Part 82

Sleepy early in the evening.

All troubles disappear in the open air.

In attempting to analyze this "abstract of symptoms," to see if the internal evidence tends to show that the recorded effects are genuine results of the drug, it is well to remember that these provings--for we infer that three observers participated therein--were made in the light of the empirical history of Pothos foet. The said history was on record before the date of these provings, and it cannot have escaped Hering's eye; he was too wide a reader for that. He was, beyond doubt, aware of the pathogenetic effects observed by Bigelow--headache, vertigo, temporary blindness, vomiting, even from small quantities. Having, then, this clue to its physiological action, these symptoms should reappear in his proving if his imagination furnished his symptoms. As only a mild headache is noted in the Correspondenzblatt, it is evident that these provers did not work from a pattern. It is also evident that the usus in morbis did not suggest the Allentown symptomatology, for the anti-asthmatic virtue of Pothos foet. is one feature on which the greatest stress had been laid, and yet the only pathogenetic suggestion of its applicability in asthma is: "Sudden feeling of anxiety with difficult (or oppressed) respiration and sweat, followed by stool and the subsidence of these and other pains." Who ever heard of an asthma relieved by stool? Who could have invented such an odd modality? As it stands it is an unicum, and by every rule of criticism this single symptom-group gives the stamp of verity to the Allentown "abstract of symptoms." But there is other and singularly convincing evidence of the genuineness of this abstract. As the reader is aware, Thacher had emphasized the efficiency of Pothos foet. as an anti-spasmodic in hysteria, although the "key-note" that indicates it in hysteria had wholly escaped his discernment.

Now this very "key-note" appears in the Allentown pathogenesis, but so unobtrusively as to show most conclusively that the prover who furnished it did not recognize its singular import and value. Such testimony is absolutely unimpugnable by honest and intelligent criticism.

It is also apparent that some of the less pronounced of its empirical virtues are reflected in the proving. For instance, Thacher found it efficacious in "erratick pains of a spasmodick nature." Is not this "erratic" feature reproduced in such conditions as:

"Headache, of brief duration, in single spots, now here, now there?"

"Pressure in both temples alternately, harder on one side than on the other?"

"Bellyache, here and there, in single spots?"

Brevity of duration and recurrence "in single spots, now here, now there," are phenomena at once spasmodic and erratic. It must be admitted that the trend of its pathogenetic action and the lines of its therapeutical application are parallel, and, therefore, that the latter are confirmatory of the former.

With such an anti-hysterical reputation as the empirical use had given to Pothos foet., it might fairly be anticipated that its pathogenesis would be distinguished by a paucity of objective data, for only a tyro in pharmacodynamics, or a "Regular," would expect to find a full-lined picture of hysteria in any "proving." And so we have in the "abstract" a flux of subjective symptoms, "erratic" enough for hysterical elements, and still further characterized by an apparent evanescence, as if its phenomena of sensory disturbance were as fleeting and unsubstantial as those of an hysterical storm.

The will-o'-the-wisp-like character of its subjective symptoms, and its physometric property (hinted at in the pathogenesis and emphasized in Thacher's case) are the features that will chiefly impress one in studying this distinctively American remedy.

That the "abstract of symptomes" evinces a cautious trial of this drug, and that more heroic experiments will add to our knowledge of its pathogenetic properties, are plain deductions from the absence in the "abstract" of such pronounced effects as Bigelow observed and also from the evidence of the usus in morbis. The remedy needs an efficient proving, especially in the female organism.

AN APPLICATION OF POTHOS FOETIDA.

Miss B----, aet. 20; a tall, spare brunette, and a good specimen of Fothergill's Arab type, brainy and vivacious. General health has been good, but she was never robust; could not go to school regularly. Between her thirteenth and fifteenth years grew rapidly in stature, and then she was easily wearied on walking; knees tired and limbs ached. Had good digestion through the growing period, but subsequently became subject to "bloat of wind" in abdomen. These meteoristic attacks came when lying down. A "weight rises from the abdomen up to the heart." She must at once spring up. This condition is relieved by eructating, by liquor, and by drinking hot water. The night attacks of meteorism are by far the worst. She is now subject to them.

Patient has found that apples, tomatoes, cabbage and onions disagree with her; no other food. She is constipated--"wants to and can't."

Her hair is unusually dry; scalp full of dandruff; skin, generally, soft and flexible.

She has frequent epistaxis; has had four and five attacks a day. Blood bright red, "runs a perfect stream," does not clot at the nostrils. Has previously a "heavy feeling" in the head, which the bleeding relieves.

In appearance she is "the picture of health;" good complexion, fairly ruddy cheeks, sparkling eyes--in a word, she is an incarnated protest against "single blessedness."

In the latter part of July, 1886, had her first "fit." She had arisen with a headache, which kept on increasing in severity. Just after a light meal had the attack; "Oh, dear! Oh, dear!" and fell insensible. Stiffened at first, then had clonic spasms. Neither bit the tongue nor frothed at the mouth. No micturition or defecation. On coming to, did not remember that she had fallen, but recollected being borne up stairs. Had a "dreadful nosebleed" after the attack. Left her very weak; could hardly lift her feet from the floor. Before the "fit" the headache had become unbearably severe.

Had her second "fit" on August 7th, 1887. Headache came on and kept growing worse; was in temples, beating and throbbing, and in eyes, "light hurt"--also on vertex, "pressing-down" pain. At 4 P.M. suddenly fell down insensible. No cry. Tongue bitten. Slight frothing at the mouth. First "stiff all over," then clonic spasms. After the "fit" knew that something had happened to her. Was prostrated for nearly a month, but not so much as after first attack.

December 10th, 1887, third "fit." On the night of the 9th her mother had been very ill, and she herself was very uneasy and alarmed. Had the attack before breakfast. Blurred vision, headache, fall; no biting of tongue, nor frothing. First rigid, then clonic spasms; after attack, nose bled profusely, head ached all day, face flushed and dark. Prostrated as usual.

In none of the attacks was there any involuntary micturition or defecation, nor was it ever necessary to use any force to hold her on the bed.

One other fact I gathered from her brother, namely: during her "fits" her abdomen bloated so rapidly and to such a degree that the family had learned to remove her clothing as soon as possible after she fell.

Of course, Thacher's case, wherein the "abdomen was remarkably tumefied and tense," came into memory at once. The old volume was taken down, and that case re-read. Then followed the Encyclopaedia, and then the English Symptomen Codex. No pathogenetic light or corroboration there. Then Curie's "Jahr." Ah! "Inflation and tension in the abdomen." Only a straw, but a pathogenetic, and I grasped it thankfully. I found also, "aching in the temples with violent arterial pulsation."

It was an open winter; my son dug some skunk cabbage roots in a swamp; a tincture was made; ten-drop doses, four times daily, were taken until six ounces had been consumed.

No "fit" up to date; no epistaxis; only once a slight headache.

I never made a diagnosis in this case; have not reached one yet, nor am I grieving over that omission. I did rashly declare that it was not epilepsy, because Sauvages tympanites intestinalis is a feature of hysteria, but not of epilepsy. But not a word of this was said to the patient. It was not a "mind cure," for I have no "mind" to spare; nor was it "Christian science," for I am not up to that. I had an amnesis in which grand-mother and grand-daughter participated. Nature had put the "key-note" in italics, not only in the patient but also in the drug. Thacher stumbled upon it empirically; Hering found it pathogenetically, and that led to its application under the guidance of the only approximation to a law in therapeutics that has yet been discovered by any of woman born: similia similibus curantur!

(Anent the foregoing paper Dr. W. C. Campbell sent the following to the same journal:)