Last year I had under my care, at the Hospital St. Jacques, a truly extraordinary case. It has been followed out by Dr. Jousset, by Dr. Cesar, head of the hospital laboratory, and by the house-physicians. It was that of a woman who entered the hospital suffering from influenza, and who, a few days after a slight amelioration of her symptoms, was attacked with a pulmonary congestion, clearly localized in the top of the left lung, and accompanied by all the clinical symptoms of tuberculosis—râles and moist crepitation, dulness, exaggeration of the thoracic vibration, nummular expectoration, fever, perspiration, spitting of blood—everything was there. Examination of the sputa showed distinctly the presence of Koch's bacilli. Everyone at the hospital diagnosed tuberculosis, myself the first. I gave her Avian tuberculin and in three weeks all the symptoms had disappeared. That woman left the hospital completely cured, and a year afterwards her health was still perfect. In my opinion this patient never had consumption; she was attacked with pseudo-phymic bronchitis, a complication which is very often found with influenza, and which may very easily be mistaken for tuberculosis; and in spite of the presence in the sputa of Koch's bacillus I would not register it as a case of tuberculosis, because, in contradistinction to that single case, I could mention twenty cases of tuberculosis whose symptoms neither Avian tuberculin nor any other such drug has cured.
There is absolutely no connection between the clinical evolution of real tuberculosis and observations based on the autopsies of old persons whose lungs contain cavities, but whose death was not due to tuberculosis. To admit, with Professor Brouardel, that three-fourths of those who have died a violent death are possessed of tuberculous lesions, whose existence was not suspected while the subject was living, would be running absolutely counter to clinical experience. The time is probably at hand when the different kinds of tuberculosis will be distinguished and separated, as we distinguish and separate the varieties of serious pleurisy and purulent pleurisy, of broncho-pneumonia arising from the presence of pneumococci, of streptococci, or of staphylococci. Malassez has already described cases of pseudo-tuberculosis, or zoogleic-tuberculosis, whose existence has only been acknowledged of late years. Courmont has discovered a pseudo-bacillosis of a bovine origin. We have a pseudo-bacillosis of a strepto bacillar origin, not to mention the "professional" tuberculoses, such as that to which persons are exposed who have to breathe the fumes of charcoal.
To return to Bacillinum, I consider this remedy as a powerful moderator of the muco-purulent secretion of consumption. While diminishing the secretion it modifies the auscultation; there is less thick sputum, the cavities are drier, the peri-tuberculosis congestion less intense. The clinical symptoms follow those of the auscultation; as the patient expectorates less he is less feeble, coughs less, gains strength, and regains his spirits; but the tubercle remains untouched. The peri-tuberculous congestion only is diminished, as one may observe with the naked eye when Koch's lymph is employed in the amelioration of lupus. The peri-tuberculous inflammation disappears; the skin seems healthy, but the yellow tubercle remains as it was, and the patient is still uncured. Such are the limits I assign to Bacillinum in its action on consumption.
Far more potent is the part played by Bacillinum in non-tuberculous pulmonary affections, for the simple reason that the struggle is with a less redoubtable opponent. Ebersole, Young, Zoppritz, Burnett, James, Holmes, Jousset, Steinhauf have published cases of the cure of acute bronchitis, influenza diarrhœa, syphilitic eruptions, cystitis, ringworm of the scalp, nephritis, idiocy, retarded dentition, cretinism, gout, rheumatism, etc., with Tuberculin or Bacillinum.
If we wish to prescribe Bacillinum successfully in non-tuberculous affections, we must observe, on auscultation, symptoms analogous to those which are perceptible in tuberculosis. The peculiar characteristics which indicate Bacillinum for non-tuberculous maladies of the respiratory organs are, in my opinion, the two following: The first is oppression; the second, muco purulent expectoration. These two phenomena show themselves always in the last stage of tuberculosis; that is to say, together with the products contained in the preparation of Bacillinum. Dyspnœa resulting from bronchial and pulmonary obstruction caused by a super-abundant secretion from the mucous membrane is marvellously relieved by Bacillinum. I put forward this fact, not on the evidence of a single isolated observation, but on that of several cases conscientiously studied. Such expectoration leads to the auscultation of sub-crepitant râles, sounding liquid and gurgling, having some analogy to the moist sounds of tuberculosis.
This power of Bacillinum to relieve oppression in pulmonary catarrh is in no way surprising from the point of view of the law of similars; for in the acute and infectious stage of tuberculosis the dyspnœa is a characteristic symptom, and is far more distressing than the cough. I have read with pleasure in the work of Dr. Mersch, of Brussels, on Tuberculin, of a fact which corroborates my statement as to the influence of Bacillinum over catarrhal dyspnœa. After the sixth dose the patient, who was suffering from bronchial asthma, was seized with violent intercostal pains, with augmented cough; but the oppression entirely disappeared after the first day, and did not return even three months after the treatment had ceased.
In L' Art Médical of January, 1894, and in the Hahnemannian Monthly of July, 1894, I published the case of an old man of eighty years of age, suffering from broncho-pneumonia, who, in the last stage of asphyxia, had been saved by Bacillinum. Two years ago I was called upon to treat another octogenarian who, as the result of a cold, developed an obstruction in the bronchial tubes, and at the basis of the lungs. He passed sleepless nights in a sitting posture, striving to draw deep inspirations. Phosphorus, Arsenic, and Stibium produced no relief. I gave him Bacillinum 30th, and he slept the whole night through. Doses of this remedy, administered at longish intervals, always produced a remarkable amelioration. Last year I was called to the house of an upholsterer. He preferred not going to bed at all to passing the night in bed without closing his eyes. He had humid asthma with incessant cough, which ended by causing him to eject thick yellow and puriform mucus. For eight days he took Arsenic and Blatta, and for a whole week he passed the nights without sleeping. From the day he took Bacillinum he was able to sleep. I saw him again this year in good health. Once or twice he was attacked with the same bronchorrhea, and had my prescription made up at the chemists, with the same success. This year, too, I have given Bacillinum to several patients at the Hôpital St. Jacques for the same symptoms, and it has never yet failed me.
When I am called upon to treat a patient suffering from an obstruction of the bronchial tubes occasioned by mucus, which is frequently thick and opaque and puriform—an obstruction extending to the delicate bronchial ramification, and causing oppression more frequently than cough, I turn my thoughts at once to Bacillinum. Bacillinum is a drug for old people, or, at any rate, for those whose lungs are old; for those chronically catarrhal, or whose pulmonary circulation is enfeebled without regard to the age of the subject; for those who have dyspnœa, and who cough with difficulty from inaction of the respiratory ducts; for the humid asthmatic, the bronchorrheal, who feel suffocated at night; and, finally, for those who, after taking cold, are straightway attacked with pulmonary congestion. Here, I believe, is the exact sphere of action of Bacillinum as a homœopathic remedy.
Bacillinum has been stigmatized as an unstable product. I consider this reproach ill-founded. Bacillinum is no more unstable than Psorinum, which is an approved remedy in Homœopathy. Typical tuberculous lungs contain practically almost invariable elements. Do not the microbes produced by cultivation and the animal extracts show any variation in quality, and do they not change in the long run?
Like most homœopathists who have made use of Bacillinum, I think it is best given in the high dilutions and at long intervals. Dr. J. Compton Burnett and Van der Berghe recommended the higher potencies—the 1000th, 100,000, etc., whereas I content myself with the 30th, which satisfies every requirement. As regards the intervals which must elapse between the doses, certain writers recommend from one to two weeks. In acute cases I generally give six globules of Bacillinum 30th every two or three days; and in chronic cases of tuberculosis, etc., one dose about twice a week.