taking Lachesis she had no more abdominal pains, and now feels bright and happy on account of the relief from her distress, yet the other symptoms remained I, therefore, prescribed two more doses of Lachesis to be taken as above,
June 26th. The menses appeared without any inconvenience, but rather profusely; the back ache and sleepiness subsided, and the appetite became quite normal, the regular meals being much enjoyed by the patient.
The rather unusually protracted absence of the menses regarded in connection with the unnutritious milk, the colicky pains with loose discharges, sleepiness, aggravation by sleep, etc., certainly pointed out Lachesis as a remedy, and I was quite satisfied with the result.
|The American Homoeopathic Review Vol. 04 No. 05-06, 1863, pages 205-210, pages 269-279
|Clinical Observations on Lachesis.
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