This new unknown remedy has a curious anecdote connected with it. I call it new because it has not been mentioned in any of our medical works, although the use of Blatta Americana (American cockroach) as a remedy for dropsy has been mentioned in journals. The Indian cockroach is used not in cases of dropsy but in cases of Asthma, a most obstinate disease to deal with. In asthma it acts almost specifically. Before I further proceed to give an account of this new, invaluable drug I shall narrate here a short story how it came into use.
Some years ago an elderly gentleman had long been suffering from asthma; for over twenty years. He took all measures and tried different methods of both recognized and unrecognized medical treatments, but unfortunately all proved in vain. At last he gave up all treatment and was getting fits daily. He was brought to such a deplorable condition that he was left to suffer. He was in the habit of taking tea. One afternoon as usual he drank his cup of tea—afterwards he noticed that his oppression in the chest was much less and that he was feeling unusually better, so much so that he felt himself a different being. This led him and his friends to inquire into the cause of it. He immediately inferred that the relief was due to the drinking of the tea, although he habitually drank the same tea but never before had experienced any such changes. So this change he attributed to something in the tea. The servant who prepared the tea was sent for and questioned. His reply was that he made the tea as usual and there was nothing new in it. The residue of the teacup was carefully examined, nothing was found there, but on examining the tea-pot a dead cockroach was discovered. So it was concluded that this infusion of cockroach did the gentleman a world of good. The very day he drank that cup of tea he had hardly any fit of asthma at night, and in a few days he got entirely well to his and his friends' surprise.
The accounts of his Providential recovery were communicated to some of his friends—one of them, not a medical man, but quite an enterprising gentleman, took this into his head and resolved to try whether cockroach does any good to other asthmatic patients. For this purpose he got a lot of cockroaches, put them alive into a quantity of boiling water and mixed it after filtering the water when cool with almost the same quantity of the rectified spirit of wine, so that it might last for some time without getting soured. This new mixture (or tincture) he began to try in each and every case of asthma that he came across. The dose was a drop each time, 3 or 4 doses daily, and more frequently during the fits of asthma. Within a short time he made some such wonderful cures that people began to flock from different parts of the country to his door. Soon the number of attendants was so great that he had to manufacture the medicine by pounds and all this medicine he distributed to patients without any charge. He has records of some of the cases.
Some two years ago a patient of mine asked me whether we make any use of Talápoka (cockroach) in our Pharmacopœia. My reply was that we use many loathsome insects as our remedial agents. I told him also that Blatta Americana (American cockroach), I had heard, had been used in cases of dropsy, but I had no practical experience with it. He then said the Indian cockroach is used in cases of asthma and he knew several cases had been cured with it. This struck me and I determined to try this in cases of asthma whenever next opportunity occurred. For this purpose I got a lot of live cockroaches, killed them and pounded to a fine pulp and triturated according to class IX of American Homœopathic Pharmacopœia, that is, two parts by weight of the substance and nine parts by weight of sugar of milk, giving 1x trituration. Thus I prepare up to 3x trituration and I also make an alcoholic solution—a few live cockroaches were crushed and five parts by weight of alcohol poured over them—it was allowed to remain eight days in a dark, cool place, being shaken twice daily. After the expiration of that period the alcoholic solution was poured off, strained and filtered, when it was ready for use.
I began to try both the preparations—drop doses of the tincture and grain doses of 1x, 2x and sometimes 3x, 3 or 4 times daily when there was no fit and almost every fifteen minutes or half hourly during the severity of a fit. Both preparations began to answer well and I was getting daily more and more encouraged about the efficacy of this new drug. I had the opportunity of trying quite a number of cases of asthma within this short time, the reports of which I wish to publish in the future, but for the present I am glad to say in many cases it acted almost specifically, that is, the whole trouble cleared away within a fortnight or so without recurrence. In some cases the severity of the paroxysm was lessened and the recurrence of the fits took place at a longer interval; in others again only temporary benefit was observed. This failure to benefit all cases alike I attribute to many circumstances. Some people did not, rather could not, take the medicine regularly according to my directions owing to their untoward circumstances; some persons were suffering from other complications along with asthma; some again got temporary relief and in the meantime discontinued the medicine and came back again when there was a recurrence of the fits, that is, they did not continue the drug for sufficient length of time. Some cases again, not having derived immediate benefit, got impatient and discontinued the medicine without proper trial.
Besides all these, I think individual idiosyncrasy has a great deal to do. The season of the year has some influence. It is usually observed in this country that those who are subject to periodical attacks of asthmatic fits are more prone to an attack either during the full or the new moon, or at both the times. I believe if it is properly watched this fact will be evident all over the world. Same is true of some other diseases, as chronic cough, chronic fevers, rheumatism, either acute or chronic, gout, elephantiasis, other glandular enlargements, etc., get aggravated or are prone to aggravation during such changes of the moon. Then some people get more severe and frequent fits during the winter than the summer and the others more during the summer than the winter. Let me here tell you that the Indian summer is very different from either the English or the American. Some part of the Indian summer season is quite rainy and the atmosphere is saturated with moisture and other irritating ingredients, consequently a class of asthmatic people suffer more during this season. I noticed to this class of cases Blatta orientalis will prove most efficacious. I have used it in bronchial and nervous asthma with better success than the stomachæ.
Second Paper.
I have of late tried Blatta orientalis indiscriminately in almost all cases of asthma that have come under my treatment, and I am glad to say I have received good results in most cases, as the reports of some of the clinical cases will show. I have not come to any definite use of this drug yet, but I shall only mention a few facts that I have observed during its use. It acts better in low potency and repeated doses during an attack of asthma; when the spasm subsides, the terminal asthmatic cough with wheezing and slight dyspnœa, etc., is better relieved with higher potencies; the low potency, if continued after the spasmodic period is over, will make the cough more troublesome and harassing to the patient and the expectoration tenacious, thick and very difficult to raise, but this will not be the case if the potency is changed. I had this difficulty in a few cases when I was less acquainted with the action of the drug, but now I manage my cases better. In four patients who continued the drug for some time in the low potency, during the paroxysm and after it was over, the cough became dry and hacking with little or no expectoration, the streaks of blood appeared in the sputa, which the patients had never observed in the course of their long illness. This appearance of blood in their sputa was the cause of a great anxiety to them and made them hurry over to my office. On inquiry I learned from two of them—one a lady and the other a young man—that while taking this remedy they felt a sensation all over the body, for four or five days previous to the appearance of the blood, as if heat were radiating from the ears, eyes, nose, top of the head, palms of the hands and soles of the feet. They attributed this sensation of heat all over the body and the appearance of the blood in the expectoration to the drug. I directed them to stop the medicine at once; this they did, and with the discontinuance of it the blood disappeared from the sputa as well as the sensation of heat, but to me it was an open question whether this appearance of blood in the expectoration was due to overdrugging, although I must say that the presence of the streaks of blood in the sputa of asthmatic patients is not an uncommon phenomenon. I resolved to give the same potency to the same patients after the lapse of some days. I did so, and to my surprise the blood-streaked sputa again appeared after they had taken the remedy ix, one grain four times daily. From this the patients understood it was the same medicine that had been given to them on the last occasion and begged me not to give it again, as the appearance of blood in the sputum frightened them, in spite of all my assurance. No more strong doses of the drug were given to them and they did not notice any more blood in the sputum. I have heard other patients complain of this peculiar sensation of heat whenever strong doses were given to them for some time. It acts better on stout and corpulent than on thin and emaciated persons. The asthmatic patients subject to repeated attacks of malaria derive less permanent benefit from the use of the drug. So, it seems to me, that in hæmic asthma, which is due to the abnormal condition of the blood, it is efficacious. I have also used this drug in troublesome cough with dyspnœa of phthisical patients with good result.
Clinical Cases.
Case I. Baln R. M., aged fifty-five, thin, emaciated and irritable temperament, has been suffering from hereditary asthma for the last twenty-five years. For the last six or seven years he suffered from asthmatic fits almost nightly and a troublesome cough with a good deal of frothy expectoration. He said he had not known what sleep was for the last six or seven years, in fact, he could not lie down in bed, as that would immediately bring on a violent fit of coughing which would not cease until he sat up, so the recumbent posture for him was almost impracticable, and he used to sit up during the night and doze on a pile of pillows. He passed his days comparatively better, but the approach of the night was a horror to him, his struggle, commencing at 9 or 10 p.m., would last till the morning. He was the father of many children and was well taken care of, but his suffering was so great that he had no ambition to live any longer. He tried almost all systems of medicine without much good. For the last ten years he took opium, which afforded him slight relief at the beginning, using as high as forty-eight grains of opium in twenty-four hours. Owing to the constant sitting posture he became stooped, and the back of his neck stiff and painful. In April, 1889, he was suddenly taken ill with fever. The fever became protracted. After an illness of over a month his condition became so bad that all hope of his recovery was given up. During this illness he was treated by an old school physician of some repute, but his condition daily grew worse, the asthmatic attacks became very violent and almost incessant, and the difficulty of breathing very great. He became so feeble that he had not strength enough to enable him to bring up the expectoration; his chest was full of it; fever was less; there was general anasarca. He was sitting with head bent forward, almost touching the bed, as that was the only position possible to him day and night. He had become almost speechless, when I was sent for, at about 3 p.m. on the 23d of May, 1889. When I was entering the patient's room a medical man came out and hinted that there was no use of my going in as the patient was just expiring. I found the patient breathing hard; unconscious; jaws were locked and saliva dribbling from the corners of his mouth; body cold; cold, clammy perspiration on forehead; eyes partially opened; in fact, to all appearance, he looked as if he were dead, except for the respiratory movements. I felt his pulse and found it was not so bad as the patient was looking. I examined the back of his chest, as that was the only portion easily accessible, and noticed that the bronchial spasms were going on with loud mucous râle. From the character of his pulse I thought that the present state of the patient was probably due to the continued violent struggle and not deep coma, and that he had become so exhausted that he was motionless, speechless and completely unconscious. His bed was surrounded by many friends and relations, who had come to bid him a last farewell; and it was with surprise that they all looked at me when I proposed to administer medicine to a patient whose death was expected every minute and for whose cremation preparations were being made.