Diphtheria, as it prevailed in the United States from 1860 to 1866, preceded by an historical account of its phenomena, its nature, and homoeopathic treatment online

assumed a very dangerous form, and the patient died. Some
other cases which he treated more carefully, he succeeded in
arresting by Bromine and Arsenic.

Ains Mellijica successful.

Dr. Kallenhach also speaks favorably of the action of Apis
fuellif. in diphtheria.

Arsenic and Mercury unsiiccessful. Ac. Muriat. — favorable
account.

Dr. Borchers, of Bremen, saw no good results from Arsenic
and Mercury, but speaks very highly of Ac. muriaticum.^

Ice.

Dr. Bonhojf speaks favorably of the employment of ice in
dii)litheria. (I have used it in many cases with great benefit.)

Dr. h'nnkel, of Kiel, has treated the disease successfully with
Kali bic/irom. and Mercury in the second and third triturations.
He was not able to give distinct indications for these remedies.
(No doubt of it. The characteristic symptoms of this blood-

' This corresponds with my own experience. Next to Calc. chlor. and
Kali hiihrinn.. I hiivo seen more beneficial effects from Ac. muriat. dil.
than from ;iny olhur remedy.



AMERICAN PHYSICIANS. 127

poison are the same in all cases, only modified by constitu-
tional idiosyncrasies, which require special treatment.)

Dr. Kafka, of Prague, in his "Practice of Medicine," speaks
of Chin, arseiiic. 3 as having been of extraordinary service
to him in scarlatina sore throat, and suggests that it might be
equally beneficial in epidemic diphtheritis.

From the account which I have given of the treatment of
diphtheria in Germany, it may be presumed that that country
has by no means been visited by the most malignant form of
this disorder. Very few or none of the cases described seemed
to possess the extremely dangerous character of the cases prev-
alent in this country.

Section IY. — American Physicians.

J. P. Dalce, M. D., of Pittsburg.

Dr. J. P. Lake, of Pittsburg, classifies diphtheria according
to the following groups of symptoms, and varies his treatment
accordingly.

1. Sensation of soreness of the throat, heat and dark red-
ness of the tonsils, uvula or contiguous parts, and diflicult
deglutition, preceded by more or less chilliness, and accom-
panied with fever, and often with headache also. (This, of
course, is the disease in its undeveloped state, as he himself
mentions.)

Belladonna and Capsicum.

Remedies employed in this form: Belladonna, Capsicum,
(with a combination of 1st, 7th, 14th and 31st dilution.s.)

2. In addition to the symptoms enumerated above, con-
siderable swelling of the tonsils, submaxillary and parotid
glands, nasal obstruction, or fluent coryza, with a general
feeling of soreness and languor, and sometimes, also, stiffness
of the neck. Remedies : Mercurius iod. Sd dec trit., in alter-
nation one day with Belladonna, and the following with Caj)-
sicum, iiiving one do.se of the Mercurius iod. to two of the other
remedies, and at intervals, between doses, of two hours;



128 HOM(EOPATHIC TREATMENT OF DIPHTHERIA.

Borax, Caiosicum, and Belladonna.

3. Disordered stomach, loss of appetite, aphthous (?) ulcers
on the tongue, in the buccal cavity, or on the tonsils and
palate ; soreness and pains in the epigastrium, occasionally
with diarrhoea ; the pulse generally rapid and small, with
moisture of surface, and general debility. Eemedies: in
third or aphthous form, Borax, second trituration, in alterna-
tion with Capsicum and Belladonna. When there is much
feverishness, he prefers Belladonna, with the Borax; when
there is great burning in the mouth and throat, Capsicum is
better.

Malignant Form.

4. In addition to the symptoms in groups 1 and 2, and
sometimes succeeding those of 3, white elevated spots on the
tonsils, uvula, arches of the palate or posterior wall of the
pharynx, appearing like the mucous membrane raised, thick-
ened, hardened and whitened, in patches varying in size from
the smallest fish-scale to that of a piece of white kid sufficient
to cover the entire throat and half the buccal cavity. These
patches have a border of deep red, and when removed leave
a raw, rough, and bleeding surface. They sometimes form
and spread very rapidly. Under successful treatment, they
loosen, break, and are thrown off in fragments, with a sauious
and bloody discharge. The breath is very oftcnsive, the pulse
small and generally rapid, with copious perspiration, and in
the later stages there is extreme debility. (This is diphtheria
in its fully developed state.)

Nitric Acid, Belladonna^ and Capsicum.

Remedies: Nitric Acid 1, in alternation with Belladonna
and Capjsicum.

Crovpoid Form.

5. Constant dry cough provoked by swallowing, and worse
when lying; hoarseness and rasping respiration, such as
characterize membranous croup.



AMERICAN PHYSICIANS. 129

These symptoms sometimes appear just after, or in connec-
tion with, those given in groups Nos. 1, 2, 3 or 4,

Bromine, Belladonna, Aconite, Nitric Acid, Spongia, Ilcpar ISnl-
2)huris, Kali Bichrom., Iodine. Not Favorable.

Remedies in this form : Bromine 2, in alternation with Bel-
ladonna ; sometimes with Aconite, or occasionally, with Nitric
Acid.

Br. D. also employed Spomjia, Ilepar snlphuris. Kali bi-
chrom. and Iodine, in this form, without any very favorable
results.

Ulceration of Nasal Ducts and Schneiderian Membrane. Am-
monium, Caustic.

In cases attended with great irritation of the nasal ducts,
and ulceration of their lining membrane, he employed Ammo-
nium caustic, with very gratifying results.

He gives a tabular view of his cases, with the results of
treatment as follows :

Class. Number of Cases. Recovered. Died.

1 12 12

2 40 40

3 51 50 1

4 74 72 2

5 16 12 4

193 1«0 7

Dr. Dalle's practice of alternating Belladonna with all reme-
dies in every group, we conceive to be a good one, for the
great affinity between diphtheria and scarlatina cannot be de-
nied.

In addition to the above observations, I will add here some
remarks from a letter received irom Dr. Lake in October, 1862:

" He who looks for remedies that will cure every case of
diphtheria, looks in vain, for they can never be found. There
are persons who, if attacked by this disease, will die under



130 HOMCEOPATIIIC TREATMENT OF DIPHTHERIA.

any method of treatment, and with any remedies. So also
with scarlet fever. The last fatal case that has "been under my
treatment, was that of a bright girl of sixteen. She was evi-
dently of a scrofulous diathesis, though generally presenting
ruddy cheeks and the ordinary appearances of health. The
left tonsil, arch, and pendulum of the palate, and the left and
posterior walls of the pharynx, were inflamed and then covered
with the peculiar diphtheritic patch. The false membrane was
successfully removed ; also the hoarseness and difficulty of
breathing, by my ordinary remedies. There was apparently
a fine recovery in progress, when suddenly, on the morning
of the nineteenth day, she began to feel cold, experienced
great oppression in the region of the heart, felt nausea and a
sense of sinking. I was called, but did not arrive till she had
been some time dead. The day before her death, she com-
plained to her sister of palpitation of the heart. From all I
could learn, I have been of the opinion that she died of paral-
ysis of the heart, — a failure of it to pass the blood through its
wonted channels." ^

Dr. B. Ehrman^ in a letter to the author, dated Cincinnati,
November, 1862, states that the reports of the Board of Health
had ceased for some time in that city, and therefore he could
furnish me with no statistics with regard to the mortality of
diphtheria in that city.

Mercurius lod. 2, Kali Chlor. jnir., in aqua.

Dr. Ehrman relies chiefly upon Mercurius iod., Id trituration,
and Kali cliloric. pur., in water. With the last remedy, he
alleges that he has been particularly successful.

Efficacy of Iodide of Mercury.

Dr. 11. I). Paine, of Albany, N. Y., in his interesting re-
port published with the Transactions of the American Insti-
tute of lIoma3opathy, speaks highly of the beneficial effect of

' Sec the obscrvaticus of Dr. Pdcr^ov, on a suhsoquciit page.



AMERICAN PUYSICIANS. 131

Iodide of Mercury in diphtheria. I shall give the following
account of his treatment: "The immense value of lodiik of
Mercury in this disease will be easily understood by those who
have experienced its efficacy in analogous diseases. We have
given it mostly in doses of the first trituration, and the en'oct
in arresting and detaching the false membranous formation
has been, in many cases, most gratifying.

Belladonna and lilius.

" Generally Belladonna or Rims have been continued at in-
tervals, — during the stages of febrile excitement, — the choice
between the two being affected by the character of the fever,
as well as by the appearance of the throat.

Arsenicum, Stibium, and Spongia.

"Arsenicum was given when, with the fetid breath, the lining
of the nostrils became affected, and discharged a viscid, foul
secretion, and there was great and increasing prostration of
strength. When the inflammation, and consequent deposit,
extend to the trachea and threaten to carry oft" the patient
with the usual symptoms of the croup, the remedies that
have been most successful in combating this alarming state
of things have been Stibiwn and Spo7i;jiay

Drs. Ludlam and Helmuth, in their respective treatises,
speak of having used the Proto iodide of Mercury with success
in some of the worst cases. In other cases, Ilelmulh found
this and other remedies without avail.

Biniodide of Mercury — reliable remedy.

Dr. J. C. Peterson, of St. J(jhns, N. B., enters the list of the
champions for the Biniodide of Mercury in diphtheria, and
publishes three cases to illustrate its action. He says : " The
remedies which have been most successful in my hands have
been Biniodide of Mercury, given in doses of one-fifth to one-
tenth of a grain, frequently repeated ; Ilepar sulph. 1, and
lodium, in doses of from one to five drops. Should the pri-
mary fever be severe, I have exhibited a few doses of Vera-



132 nOM(EOPATHIC TREATMENT OF DIPHTHERIA.

trrim viride, and occasionally T have given Belladonna. But
I have found that the Bintodide of Mercury is the reliable
remedy, and I feel assured in stating that it has in many in-
stances arrested the disease."

Iodide of Mercury unsuccessful. Nitric Acid.

Dr. J. Davies, of Chicago, Illinois, publishes, in the North
American Journal of Homoeopathy, three malignant cases.
In the first case, rather severe, with the usual symptoms, that
of a young lady of sixteen, he employed at first Ifercurius
iod. 1, in alternation with Arsenicum 1, with a wash of the
Chlorate of Potash. He says that an improvement was mani-
fest. Notwithstanding, he changed the remedies, on the fourth
day, to Nitric Acid 1, internally, and strong Nitric Acid exter-
nally. "We presume, therefore, that from the first remedies
the improvement was not very lasting.

Iodide of Mercury, Gelseminum, Nitric Acid, Chlorate of Potash,
Ajyis Mellifica, and Nitrate of Silver. ,

In the second case, that of a gentleman aged thirty-two,
Iodide of Mercury 1, in alternation with Gelseminum 1, was
given in water. He was better on the third day, but worse
on the fifth ; whereupon the treatment was changed to Nitric
Acid, externally and internally. After a week he found it
necessary to alternate the Nitric Acid with the Chlorate of
Potash. In the third week he also applied Nitrate of Silver
to the membranous deposit, and gave A2ns mellifica and Chlo-
rate of Potash internally, which completed the cure in the
third week.

Chlorate of Potash and Iodide of Mercw'y, successful.

Under No, 3 was mentioned a family of six children, the
youngest of which was eight years of age, all of whom were
treated successfully by the Chlorate of Potash and Iodide of
Mercury. The cases do not appear to have been very malignant.

Although these cases cannot be held up as models for imi-
tation, I do not blame our colleague, who, in a dangerous and



AMERICAN PHYSICIANS. 188

often fatal disease, like diplitberia, so often changes his reme-
dies. We are only too glad to save life.

I have only quoted these instances to show that Iodide of
Mercury, although used with faithful perseverance, does not
always even arrest the progress of the disease, and other reme-
dies have to be tried to eft'oct that purpose. A clear, decided
effect of the remedy was by no means perceptible.

Iodide of Mercury. No striking similarity to Diphtheria.

Dr. D. A. CoUon, of Chicago, Illinois, (N. A. Journal of
Horn., vol. xi., p. 237,) says of Merc. iod. that " in its poisonous
pathogenetic efiects, it does not make so complete and strik-
ing a picture of diphtheria as to authorize us in relying upon
it, if the disease does not soon yield under its administration."
Dr. C. is in favor of the lower dilutions.

Large Duses. Merc. Iod. alternately ivith Belladonna and
Ammonium Caustic, successful.

Dr. J. J. Diller, in an original article published in the
Western Homoeopatiiic Observer, failing to cure diphtheria
with the higher and middle potencies, afterwards gives Merc,
iod. 1, at first with Bellad., and afterwards in alternation with
Ammon. caustic, with success.

Proto-Iodide of Mercury.

In the transactions of the Illinois Homoeopathic ^fedical
Association several members speak favorably of the action
oi i\xQ Proto-iodide of Mercury. The discussions are highly
interesting.

Dr. A. F. Small. Identity of Membranous Croup and Diphtheria.

Dr. A. E. Small was of opinion that it would be generally
considered that diphtheria and croup in its various forma
were essentially the same.

This was contested by Dr. Patchin, of Fond du Lac, Wis-
consin, maintaining that "in croup the convalescence is well-
marked and rapid — not deceptive, insidious, and protracted,



134 HOMOEOPATHIC TREATMENT OF DIPHTHERIA.

as in diphtheria. In croup, the whole disease seems to be
localized in the throat and trachea ; there are no constitutional
symptoms indicative of extreme debility. In diphtheria, the
general symptoms are no less marked than the local ones ;
the poison aflccts the foot as well as the throat ; every part,
every tissue, is more or less implicated." To which Dr.
Small rejoins, that "the pathology of both diseases is the
same. The moment the blood fails to be furnished with air
in requisite quantity and purity, respiration becomes abnor-
mal, and suffocation ensues. This is what happens in croup,
and well accounts for all the toxical symptoms of diphtheria."
Dr. Small truly remarks that "there is a wide difference
among cases of croup as well as of diphtheria. A great dif-
ference between spasmodic and membranous croup, etc."
During the prevalence of diphtheria in Philadelphia, for the
last five or six years, I have often seen cases of membranous
croup, which were exactly the same as those I formerly at-
tended, when no such epidemic prevailed. When the disease
was only local in the larynx, and not the whole system
poisoned, the cases all got well. I only considered them as a
milder variety of the more deadly miasmatic diphtheria.

Dr. R. Lndlam, taking part in the disputation, says : " It
seems to me that the part of hereditary influence in determin-
ing a liability to croup should be taken into account, while
such predisposing causes seem possessed of little modifying
influence over an epidemic of the malignant diphtheria.
Furthermore, it is a recognized fact, that a liability to re-
peated attacks of the croup is by no means uncommon ; in-
deed, in this country, is a very ordinary result of one such
illness. Well authenticated cases of diphtheria occurring
the second time in the same person are exceedingly rare." I
have seen diphtheria return in the same person three or four
times, sometimes every winter for several years, but of less
severity than the first time. Scrofulous coustitutious are
most liable to diphtheria as well as croup.



AMERICAN PHYSICIANS. 135

Unfavorable effects of Bromine in Diphtheria.

Dr. Lord, the chairnuni, rcniarkod, that lironiiue was not
HoMioeopathic to diphtheria, not producing similar constitu-
tional or local eft'ects. Dr. Small is of the same opinion. I
must confess that I never saw any beneficial cllccts of this
remedy, in any severe case.

Carho Vegeiabilis for the state of Collapse.

Drs. Kellogg and Pratt spoke favorably of Carho vegetabilis,
in the third trituration, for the state of sinking.

7\ro malignant cases of Cronpoid Form cured by Bichrom. of
Potash.

In conclusion, two interesting cases of diphtlieria, from Dr.
Lord's practice, are reported in detail. They were both of
the croupy and malignant form, and apparently cured by the
first triturations of Kali bichrom. Other remedies were ex-
hibited, uf which Muriatic Acid and Cantharides had the best
effect.

Lnhalation of Bichrom. of Potash.

According to Dr. Lord, of all remedies. Aconite and Kali
bichrom,. had the most decidedly beneficial effect. " When-
ever the cough became dry, and respiration whistling, and
suffocation seemed imminent, m\\^\i\\\o\\s,oi BicJirom. of Potash
were used with prompt relief. Of course it was only tempo-
rary, but it was a respite. It did not fail in a single instance
of easing the breathing and loosening the cough, and ejection
of membrane or large quantities ol stringy mucus followed.
The Muriatic Acid seemed at first to answer the same purpose,
but the subsequent trials showed that it had no such effect.
Perhaps its inhalation would have answered better." (The
Chloride of Lime, according to my experience, internally ad-
ministered, would have answered a better purpose.)

Prof. Ludlam, of Chicago, Illinois, who, in all his writings,
is profound and exhaustive, groups, in his work on diphtheria,



136 HOMCEOPATHIC TREATMENT OF DIPUTHERIA.

the different remedies under the various indications thej are
calculated to meet. Thus he prescribes certain remedies for
the febrile symptoms; for the cerebral disorder; for the
mouth and throat, etc. He will permit me to differ from him
with regard to this method of application. If diphtheria
arises, as he himself says, from "a specific, invisible cause,
which, in order to produce its legitimate pathological fruits,
must first be introduced into the blood," this poison is the
same, whether it attacks the brain, throat, or any other part
of the human body. It must, therefore, be met by such
remedies (simillima) as are most antagonistic to this poison,
no matter what the locality of the disease. But, as this
poison is undoubtedly modified by constitutional idiosyncra-
sies or peculiarities, many other remedies may come into
play as adjuvants, but not as Homoeopathic remedies, (spe-
cifics,) for this particular miasma.

At the conclusion of the work, the author remarks that
constitutional treatment offers the only hope of life for the
patient, or reputation for the physician, an observation to the
justice of which I can cordially subscribe,

Phytolacca Decandra.

In JDr. Lodgers Homoeopathic Observer, Detroit, 1864, Dr.
W. II. Burt gives an account of his treatment of diphtheria
by Phytolacca decandra. I shall quote the following data
from his article :

" Pathogenetic effects of Phytolacca decandra, resembling
diphtheria: Constant, dull, frontal headache, aggravated by
motion. Drawing sensation above the root of the nose.
Pressure in the eyes ; dull, aching pain in the eyes. Loss of
taste. Tongue is very rough, with blisters on the sides that
smart severely. Pressing pain in the right side of the throat.
Sore throat with great roughness in the pharynx. Constant
inclination to swallow, which produces severe pains in the
root of the tongue and fauces. Violent inflammation of the
soft palate and tonsils ; the left tonsil is swollen as large
again us the right. Thick, white and yellow mucus about



AMERICAN PHYSICIANS. 137

the fauces. Violent inflammation of the oesophagus. Feeling
as if something had lodged in the cosophagus. Profuse
hemorrhage from the nose. Loss of appetite. Urine strongly
albuminous. Bowels either constipated or loose. Violent
aching of the back and limbs. Very weak and faint."

Dr. Burt continues: "These symptoms were all produced
in myself. I took the remedy until I could not swallow any
thing for two days, but a little liquid food. The toxical effect
of the Phytolacca is mostly all spent on the throat. Among
all the long list of remedies in our school we have none that
can equal the Phytolacca in diseases of the throat.

Successful Treatment of eighteen cases by Phytolacca Decandra.

" In the treatment of diphtheria, Belladonna and the prepa-
rations of Mercury cannot be compared to it. I have treated
eighteen cases of diphtheria with nothing else but the Phyto-
lacca decandra. Twelve of these cases were of a very danger-
ous character ; all of these were cured in from three to eight
days. The one that lasted eight days, that of a young lady,
was an extremely bad case. Two had died in the family
under old school physicians. My case was the worst of the
three."

Br. B. publishes four cases, two of which were adults and
the other two children, of respectively nine and four years of
age. None of them appear to me as cases of the most malig-
nant kind.

The experience of Br. B. with Phytolacca decandra has
been corroborated by several physicians, who have been, as
they allege, equally successful.

Phytolacca Decandra successful in Spurious Diphtlieria.
Dr. Smith Rogers also treated successfully many slight cases
of diphtheria or what he calls " spurious diphtheria." with
Phytolacca decandra, in alternation with Guaiacum. lie truly
says, that " during the prevalence of any epidemic there is a
strong tendency, in every affection, to assume some appear-
ance of the particular form of disease which is prevailing."
10



13S HOiKEOPATHIC TREATMENT OF DIPHTHERIA.

Kali Bichrom. more successful than Proto-Iodide of Ilercury.

In the transactions of the Michigan Institute of Homoeop-
athy, Dr. J. N. Eldridge speaks very favorably of Kali
bichrom. in diphtheria, but not so well of the Proto-iodide of
Mercury.

Gelseminum in Paralysis following Diphtheria.

Gelseminum is favorably noticed by Drs. Lodge and Smith
Rogers, as curative in the paralysis following diphtheria.

Antim. Tartar, in Paralysis of the Lungs.

Dr. J. K. Spranger details a case of paralysis of the lungs
following diphtheria, cured by Antim. tartar., ^ gr. in a tum-
blerful of water.

Dr. Freligh. Antim. Tartar, and Merc. sol. successful.

Dr. Freligh, of New York, treated six cases of diphtheria
most successfully with Antim. tartar. 1 and Merc. sol. 1, with
the external use of Nitrate of /Silver. No details given.

Sigh Potencies in Diphtheria. Dr. Ad. Lippe. Kali Bich. 200
successful.

Dr. Ad. Lippe relates two cases of diphtheria cured by Kali
bichrom. 200.

The first case, a child, aet. 5, at first received Belladonna 200,
followed in thirty-six hours by one dose of Lachesis 200, which
removed all diphtheritic symptoms, and the case was consid-
ered cured, but afterwards had a relapse, when Hepar 200 and
Bromine 200 were administered without any effect. The throat
could not be examined, because the child would not open the
mouth. In order to show the importance of small symptoms
in the selection of remedies. Kali bichrom. 200 was prescribed
on account of the presence of the following symptoms : "Vio-
lent stitches in the left ear, pain in the left side of the head
and neck, where a large swelling with redness and inflamma-
tion appeared, which was also worse after midnight. Dry,



AMERICAN JMIYSICIANS. 1S9

hard, spasmodic cough." The abscess on the neck broke on
the ninth day and the chikl recovered. (When the swelling
was only on one side, I always considered the cases very
slight, although tedious.) The other case, that of a young
lady thirteen years of age, was also cured by Kali hichrom.

In my estimation Kali hichrom. is one of the best remedies
in diphtheria, although inferior in power to the Chloriile of
Lime. I have generally administered it in the first and second
triturations. Dr. Lippe, at the conclusion of his article, makes
the following observation :

"For the gratification of 'non-IIomoeopathicians' (?) I only
remark, that most all cases of diphtheria which have come
under my care have yielded to one dose of one, seldom two,
properly selected Homccopathic remedies, in the smallest dose.
The nou-Homoeopathicians who sneer at such reports would
do better to make ' the experiment ' before dealing denimcia-
tions."

I am far from sneering at his report, believing that we re-
quire all possible light in this intricate disease. Regarding