Leaders in Typhoid Fever by Eugene Beauharnais Nash, M. D.

Leaders in Typhoid Fever.

by Eugene Beauharnais Nash, M.
D.
Presented by

LEADERS IN TYPHOID FEVER.

     If there is any one
disease which more than another cannot be prescribed for by name, it is
this one. No disease is more varied in its symptoms during its
inception, invasion, and course, and none more liable to spend its force
in different localities in the subject. In one case the cerebral and
nervous symptoms will greatly predominate so as to take the form of
typhus cerebralis ; in another, in the abdomen (Typhus
abdominalis), and in still others, in the lungs and bronchi (Typhus
pneumalis or Pneumo-typhus). Not only this, but during the course of any
single case the form may change so as to assume these different
manifestations. So in writing of the therapeutics of typhus we cannot
arbitrarily divide the remedies into classes, but give the indications
for their use in one or all forms according to symptomatic indications.
Nevertheless there are certain remedies that are generally adapted to
the first, second and third weeks, or stages, of the disease that it is
well to recognize. To simply give a list of symptomatic indications
beginning with Aconite and ending with Zincum is liable to be very
confusing to the beginner, and he will have to take the time and have
the experience to find out what the older practitioner might have told
him at the start. We went over that route once and found it a “hard
road to travel.”

REMEDIES IN THE BEGINNING OF A CASE.

     Every case must have
its beginning, and if the symptoms during the

prodromic
stage
are closely watched, and the homśopathic remedy properly applied, my
word for it, very few cases need go on to a course
of fever.

     This is one place where
the homśopathic treatment is superior to the old methods, for we may

treat
the patient before the disease may be
certainly pronounced a confirmed case of typhoid or some such unwelcome
diagnosis. I know we are sometimes charged with treating such cases and claiming
to have “broken up” a fever, and it is not impossible that
mistakes along that line have been made ; but I submit that an old
practitioner of abundant experience treating cases during a prevailing
epidemic of the disease, would have to be given credit for knowing
something of the case he was treating before it had reached the point
where all the most serious diagnostic indications were developed, and be
reasonably sure he had “aborted” a case, which some, claim to
be impossible. Those who claim to treat disease by name, with diagnosis
fully established, must, to be consistent, wait until the time for
preventing the disease is past. No wonder they claim that typhoid cannot
be aborted. Such proceeding would be criminal with the homśopathist. In
our indications for remedies we will follow out our own experience in
the treatment of the disease, prodroma
and all. Forty years ago if asked from our knowledge of remedies what
were the remedies most likely to be needed in this (the prodromic)
stage, we would have answered Bryonia,
Nux vomica, Thus toxicod., Pulsatilla
and Belladonna.
It is different now, for there are two remedies that are oftener
indicated than any of those named and which must be added, viz. : Gelsemium
and Baptisia.

INDICATIONS FOR BRYONIA, GELSEMIUM AND BAPTISIA.

     Of the three,

Bryonia,
Gelsemium and Baptisia,
I cannot decide which is oftenest indicated in this stage. The symptoms
which may be called “leaders” indicating Bryonia
are : Great
lassitude or weakness. Pains in head, back and limbs, agg. on
moving ; white-coated tongue, dry parched lips and mouth, without
or with thirst for water in large quantities at a time ; loss of
appetite, empty eructations and constipation ; with restless sleep,
which is accompanied by dreams of business, tiring him out, and
particularly when the patient does not want to
move,
as all his bad feelings
are greatly
aggravated by
it. One very characteristic symptom often but no always present is that
the patient gets sick
and faint when rising up from lying down.
Many cases begin with this array of symptoms, and my custom is to
dissolve a few pellets of Bryonia 30th in two-thirds glass cold water
and give dessert-spoonful doses once in two hours for three or four
doses, and then wait for twenty-four hours. If there is amelioration at
the end of that time I continue sac. lac. as long as improvement
continues, and seldom have to repeat it or change the remedy. It cures,
and that is the end of it.

     Now the indications for

Gelsemium : Extreme
muscular and nervous prostration, with
general trembling
as a consequence. He wants to lie down, he feels so
weak. If he attempts to walk the legs
tremble, or the hands
tremble if he attempts to lift
them ; the tongue
trembles when he attempts to protrude
it ; the pulse becomes weak and slow, but is accelerated on the
least motion ; there is some chilliness, hands and feet cool, while
there is crimson flushing
of the face ; inclination to drowsiness, or sleeps frequently, with
incoherent muttering ; head feels “big as a bushel,” with
vertigo and dimness of vision ; tongue slightly coated, or not at
all ; speech thick, because the tongue, like all the rest of the
muscles, “refuses to obey the will” from sheer inability, or
from weakness, to do so. There is generally little or no thirst, no
constipation or diarrhśa, and at this early stage, no stomach or bowel
symptoms, unless it be, in some cases, the same sense of weakness
(sometimes expressed as goneness)
which is felt in general. Drooping
of the eyelids is very characteristic
and in keeping with the general
prostration. Now this is the picture of
a case which, if not helped out with Gelsemium,
will surely go on to the lowest form of typhoid fever, and many are the
cases that have been relieved and cured by me. Many patients have told
me voluntarily that the effect of that medicine was wonderful. It sent a
pleasurable thrill through their whole system and seemed to lift them
right out of that prostration. This may seem to some like painting it
too strongly, but having felt the same sensation in myself I cannot
doubt it.

     As to dose, I have
received the same testimonial from the use of the 200th, 30th and the
tincture, the latter two drops in the usual two-thirds glass cold water,
dessert-spoonful doses. When the effect is apparent always stop the
remedy and give sac. lac. as long as reaction continues.

     Baptisia

.
Great prostration and soreness as if bruised in whatever position the
patient lies ; the
parts rested upon feel sore and bruised.
(Arnica.)
Stupor ; falls asleep while being spoken to, or in the midst of his
answer ; face flushed, dusky, dark red, with a stupid,
besotted, drunken expression. Tongue
coated with a well-defined streak down the middle, at first white, but
very soon turns brown, with red edges. Sometimes the tongue is large and
flabby, with a red dry tip, but not distinctly triangular like Rhus
tox. Exhalations and discharges early
become fetid, and
offensive breath, stool, urine and
perspiration. Nervous,
cannot get to sleep because she cannot get herself together ; feels
scattered about, tosses around to get herself together.

     This is a picture of a
rapidly advancing case of abdominal typhoid. The diarrhśa and
decomposition of fluids set in early and progress rapidly, and if not
speedily checked by

Baptisia
will come to the stage of Arsenicum,
Carbo veg. Or Muriatic
acid. We could not do much with such
cases, in the way of checking their progress, in their incipiency until
Dr. Burt gave us Baptisia.
Now we can, and have almost a sure relief in this remedy.

     Again this remedy is
like

Gelsemium,
efficacious in either the high, or low, preparations. The judgement of
the prescribe must decide in each case. So far as my own experience in
regard to dose is concerned, if I were obliges to discard all but one I
would reserve the old Hahnemannian 30th potency ; and I oftener
prescribe it here than the higher or lower, and very seldom have to
change. I think that mistakes are oftener made in the direction of too
low, oft repeated, and long continued dosage than from the other
extreme. The great majority of cases of typhus will in the beginning
come within the range of these three remedies.

DIFFERENTIATIONS BETWEEN BRYONIA, GELSEMIUM AND
BAPTISIA.

     Then it is necessary
that we understand them thoroughly, so as to apply them correctly, for a
mistake at this stage is not easily corrected later, and may prove
fatal. Let us compare a little. All three remedies have

muscular
soreness and prostration ;
but if the soreness is most prominent Baptisia
leads ; if the prostration,
Gelsemium. Gelsemium
and Baptisia
are both drowsy with red face, but with Baptisia
the mind is very clouded, with Gelsemium
not nearly so much so. Gelsemium
and Bryonia
want to lie still, and dread motion – Gelsemium
because he is so weak,
Bryonia
because his pains (especially in the head) are greatly aggravated. Bryonia
is constipated, Baptisia
diarrhśic, Gelsemium
neither. With all three the face is red. Baptisia
most so “besotted,” Gelsemium
next. Bryonia
least, and turns pale on rising or sitting up. Tendency to decomposition
comes early with Baptisia,
not so with the others. The delirium of Bryonia
is about the business of the day, Baptisia
cannot get himself together. Gelsemium
not characteristic. The tongue of Bryonia
is white, with parched
lips and thirst. With Gelsemium
the tongue is thinly coated or not at all, there is no thirst, and the
tongue trembles
when attempting to protrude it ; while Baptisia
is the only one that turns dark in a well defined streak through the
middle in this stage. The urine with Bryonia
is scanty and high colored, if changed at all, with Gelsemium
may be profuse, and with Baptisia
is scanty, dark and offensive. Other diagnostic differences between
these remedies might be added, but enough is done to show that there is
no reason for confusing them or difficulty in choosing between them.

NO ROUTINISM.

     Now let one, because I
have taken pains to set forth the indications of these three remedies,
so as to make them easily and quickly available, accuse me of a spirit
of routinism ; and let it not for a moment be supposed that I mean
to convey that any other remedy indicated by the

symptoms
must be ignored, because there are other remedies that may in some
individual case rule all these three out. For instance, if I should find
a case in which the excessive soreness and bruised feeling, complaining
of hardness of bed and prostration, and even coupled with a dark streak
through the middle of the tongue, so strongly indicating Baptisia
as above described, and the history of the case should show that the
patient had come to this state through the strain of overwork and
fatigue, I should consider and compare Arnica,
notwithstanding this remedy is not generally useful until later in the
course of ordinary fevers. Rhus
toxicodendron also will come strongly to
mind in cases arising from similar causes.

     In other cases in which
those who, during an epidemic of fevers, had come down after a long
strain of night watching and broken rest in taking care of the sick, no
remedy so helps them as

Cocculus ;
Cuprum stands
next.

PULSATILLA AND NUX VOMICA.

     Pulsatilla

.
If there is much
chilliness yet the patient cannot bear
to be in a close room,
it oppresses her ; white
tongue without thirst ; bad taste
in the mouth ; sour eructation, and especially if the menses
retard, or are suppressed ; very
greatly discouraged, or gloomy and lachrymose.

     Nux
vomica

. In the case of sedentary men who
come down with severe headache and constipation, with frequent desire
for stools, which do not satisfy, or ineffectual efforts at stool, and
especially if with very high
fever and bright red face there is constant desire to be covered, for he
is chilly if he moves or is uncovered in the least.
The patient is very nervous, sensitive and easily affected by external
impressions.

     I put these two
remedies here together because I think they belong here. The

Nux
vomica picture is predominantly found
among men ; the Pulsatilla
in women. If some should object that these are not typhoid fever
remedies, because they do not create or cause the pathological changes
that characterise a fully developed case of this disease, I answer that
any remedy having the symptoms of the patient,
even though they be only subjective symptoms, is homśopathic to the
case, and that if applied when and where it belongs the pathological
changes so characteristic may be averted. To
meet and defeat in this way disease at the very outset is one of the
chief excellencies of our art as compared with the old school of
medicine. The “practice of medicine
made easy” by prescribing the one remedy for all cases of one
(nominal) disease, without regard to the individual, or peculiar,
symptoms in the case, is simply in the line of the old mistake of Quinine
for malarious affections, Mercury
for syphilis, etc., etc. We know the result.

     It is not possible to
tell what exceptional remedy will be the indicated one in the first, or,
indeed, in any stage of typhoid fever.

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