William F. Baker, A.M., M.D., Philadelphia, Pa.
In the further attempt of your sectional meeting to develop and study the materia medica of the homoeopathic school, it is my privilege to present the drug Chelidonium to you and invite your inspection of the slides in this drug which vary all the way from a simple hepatitis to a necrosis of liver cell and the formation of scar tissue in those specimens where the drug, continued for a while, was interrupted in an attempt to produce artificially a cirrhotic liver. In the last specimen presented you will note the typical hobnailed appearance characteristic of atrophic conditions of the liver and in the early specimens you will notice an infiltration of liver cell which is characteristic of hepatitis. That this drug expends a large part of its force on the liver has long been recognized clinically but what are primary effects in the early administration of the drug to healthy animals. This will be the principal study of the evening and the slides are at your disposal for study and diagnosis.
There are several objects in a study of this character to determine:
- Symptoms of greatest importance.
- Exciting causes of other symptoms.
- Order of occurrences of symptoms.
There is no other plausible way to determine the totality, which is the ultimate goal of the homoeopathic prescription.
Our aim then is to develop symptoms and a corresponding pathology between the animal and the drug and we will permit you the application to clinical evidence.
These factors are beneficial in proving our materia medica.
According to most writers this drug has been classed primarily with liver remedial effects, and causative, in hepatitis, but our experience with the drug leads us to class it in the gastroenteric sedative group.
You will observe that there is considerable ballooning of the small bowel in this case that has had only a few days’ treatment with chelidonium and that it appears as though the liver sequels were secondary to this bowel obstruction at the ileocacal valve as the condition of the bowel is invariably observed first before liver symptoms develop. You will see under the scope various grades of hepatitis to a complete for a long time.
Your attention is called at once, in the administration of the drug to a healthy animal, that the appetite increases immensely and is associated with constipation which is quite the contrary in the control animals. Following this constipation is a catarrhal mucoid and yellowish discharge from the bowel with odor. Later there is a slight jaundice and great discomfort when the animal is palpated in the region of the liver, so much so that when the animal is handled it utters a shriek similar to the danger signal in these animals when in pain, for ordinarily they are very slow to evidence pain. After the second day abdominal rigidity is marked on the right side and in the right pelvic region.
The kidney soon shows irritation by means of the secretion of jaundiced urine.
With these symptoms developing the animal becomes quiet and seemingly takes on weight rapidly until as cites develops and death.
The effects of chelidonium are to be classed then:
- Gastroenteric sedative.
- Hepatic sequelae.
- Focal infections having their origin in the liver and intestines.
- Autointoxications due to inactivity of portal circulation.
- Dilatation of the small intestine at or around the ilecaecal valve or symptoms correlated in the storm area analogous to appeandicitis and typhlitis.
- Right ovarian and broad ligament infiltration.
- Gastric ulceration.
In recent years much has been written concerning fecal infections and with elimination of the movement in the upper bowel, so that the bowel cannot empty itself fermentation goes on. It is a good culture medium for such focal infections. Cholecystitis, appendicitis, pancreatitis and various skin lesions may have their origin in such a focal infection. Most important are the various forms of arthritis that cannot be classed as essentially gouty.
The rigidity of the abdominal muscular system in these animals tends to show intraabdominal lesions of various kinds, and not alone the liver. It seems as though the liver were the seat of the greatest number of focal infections arising from the intestines, next the kidney and in two cases a right-sided-pneumonic exudate developed.
The examination of the duodenal fluid in these early cases shows interesting changes and bile is usually found in excess giving decided reactions to test. It is usually turbid. The laboratory reports are increase of tryptic power with libase variable. If the remedy is persisted in, the animal dies of autointoxication. If the remedy is discontinued prompt recovery takes place in about 3 days’ time. In one rabbit the drug was administered intermittently over a period of 9 months when a resulting liver appears as you see this one, viz: hard and hobnailed showing an overproduction of fibroid tissue.
With the pathology of intestinal stasis established we can by reference to other observers easily outline the therapy and symptomatology of this drug. Sir Lauder Brunt on has shown the bacillus coli present in such cases to be a prevalent factor in the production of fatigue toxin. Mantle has shown joint symptomatology. Dr. Langden Brown has shown “the diamines discovered by Barger and Dale to arise in the decomposition of histidine,” protein breakdown, therefore is an important step in the production of arteriosclerosis and particularly since the liver is involved we must expect some arterial sclerotic changes similar to those found in men and women of sedentary habits. The poisonous substances found in the intestines do not give rise to antibodies and the only solution of bactericidal power lies in intestinal tone. Dr. B. Thorn writing along these lines says, “there are few phases of cardiovascular trouble with which disorder of some part of the alimentary tract is not causatively associated. The great majority are directly associated with alimentary toxaemia.”
Why should chelidonium affect the ileocacal sphincter is more than I am prepared to say yet there is not hesitancy in predicting this result when chelidonium is used in appreciable doses.
A. Lane, of Guy’s Hospital, attributes to intestinal toxaemia, inflammations of the gall duct, bladder, gall stones, pancreatitis, duodenal spasm, cirrhosis of the liver and arteriosclerosis. We must not forget that iliac stasis is essential for normal digestion yet when that condition persists for a long period of time we have all class of symptoms due to obstruction. Alimentary stasis is a term that is open to objection but its peculiar aptitude for selecting the right iliac fossa with secondary changes in the liver and kidneys lead us to look upon this “storm area” of the abdomen as being affected by the remedy, hence the pathology would suggest the remedy to be used in potency in these conditions especially the acute non-surgical variety. From my own clinical experience I look upon chelidonium as a greater remedy in many respects than our standard of nux vomica in gastric cases. In gastric ulcer it has given me very good results and also in the symptoms and complaints of sedentary men and women, retired business men and those bordering upon the cardio-vascular stage of middle or advanced life. I consider it to be the best remedy in increasing blood pressures in the obese and in the neurotic conditions with constipation, etc., affecting multi pare where the abdominal walls are lax. Generally speaking I consider chelidonium to be the greatest gastroenteric sedative in our materia medica due to acute irritating causes.
Post Mortem Appearances – Body a well-developed rabbit shows abdominal distension and rigidity. Upon incision there is found a small quantity of turbid fluid and the tissues appear bile-stained. The stomach is distended with semisolid food and shows a marked congestion at the pyloric orifice external. Upon rotation of the organ there is seen to ooze a liquid from a small punctuate ulceration which had been torn from its adhesion which adhesion had evidently closed the opening. With the escape of a large quantity of gas the stomach lost its distension.
The ileum seemed to push itself up into the wound next and appeared distended with semi-solid and liquid putrefying substances. From this point down to the rectum and colon seemed almost empty, a slightly discolored fluid being pushed out. Above the point of dilatation of the ileum the faeces seemed to be forming normally.
The liver presented the greatest changes in that it was swollen to a remarkable degree, of a bluish red color and with large areas of blood congestion appearign similar to post-mortem changes, yet the animal was killed but a few minutes previous. Upon section the organ seemed surcharged with blood and bile, a typical hepatitis.
The kidney was enlarged and showed marked glomeruli and cortical irritation.
The drug effects thus studied are quite separate and distinct from the recorded efforts of writers in Materia Medica, and are procured by the administration of small doses of medicine over an extended period of time to determine.
- Specific or organic selection of action.
- Course of the lesions produced.
- Final pathology or terminal pathology.
- Associated organic condition.
At once the method appears different from the ordinary standardization methods that are carried out by proprietary drug houses and laboratories in general simply because they limit the action of the drug in their observations to either organic selection or death. It in not the purpose of these experiments to produce death simply to build up a pathologcal picture of the whole period of action of the drug in small doses. As the matter now stands only 38 or 40 drugs have been standardized by any attempt near the physiological and yet the philosophy of your practice carries you as homoeopath beyond this initial stage, and in our own school only about 29 drugs have been completely studied. Several questions at once arise: First, are animals to be taken as standard for the human; and this can be answered by pointing to the fact that all modern medicine admits their use for study, taking into account their susceptibilities.
The study of this method is difficult simply because we attempt the problem from the synthetic aspect with a healthy animal as our premise. Heretofore all medical problems were essentially. Analytic and subject to grave error in preliminary diagnoses. The pathologist has not been as broad in his conception of disease simply because he is looking to an end result only. Until the advent of bacteriology he must wait for death or surgical procedure to procure a specimen. Proceeding from our premise we study the organs related and become pathological anatomists.
CHELIDONIUM No. 20.
July 26: One young healthy rufus red rabbit was selected for the proving of chelidonium. The rabbit wasfed one drop of chelidonium upon 2 ounces of bread daily.
July 30: Sneezing and excess of sleeping.
Aug. 4: The rabbit was found lying upon its stomach unable to move its limbs, rolling its eyes continuously and breathing very slowly, the animal rolled from once end of the cage to the other and finally died.
Congestion and inflammation of the liver. Some evidence of fatty degeneration. Capsule adherent and strips with tearing. Liver adherent to adjacent structure.
Stomach congested at pyloric surface with an anaemic appearance at cardiac end. Stomach is enlarged. Faecal mass in the upper intestine, which is swollen, tense and with plastic exudate.
From ileocacal valve to rectum there is a distention with a clear straw color faces, but no hard substance. Rectum empty. The stool is compact and formed in large lumps. Slight evidence of jaundice in eyes. Urine shows bile and bile pigments and excess of uric acid.
The next advance in the study of drugs from this viewpoint lies in the observation that diseases with similar physical signs when studied a longs with the associated symptoms often call for different remedies and yet we are led to believe that they are one and the same general types of infection. It teaches us that no one organ of the body can be singled out in a special pathology and made the basis of an accurate and comprehensive prescription of a drug. Lastly it teaches us that the idealist in homoeopathy is not passing out but is rapidly coming into his own in that percentage of cases which can be classed as curable, for the ideal homoeopathic view of medicine is the only view which will enable one to look at the synthetic aspect of medical problems as against the one-sided view viz., the analytic.
Former attempts to reproduce for the purpose of study have been confined to the study of the biological life of a few infections and the standards of a very few drugs, but a continued study of drug effects over an extended period of time such as is consumed in our management of an ordinary case of illness has never as yet been systematically carried out and it is the purpose of these experiments and demonstrations to study the problem of homoeopathic practice from this standard i.e., the small dose repeated often and continued to the completion of action of the drug, for this takes in not only the biological life of all infections but also the study of the resisting forces of nature and their disturbances. The study of the medical problems from the homoeopathic view is broader and more comprehensive than a limited study of a special type of lesion. The study of the homoeopathic practice of medicine substantiates the materia medica as proven and written from human provings and also opens up a field of pathology as distinct as can be and yet almost totally neglected by our own homoeopathic clinicians. Many have gone so far as to deny the existence of a separate and distinct pathology and to those I would urge either a truer statement of the facts as seen or individual work.
With the good laboratory facilities that homoeopathic colleges have now at hand it would seem as though the distinctive sectarian view of medicine ought to have at least a fighting chance.
The idealist in therapy is not passing; he has never had a fighting chance.
Reiman in the New York Medical Journal of February 28, 1020, really outline the usefulness of the homoeopathic materia medica in clinical research when eh speaks of the errors in abdominal diagnosis as seen by the pathologist. Ewing is quoted as saying that there were very few expert pathological anatomists (the government could find few), i. e. the life history of the pathology is more important in a sense than the end result, A simple laboratory test standing alone means little except when considered with the history of the case. A study of pharmacodynamics will enable an observer to start and end pathology, studying its course throughout, including all tissue changes.
One must admit that the greater part of our pathology has been gathered from the surgeon who in the majority of cases is handicapped by a long-lasting lesion complicated with other inflammatory and structural changes and his interest lies in the fact as to its malignancy.
The homoeopathic materia medica as studied in the laboratory offers a complete study of tissue changes, almost unlimited and these changes can be studied throughout their entire course.
It is the opinion of the writer that homoeopathic medicine and research owes its value to these conditions and possibilities.
Conclusion – it is very evident from this specimen that the pharmacodynamic action of the medicinal substances offers to us a field of study in synthetic problems of medicine as against the analytic and is of far greater value in the study of medicine because it enables one to build up a pathological anatomy, study its course and observe its terminal findings. It is the expressed need of all.
It also differentiates the biological life of the infecting agent and takes into consideration all factors.
The pharmacodynamics offers to the homoeopathic student a greater approach to medicine than other forms of research. To doubt it is to reflect upon one’s own ability to observe. To substitute is to hinder one’s conception of it and to study it is to establish the idealist in homoeopathy. The place for such observation is evidently in a homoeopathic college.