C. (Charles) Neidhard.

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

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Online LibraryC. (Charles) NeidhardDiphtheria, 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 text (page 13 of 15)
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death is only apparent before becoming real. We have twice,
and even thrice, seen this fictitious death repeated, and on
these occasions, this apparent death so closely resembled the
real death that the instinct of the great blue fly was deceived
by it. A swarm of these flies, that deposit their larvae on meat
when it is beginning to spoil, covered the commissure of the
eyelids, the lips and the apertures of the nostrils with a thick
and rounded layer of these larva). Each of these succcs-sive
fits of lethargy was generally prolonged more than twenty
minutes, without one's being able to perceive enough indica-
tion of life to excite even a dubious movement of the heart, —
when, to our great astonishment, we saw a kind of resurrec-


tion, at first slow, then more rapid, so that the animals became
able to stand and to walk. Subsequently, there was a pro-
longed relapse, and finally complete extinction of life."

Contemplating this similarity, wonderful in many respects,
it is not surprising that several physicians, as well as myself,
should have conceived the idea that this remedy was probably
the principal specific in diphtheria; although, as I motioned
in a previous page, subsequent and more thorough study
forced me to abandon it. Prescribed in the first dilution, it
was useful in those slighter cases which almost any careful
treatment may cure ; but we must still hold firmly by the
principle that severe forms of a disease are the true test of a
remedy professing to be a specific against them, and in such
forms Cantharides failed. The following remarks oi Breton-
neau, page 189, are applicable here.

"If arguments were drawn against the speciality of the
Egyptian disease (diphtheria) from the similitude of the blis-
tering and poisonous action of the oil of Cantharides and
of the Egyptian disease, a great error would be committed ;
for, notwithstanding this apparent identity, there is a marked
difl'erence in the operation of these two agents. Cantharides
croup, developed by the injection of a small quantity of oil of
Cantharides into the trachea of a dog or a goat, produces the
symptoms of Egyptian (diphtheritic) croup ; but this cantha-
ridic croup is far from extending or becoming aggravated.
As soon as the expulsion of the false membrane is elYected,
the animal begins to recover ; and, after this expulsion, I have
tried in vain to prolong and aggravate the disease by repeated
cantharidic injections; for the mucous membrane resisted
more and more the vesicant action of the epispastic oil, and
was seen exposed on the surface of the dog's tongue when
wiped, as I have before stated. In the same manner, the
eflects of Croton Oil, when reapplied several times to the same
region of the skin, have been seen to cease to be reproduced."'

' Bretonneau. Fifth Memoir. Translated by Robert Iluiitcr Semple,
M. D., and published by the New Sydeuham Society. London, 1859.


So far Bretnnneau, who never thought of using Cantharides
as a remedy, lie might have added that tlie diphtheritic mem- ;
brane arising from an infected state of the blood can return(^
three or four times, or even more frequently, and can hardlyy
be extinguished.

To show the difference between a poisonous remedy like
Cantharides and a miasmatic poison, he refers to the large
doses of Tartarized Antimony gradually increased, exhibited
by Rasori, not longer exciting vomiting. From Arsenic taken
in poisonous doses, arsenic-eaters derive beauty, health and

In a considerable number of cases, particularly adults, there
was only a slight diphtheritic deposit, a few specks, like the
remains of a blister, or a few white, and sometimes brownish,
specks, the skin underneath being red and raw. There was
often a croupy cough which, if the other symptoms were not
very severe, was of little consequence ; but if accompanying ,
symptoms were of an aggravated nature, the croupy form-,
became very dangerous. I do not consider this form so
inevitably fatal as some writers do. One case, in which I
was consulted by another physician, and which proved fatal,
was subjected to a very careful auscultation, and by this
means we found that the disease had penetrated the most
minute ramifications of the bronx3hial tubes ; a post-mortem
examination was unfortunately denied. In slighter cases,
this cough was not dangerous, but would often last three or
four weeks; it was mostly confined to older children and
grown persons. That this cough was of diphtheritic nature,
the small patches of the membrane visible on the pharynx
testified. From seventy to eighty cases of the mild as well
as the more aggravated form, were treated by me with Can-
tharides in the first and second dilutions, with decided benefit.
The disease seemed to be arrested by this remedy, although
rather slowly. Mentioning this fact to my friend, Dr. A. H.
Okie, of Providence, R. I., who happened to be in the city at
that time, he corroborated my experience with Cantharides.


He made use of it with success even in the most malignant

I subjoin a few cases treated hj Cantharides exclusively.

Mrs. had symptoms of a hard cough,

Successful treat- with tickling in the throat and hoarseness.
ment of slighter Diphtheritic patches were visible in. the
cases with Can- throat. Several remedies, such as Lauro-
tharides. cerasus, Belladonna, and Merc. S., were

prescribed with very indifl'erent success.
Although Cantharides seemed less adapted to the mere symp-
toms, it cured the case because it had more afl&nity for the
whole disease. The most deep-seated symptoms, as well as the
pathology, must correspond to a true remedy.

Meta Y. had four white patches on the right tonsil; the
corresponding parotid gland was slightly swelled ; foul breath ;
enuresis ; tongue coated white ; great drowsiness ; fever mode-
rate; slight perspiration. Cantharides produced violent per-
spiration, curing the case in a short time.

Argentum Nitric.

On comparing the pathogenesis of Nitr. Argenti with diph-
theria, it will be perceived that there is a very striking simi-
larity between the two. Even in the third trituration, the
efiect of this remedy upon the membrane is very evident.
Its effect upon the general symptoms, also, is very beneficial.
This will explain why the caustic application is so often suc-
cessful, since the caustic effect alone is not sufficient to accoupt
for it. In Bretonneau's hands, the local application of Nitrate
of Silverhas given better results than Alum and Hydrochloric
Acid. In Germany, Dr. Lohethal, of Breslau, a Homoeopathic
practitioner, makes the same observation.

Bretonneau refers to six malignant cases of diphtheria re-
stored by the application of caustic alone. In several cases
of very malignant type Argentum nitric, from the first dec.
to the third triturations, was of the greatest service. The
symptoms were of a very severe character : palate and tonsils
covered by the membrane, which spread also over the tongue


and fauces, and returned again and again after liaving been
removed by remedies. (This was a usual occurrence, and
was seen by me in nearly all malignant cases.) Subnia.xillary
glands very much swelled, together with the face and whole
head ; sopor. The Nitr. Argent i was seldom exhibited alone,
but usually alternated with Crotalus hor.

The following severe and most malignant case was entirely
cured :

Laura P , a}t. two years and four months. The symp-
toms noted upon my first visit were as follows : Swelling of
tonsils, with here and there a speck of membrane ; yellowish
aspect ; fever, with constant drowsiness, with eyes half open ;
tongue, smooth and red, with dryness in the middle and swell-
ing; moderate swelling also of the parotid glands and all the
glands of the neck — the face, too, being involved ; a red erup-
tion overspreads the back. All these symptoms, thus early
developed, denoted the commencement of a very severe case of
the disease. 1 commenced to treat her with Belladonna 1 and
Cantharides 1 in water, alternately every hour. The next day,
all the symptoms had vanished as if by magic ; the child was
sitting up on the sofa, and looked very well. The remedies
were continued in the same way. The next day, all tho symp-
toms returned with greater violence, and the red eruptions had
so extended over the body that the disease might readily have
been taken for scarlatina.

The Belladonna and Cantharides, appa-
rently remaining powerless in arresting Belladonna and
the disease, Kali hichrom. ^'^ and Iodide of Cantharides pow-
Mercury ,'q were prescribed, with some erless; as also To-
diminution of the immensely increasing dide of Mercury
swelling of the parotid glands, the tonsils, ayid Kali bichrom.
and in fact the whole face. The sopor

The improvement from the Iodide of Mercury and Kali
bichrom. continued for a short time only. The disease re-
turned with renewed violence, and all the symptoms were
aggravated. Iodide mercur. ^'j, administered by itself, every


hour, caused an increase of all the worst symptoms. Crotahbs
h. 3, alone, had a beneficial effect on the sopor and the poison-
ing of the blood ; but the disease, as localized in the throat,
continued to increase and to spread around the palate, and
even to cover the tongue. We all thought the patient's end
was near ; but, as a trial in the critical emergency, I resorted
to Niir. argent. j\ in alternation with Cro-
Crotalus andArg, talus hor. 2, every half-hour, day and night.
nitr. successful. An improvement was visible within twenty-
four hours; the appetite, which had entirely
disappeared, was so far restored that the child was able to take
some milk and wine whey. The medicine was continued. On
the fourth day of the improvement, the little patient easily

e;pt awake till three o'clock in the afternoon. Large pieces
' the diphtheritic membrane were daily found by the mother
the passages of the bowels. The right eye was now less
closed, and the swelling of the whole face, as well as the
swelling beneath the chin and in the parotid glands, had very
much subsided. The tongue, however, was more swollen than
it had been ; the child would not show it, but by opening the
mouth, I could see the swelling, and a white mucus adhering
to both tongue and mouth. The discharge from the nose and
eyes was much less ; the heat in the forehead almost gone ; and
the pulse stronger, from 110 to 120. Faeces very fetid and
still having the membrane mixed with them.

I continued the use of the Nitrate of Silver in alternation

with Croialus from the 18th of September to the 7th of

October, 1860, gradually lengthening the intervals between

the doses. I now and then made the experiment of omitting

^ the medicines for a short time ; but the disease returned with

j violence, and I was obliged to continue them through the

Vprotracted period specified above. The struggle between the

disease and the remedies was prolonged and terrible.

At a later period, the eyes, nose and ears discharged an
acrid and fetid humor. There also appeared a large abscess
behind the left ear. The tongue had, for a long time, a smooth,
glazed, reddish appearance, and the appetite would not return.


Spirit Terehinth. 1 was prescribed with the most happy
effect. It not only increased the appetite, but restored the
voice, which had been gone for three weeks. After taking
this remedy for a few hours, the child begun to talk for the
first time.

Besides the remedies mentioned above, Cah. phos., and
afterwards Sulphur, were prescribed for the swelling of the
glands of the neck, after the subsidence of the more violent
symptoms; both with evident benefit. Whilst writing this —
five weeks since the commencement of the disease — the dis-
charge from the ear still continues. In every other respect,
the child is perfectly well.

In the second year of the epidemic, there occurred in ray
practice a case of diphtheria entirely different from any other
that I ever treated, and which I wish
briefly to relate here. Intestinal Diph-

C. C, a boy, aet. 12, and his sister, oet. 9, iheria. Crotahis
were attacked by the disease with equal h.BandArj.nitr.
severity ; diphtheritic deposits on the mu- 1 7iot successful.
cous membrane of the nose, tonsils, palate,
and pharauyx on both sides, with swelling of the submaxil-
lary glands and face. The sister recovered in a few days,
under the exhibition of A rg. Nitr. 1 and Crotalus h. 3. The
boy improved very much under the same remedies, but the
disease seemed to have made a more powerful inroad upon
his constitution, and he continued very weak. Nevertheless,
in ;i comparatively short time, the swelling in the glands of
the neck and in his face, together with the diphtheritic mem-
brane in nose and throat, had entirely disappeared. There
remained only an unaccountable weakness; there were also
a redness of the tongue, slight drowsiness, and occasional
vomiting. It was with difficulty that he could be prevailed
on to take any nourishment, and he had as unconquerable
an aversion to the stimulants which were ordered.

Vomiting being the most promment symptom, it waa ar-
rested by 01 terebinth., in alternation with Calc. carl.; but
soon a violent pain iu the region of the stomach came on,


Y i"^


together with soreness, under touch, of the whole abdomen.
From these symptoms I judged that, though the local indica-
tions of the disease in the throat had been removed, the
poison was still in the blood, and had penetrated to the
intestinal canal, an opinion which a subsequent post-mortem
examination confirmed.

Upon the appearance of the abdominal symptoms, sopor
returned, with deadly paleness of face, (anaemia.) Towards
the last, he lost his sight, and slept all the time. The remedies
which had relieved him before, failed in their effect, and he
died in two weeks from the date of his attack.

This case proved conclusively to my mind, that though the
local symptomatic expressions of this blood disease may be
cured in the throat, the poison may remain and develop itself
in other organs ; and that we must recognize the destruction
of the dyscrasia in the blood as the only radical cure in malig-
nant cases.

In many cases of malignant diphtheria, I have derived the
greatest benefit from the action of Crotalus and Lachesis^ in
preventing the poisoning of the blood and the consequent
unfavorable constitutional symptoms. No remedy sooner than
Crotalus, in the 2d and 3d triturations, will cure the fever and
sopor, as well as the swelling of the submaxillary glands;
and although, since my first employment of these medicines,
I have discovered a remedy that is a truer antidote to the
disease, I frequently make use of Crotalus to counteract the
poisoning of the blood.

Acid Nitric, Cantharides, Belladonna. — L. K., five years of

age, was attended by Dr. , for four or five days before

I was called in consultation. The case
Unsuccessfrd treat- presented the following features, when I
merit by Canthar., first saw it. There was such a peculiar,
Bcll.^ Lachesis and bluish- white appearance, from the fore-
Crotalus. head down the centre of the face to the

chin, that the most casual observer would
be struck by it. The eyes were duller than usual, but still
bright. The glands of the neck, on the right side, were con-


siderably swollen. On examining the pharynx and soft
palate, a thick diphtheritic membrane was visible on each
tonsil. The breath was foul, the appetite entirely lost, and
there was constant drowsiness. The remedy which had had
the best effect, prior to my consultation, was Nitric Acid
Under its influence the disease seemed to have been arrested
for a time, but it subsequently reappeared with all its former
violence. (This same recurrence of the disease occurred, it
will be remembered, in a case of my own, given above. The
patient appeared to be almost out of danger for three days,
but afterwards succumbed to the disease in its recurrent
form.) We immediately concluded to prescribe Cantharules,
every hour, and a frequent repetition, in small quantities, of
such stimulants as milk punch, etc. The beneficial effect
was very perceptible, the patient's countenance became more
animated and most of the other symptoms improved. But
again, in a few days, this seeming convalescence ceased, and
new symptoms of a dangerous character made their appear-
ance: very fistid breath, sordes of the teeth, dryness and
swelling of the tongue, and so great an aversion to food that
it had to be forced down the throat ; very slow, full pulse.
There was also a great drowsiness ; yet, on being roused from
sleep, the boy was perfectly conscious. Belladonna in alter-
nation with Arsenicum, and afterwards with Lachesis, (all in
low dilutions,) repeated every hour, seemed again to resusci-
tate his life, which was fast ebbing away; the pulse became
more frequent, there was fuller consciousness, the swelling of
the mouth and tongue was diminished, and, what was more
remarkable, the swelling of the face and of the glands of the
neck entirely disappeared. But notwithstanding these favor-
able appearances, we both thought the case hopeless, since
there was hardly any strength left with which the organism
might rally from its utter prostration. As a dernier resort,
Crotalus h. 3, in water, was recommended, and I left word
that if there was the least favorable change I should be
notified of it. To my surprise, I was summoned, two days
afterwards, to the bedside of our little patient, with the joyful


news that he was better. On examination, this could not be
gainsaid. The whole disease seemed to have disappeared.
The swelling of the face and neck was entirely gone; while
the swelling and the color of the tongue were better. The
boy was still drowsy, but answered every question correctly.
There was no coma. The medicine had apparently conquered
the disease, but the patient's strength was exhausted ; stimu-
lants, in small doses, were only of temporary benefit, and the
child sank towards evening and died without a struggle.


When I was first called to see cases of croupy cough with
the diphtheritic membrane visible in the throat, I thought

they would require special remedies. And ]
Crotalus h., Bro- such an opinion is undoubtedly true. We ^
mine, Antim. sul. must vary our remedies according to con- \
aur., Cede. phos. stitutional idiosyncrasies. But if we are in

possession of a true remedy for the blood j
dyscrasia, it should never be omitted ; and the other remedies j
ought to be made to alternate with it. At that time, I con-
ceived Crotalus and Lachesis to be the chief remedies for the
poison in the blood ; consequently I gave them (particularly
Crotalus) in alternation with other remedies, in cases of the
croupy form of diphtheria, and was generally very successful.
According to the predominating symptoms, Anfim. sulph.
aur., Kali bichrom., Bromine, or Calc. phos., were exhibited.
In scrofulous children subject to chronic cough, Antim. sulph.
aur. and Calc. phosph. were prescribed. To persons more
particularly liable to croup. Bromine was administered when
the disease assumed a febrile form, and Kali bichrom. in the
more chronic form.

I was called in consultation by several physicians in five
cases of the croupoid form of diphtheria. lu all these cases

Bromine had b'een extensively used pre-
Experience with vious to my being called in, but without
Bromine not sue- success ; they all resulted in death. Such
cess/ul. persistence of unfavorable issue did not en-


courage me to proceed in the path that seemed to have led
to it; and although numerous cases of the croupoid form
came afterwards under my treatment, in no one instance did
I rely upon this remedy alone to effect a cure.

My experience with the Iodide of Ammoniinn in the croupy,
as well as in other malignant forms, is not more favorable
than that with Bromine. A cure of the croupy form by this
means is, however, detailed in the United States Homoeo-
pathic Journal.

Neither can I give a better account of the Chhrate of Potash,
so highly extolled by the old school. It
was absolutely powerless in several malig- CJdor. of Potash.
nant cases in which I used it, and other
remedies had to be resorted to.

Liquor Potassse Causticum.

From the similarity of the symptoms, the Liquor Po-
tassse caustic^im was also tried in several
cases of diphtheria, and apparently with Liq. Potas. Canst.
benefit. In fact, the slighter cases are
cured by almost any remedy that has some affinity to the


At the close of the second year of the epidemic, there were
presented a number of cases (I counted eighteen) of diph-
theritic fever, a disorder that might have
readily been mistaken for some other dis- Borax in Diph-
ease, if the characteristic membrane had theritic Fever.
not been discovered in the throat in every
instance. These cases were defined by the following phe-
nomena : Chilliness towards evening, (four cases,) after which,
fever all night. The head hot, but the rest of the body cold,
(three cases.) During the fever, thirst, foul breatli, want of
appetite, and nausea, (three cases.) Constipation of bowels,
(three cases.) Sometimes pain in the right knee ; towards


evening stiff neck. No perspiration. Tonsils swelled with
diphtheritic deposit. In these cases Borax was the prominent
remedy, selected according to similarity of symptoms. Some
of them were aided also by Cantli., Arg. nitr., and Crotalus.
None of them was of serious import.

Solanum Mammosum Tuherosum., Ammon. Causlic, Calc.

Influenced by some very striking symptoms of the Solanum
tuherosum segrotans, contained in Mute's Materia ITedica, I have
employed this remedy in several cases of diphtheria. The
benefit derived from it was evident, but not sufficiently de-
cisive to induce me to make extended trial of it.^

Only in one very malignant case had I occasion to make

use of Ammon. causticum. Its action was
Ammon. causii- not so favorable as to induce me to employ
cum. it in other cases.

The conclusions to which I was forced,
by my experiments with the various remedies thus far detailed,
gave favorable pre-eminence to Kali bichromic, Cantharides,
Nitrate of Silver, and Crotalus. Still, since several of my
malignant cases had succumbed to the disease notwithstanding
active exhibition of those agents which my experience had
proved to be the most efficacious, I could not help feeling that
there must be some remedy of still greater affinity to the dis-
ease both in its chemical and its dynamical relations. Such

a remedy I conceived to be the Chloride of
Effect of Chlo- Lime. In the first place, in all the recorded
ride of Lime. instances, the local application of Muriatic

Acid to the membrane seemed to have ex-
erted a decidedly beneficial effisct, more than a mere chemical

' It is a curious circumstance that diphtheria and the potatoe disease
seem to have made their appearance at the same time ; and it is no-
ticeable, too, that a German agriculturist, by washing his potatoes in
Chlorine water, and drying them before planting, secured the greatest
immunity from this disease.


efiect. Of all the solvents, as lias been seen above, Lime-water
was the best. Besides, upon comparing the symptoms of CaU
carea and Muriatic Acid with those of diphtheria, the similarity
is very striking. It is true that Chloride of Lime has never
been proved ; but in dangerous cases wc have not always
time to wait for such a proving. The proving of Chlor., by
Dr. C. Bering, will give us very suggestive hints. E. g. : " He
could not swallow. Fetid ulcers in the throat. Malignant
inflammation of the throat. The mucous membrane of the
mouth and nose severely affected. Immediately after taking
diluted Chlorine icater it penetrates the bronchia, causing a
feeling of suffocation with violent cough. The attack ceases
with an increased secretion of mucus."

Br. E lb, oi Dresden,^ says: "That C/Jonn

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Online LibraryC. (Charles) NeidhardDiphtheria, 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 text (page 13 of 15)