By Eric Graf von der Goltz, M.D.

       Ch. D., a young girl of fifteen years of age, had suffered on board of the ship, while coming from Europe to New York, a slight accident, as it seemed at the time, somebody having stepped on the great toe of her right foot.

About fourteen days after coming to New York she fell sick (March 10th,’ 07) did not feel well, had headaches and chills, and also pains in this injured toe.

The toe beginning to swell, a physician was called; from his prescribed compresses, with a lotion, the whole foot and leg began to swell and became inflamed in such a way that the relatives of the patient called another physician, and, later, still another was consulted without any result.

Finally. Again, the first physician was called who, in consultation with another, a hospital surgeon, recommended an extensive operation, respectively, amputation of the leg.

The family and patient, not consenting to this proposal, the writer was called May 25th, and found her in the following condition: the patient was sitting in bed, holding the best leg with both hands.

The foot and leg were swollen to the double size of their normal state, all tendons of the knee shortened, so that the leg could not be stretched.

On the leg, and also on the foot, from different points. Matter was oozing. The foot and leg, up to the hip, were very sensitive to the touch.

Sleeplessness – the most pains happening at night from relaxation and changing of the position while filling asleep.

It was necessary, at first, to combat the exhausting low fever and to stop the general pyaemic cellulitus involving the bone the patient was, besides, nearly starved, as her stomach revolted against everything – the primary biochemic remedies were Kali phos. 6x and Silica 12x, changing every two hours.

May 27th – Idem.

May 31st – Idem.

June 6. – Gradually an improvement appeared. Since about twenty-four hours, instead of the general and diffuse pain – they had exclusively settled in the bones, especially at night – Kali iod. 6x, one dosis every hour.

June 22d. – The general swollen state of the whole limb had gone down. A perceptible mobility of the knee-joint and the hamstring condition had been ameliorated. As the pains and the disease seemed now to locate mostly around the knee-joint. Kali iod. 6x and Alumina silico-culfocalcarea 6x were given in a two hours change.

The general state was better, as with diminishing of the pathological process, the appetite had returned to some degree.

July 6th. – The further improved state of the patient allowed, for the first time, a more exact examination of the deeper layers of foot and leg. It was found that on many places, especially near the oozing points along the leg (either broken on own accord. Or lanced by the former attending physicians). The surface of the bone appeared to be elevated and knobby. Medication now Calc. fluor. 12x and Kali mur. 6x, the latter, especially, for the soft parts, in a two hours’ change.

July 21st. – Patient begins to improve in a more observable way. The pain appear now only at intervals. The sleep and rest is less disturbed. The knee-joint continues to improve, especially in regard to mobility. The latter fact was the greatest concern for the writer, as it is well known what trouble such a neglected anchylosis of a joint will give.

Same medication.

August 11th. – Slow, but constant progress; as observation had taught in former cases, where several remedies are necessary, the greatest benefit will often be gained by compound salts, so here it was deemed necessary to give, as sole medication, Calcarea silic 0-fluorata 6x, one dosis of three grains, three times a day.

August 23d. – Good progress in every way. – Idem.

September 7. – Idem.

September 17th. Further uninterrupted improvement; the swelling has fallen off considerably. Patient is able now to stretch the leg slowly so far that the foot, with the sole, save a small part of the heel, rests on the ground. The knee-joing remains flexed only to a slight degree. – Idem.

November 9th. – Patient can walk around unrestrained. The foot remains still a little swollen; same medication (continued since August 11th).

November 27th. – Patient discharged fully cured, all remaining swelling having disappeared.