– American Institute of Homoeopathy, 65th Session, 1910,
A Comparative Study of a Few of the Complementary Remedies Necessary to Cure After Pulsatilla Has Been Well Indicated and Properly Administered
Dd cycl., echi., kali-s., lac-c., puls., stann.
The study of Pulsatilla and a few complementary remedies will be of greater interest and far more useful to the trained physician, the Hahnemannian homoeopath, than to those who substitute one or more varieties of the palliative practice so common in modern medicine.
The allopath, or the so-called homoeopath, who prescribes like the allopath, will see little or nothing, in this paper, of value.
The eclectic, or the homoeopath who treats his cases like the eclectic, may also be unable to appreciate the fundamental truth so important in this discussion.
The surgeon, the X-ray-electro-specialist, the osteopath, or the eye, ear, nose and throat specialists who largely give local and mechanical treatment to remove or correct malformations – the end product or results of disease – will regard this study as a “back number” and prefer something more “scientific.”
However, the doctors who really want to be homoeopaths and desire to give curative, rather than palliative treatment, by selecting the remedy best indicated in the individual case, will naturally become the most interested auditors during the next ten minutes. The remedy “best indicated” for permanent curative results must be based upon the constitutional individualizing symptoms more than upon the pathology and symptoms of the local disorders. The latter lead more often to palliation only, by the removal of disease results, while the former lead toward a cure and the removal of the causes.
Pulsatilla is a peculiar and interesting remedy. Peculiar because presenting such a diversified and contradictory pathogenesis, and interesting because when well understood it ranks high with the drugs in the homoeopathic materia medica for usefulness and curative results.
Pulsatilla, being more superficial in its action than many other medicines, will often be well indicated as the first prescription and if properly used, and not abused, as it often is, will bring prompt and pleasing results to the patient as well as the physician. However, when the constitutional condition, presented by the symptoms, shows a deeply seated disorder, whether due to a bad inheritance, an intemperate life or faulty environment, then the skill of a well trained, closely observing, homoeopathic physician is needed to select the complementary remedy required to complete the cure so well begun by Pulsatilla.
This is the place where the doctor, often thoughtlessly, brings discredit upon a good remedy, upon himself and upon Homoeopathy, by the careless remark that, “The remedy has failed.” An indicated remedy does not fail in curable cases, when its sphere and limitations are understood, but the doctor often fails by expecting a remedy to do work not warranted by its nature and pathogenesis.
Pulsatilla has been thus abused by unskillful prescribers because, when indicated in the beginning of the case, they continue to give the medicine too often, or too long, producing an aggravation, and greatly confusing rather than curing the case. To know when a remedy is indicated is of great importance, but to discontinue giving when its limitations have been reached is quite as important, especially in chronic cases.
There are many peculiar and characteristic symptoms of Pulsatilla, but in this limited paper only three will be considered.
First. – Great Sensitiveness. – Morally so sensitive that the Pulsatilla patient is easily shocked by wrongs done to a friend, a neighbor, a community, a state or a nation, by unjust treatment or legislation, hence, a large majority of the ministers, prohibitionists and socialists are Pulsatilla patients, who are so sensitive to wrong-doing that their sympathies are expressed in active reform work.
Mentally. – This same nature is full of weeping, sadness, melancholy, etc., so sensitive to personal wrongs, pain, or suffering.
Physically. – So sensitive that the tissues of affected parts cannot sustain long pressure without causing discomfort, nervousness and pain. This is why the Pulsatilla patient will not endure the clothing tight about the neck, waist, wrists or ankles and prefers to go without high collars, corsets, cuffs and high laced shoes.
Second. – The changing, wandering, diversified and often contradictory nature of the symptoms which so often puzzles the physician who sees only the pathology and tries to select a physiological remedy. Gross’s “Comparative Materia Medica” gives more comparisons with Pulsatilla than any other remedy because of this well known characteristic.
Third. – The aggravation by heat and the amelioration by cold so pronounced in the remedy; fresh cool air, cold drinks and food, cold bathing of the entire body or affected parts are demanded by the Pulsatilla patients. They make up the class most benefited by open camp life – but sometimes the reverse of this is true of Pulsatilla. There are other prominent characteristics belonging to this drug, but the above will be taken as a basis for comparison within the limitations of this paper. These characteristics form a so-called “three legged stool” for Pulsatilla in this study, and must be kept in mind while considering a few complementary remedies.
Attention will be first called to the remedies not commonly regarded as complementary to Pulsatilla leaving Lycopodium, Silica and Sulphuric acid, until later, if time permits, as they are recognized by all and well understood by most homoeopathic physicians, as sustaining such a complementary relationship. Only a passing reference can be made to each remedy which will be more suggestive than exhaustive and, I trust, be introductory to a profitable discussion.
Cyclamen is like Pulsatilla in that both are suited to anaemic and chlorotic patients, with almost identical menstrual irregularities, accompanied by similar mental states of melancholy and also mental derangement during the climatic period. Hering says. “The occurrence of these two remedies is very remarkable – want of thirst, nausea in the throat, disgust for fatty things, disagreeing of pork, sensation of fullness in internal parts, sore bruised pain in external parts, both have the same aggravation at rest and improvement when rising from a seat, when walking and from motion generally.”
Some distinctions between these two remedies are well marked. Cyclamen has more thirst: is aggravated in the open air and ameliorated being in-doors; in nearly all complaints, the opposite of Pulsatilla. Farrington says. “The Cyclamen patients suffer from a peculiar kind of debility and torpidity, both of the mind and body, with languor. They cannot think, but are better when aroused and forced to exercise.” This is true of Cyclamen in the morning, passing off through the day while Pulsatilla is commonly worse during the afternoon continuing into the night. Hering says, “Cyclamen lacks the over-sensitiveness of Pulsatilla and generally, also, the sensation of numbness in suffering parts.” Cyclamen differs in two of the characteristics previously named – great sensitiveness and the open air modality.
Stannum is a deep acting metal and is often indicated when the Pulsatilla patient is suffering from acute or chronic sore pain, especially of the chest, when the soreness spreads or extends from above downward. Instead of great sensitiveness like Pulsatilla, Stannum has intense soreness of affected parts where the tissues have been injured by inflammation or wounds. The mental state is like Pulsatilla, there being much sadness and weeping and when present, with great weakness and soreness, will cure serious chest symptoms which will not be reached by Pulsatilla. The general weakness and soreness of affected parts will often suggest Stannum, especially in the Pulsatilla patient, who is developing pneumonia or tuberculosis. The two points of difference noted are, instead of the wandering pains of Pulsatilla, there are the sore spreading pains of Stannum, and instead of the general over-sensitiveness, the soreness of the affected parts.
Lac Caninum is to be thought of in Pulsatilla patients where the changing, wandering pains in rheumatism, and kindred complaints, are only palliated by Pulsatilla – especially is this true if there is a shifting and alternating from side to side. Many of our best prescribers have observed that “Lac caninum follows Pulsatilla in rheumatism” where the characteristic wandering pains predominate.
The affected parts, like Pulsatilla, are very sensitive to touch and relieved by cold applications; thus in this remedy there is a marked degree of agreement upon all three characteristics of Pulsatilla noted in the beginning of this paper.
Kali sulphuricum, known mostly because it belongs to the group of Schussler’s remedies, is often well indicated after Pulsatilla has done good work but the chronic state of the patient has not been changed to permanent health. This medicine has two deep and long acting drugs combined and potentized together, and when suited to a chronic case it becomes remarkably curative in its action if given at long intervals in single doses. Not being a well proved drug, but having more of a clinical record, it should be used with care and caution.
Like other combined metals and minerals not thoroughly proved, much confusion in chronic cases and harm to the patient may result if given when not well indicated, or too often or for too long a time. This I learned by testing some of them myself as well as observing the effects upon others.
Dr. J. H. Clark, in his Dictionary of Materia Medica, says, “Kali sulphuricum is Schussler’s Pulsatilla.” Kent has written, “It takes up the work and finishes as a complement to Pulsatilla.”
While this newer, unproved remedy has many symptoms like Pulsatilla, perhaps the most characteristic likeness is the modality, warmth aggravates, better in the cool open air. “All complaints better in the open air.” says one authority. It also has in a more moderate degree oversensitiveness, especially to noise, with wandering sticking pains, conforming as much as any other remedy to the three selected characteristics of Pulsatilla.
However, unlike Pulsatilla, the patient is more irritable, apprehensive and anxious. Impatient, always in a hurry. Dreams of falling and of ghosts. I have been successful in a few cases where constitutional gonorrhoea, or sycosis, has been well marked, by the use of this medicine where the above symptoms predominated. For instance, the young married Pulsatilla woman who has been the victim of the young man who, after giving attention to his “wild oat” crop, had been cured of acute gonorrhoea by injections. When Pulsatilla does not cure such cases, think of Kali sulphuricum.
Thus far remedies have been considered which agree with the cold and warm modality of Pulsatilla, but other drugs having the reverse of this peculiarity are prominent complements. The Pulsatilla patient, so changeable and contradictory, as before stated, when in a condition of lowered vitality and faulty reaction becomes chilly and cold for a time, then, after the indicated remedy has prompted good reaction and the vitality has been restored, there will be a return to the original warm condition. It is not unusual for a patient under the influence of a deep acting medicine to shift back and forth in this modality for the reasons just stated and the Pulsatilla patient does this very often.
In this cold state, – a lack of reaction, – is where Lycopodium, Silicea and Sulphuric acid will be needed, according to the symptoms, to complete or advance the cure started by Pulsatilla.
If, after one of these remedies has been administered, followed by a good response, the patient changes to a warm subject, then Kali sulphuricum or some warm remedy may be needed to complete the cure. The modalities, as much, if not more, than any other part of the symptoms picture, will guide the careful prescriber in the selection of the remedy.
There is one other condition of the Pulsatilla patient calling frequently for a complementary remedy, which will meet the chronic effects of Mercury. This sensitive patient very often is made sick, or continually ill, by this enemy to the human race. Even the presence of Mercurial fillings or the pink (colored with Mercury) plate in the mouth will sometimes prevent a cure until removed and antidoted as the symptoms direct, – Hepar, Natrum sulph., Nitric acid, Lachesis, Sulphur or some known antidote to the vicious poison of Mercury may be called for by the symptoms. These are hard cases to cure and usually cannot be cured unless all Mercurial exciting causes are eliminated.
Another condition, similar to the one just mentioned, is where the Pulsatilla patient has syphilis, in the later stages and has been heroically treated with Mercurial preparations until symptoms of rheumatism, neuritis, locomotor ataxia, etc., may have developed. In these cases Mercury causes more of the complaints than syphilis, but both combined present a complication which taxes all the skill of the best prescribers. Kali iodatum, Aurum metallicum, Phytolacca and Asafoetida may be added to the list given above because of the drugging by Mercury more than the syphilis. Hahnemann observed this nearly one hundred years ago and wrote exhaustively upon the subject, the same being compiled and published in his “Lesser Writings.”
As before stated, this paper is more suggestive than exhaustive, and I fully expect the comments and the discussions to follow will add much of interest to this interesting study.
Dr. C. E. Lane, Poughkeepsie, N. Y.: The doctor speaks of great sensitiveness as being a characteristic indication, which reminds us somewhat of the hyperaesthesia of Belladonna. In a pamphlet by – – – , and in his lectures, he speaks of the keynote of Silicea as being sensitiveness. The writer speaks of sensitiveness about the neck and body. The contradictory symptoms reminds me of Echinacea. The sensitiveness to heat and cold reminds me of a patient I had in my early practice, a lady who had organic heart disease with chronic bronchitis and asthma. During one of her acute attacks she had been unable to lie down for two days. Had to sit up in bed, leaning slightly forward. Was cold and chilly, and yet she could not breathe warm air. Had to have the windows open and the room cool. Well hind sight is often better than foresight, and being in doubt as to the remedy indicated, Dr. – – – was called in consultation. The lady had been treated by one of the other professors of the New York College at that time, several remedies had been tried, and the prognosis was very unfavorable. The doctor, on looking the patient over, said, “She will get well.” I said, “What will you give her, doctor?” “Pulsatilla.” “How?” “A sixth.” “How often?” “Every two hours.” Well, she got this treatment, and nothing else. I remained with the patient and in four hours she was lying down and asleep. In a week she took a railroad trip of 80 miles, a stage trip of 5 or six, in order to reach home. The remedy was indicated in similar conditions for years after that, and with the same results.
To revert to the speaker’s paper, I was somewhat surprised that he did not speak of Echinacea in comparing remedies to Pulsatilla. I have found it very difficult, at times, to decide whether to give a patient Pulsatilla or to give Echinacea. Of course, if we take some time to look for symptoms, and if we can get a very full picture perhaps it ought not to be so hard, but, as a matter of fact, I find that it is very hard sometimes to decide between Pulsatilla and Echinacea. Both remedies have a hyper-sensitiveness. Both remedies have a hysterical condition. Of course, we realize that Pulsatilla is not a remedy for hysteria like Echinacea, but in a great many of the symptoms, in the minor symptoms, and in the picture, as a whole, I find it very hard to decide between the two remedies, especially in nervous cases, and I would be much obliged if the doctor would enlighten me a little in regard to these two remedies.
Dr. G. P. Warring, Chicago, Ill.: Mr. Chairman, I was in hopes that some one would challenge what I said, or agree with me, or, at least, discuss the question, whether Mercury produces more deep-seated chronic troubles than syphilis. I took a very positive stand, expecting that some one would challenge the statement. If there is any one present who takes exception to that statement I wish he would challenge it. If there are any present who think that Mercury itself is more harmful to the patient even than syphilis, I would like to know why you think so. I believe, personally, that locomotor ataxia is very uncommon in a patient who has not had heroic doses of Mercury, although our friends of the dominant school always attribute the cause to syphilis.
Dr. S. Kaistha, M. D., Amritzar City, Punjab, India: In regard to the remarks of Dr. Waring, as to the action of Mercury, I had a very interesting case just when I graduated in India. A tailor, about 45 years of age, came to our dispensary. His trouble was a discoloration of the skin, the part most affected being the forehead. Some other parts were a little dark, but the forehead was black like tar. He had consulted several other doctors, Allopath, Greeks, Hindus, etc., but up to that time had not had the chance to consult a Homoeopath. He said that no one had as yet made a diagnosis. He had been suffering from the trouble for, at least, 20 years, and, although he had tried many remedies, nothing seemed to help him. I took up the case, but in getting the history the man seemed to conceal many facts. I thought there might be some venereal history. I questioned him, but he denied having had any such trouble. I tried the indicated remedies, and took up almost all kinds of drugs indicated, but no relief was obtained. One day I took him to my private room, and asked him if he had ever had any kind of trouble before. He denied absolutely, and said that he was a very pure man. I said to him, “Have you ever had any other disease?” He said he had been very healthy all his life. I thought of syphilis, and other things, but, of course, there was no evidence. I thought, perhaps, he might have inherited from his parents or grandparents, trouble of some kind. Still he said his parents and grandparents had been very healthy and strong. I went on treating him, but with no results. Finally, one day I said, “Cannot you tell me something about your career, when you were a boy about 14 or 15 years old?” He told me many things, but still denied any contagion or infection, but he said, “Doctor, there is one thing I have not told you, and that is, on a certain occasion I had some trouble. I thought it was no trouble at all, but my friends told me that I had syphilis, and chancroids, and on that assumption I went to some layman and he gave me some medicine. He said he could not tell me what it was, but I think it was raw Mercury.” I asked him what the results were, and he said that he was all cured of his trouble. I forget how many pills he would take, but he went on taking the treatment for four months, and everything went on smoothly, until five or six years later he noticed there was some discoloration of the forehead. The trouble increased until the whole forehead became black like tar. I felt sure that it was Mercury which he had been given, because in some of the remedies given by laymen you will find a little raw Mercury. Well, this man went on taking the mixture, and his system being susceptible to the action of the Mercury, the condition was the result. He was 45 years of age when he came to us, and there was, of course, no help for him. I believe, as the doctor said, that the action of drug is more serious than the disease itself.
Dr. J. C. Fahnestock, Piqua, O.: I would like to ask the doctor if in his experience he gives anything in the way of an antidote to get the drug out of the system. I have a severe case that is not yet cured. The patient is salivated from taking Mercurial tablets. The gums are very blue and spongy, and there is a foetid odor from the mouth. I gave Iodide of Potassium in about one-eighth for a dozen doses, and I also prescribed an antiseptic mouth wash.
Dr. G. P. Waring, Chicago, Ill.: The only experience I have along this line is the use of the remedies indicated, having an antidotal relationship, in the 200th potency, or higher, therefore, I could not help you out by suggesting a chemical or physiological antidote.
In the lower potencies I have had no experience, but I do find that I am able to help a great many patients by selecting that antidote best indicated, going entirely by symptoms, not alone on constipation, indigestion, nervousness, locomotor ataxia, nor epilepsy, not basing the prescription on any one of these, but taking the whole patient into consideration, especially the symptoms lying closer and having a closer relationship to the vital force. Basing the prescription upon these symptoms you will get the best possible antidote to help the patient.
Dr. W. J. Gundelach, St. Louis, Mo.: The previous speakers called for an antidote for salivation. I do not know whether I could name an effective antidote in such an acute condition as the one mentioned. I have treated quite a number of syphilitics, and I believe Mercury is almost a specific remedy for acute syphilis, consequently I give Mercury in material doses in those cases in which I want a quick effect. A patient comes to you with secondary syphilis, and his first question is, “How long is it going to take to cure me?” You tell him that it will probably take several years. Now if you can palliate that patient’s symptoms in three or four weeks, if you can rid him of the external manifestations, you will find a very grateful patient, and I have resorted to Mercurial inunctions in these cases, but I have had the experience a number of times that the improvement which is very manifest at first, after reaching a certain stage seemed to cease. You would have a Mercurial stomatitis, and other symptoms of Mercury. In these cases I have found that if I gave Mercurius sol. in 1000th potency once a day, or once every two days, that the symptoms would clear up, the stomatitis improve, the patient gain in weight, and, in fact, improve in every way. It has sometimes been necessary in these cases to go back to material doses later on. I do not believe that Iodide of Potash will remove the bad effects of Mercury. I believe that Hepar sulphur is the best remedy in chronic cases to antidote the effects of Mercury, and in acute conditions Mercurius sol. high. I have tried Nitric acid high in about six cases, but could never see any good effects.
Dr. G. P. Waring: So far as the likeness between Echinacea and Pulsatilla is concerned, that is, of course, true, but as I stated in my paper, I could not cover all the remedies that bear a likeness to Pulsatilla; however, if you will notice the group they are deeper acting remedies, all of them, than Pulsatilla, and I believe that they would be indicated, rather than Echinacea, to complete the work of Pulsatilla. There are many remedies that could be compared in their acute action with Pulsatilla, a great many. Gross compares nearly 40, almost as many again as any other remedy.
The only vital point in regard to this antidotal question is that Mercury has disturbed the vital forces, has disturbed the vital process of the human economy. That is what Mercury has done, and if you are going to antidote it, you want to go over your patient’s symptoms to see how the vital force is disordered, study your remedy and the symptoms growing out of that disturbed vital force. If you will do this you will get the best antidote, you will get the vital force restored to order again, and you will get the vital processes continuing in harmony, to eliminate as much of the poison out of the system as possible. A perfectly working vital force will “clean house,” but a disturbed vital force cannot do it so well. If Mercury has greatly disturbed the vital force – the vital economy of the patient – the remedy you want is something to restore that vital force. The vital force must do the eliminating. The remedy and its action refer to the dynamic not to the chemical plane.