In the third section of the “Organon,” Hahnemann says: “When the physician clearly perceives the curative indication in each case of disease, when he is acquainted with the curative effects of medicines individually, when guided, by evident reasons, he knows how to make such an application of that which is curative in medicine to that which is diseased in the patient, both in regard to the choice of the substances, the precise dose to be administered, and the time of repeating it, so that a cure may necessarily follow, and finally, when he knows what are the obstacles to the cure, and can render the latter permanent by removing them, etc., etc.”
The last clause of the section touches the subject of this paper very closely. In a case of epilepsy, what are the obstacles in the way of a cure, and how are we going to remove them? The former part of the section just as closely touches the question of remedy; the kind, quantity and time of its administration.
The first question suggests another: What is the cause of epilepsy? It is not my purpose to give you a learned discourse on the etiology of this malady. You can get thirty or more causative reasons for epilepsy in Oppenheim or Sprattling, but I doubt very much if they will serve you to any great extent in your endeavors to cure your epileptic patients. And yet it is quite necessary and proper that you should be conversant with all of them and to know as much as possible regarding the disease from every standpoint. I will, therefore, take the responsibility upon myself of adding one more to the list of causes and present it from a homoeopathic viewpoint and try to prove my contention by the clinical cases I have to submit to your unbiased consideration. Here it is! Epilepsy is the outward manifestation of a deep-seated distunment of the life forces which control the nervous functions and apart from mechanical causes, to one of the three chronic miasms or their combinations, all the trouble may be attributed.
Case I. – The first case I have to present to you is a very interesting one. I find, however, in looking up the records of treatment, which extended over a period of three years, that it would be very tedious to burden you with every detail of the treatment. I, therefore, content myself with a general outline, and trust it will serve every purpose.
Cora S., age 15, began having epileptic seizures at her 12th year, then every three or four weeks. Would have several fits, perhaps spread over several days. Symptoms: Head hot before and at the time of the spasms. Twitching or a quick, nervous shock through the body, causing her to raise her hands suddenly, precedes the fit. Depressed mentally. Felt as if she had committed some great sin and the fits came on as punishment. Very persistent in having her demands satisfied quickly. Bowels at this time inclined to be constipated. Stomach: Appetite ravenous, especially for meat previous to the attacks. Vomits some time during attack. Menstrual: Has never menstruated, although she is large and well developed for her age. Has a sore feeling, however, in the hypogastrium, especially during time of attacks. Hands cold and clammy to feel. Must have doors and windows open. Cannot bear a close roof. Makes her sick. Was injured at birth by a bungling doctor, who left her slightly paralyzed in left hand and foot. Had mumps, measles and whooping cough, and all the other children’s diseases. At the age of 11 the thyroid began to enlarge. Treated for a year, – strange to say, – by a homoeopathic physician with local applications of Iodine, which cured the goitre. The cure being followed, almost immediately, by epilepsy. Has had a year of the Bromide treatment, with dilating of the cervix, and electricity, in order to bring on the menses; also 22 months of the viava, which is a process of massage and inunctions of a Cerate and the use of a vaginal suppository; generally speaking, an all-round fake. Came under my care July 10th, 1896, and received rather hurriedly Sul. c.m. , the only potency I had with me at the time. August 20th, had an attack consisting of one spasm instead of a series of them. December 21st, been on Sul. c. m. several times repeated for five months, and to-day I gave her a dose of Cal. c. 200 on the symptoms cold feet, clammy and damp, and thought it might influence the amenorrhoea. December 26. Father called to say that the patient menstruated on the night of the 24th without pain. Flow profuse, but natural. On the 25th, some pain in region right ovary with a tendency to spasms. Momentarily, however, December 27. Flow profuse, dark colored. Some downward pressure. Patient very cross and irritable. Nux vom., R.: 2c. one powder. December 28. Flow slight. Child feels bright and happy. January, February and March. Menstruated all right with the exception of a great deal of mental disturbance. Says the spasms will come on again. Mental depression. Soreness in the region of the uterus and for which she received a dose occasionally of what we considered the indicated remedy, always in a high potency and not repeated. One feature I might mention as being really connected with the cure of the case. I mentioned the lightning-like shocks which preceded an attack. They generally became troublesome a week before the menses appeared and continued for a few days after. For this she received Cimicifuga 200, which always promptly relieved.
Those of us who look to an objective cause, merely, would naturally come to the conclusion, at this point, that the cause of this epilepsy was due to a failure on the part of nature to bring on the menses, and these, once established, there would be no further trouble; but the subsequent history, which I am about to relate, disproves that idea, or, at least, modifies it to a considerable extent.
April 13, 1897. Patient has had another attack. Has had 16 spasms in the series, one more than she ever had previously. As this was the only time I witnessed an attack, I wish to give the history of an attack itself, as it presented itself objectively.
Previous to attack, nervous, restless, irritable. Wants things done at once. Persistent in her demands. Says she feels muscles twitch and a nervous feeling in stomach. Head hot, feet and hands cold. Wants doors and windows open. During spasm, head turns to left, crosses her feet, fingers cramped but spread apart. Twitching at corners of mouth. Jaws set, but mouth wide open, which closes with a snap when clonic stage sets in. Attack came on a week before time for menses to appear. Bilious vomiting during attack. Nux and Belladonna and finally a dose of Park, Davis and Co.’s extract of horse nettle perhaps helped to shorten the series of epileptic seizures. After the attack, in looking over the case, I could see nothing better than my former prescription and gave Sul. c. m. with Cim. 200, as before, when the nervous shocks began.
1889. I will skip a period of two and one-half years, in which time patient was free from these fits, but every menstrual period was looked forward to with anixety on the part of the patient, her parents and the physician. There were a great many troubles of one kind and another, mostly mental, which were prescribed for with medicines which would not interfere with the action of the chronic remedy.
November 16, 1899. Goitre somewhat large. Feels collar uncomfortable. Prescription, Iod. 20 m. and c. m. cured in a few months.
I will close the clinical history of the case here by saying that not until the patient was free from the fits a year, did I hear of the goitre. When it began to re-appear, I felt that victory would crown our efforts.
Was this not a case of psora, manifesting itself as an enlargement of the thyroid, and the supposed cure a suppression, driving it in upon the nervous system, already aroused by the process of nature incident to the approaching menstrual period. Be that as it may, the case is before you, and each one can judge of the strength or weakness of my conclusions as seems best to him. Twelve years have now elapsed since the last attack reported in this paper. Three years ago, however, the young lady became very much run down through over-study at a boarding school. On her return home, a local physician in Wisconsin, where they now reside, gave her electrical treatments, which acted badly and she had one spasm. The treatment was discontinued and I was asked to send her some medicine, since which there have been no more spasms.
This case has many interesting features and suggestions running through it. Many of the symptoms are such as you will find in the provings of Iodine, and it might occur to you, as it did to me after I learned of the goitre and its suppression, that the whole trouble might be due to poisoning by this drug. Hahnemann, in the Chronic Diseases, records many symptoms from goitrous subjects as having been produced by the use of this drug. Clark, also, in his dictionary of medicine, says that “facial paralysis and epilepsy have followed suppression of goitre by large doses of Iodine.”
Unfortunately, in reporting the two following cases, I will have to do it from memory, as I in some way misplaced the records, and will have to content myself with a general outline.
Fred. W., age 36, began to have epileptic attacks four years previously. Came into my care September 11, ’03. The patient was large, inclined to be fleshy, tires easily, perspires easily and profusely on exertion, especially about the head. Inclined to be cold and chilly. Feet always cold and damp. Mentally depressed, afraid to be alone in the evening. Attacks worse in the full of the moon. Stomach, appetite good, – too good. Bowels normal. Peculiar symptom. Just previous to an attack and, in fact, all the time, to some extent, the patient complains of a soreness in the pit of the stomach. Aggravated by bending over forward; this, if persisted in, will bring on the spasm; better by straightening the spine, thus relieving the pressure.
Past History. – He says he was generally healthy. Has had a slight gonorrhoeal attack some time before the epilepsy began, which was cured in the usual way by local methods.
Cal. c. 2c was prescribed with a gradual lessening of the attacks. He would go two or three months without an attack and then come down. Once he went nearly six months. We were congratulating ourselves that the cure was complete, when the most terrific attack ensued, lasting for two days and nights, with a seizure every half hour in spite of all we could do. The seizures resembled very much puerperal convulsions. The temperature began to rise until it reached 105. We prescribed Bell., high and low. Neurosine, a preparation containing the Bromides, was recommended by my consultant and tried without avail. Finally Cicuta 30, a dose every 15 minutes, controlled the spasms, which were the last he has had. Five years have now elapsed and there has been no return.
Note. – During one of the attacks, he became uncovered, and I noticed a large, reddish wart on the glans penis. I gave him Thuja, and the wart disappeared in two weeks.
The family history, in this case, was good. Along with the homoeopathic remedies, I used the vibrator a few days previous to the expected attack, and I think it soothed the patient considerably.
On a careful review of the case, I am convinced that the miasm sycosis figures in black type in this case.
Mable C., age 15, was placed in my care September 6, 1900. Has had epileptic spasms for nearly a year. The attacks generally come on in the night. Just before the first attack, she received a severe fright. She was walking on the ocean beach with some companions, and the incoming tide shut off the passage around a jutting point and it became necessary to climb up a high sand bank to escape. The sand began to slide downward with the girl, which frightened her very much. That night she had a spasm. Before an attack came on, she would moan in her sleep as if frightened, and if awakened and given a drink of water, the attack would be warded off for that time.
This patient came to me from old school hands and had taken all the Bromide combinations without benefit; in fact, she grew gradually worse, the attacks coming closer together.
I took down all her symptoms carefully. The fright, the sterterous breathing in the heavy sleep following the attack, and prescribed Opium 1m and occasionally Ignatia 200 potency, to meet certain nervous conditions coming up from time to time, which were covered by this drug.
The cure in this case was complete in six months, as a period of over eight years has elapsed without any return. The cause of the trouble in this case was plainly fright. The girl was a very nervous subject and the shock was sufficient to disturb the harmonious play of the functions controlled by the vital force and dynamic influence of the remedies restored functional harmony, – the one thing necessary to a cure.
I had intended to give an equal number of cases of epilepsy which I did not cure, and the reason of failure, but the paper is already long, and I close.