When I reached home that evening I do not think my patient was any happier than I was over my success with the nux vomica in a purely experimental case. The next morning Mr. M. informed me that he had slept through nearly the entire night, which, owing to the cough, he had not been able to do in a week. The patient from that night had no return of severe paroxysm of coughing. I furnished him with fresh drops every day, and he became so well posted in their dosage and use that in a few days the cure of the cough was complete. And I may here add that I have had several similar cases of cough since that, and the nux vomica has succeeded in all. If physicians would more closely diagnose their cases of cough, I will venture to say, there might be discovered more than one case of neurotic origin and laryngeal.
Case IV.—Mrs. L. S., age 40, is of nervous temperament and has occasionally attacks of a mild form of hysteria. About one month ago I was called to Mrs. S., who, I found, had the usual symptoms of “grippe.” I treated her accordingly, and she was convalescing nicely. I had made my morning call, and found her doing fairly well—excepting that she complained of a slight shortness of breath. I carefully examined her lungs, but there were no indications of pneumonia. In the afternoon, about 3 o’clock, I received a hurried message to come without delay to see Mrs. S. I found her in a very nervous, somewhat hysterical and desponding condition; her face was flushed, she had distressing dyspnea, cardiac palpitation, pulse 112, small, weak and frequent, which of course was due to the functional cardiac derangement—there being no indication of organic disease. She called my attention particularly to her difficult breathing so soon as I reached her bedside, and begged for relief. I took in the situation at a glance, and wasted no time in thinking of a remedy to meet the case. My previous experience, and knowledge of the efficacious therapeutic action of nux vomica in neurotic affections, prompted its immediate use in this case.
The fifth one drop-five-minute dose reduced the pulse to 100, and in a measure relieved the distressing dyspnea. When four more doses had been given the pulse dropped to 90, and the dyspnea was so nearly conquered that the patient expressed her thankfulness for such speedy relief after a steadily increasing suffering of over four hours. By the time four more doses had been taken respiration was normal and the pulse 84. My medical mission was accomplished, and I left my patient—who was now feeling very comfortable—with instructions to continue the one-drop doses every half hour for four more doses, and then every hour up to bedtime. Next morning she was sitting up in her bed feeling quite comfortable, with respiration normal and pulse 78, the palpitation having entirely subsided. She has had no further trouble up to date.
Case V.—About two weeks after the occurrence of this last, I was called to Mrs. E. C., age 31. I found her suffering from great dyspnea and palpitation. She was also greatly troubled with flatulent dyspepsia and frequent eructations. The difficulty of breathing and the palpitation of the heart had been increasing for several hours, and as it was a new experience in her life, she and her husband became greatly alarmed lest the attack should prove fatal. But I knew my patient, as she had been one of my clientele for many years. I knew she was of nervous temperament and slightly hysterical. I wasted no time, but administered tinct. nux vomica according to my usual plan; the particulars in this case would only be a repetition of others, and it is unnecessary to recite them. The result was an equally happy recovery.
314 W. 126th St., New York.
THE THERAPEUTICS OF STRANGULATED HERNIA.
By W. C. Abbott, M. D.
No doubt some will smile at the above caption, and say: “The idea! Who ever heard of such a thing?” Others will read what follows and, perhaps, profit thereby.
Strangulated hernia is looked upon as, strictly, a surgical affair, only two ways of treatment being thought of, i. e., reduction by taxis or, in case of failure—and if the patient and family will consent, the knife. The former usually fails, and consent to the latter is frequently so long deferred that the result is anything but satisfactory; hence, any measure which is at the same time simple and helpful should be looked upon as a valuable acquisition.
The plan of treatment which I wish to present will best be understood if illustrated by the record of a case in hand. One morning, recently, I was summoned hurriedly to see an elderly German laborer, whose “breach was down,” so the messenger said, and it surely was. Such a scrotal display I never saw before; a mass larger than a child’s head, and as hard and tense as a foot-ball. I thought, at first, that part of it must be an old hydrocele, but was assured by the sufferer that “him all goes back.” This rupture was of some ten years standing. Formerly the hernia was retained with a truss, but of late years it had been allowed to go up and down according to circumstances, never having become strangulated before. Now, my experience has been that when an old man who has had years of practice reducing his hernia fails to put it back, the surgeon has a job on his hands.