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Comments on the homœopathic treatment of diabetes
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COMMENTS ON T H E HOM(EOPATHIC TICEATMENT OF DIABETES* By DR. KENYON MR. PRESIDENT,
I am not sure whether these observations should be made about that insulinogenic deficiency of the pancreas that is called Diabetes or about the homceopathic treatment of hyperglyc~emia in general. However, as hyperglyc~emia, whatever its cause, if allowed to continue, produces dam. age to the Islands of Langerhans, this is probably a quibble over definition. My motive for commenting on the homceopathic treatment of diabetes mellitus is because this very prevalent complaint is often unresponsive to our drugs. The foremost reason for this, I think, can be ascribed to the difficulty we experience so often in finding satisfactory symptoms and modalities on which to prescribe. Because of this, we are tempted to give remedies chosen on account of their power (on occasion) to produce glycosuria. When treatment is given in this way the result is usually unsatisfactory ; in most cases it is dismally ineffective. In my view, there is no illness in which a careful and exhaustive homoeopathic case-taking is more vital, and, more fruitful. On the other hand, there is no disturbance in which " easy cuts to treatment ", that is prescriptions based on end actions of disease, is more futile. In the treatment of a case of diabetes there are, of course, many valuable orthodox methods to be followed. The giving of a balanced diet ; the removal of septic loci and infections which we know block the action of body insulin ; the giving of insulin when necessary ; the restraint of over-eating in the obese diabetic; such treatment may stabilize the body with the result that the patient develops a sugar tolerance and recovery may occur. But, in addition to this the homceopathic remedy has its place and its place may be unsurpassed in speeding recovery. If, as I believe, the correctly chosen drug can be so potent in its effect, it is desirable to observe the full response to diet (and insulin when required) before giving the homceopathic remedy and therefore forming a judgment on its action. I have been asked on occasion if it really matters what helps the patient to recover: diet, insulin, and remedy, so long as the patient gets well. I n view of the important place that the homceopathic drug takes in the treatment, I think that it matters very much indeed. Towards the end of the attack on this country by flying bombs, I was asked to examine 135 apparently healthy young adults living in the south suburbs. Thirty of these persons had sugar and acetone in the urine. Fortunately, I was given the opportunity of investigating fully each case. Each one of these thirty patients had a high blood sugar two and a haft hours after the beginning of a good meal, and they all showed a glucose tolerance curve of a mild diabetic type. Each case was treated by diet alone. When checked up in three months normal readings of the glucose tolerance curve were obtained in every instance ; and six months later each one of them was found to be in good health and biochemically normal. In itself this is not a particularly interesting observation. Mild cases of hyperglycmmia do clear up under dietetic treatment. But, in conjunction with the next series of cases, there is something of interest to the homceopathist. In the summer of 1946, I examined ninety-six young adults from the same district, and under the same conditions, except that bombing had ceased. Only one of these cases showed a trace of sugar (transient) in the urine. * Paper delivered at the Faculty of Hom~eopathy, June 5th. 1947.
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When I was thinking about the first series of cases, I wondered how much a heavy carbohydrate diet and how rmach fear had played their respective parts in the production of the hyperglyczemia. A consideration of these 200-odd cases, thirty of which had developed a definite hyperglycmmia under certain environmental conditions, suggests that emotional stress does play a part in the incidence of diabetes. This, again, is not an original conclusion. Dr. Lawrence says that " When shares go down in Wall Street, diabetes goes up ". This view, however, is not shared by all writers on the subject. Nevertheless, these two series of cases that I have just quoted did turn my mind to consider etiology more carefully when seeking for a homceopathie remedy in difficult cases. When preliminary treatment such as diet and so forth has been given and the effects noted, then the homceopathic remedy is given when required. I f the remedy is to be considered to be effective, there should be a swift improvement in the general health of the patient, if the health has not been good previously. I look for a rapid improvement of symptoms, when symptoms have been present. Treatment should also result in a reduction of hyperglyceemia two and a half hours after the beginning of a meal ; and, in responsive cases, one often finds a levelling in the urine-sugar graph which every patient charts four times daily. Sometimes a diabetic patient is homceopathically symptomless. I have he/~rd it suggested that such a patient requires no treatment, even though he has a heavy hyperglycmmia. This view must be regarded as dangerous and pestilential. These physicians seem to forget that a case that is homoeopathically symptomless may be most scriously ill. At any rate, it is generally considered that hyperglyczemia, whatever the cause, eventually overstrains the Islands of Langerhans and the result will be a frank diabetes. Some cases of diabetes are easy to treat homceopathically because they present good prescribing s y m p t o m s ; many are less responsive to treatment because the symptoms are elusive and difficult to find. Other eases seem to have no prescribing symptoms whatever, and do not, therefore, yield very much to our remedies. The cases i am going to give you are few, but they arc rcpresentative of many. They have been chosen because there appear to be certain points of interest relevant to my comments. :Not all these patients have recovered, but a litany of therapeutic triumphs is abhorrent to listeners and of little value for discussion. The cases fall under three headings: the divisions arc quite artificial and are only so divided for the purpose of description. TYPE I. Many diabetics have abundant prescribing symptoms : the choice of the remedy (or remedies) is e a s y : the response to treatment is swift. Here is an example: This case is of interest because she had been under treatment for some time at a diabetic clinic. She had been stabilized on diet and insulin, but she decided to consult a homceopathist because she did not consider that she was in as good health as she expected to be. Case A. Female, aet. 21 years. She was diagnosed as suffering from diabetes in September, 1943. She attended a diabetic clinic when she was stabilized on diet and insulin and continued with this treatment until she consulted mc in April, 1946. At this time she was taking 40 units of soluble insulin and 30 units of Zn protamine daily. When she first saw me in the spring of 1946, she complained that she felt weak ; lack of energy ; her memory was poor ; she was unable to concentrate and was extremely anxious about her health and her prospects of earning her
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living. She was a tall, thin, and very intelligent y o u n g woman, with a family history of tuberculosis. Her weight was 7 st. 11 lb. as against 9 st. 2 lb. in 1943. I t is not relevant to m y comments to discuss the reasons for the remedies she received : the first prescription is obvious to anyone. Actually she received Phos. 200 and over the next year Tub. Koch 200, Nat. phos. 200, and Sulphur 30. These remedies were easily chosen on good prescribing symptoms. I n the April of this year she felt fairly well. The w e i g h t - - 8 s t . - - h a d remained steady for some months. Her daily insulin is now 10 Soluble and 2 Cloudy units per day, t h a t is a drop of 60 units in a year. I t is necessary to add t h a t this controls her hyperglycmmia. I t seems a fair assumption to claim t h a t homceopathy has been of some help in this case. TYPE II. Then there is the type of case t h a t has few useful prescribing s y m p t o m s , but a careful taking of the case brings to light some exciting etiological factor. During the past few years an i m p o r t a n t exciting cause has been t h a t of fear.
The case I am quoting is t h a t of a child and is of interest for two reasons. I n childhood the presence of h y p e r g l y c e m i a and diabetes is potentially serious. This case is one of six children 1 had to treat. These children came from different families, but they all lived in the same district where they had been exposed to h e a v y bombing. The six of t h e m developed hyperglyc~emia. T h e y were all put on diet and four of them recovered quickly. The blood sugar and urine became n()rmal within a few weeks and have remained normal. Two of these children continued to haye a hyperglyc~emia and became ill. T h e y both required homceopathic t r e a t m e n t in addition to a balanced diet, but insulin had not to bc given. Case B was a boy aged 11 years, who was brought to me in J a n u a r y , 1944, suffering from pustules on the skin. This was some time after sugar had been found in the urine and the boy had been p u t on diet. His mother was more worried because he was feeling unwell ; readily tired and was working badly at school, though he was a very energetic and clever boy. The boy looked ill and, in spite of careful dieting, sugar and acetone were found in the urine. The blood sugar was 281 mgs. per cent. (Blood sugar rea~lings quoted in this paper are those recorded 2~- hours after a meal.) As he had a considerable a m o u n t of acetone in his urine, he was given Cassia 6c t.d.s, for five days. A fortnight later, the urine was loaded with sugar, but there was no acetone. The blood sugar was 268. The diet was continued, but no r e m e d y was given. On F e b r u a r y l l t h , 1944, the blood sugar had dropped to 218 rags. per cent. and there was a marked glycosuria. The boy was ill ; listless ; lacking in energy ; t o u c h y and irritable. His mother had formed the opinion t h a t his ill-health had dated from a fright and from anxiety following air raids. He was given Natrum mur. 200. (The reason for the prescription is, of course, evident, but the point in quoting this case is to demonstrate the value of etiology in prescribing.) I did not see him again until April, 1944, when his blood sugar was 131. The urine had been examined four times daily, the glycosuria had gradually diminished and was now absent.
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During the next eighteen months there were intermittent rises of his blood sugar and remedies were given according to the symptoms. (The two remedies he required were Nat. mur. and Phosphorus.) During 1946 the boy remained well : the urine was consistently free of sugar and acetone, and the blood sugar at a normal level. In January, 1947, the G.T.T. showed a normal curve. There are many cases where etiology, other than emotional stress, guides one to a prescription. I am quoting this case because it has been a difficult one. The etiology is not certain: the treatment is not completed. However this may be, it certainly emphasizes the need of exhaustive case-taking, in such difficult conditions. I should like to say here how much I am indebted to Dr. Chand for his indefatigable industry in working on this case with me. This brief report gives no indication of the hours of routine work Dr. Chand has devoted to this investigation. Case C is a married woman, aged 59 years. She came under our care during the latter part of April, but she had" been on a balanced diet for a month previously, and had received Tub. bov., Belladonna, and Sulphur. Her blood sugar was 193 mgs. per cent. Dr. Chand reports that after prolonged and patient questioning very few symptoms on which to base a prescription could be elicited. But, he remarks, that it is of interest to note that all her complaints date back to Christmas, 1946. At that time there was an unhappy incident which led her to fear that she had contracted syphilis. On enquiring into the history we found that she had developed an ulcer on the lip which had been treated with penicillin injections. All blood tests were negative and there was nothing to suggest that she had acquired a specific infection. I t was quite impossible to reassure her, and because of this obsessional state (rather than any belief that she was, in fact, suffering from syphilis) we decided to give her Lueticum 200 which she received on May 21st. Since then her burning sensations and vague pains vanished. Her glyeosuria showed an immediate improvement which has been maintained up to the present. (A chart of the glycosuria indicating this improvement was shown to the Meeting.) There was also a slight improvement in the hyperglye~emia-186 mgs. per cent. on May 16th. Three weeks later she appeared to be slipping back in general health and the case was retaken, after which Pulsatilla 30 (four doses) was given. After this remedy she improved again and her blood sugar dropped within a few days to 170 rags. per cent. This case has not recovered, and is quoted to illustrate the necessity of searching c~e-taking.
TYPE iII. The most baffling case of all is that wherein the prescribing symptoms are difficult to find ; such symptoms as are found are odd. These eases call for a considerable amount of wit on the part of the physician to select a prescription. Case D. This lady, aged 50 years, on March 15th, 1946, complained of a discharging eczema behind both ears. She stated that she had been losing weight ; that she felt generally unwell ; weary and very thirsty. On examination, sugar and acetone were found in her urine. The G.T.T. read 120 mgs. fasting, and half hourly 220, 250, 280, 210 and 200 at 2~ hours after the administration of the glucose. She appeared to be very ill, more sick than her G.T.T. suggested, and so diet and insulin were started. She received 7 units night and morning. Over the next few months she ran downhill and increase of her insulin did not control her health or hyperglycsemia.
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I t was very difficult to find symptoms on which to prescribe, but she received many remedies (e.g. Sulphur, Opium, Syzygium, Uranium nit., Lactic acid, etc.) without any benefit. I n December, 1946, she still felt ill, had a high blood sugar, 300 rags. per cent., and was taking 70 units of insulin daily. The matter appeared serious and the case was once again taken very carefully. No helpful prescribing symptoms were found, but I did discover that she had suffered from severe indigestion for many years with inability to take vegetables and fruit. This condition completely cleared up about the time her present illness developed. This change of complaint suggested Abrotanum which I gave her with considerable hope. In a month's time, to my disappointment, she was no better in general health, her blood sugar was 281 rags. per cent., but she did present some definite prescribing symptoms. She gave me a very clear picture of Natrum tour. which she received. In another month's time (February 6th, 1947) she reported and was no better either in health or biochemically. Her blood sugar was 280 mgs. per cent. I then recalled that Lac defloratum is a useful remedy in diabeW~s, that one of its most important constituents is Natrum mur., that the general and emotional symptoms of both drugs have a marked resemblance to each other. The patient therefore received Lac defloratum lm. On February 27th she was at last able to report an improvement in health, and her blood sugar was 18t rags. per cent. I ventured to reduce her insulin to 40 units per day, and I repeated the dose of Lac defloratum. On March 13th she was still improving in general health, her weight had increased from 8 st. 13 lb. to 9 st. l0 lb. in two months. Her insulin intake was reduced to 12 and 15 units daily. No remedy was given. On May 8th, 1947, she felt in good health. On the day of the examination her blood sugar was 138 mgs. per cent., but her four-hourly urine chart still showed some intermittent glycosuria. My conclusion is that this patient has improved, but not recovered. My purpose in quoting the case is to illustrate the need for ingenuity and thoughtfulness if one wishes to discover the appropriate remedy in certain difficult cases. Mr. President, I am aware that these comments are scrappy and inadequate. I should liked to have arrived at some more definite conclusion, There are some cases of diabetes which have good prescribing symptoms. when the drug is easily chosen and the result is swift and often lasting. But there are more difficult cases wherein symptoms are difficult to discover and where recovery is not complete or lasting. These difficult eases do lead us to the conclusion, I think, that diabetes is an expression of some mia~m provoked by one of many exciting causes. No doubt the reason why the remedy s o often eludes us is because we have failed to discern and treat the basic underlying disorder. Probably treatment by nosodes should play a more prominent part than I , at any rate, have given to them in the past. I am looking forward to your comments. Usually they are searching, but always they are relevant and helpful. DISCUSSION Dr. FOUB]ST~R thanked Dr. Kenyon for his paper, and said that diabetes mellitus was a disease fairly well controlled by orthodox treatment. T h e question was could we do better by substituting homeeopathic treatment f o r control by insulin and diet, or by supplementing orthodox treatment by
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homceopathic r e m e d i e s ? T h e answer to t h a t question seemed to lie in the p a t h o l o g y . A l t h o u g h this was b y no m e a n s clearly u n d e r s t o o d , it was certain t h a t t h e r e were cases where t h e p a t h o l o g y was reversible, a n d cure was possible. lit was i m p o r t a n t t o n o t e t h a t cure could occur with or w i t h o u t t r e a t m e n t , a n d in this connection it was necessary to assess critically a n y i m p r o v e m e n t which m i g h t occur following t h e a d m i n i s t r a t i o n of a homoeopathic medicine. A t t h e o t h e r e n d of the scale, t h e r e were t h e cases where t h e p a t h o l o g y was irreversible, a n d cure in t h e t r u e sense impossible. P r o b a b l y m o s t cases came in between t h e two extremes. Dr. K e n y o n h a d t a k e n t h e now generally a c c e p t e d line t h a t a case of d i a b e t e s should be stabilized on insulin a n d diet, a n d t h e n an a t t e m p t m a d e to i m p r o v e or cure t h e case homceopathically. One d i d n o t often see t h e effect of a homceopathic r e m e d y in t h e a c u t e phase of the disease u n a i d e d b y insulin a n d o t h e r t r e a t m e n t a p p r o p r i a t e to t h e prec o m a t o s e or comatose state. I n t h a t connection the following case m i g h t be of interest. Some y e a r s ago, a m i d d l e aged male came complaining of sciatica of a week's d u r a t i o n . H e was obviously ill, a n d a full e x a m i n a t i o n was m a d e . T h e urine wa,~ l o a d e d w i t h sugar a n d acetone. H i s r e m e d y was clearly Sulphur a n d he was given Sulphur 10m one dose, a n d sent from o u t - p a t i e n t s d e p a r t m e n t to t h e l a b o r a t o r y for a blood sugar to be done. I t was i n t e n d e d t h a t the p a t i e n t should be a d m i t t e d , to be stabilized, b u t p r o b a b l y because of his m e n t a l condition, he m i s u n d e r s t o o d t h e instructions given him a n d left t h e hospital after visiting t h e lab. The blood sugar t a k e n in t h e late afternoon was 260. A l e t t e r was sent off rcquesting t h e p a t i e n t to r e t u r n to t h e hospital, b u t t h e p a t i e n t d i d n o t t u r n u p u n t i l a week later, when his general health was m a r k e d l y i m p r o v e d , his sciatica had gone and his urine normal. A blood sugar curve was done a n d it was also normal. This m i g h t h a v e been a coincidence, b u t it seemed w o r t h while relating. R e g a r d i n g setiology, as D L K e n y o n h a d p o i n t e d out, m e n t a l stress is a factor of i m p o r t a n c e , and his observations of t h e high incidence of glycosuria in y o u n g a d u l t s in t h e blitzed a r e a were interesting. This factor has long been t a k e n into consideration in homceopathic pre~cribing. A n o t h e r factor w o r t h considering was t h e well-known liability of diabetic p a t i e n t s to infections, p a r t i c u l a r l y s t a p h y l o c o c c a l a n d tubercular. There was e v i d e n c e also t h a t infection m a y be t h e cause or p r e c i p a t i n g factor in diabetes. H e k n e w of a p a t i e n t with a carbuncle w i t h o u t previous d i a b e t e s requiring 100 units of insulin d a i l y to control t h e d i a b e t e s which came on with the infection and cleared up c o m p l e t e l y when t h e carbuncle was cured by penicillin. ] t is n o t e w o r t h y t h a t the remedies used for these infections are f r e q u e n t l y i n d i c a t e d in diabetes. W h a t he liked a b o u t Dr. K e n y o n ' s p a p e r was t h a t he h a d n o t m e r e l y given a series of successfully t r e a t e d cases. T h a t would n o t h a v e given a t r u e p i c t u r e of the problem of t r e a t i n g d i a b e t e s homeeopathically. Dr. K e n y o n h a d e m p h a s i z e d t h e difficulties a n d t h e f r e q u e n t failures or p a r t i a l successes which are the e x p e r i e n c e of m o s t of us. b[e t h o u g h t we should do m o r e of this a n d t h a t t h e orth(niox profession would be m o r e likely to be interested in Homccop a t h y if an e n d e a v o u r were m a d e to outline its sphere of usefulness. Dr. TEMPLETON said t h a t s o m e b o d y a s k e d a b o u t t h e action of r e m o t e fear on the diabetes. Dr. FOUBISTER t h o u g h t it was a question of t h e soil. I n t h e 200 cases e x a m i n e d b y Dr. K e n y o n in K e n t only 30 had diabetes. I t was n o t a q u e s t i o n of fear r e m a i n i n g for a n u m b e r of years, b u t it was a question of a p a r t i c u l a r h u m a n soil which was specially susceptible to fear. Dr. KENYON said t h a t n o t e v e r y b o d y r e s p o n d e d in t h e same w a y to fear. Dr. G. R. MITCHELL said t h a t Sulphur h a d been m e n t i o n e d m o r e t h a n o n c e a n d t h a t he could record a n o t h e r Sulphur case. The p a t i e n t himself a t t r i b u t e d his d i a b e t e s to fright caused b y a r a i l w a y accident nine years before. D i e t alone h a d h i t h e r t o controlled the condition satisfactorily, b u t
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eight months before consulting the speaker he had begun to lose weight and this loss was continuing more rapidly than he liked. He had literally no symptoms and on t h a t account alone he was given Sulphur. In one month the glycosuria had dropped from 5 per cent. to 389 per cent. and there had been no further loss of weight. During the next two months glycosuria remained at 3t per cent. There was at first a gain in weight of 289 lb. followed by a loss of 1 lb. During the next few months he had several other remedies on account of a s t e a d y loss of weight and rise in glycosuria. J u s t over a fortnight ago the loss had reached 6~ lb. and the glycosuria had risen to 6 per cent. plus. Sulphur was repeated and he was advised to return in a fortnight instead of the usual four weeks. Seen three days ago he had gained 389 lb. a n d glycosuria had dropped to 2 per cent. Another case was one of diabetes complicated by epilepsy. In spite of carefully estimated insulin dosage and probably because of the epileptic background her condition was one of extreme instability. Glycosuria could vary by 10 per cent. in the course of one hour. Her husband had become expert at diagnosing when she was becoming hypo- or hyper-glyc~emic, but invariably, unless circumstances made it impossible, checked up with urine tests before giving extra insulin or glucose. One dose of Lycopodium 30 has, with a repetition of the dose three months later, satisfactorily controlled the instability for nine months. During the whole of t h a t period she has been able to live comfortably on a regular insulin dosage. Dr. MASON said she had a patient, but had not started finding out about her yet. She had glycosuria and a very bad tubercular history. Her mother died of tuberculosis and various members of her family had had it. In such a case would one start by giving her Tuberculinum whatever remedy might be indicated or should the indicated remedy be given first ? Dr. BOMA~-BEHRAM said t h a t he had very little experience in treating diabetic patients, but he found after giving the indicated remedy t h a t the patient was considerably improved and he asked himself " W h a t next ~. " He had had one peculiar case as follows : - A man about 50 consulted him because he had a bad odour, and on complete examination he found the teeth were bad, the heart was enlarged, the blood pressure 180/110 and he had a loss of sensation from below the knee. The urine contained 6 per cent. sugar. I t was a case of diabetic neuritis and pyorrhcea and cardiovascular trouble. The patient was keen to have his teeth extracted, but he persuaded him to wait. The indicated drug was Phosphorus and he was given one dose of Phosphorus 200. The pyorrhcea had disappeared except on two teeth in a fortnight's time, the loss of sensation in the leg was confined to the foot, the blood pressure was down to 160/90 and the sugar content was 2 per cent. There was no doubt a remarkable improvement on Phosphorus. The patient was watched, every time his neuritis went back to the knee he had to have a dosb of Phosphor~ts. He was never laid up, he did not have his teeth extracted and he carried on his work with his usual diet and without insulin. He carried on like this for two years, but his wife was very nervous and persuaded him to take a second opinion. He did not like to take complete responsibility and thought it advisable to refer the patient to the best consultants in Bombay. He put him in the hands of an allopathic consultant who advised insulin and plenty of vitamins. After two months he was called again by the son and found t h a t the patient had a diabetic gangrene of the hand. He was in a high fever, but would not think of going to the hospital. The hand was entirely blue and swollen. He was given a dose of Lachesis 30 and he improved. He had his hand lanced, he was treated for two months in hospital and he recovered, but died on the d a y he was to be discharged. If the Phosphoru,9 had been continued perhaps he could have carried on for another two years.
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A f t e r t h e m a r k e d i m p r o v e m e n t on Phosphorus w h a t n e x t ? Should t h e p a t i e n t h a v e been given a nosode or w h a t should h a v e been t h e further line of t r e a t m e n t . Pho,,phorusm e t his case considerably, b u t was there a n y chance of doing a b i t more t h a n t h e Phosphorus h a d done ! Dr. QU~NTON said there were two points which occurred to him, one was t h a t in Dr. Mitchell's case where i n s t a b i l i t y ws so m a r k e d he t h o u g h t Ignatia was indicated. I n Dr. Mason's case h e t h o u g h t t h e c o n s t i t u t i o n a l r e m e d y should be given before t h e nosode. Dr. MCCRAE said t h a t he was m o s t i n t e r e s t e d in t h e cases which Dr. K e n y o n described as s y m p t o m l e s s . This was a t y p e of case which reveals t h e value of w o r k w i t h the e m a n o m e t e r . Through electro-physical indications it was possible to arrive a t a r e m e d y when other m e t h o d s failed. I n this m a n n e r one f r e q u e n t l y came across u n u s u a l medicines a n d it revealed t h e necess i t y to persevere with more a n d more provings. There were now sufficient i n s t r u m e n t s of scientific precision a n d m e t h o d s of l a b o r a t o r y technique to e x t e n d the value of our provings. Because of this we m i g h t v e r y well find t h a t some provings will d e m o n s t r a t e t h e a p p e a r a n c e of glycosuria or even a rise of blood sugar w i t h o u t a n y n o t a b l e s y m p t o m s in t h e p r o v e r s . T h a t would be something of g r e a t value to a d d to our m a t e r i a medica. Through such m e t h o d s of l a b o r a t o r y control we would possess a guide as to the limits we could go in safely pushing our provings w i t h o u t d e t r i m e n t to t h e prover's health. Dr. SUNDEI~ said t h a t t h e p a p e r was v e r y s t i m u l a t i n g a n d he would like t i m e to t h i n k a b o u t it. H e was p a r t i c u l a r l y interested to h e a r t h a t Dr. K e n y o n gave some of his p a t i e n t s Tuberculinum, a n d would like t o ~ whether he h a d h a d experience of this t y p e of case. H e himseff could t h i n k of two, first a medical m a n who was a ship's surgeon a n d who d e v e l o p e d tuberculosis a n d came into the s a n a t o r i u m where artificial p n e u m o t h o r a x was carried o u t over a period of five years. The p a t i e n t also had diabetes to a v e r y severe extent. His insulin r e q u i r e m e n t was 140 units per d a y a n d on t h a t a n d his p n e u m o t h o r a x he k e p t e x t r e m e l y well. I f t h e insulin was r e d u c e d he got into trouble. H e w o n d e r e d w h e t h e r Dr. K e n y o n could t h r o w a n y light on t h e reason w h y t h e t u b e r c u l a r p a t i e n t should be so resistant to t r e a t m e n t . H e was speaking as an allopath. A n o t h e r p a t i e n t in t h e s a n a t o r i u m a t t h e present t i m e h a d been worked on for weeks to find the r i g h t dose. H e was given 70 units a n d got hypoglycsemia, he h a d 60 a n d g o t hyperglycmmia, a n d he was also a case of t u b e r culosis. T h e r e s i s t a n t cases h a d been t h e t u b e r c u l a r cases. One m o r e p o i n t was t h e influence of fear. The t r a n s i e n t influence of fear m i g h t be enough to bring on glycosuria. W a s it well recognized t h a t fear, t h e cause for which h a d ceased, would produce a glycosuria several years afterw a r d s ~. T h a t was an i m p o r t a n t p o i n t a n d he would like Dr. K e n y o n ' s considered r e p l y to t h a t . Dr. FERCIE WOODS said t h a t d i a b e t e s i n t e r e s t e d him v e r y much. H e h a d been in practice almost f o r t y years a n d supposed he h a d seen an average n u m b e r of diabetic p a t i e n t s and h a d never once given insulin. H e did n o t s a y t h a t he h a d cured t h e p a t i e n t s , b u t he found t h a t with homceopathic remedies, plus a certain a m o u n t of dieting, one could keep a diabetic p a t i e n t in good h e a l t h a n d a c t i v i t y y e a r after y e a r for a n a l m o s t indefinite period w i t h o u t a n y insulin. This was an a d v a n t a g e because one h a d to a d m i t t h a t insulin h a d its risk. I t was also i n c o n v e n i e n t a n d t h e diet h a d to be v e r y s t r i c t l y controlled. H e found t h a t diabetic p a t i e n t s u n d e r homceopathic t r e a t m e n t could usually eat o r d i n a r y wholemeal b r e a d a n d c a r r y on a n o r m a l life w i t h o u t a n y fear of complications. H e h a d never seen a complication y e t in a n y of his diabetic patients. The t y p e of p a t i e n t which developed diabetes was usually the m e n t a l t y p e r a t h e r t h a n the m a t e r i a l t y p e which m i g h t explain w h y Lycopodium
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and Phos. avid wcrc common remedies in this condition. Szdphur, hc agreed, was useful when there were very few symptoms to go on. He looked upon one of the chief symptoms of Sulphur to be lack of symptoms, but most of the patients he had had, had done well on Phos. a~id and Lycopodium. Dr. A. MO~qCRIEFFsaid that she had had very slight experience of diabetic cases and what patients she had had showed the best results with Sulphur. She had rather explained it on the grounds that diabetic patients, on the whole, fell into Dr. Kenyon's class of not many symptoms and she agreed that one of the great points of Sulphur was that very often there were very few symptoms. A patient she had at out-patients two or three years before the war was a woman of 50 who told her that she had her husband, brother-in-law and five sons for whom she had to cook, wash and do everything for. She had marked glycosuria, the blood sugar was 300, and she did her best to persuade her to go into hospital. The patient felt that she was quite indispen~ble, so she was threatened with immediate death but was given Sulphur 10m. The patient came ba~ck in a month, and her blood sugar was practically normal. Quite often pregnant women developed a certain amount of glycosuria, she never worried about it. She thought it was recognized that it had to do with thc alteration of the metabolism during pregnancy. She wondered, however, if the element of fear had anything to do with it. Many patients were afraid of labour. Did Dr. Kenyon think that that might have something to do with the temporary glycosuria which cleared up when the baby arrived. Dr. Foubister seemed to think they should limit their cases to those which Homoeopathy could help. She disagreed. She did not think there was a limit to the cases which could be helped by Homceopathy. I f all the islets of Langcrhans were destroyed they could not be replaced, but all the ductless glands interconnected with each other and it was possible by stimulating the other glands to enable the patient to carry on with less insulin than would be necessary if one did not give homceopathic treatment. Dr. MITCHELLasked Dr. Kenyon's opinion as to the effect of using insulin along with Homceopathy. Did the use of insulin damp down the effect of the homocopathic remedy ? This was a question which would apply to all deficiency disea~ses, and was one about which it was difficult to make up one's mind. He wondered whether Dr. McCrae could help on this point. I f one test were taken before and another after the administration of insulin would these tests show different reactions.on the emanometer ? Dr. MCLMAE : I could not answer that. Dr. CHAND said that he had not practised for long in homceopathy and he could not give any definite idea as to the degree of diabetes in India or the eastern countries. It was common, but he did not know the difference between the incidence in the eastern and European countries. Dr. TEMPLETON said that it was quoted as being very common in India and Ceylon. Dr. SU-~DELL said that there was one race which was liable to get it and that was the Hebrew race. Would that not be due to the easier reaction to fear and the adrenal stimulus .~ Dr. TEMPLETON thought Dr. Kenyon was to be congratulated not so much on his cases, but on tackling the subject at all. Most of them fought shy of diabetes, at least of talking about it, because of an inferiority complex. They were not as shy as Dr. Quinton who handed his cases on to another physician to treat, but if there was anything which the discussion had shown it was the variability of diabetes. The number of cases which had reacted to the different remedies made it almost certain that diabetes was not a disease in the true sense of the word. He had hoped to hear something about heredity. Diabetes mellitus was supposed to be hereditary, 48 per cent. of the age group 25 to 45 inherited the condition. He believed that Mr. MacDonagh had said that we could never touch heredity. He wondered if any of them thought t h a t
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t h e y were touching h e r e d i t y in a n y w a y a t all ? W h e n one t h o u g h t of t h e p a u c i t y of i n f o r m a t i o n which t h e o r t h o d o x books gave o n the mtiology of d i a b e t e s t h e homceopathic p h y s i c i a n h a d no reason to be a s h a m e d of his a p p r o a c h . H e r e d i t y was a m o s t interesting p r o b l e m to us. Of the exciting causes mentioned, t h a t which i n t e r e s t e d him m o s t was a n x i e t y , a n d t h a t was where t h e homceopathic physician came into his own. I n t h e ~etiology it was t h e a n x i e t y or its effects which we could t r e a t more successfully t h a n most. Then, he t h o u g h t , Dr. K e n y o n was to be c o n g r a t u l a t e d in t a c k l i n g these cases as successfully as he h a d . B u t h a d he a definite m e t h o d of stabilizing t h e p a t i e n t first a n d t h e n giving t h e r e m e d y ? D i d he do t h a t as a rule ? T h a t seemed to be t h e b e s t m e t h o d b u t it was difficult to stabilize under some conditions. W h a t was one to do, i f one could n o t get t h e m stabilized a t all ? One m u s t then, of course, t r y t h e r e m e d y to see if a result could be achieved b y t h a t means. W i t h r e g a r d to t h e case which was q u o t e d where i n s t a b i l i t y was so m a r k e d he w o u l d have t h o u g h t of Pul~satilla r a t h e r t h a n Ignatia. Dr. Q u i n t o n ment i o n e d giving t h e nosode first, t h e n t h e c o n s t i t u t i o n a l r e m e d y . W h y d i d he give a nosode first ? Dr. K e n y o n m i g h t know s o m e t h i n g a b o u t w h a t was in his m i n d in t h a t p a r t i c u l a r m a t t e r . H e w o n d e r e d if Dr. Sundell could h a v e given t h e m some idea if t h e r e was a large p r o p o r t i o n of people on diet a n d stabilized who u l t i m a t e l y r e d u c e d their insulin a n d even if t h e r e was a proportion of cures. W e r e a n y of these figures a v a i l a b l e ? Each case was different : t h e y r e a l l y could n o t be classified into percentages a n d so forth. The other p o i n t which s t r u c k him was w h e t h e r t h e n u m b e r of d i a b e t i c s was known. T h e y were said to be increasing e v e r y d a y . W h y ? Because the diabetics lived longer a n d p r o d u c e d children ? T h a t would p r o v e the heredit a r y factor. Quoting o d d cases was no use. H e k n e w of a y o u n g m a n who was rejected for t h e A r m y , he was investigated, g a v e a d i a b e t i c curve, a n d w i t h i n a m o n t h w i t h o u t t r e a t m e n t he h a d no sugar a t all in his urine. H e was n o t frightened, he was anxious t o join t h e A r m y , and he was a c c e p t e d on his second a t t e m p t , a n d r e m a i n e d in the services.* Re Dr. F o u b i s t e r ' s case, one would h a v e t h o u g h t t h a t t h e carbuncle was a c o m p l i c a t i o n of diabetes, n o t t h e cause of t h e diabetes. Could Dr. Fergie W o o d s h o n e s t l y s a y t h a t no d i a b e t i c p a t i e n t w h o m he h a d t r e a t e d h a d d e v e l o p e d complications ? N o c a t a r a c t ? .No gangrene ~. H o w d i d these cases s u r v i v e if t h e y a t e e v e r y t h i n g a n d a n y t h i n g ? D i d t h e insulindiet t r e a t m e n t p r e v e n t t h e onset of c a t a r a c t and retinitis ? Some people said " N o ", b u t he would like to k n o w more a b o u t t h a t . P r o b a b l y m o r e t h a n m o s t diseases d i a b e t e s was an i n d i v i d u a l p r o b l e m a n d t h a t was true of its homceopathic t r e a t m e n t as had been shown b y Dr. K e n y o n to-day. Dr. KEn'YON, r e p l y i n g to t h e discussion, said t h a t w h a t he claimed was t h a t a homceopathic r e m e d y could speed recovery of t h e p a t i e n t in a g r e a t m a n y cases. W i t h r e g a r d to t h e p o i n t raised a b o u t t h e r e l a t i o n b e t w e e n d i a b e t e s a n d infections such as carbuncles, he considered t h a t while t h e d i a b e t i c was more prone to such infections, nevertheless n o n - d i a b e t i c persons suffering from carbuncles sometimes d e v e l o p e d a t e m p o r a r y hyperglycsemia which d i s a p p e a r e d when t h e infection cleared up. Dr. Sundell h a d s t a t e d t h a t he was innocent of the homceopathic t r e a t m e n t of diabetes. This was a gross u n d c r s t a t e m e n t as a c t u a l l y Dr. Sundell was m o s t successful in dealing w i t h this disease homceopathically. H e h a d only h a d experience of one t u b e r c u l a r p a t i e n t who h a d d e v e l o p e d d i a b e t e s a n d this p a t i e n t r e q u i r e d v e r y large doses of insulin. As infections block t h e action of insulin, he a s s u m e d t h a t this was t h e reason for the large dose required. * This case after demobilization
has again shown signs of a mild diabetes.
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Dr. Kenyon said t h a t Dr. Fergie Woods had certainly been more successful than he had beenin treating all cases of diabetes without having to resort to insulin. With regard to the question about giving the nosode in a tubercular diabetic, he would give the nosode (or an intestinal non-lactose fermenting potency) provided the patient's tubercular condition was not advanced. He quite agreed with Dr. Templeton that instability of symptoms would direct one's thoughts to Pulsatilla. He had treated a man who was practically homceopathically symptomless and suggested Sulphur, to which drug he had not responded. His hyperglyc~emia and glycosuria were so variable and inexplicable in point of time that Pulsatilla was given with definite benefit. Dr. MASON said that a friend of hers, a doctor, was taken prisoner at Singapore. While in captivity the diet was very low and he said that diabetics did very well on a low diet. Dr. KENYON said that the line he usually followed was firstly to stabilize the patient on diet (and insulin if required) keeping a slight glycosuria present in order to judge the effect of the remedy.
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COMMENTS ON T H E HOM(EOPATHIC TICEATMENT OF DIABETES* By DR. KENYON MR. PRESIDENT,
I am not sure whether these observations should be made about that insulinogenic deficiency of the pancreas that is called Diabetes or about the homceopathic treatment of hyperglyc~emia in general. However, as hyperglyc~emia, whatever its cause, if allowed to continue, produces dam. age to the Islands of Langerhans, this is probably a quibble over definition. My motive for commenting on the homceopathic treatment of diabetes mellitus is because this very prevalent complaint is often unresponsive to our drugs. The foremost reason for this, I think, can be ascribed to the difficulty we experience so often in finding satisfactory symptoms and modalities on which to prescribe. Because of this, we are tempted to give remedies chosen on account of their power (on occasion) to produce glycosuria. When treatment is given in this way the result is usually unsatisfactory ; in most cases it is dismally ineffective. In my view, there is no illness in which a careful and exhaustive homoeopathic case-taking is more vital, and, more fruitful. On the other hand, there is no disturbance in which " easy cuts to treatment ", that is prescriptions based on end actions of disease, is more futile. In the treatment of a case of diabetes there are, of course, many valuable orthodox methods to be followed. The giving of a balanced diet ; the removal of septic loci and infections which we know block the action of body insulin ; the giving of insulin when necessary ; the restraint of over-eating in the obese diabetic; such treatment may stabilize the body with the result that the patient develops a sugar tolerance and recovery may occur. But, in addition to this the homceopathic remedy has its place and its place may be unsurpassed in speeding recovery. If, as I believe, the correctly chosen drug can be so potent in its effect, it is desirable to observe the full response to diet (and insulin when required) before giving the homceopathic remedy and therefore forming a judgment on its action. I have been asked on occasion if it really matters what helps the patient to recover: diet, insulin, and remedy, so long as the patient gets well. I n view of the important place that the homceopathic drug takes in the treatment, I think that it matters very much indeed. Towards the end of the attack on this country by flying bombs, I was asked to examine 135 apparently healthy young adults living in the south suburbs. Thirty of these persons had sugar and acetone in the urine. Fortunately, I was given the opportunity of investigating fully each case. Each one of these thirty patients had a high blood sugar two and a haft hours after the beginning of a good meal, and they all showed a glucose tolerance curve of a mild diabetic type. Each case was treated by diet alone. When checked up in three months normal readings of the glucose tolerance curve were obtained in every instance ; and six months later each one of them was found to be in good health and biochemically normal. In itself this is not a particularly interesting observation. Mild cases of hyperglycmmia do clear up under dietetic treatment. But, in conjunction with the next series of cases, there is something of interest to the homceopathist. In the summer of 1946, I examined ninety-six young adults from the same district, and under the same conditions, except that bombing had ceased. Only one of these cases showed a trace of sugar (transient) in the urine. * Paper delivered at the Faculty of Hom~eopathy, June 5th. 1947.
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When I was thinking about the first series of cases, I wondered how much a heavy carbohydrate diet and how rmach fear had played their respective parts in the production of the hyperglyczemia. A consideration of these 200-odd cases, thirty of which had developed a definite hyperglycmmia under certain environmental conditions, suggests that emotional stress does play a part in the incidence of diabetes. This, again, is not an original conclusion. Dr. Lawrence says that " When shares go down in Wall Street, diabetes goes up ". This view, however, is not shared by all writers on the subject. Nevertheless, these two series of cases that I have just quoted did turn my mind to consider etiology more carefully when seeking for a homceopathie remedy in difficult cases. When preliminary treatment such as diet and so forth has been given and the effects noted, then the homceopathic remedy is given when required. I f the remedy is to be considered to be effective, there should be a swift improvement in the general health of the patient, if the health has not been good previously. I look for a rapid improvement of symptoms, when symptoms have been present. Treatment should also result in a reduction of hyperglyceemia two and a half hours after the beginning of a meal ; and, in responsive cases, one often finds a levelling in the urine-sugar graph which every patient charts four times daily. Sometimes a diabetic patient is homceopathically symptomless. I have he/~rd it suggested that such a patient requires no treatment, even though he has a heavy hyperglycmmia. This view must be regarded as dangerous and pestilential. These physicians seem to forget that a case that is homoeopathically symptomless may be most scriously ill. At any rate, it is generally considered that hyperglyczemia, whatever the cause, eventually overstrains the Islands of Langerhans and the result will be a frank diabetes. Some cases of diabetes are easy to treat homceopathically because they present good prescribing s y m p t o m s ; many are less responsive to treatment because the symptoms are elusive and difficult to find. Other eases seem to have no prescribing symptoms whatever, and do not, therefore, yield very much to our remedies. The cases i am going to give you are few, but they arc rcpresentative of many. They have been chosen because there appear to be certain points of interest relevant to my comments. :Not all these patients have recovered, but a litany of therapeutic triumphs is abhorrent to listeners and of little value for discussion. The cases fall under three headings: the divisions arc quite artificial and are only so divided for the purpose of description. TYPE I. Many diabetics have abundant prescribing symptoms : the choice of the remedy (or remedies) is e a s y : the response to treatment is swift. Here is an example: This case is of interest because she had been under treatment for some time at a diabetic clinic. She had been stabilized on diet and insulin, but she decided to consult a homceopathist because she did not consider that she was in as good health as she expected to be. Case A. Female, aet. 21 years. She was diagnosed as suffering from diabetes in September, 1943. She attended a diabetic clinic when she was stabilized on diet and insulin and continued with this treatment until she consulted mc in April, 1946. At this time she was taking 40 units of soluble insulin and 30 units of Zn protamine daily. When she first saw me in the spring of 1946, she complained that she felt weak ; lack of energy ; her memory was poor ; she was unable to concentrate and was extremely anxious about her health and her prospects of earning her
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living. She was a tall, thin, and very intelligent y o u n g woman, with a family history of tuberculosis. Her weight was 7 st. 11 lb. as against 9 st. 2 lb. in 1943. I t is not relevant to m y comments to discuss the reasons for the remedies she received : the first prescription is obvious to anyone. Actually she received Phos. 200 and over the next year Tub. Koch 200, Nat. phos. 200, and Sulphur 30. These remedies were easily chosen on good prescribing symptoms. I n the April of this year she felt fairly well. The w e i g h t - - 8 s t . - - h a d remained steady for some months. Her daily insulin is now 10 Soluble and 2 Cloudy units per day, t h a t is a drop of 60 units in a year. I t is necessary to add t h a t this controls her hyperglycmmia. I t seems a fair assumption to claim t h a t homceopathy has been of some help in this case. TYPE II. Then there is the type of case t h a t has few useful prescribing s y m p t o m s , but a careful taking of the case brings to light some exciting etiological factor. During the past few years an i m p o r t a n t exciting cause has been t h a t of fear.
The case I am quoting is t h a t of a child and is of interest for two reasons. I n childhood the presence of h y p e r g l y c e m i a and diabetes is potentially serious. This case is one of six children 1 had to treat. These children came from different families, but they all lived in the same district where they had been exposed to h e a v y bombing. The six of t h e m developed hyperglyc~emia. T h e y were all put on diet and four of them recovered quickly. The blood sugar and urine became n()rmal within a few weeks and have remained normal. Two of these children continued to haye a hyperglyc~emia and became ill. T h e y both required homceopathic t r e a t m e n t in addition to a balanced diet, but insulin had not to bc given. Case B was a boy aged 11 years, who was brought to me in J a n u a r y , 1944, suffering from pustules on the skin. This was some time after sugar had been found in the urine and the boy had been p u t on diet. His mother was more worried because he was feeling unwell ; readily tired and was working badly at school, though he was a very energetic and clever boy. The boy looked ill and, in spite of careful dieting, sugar and acetone were found in the urine. The blood sugar was 281 mgs. per cent. (Blood sugar rea~lings quoted in this paper are those recorded 2~- hours after a meal.) As he had a considerable a m o u n t of acetone in his urine, he was given Cassia 6c t.d.s, for five days. A fortnight later, the urine was loaded with sugar, but there was no acetone. The blood sugar was 268. The diet was continued, but no r e m e d y was given. On F e b r u a r y l l t h , 1944, the blood sugar had dropped to 218 rags. per cent. and there was a marked glycosuria. The boy was ill ; listless ; lacking in energy ; t o u c h y and irritable. His mother had formed the opinion t h a t his ill-health had dated from a fright and from anxiety following air raids. He was given Natrum mur. 200. (The reason for the prescription is, of course, evident, but the point in quoting this case is to demonstrate the value of etiology in prescribing.) I did not see him again until April, 1944, when his blood sugar was 131. The urine had been examined four times daily, the glycosuria had gradually diminished and was now absent.
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During the next eighteen months there were intermittent rises of his blood sugar and remedies were given according to the symptoms. (The two remedies he required were Nat. mur. and Phosphorus.) During 1946 the boy remained well : the urine was consistently free of sugar and acetone, and the blood sugar at a normal level. In January, 1947, the G.T.T. showed a normal curve. There are many cases where etiology, other than emotional stress, guides one to a prescription. I am quoting this case because it has been a difficult one. The etiology is not certain: the treatment is not completed. However this may be, it certainly emphasizes the need of exhaustive case-taking, in such difficult conditions. I should like to say here how much I am indebted to Dr. Chand for his indefatigable industry in working on this case with me. This brief report gives no indication of the hours of routine work Dr. Chand has devoted to this investigation. Case C is a married woman, aged 59 years. She came under our care during the latter part of April, but she had" been on a balanced diet for a month previously, and had received Tub. bov., Belladonna, and Sulphur. Her blood sugar was 193 mgs. per cent. Dr. Chand reports that after prolonged and patient questioning very few symptoms on which to base a prescription could be elicited. But, he remarks, that it is of interest to note that all her complaints date back to Christmas, 1946. At that time there was an unhappy incident which led her to fear that she had contracted syphilis. On enquiring into the history we found that she had developed an ulcer on the lip which had been treated with penicillin injections. All blood tests were negative and there was nothing to suggest that she had acquired a specific infection. I t was quite impossible to reassure her, and because of this obsessional state (rather than any belief that she was, in fact, suffering from syphilis) we decided to give her Lueticum 200 which she received on May 21st. Since then her burning sensations and vague pains vanished. Her glyeosuria showed an immediate improvement which has been maintained up to the present. (A chart of the glycosuria indicating this improvement was shown to the Meeting.) There was also a slight improvement in the hyperglye~emia-186 mgs. per cent. on May 16th. Three weeks later she appeared to be slipping back in general health and the case was retaken, after which Pulsatilla 30 (four doses) was given. After this remedy she improved again and her blood sugar dropped within a few days to 170 rags. per cent. This case has not recovered, and is quoted to illustrate the necessity of searching c~e-taking.
TYPE iII. The most baffling case of all is that wherein the prescribing symptoms are difficult to find ; such symptoms as are found are odd. These eases call for a considerable amount of wit on the part of the physician to select a prescription. Case D. This lady, aged 50 years, on March 15th, 1946, complained of a discharging eczema behind both ears. She stated that she had been losing weight ; that she felt generally unwell ; weary and very thirsty. On examination, sugar and acetone were found in her urine. The G.T.T. read 120 mgs. fasting, and half hourly 220, 250, 280, 210 and 200 at 2~ hours after the administration of the glucose. She appeared to be very ill, more sick than her G.T.T. suggested, and so diet and insulin were started. She received 7 units night and morning. Over the next few months she ran downhill and increase of her insulin did not control her health or hyperglycsemia.
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I t was very difficult to find symptoms on which to prescribe, but she received many remedies (e.g. Sulphur, Opium, Syzygium, Uranium nit., Lactic acid, etc.) without any benefit. I n December, 1946, she still felt ill, had a high blood sugar, 300 rags. per cent., and was taking 70 units of insulin daily. The matter appeared serious and the case was once again taken very carefully. No helpful prescribing symptoms were found, but I did discover that she had suffered from severe indigestion for many years with inability to take vegetables and fruit. This condition completely cleared up about the time her present illness developed. This change of complaint suggested Abrotanum which I gave her with considerable hope. In a month's time, to my disappointment, she was no better in general health, her blood sugar was 281 rags. per cent., but she did present some definite prescribing symptoms. She gave me a very clear picture of Natrum tour. which she received. In another month's time (February 6th, 1947) she reported and was no better either in health or biochemically. Her blood sugar was 280 mgs. per cent. I then recalled that Lac defloratum is a useful remedy in diabeW~s, that one of its most important constituents is Natrum mur., that the general and emotional symptoms of both drugs have a marked resemblance to each other. The patient therefore received Lac defloratum lm. On February 27th she was at last able to report an improvement in health, and her blood sugar was 18t rags. per cent. I ventured to reduce her insulin to 40 units per day, and I repeated the dose of Lac defloratum. On March 13th she was still improving in general health, her weight had increased from 8 st. 13 lb. to 9 st. l0 lb. in two months. Her insulin intake was reduced to 12 and 15 units daily. No remedy was given. On May 8th, 1947, she felt in good health. On the day of the examination her blood sugar was 138 mgs. per cent., but her four-hourly urine chart still showed some intermittent glycosuria. My conclusion is that this patient has improved, but not recovered. My purpose in quoting the case is to illustrate the need for ingenuity and thoughtfulness if one wishes to discover the appropriate remedy in certain difficult cases. Mr. President, I am aware that these comments are scrappy and inadequate. I should liked to have arrived at some more definite conclusion, There are some cases of diabetes which have good prescribing symptoms. when the drug is easily chosen and the result is swift and often lasting. But there are more difficult cases wherein symptoms are difficult to discover and where recovery is not complete or lasting. These difficult eases do lead us to the conclusion, I think, that diabetes is an expression of some mia~m provoked by one of many exciting causes. No doubt the reason why the remedy s o often eludes us is because we have failed to discern and treat the basic underlying disorder. Probably treatment by nosodes should play a more prominent part than I , at any rate, have given to them in the past. I am looking forward to your comments. Usually they are searching, but always they are relevant and helpful. DISCUSSION Dr. FOUB]ST~R thanked Dr. Kenyon for his paper, and said that diabetes mellitus was a disease fairly well controlled by orthodox treatment. T h e question was could we do better by substituting homeeopathic treatment f o r control by insulin and diet, or by supplementing orthodox treatment by
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homceopathic r e m e d i e s ? T h e answer to t h a t question seemed to lie in the p a t h o l o g y . A l t h o u g h this was b y no m e a n s clearly u n d e r s t o o d , it was certain t h a t t h e r e were cases where t h e p a t h o l o g y was reversible, a n d cure was possible. lit was i m p o r t a n t t o n o t e t h a t cure could occur with or w i t h o u t t r e a t m e n t , a n d in this connection it was necessary to assess critically a n y i m p r o v e m e n t which m i g h t occur following t h e a d m i n i s t r a t i o n of a homoeopathic medicine. A t t h e o t h e r e n d of the scale, t h e r e were t h e cases where t h e p a t h o l o g y was irreversible, a n d cure in t h e t r u e sense impossible. P r o b a b l y m o s t cases came in between t h e two extremes. Dr. K e n y o n h a d t a k e n t h e now generally a c c e p t e d line t h a t a case of d i a b e t e s should be stabilized on insulin a n d diet, a n d t h e n an a t t e m p t m a d e to i m p r o v e or cure t h e case homceopathically. One d i d n o t often see t h e effect of a homceopathic r e m e d y in t h e a c u t e phase of the disease u n a i d e d b y insulin a n d o t h e r t r e a t m e n t a p p r o p r i a t e to t h e prec o m a t o s e or comatose state. I n t h a t connection the following case m i g h t be of interest. Some y e a r s ago, a m i d d l e aged male came complaining of sciatica of a week's d u r a t i o n . H e was obviously ill, a n d a full e x a m i n a t i o n was m a d e . T h e urine wa,~ l o a d e d w i t h sugar a n d acetone. H i s r e m e d y was clearly Sulphur a n d he was given Sulphur 10m one dose, a n d sent from o u t - p a t i e n t s d e p a r t m e n t to t h e l a b o r a t o r y for a blood sugar to be done. I t was i n t e n d e d t h a t the p a t i e n t should be a d m i t t e d , to be stabilized, b u t p r o b a b l y because of his m e n t a l condition, he m i s u n d e r s t o o d t h e instructions given him a n d left t h e hospital after visiting t h e lab. The blood sugar t a k e n in t h e late afternoon was 260. A l e t t e r was sent off rcquesting t h e p a t i e n t to r e t u r n to t h e hospital, b u t t h e p a t i e n t d i d n o t t u r n u p u n t i l a week later, when his general health was m a r k e d l y i m p r o v e d , his sciatica had gone and his urine normal. A blood sugar curve was done a n d it was also normal. This m i g h t h a v e been a coincidence, b u t it seemed w o r t h while relating. R e g a r d i n g setiology, as D L K e n y o n h a d p o i n t e d out, m e n t a l stress is a factor of i m p o r t a n c e , and his observations of t h e high incidence of glycosuria in y o u n g a d u l t s in t h e blitzed a r e a were interesting. This factor has long been t a k e n into consideration in homceopathic pre~cribing. A n o t h e r factor w o r t h considering was t h e well-known liability of diabetic p a t i e n t s to infections, p a r t i c u l a r l y s t a p h y l o c o c c a l a n d tubercular. There was e v i d e n c e also t h a t infection m a y be t h e cause or p r e c i p a t i n g factor in diabetes. H e k n e w of a p a t i e n t with a carbuncle w i t h o u t previous d i a b e t e s requiring 100 units of insulin d a i l y to control t h e d i a b e t e s which came on with the infection and cleared up c o m p l e t e l y when t h e carbuncle was cured by penicillin. ] t is n o t e w o r t h y t h a t the remedies used for these infections are f r e q u e n t l y i n d i c a t e d in diabetes. W h a t he liked a b o u t Dr. K e n y o n ' s p a p e r was t h a t he h a d n o t m e r e l y given a series of successfully t r e a t e d cases. T h a t would n o t h a v e given a t r u e p i c t u r e of the problem of t r e a t i n g d i a b e t e s homeeopathically. Dr. K e n y o n h a d e m p h a s i z e d t h e difficulties a n d t h e f r e q u e n t failures or p a r t i a l successes which are the e x p e r i e n c e of m o s t of us. b[e t h o u g h t we should do m o r e of this a n d t h a t t h e orth(niox profession would be m o r e likely to be interested in Homccop a t h y if an e n d e a v o u r were m a d e to outline its sphere of usefulness. Dr. TEMPLETON said t h a t s o m e b o d y a s k e d a b o u t t h e action of r e m o t e fear on the diabetes. Dr. FOUBISTER t h o u g h t it was a question of t h e soil. I n t h e 200 cases e x a m i n e d b y Dr. K e n y o n in K e n t only 30 had diabetes. I t was n o t a q u e s t i o n of fear r e m a i n i n g for a n u m b e r of years, b u t it was a question of a p a r t i c u l a r h u m a n soil which was specially susceptible to fear. Dr. KENYON said t h a t n o t e v e r y b o d y r e s p o n d e d in t h e same w a y to fear. Dr. G. R. MITCHELL said t h a t Sulphur h a d been m e n t i o n e d m o r e t h a n o n c e a n d t h a t he could record a n o t h e r Sulphur case. The p a t i e n t himself a t t r i b u t e d his d i a b e t e s to fright caused b y a r a i l w a y accident nine years before. D i e t alone h a d h i t h e r t o controlled the condition satisfactorily, b u t
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eight months before consulting the speaker he had begun to lose weight and this loss was continuing more rapidly than he liked. He had literally no symptoms and on t h a t account alone he was given Sulphur. In one month the glycosuria had dropped from 5 per cent. to 389 per cent. and there had been no further loss of weight. During the next two months glycosuria remained at 3t per cent. There was at first a gain in weight of 289 lb. followed by a loss of 1 lb. During the next few months he had several other remedies on account of a s t e a d y loss of weight and rise in glycosuria. J u s t over a fortnight ago the loss had reached 6~ lb. and the glycosuria had risen to 6 per cent. plus. Sulphur was repeated and he was advised to return in a fortnight instead of the usual four weeks. Seen three days ago he had gained 389 lb. a n d glycosuria had dropped to 2 per cent. Another case was one of diabetes complicated by epilepsy. In spite of carefully estimated insulin dosage and probably because of the epileptic background her condition was one of extreme instability. Glycosuria could vary by 10 per cent. in the course of one hour. Her husband had become expert at diagnosing when she was becoming hypo- or hyper-glyc~emic, but invariably, unless circumstances made it impossible, checked up with urine tests before giving extra insulin or glucose. One dose of Lycopodium 30 has, with a repetition of the dose three months later, satisfactorily controlled the instability for nine months. During the whole of t h a t period she has been able to live comfortably on a regular insulin dosage. Dr. MASON said she had a patient, but had not started finding out about her yet. She had glycosuria and a very bad tubercular history. Her mother died of tuberculosis and various members of her family had had it. In such a case would one start by giving her Tuberculinum whatever remedy might be indicated or should the indicated remedy be given first ? Dr. BOMA~-BEHRAM said t h a t he had very little experience in treating diabetic patients, but he found after giving the indicated remedy t h a t the patient was considerably improved and he asked himself " W h a t next ~. " He had had one peculiar case as follows : - A man about 50 consulted him because he had a bad odour, and on complete examination he found the teeth were bad, the heart was enlarged, the blood pressure 180/110 and he had a loss of sensation from below the knee. The urine contained 6 per cent. sugar. I t was a case of diabetic neuritis and pyorrhcea and cardiovascular trouble. The patient was keen to have his teeth extracted, but he persuaded him to wait. The indicated drug was Phosphorus and he was given one dose of Phosphorus 200. The pyorrhcea had disappeared except on two teeth in a fortnight's time, the loss of sensation in the leg was confined to the foot, the blood pressure was down to 160/90 and the sugar content was 2 per cent. There was no doubt a remarkable improvement on Phosphorus. The patient was watched, every time his neuritis went back to the knee he had to have a dosb of Phosphor~ts. He was never laid up, he did not have his teeth extracted and he carried on his work with his usual diet and without insulin. He carried on like this for two years, but his wife was very nervous and persuaded him to take a second opinion. He did not like to take complete responsibility and thought it advisable to refer the patient to the best consultants in Bombay. He put him in the hands of an allopathic consultant who advised insulin and plenty of vitamins. After two months he was called again by the son and found t h a t the patient had a diabetic gangrene of the hand. He was in a high fever, but would not think of going to the hospital. The hand was entirely blue and swollen. He was given a dose of Lachesis 30 and he improved. He had his hand lanced, he was treated for two months in hospital and he recovered, but died on the d a y he was to be discharged. If the Phosphoru,9 had been continued perhaps he could have carried on for another two years.
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A f t e r t h e m a r k e d i m p r o v e m e n t on Phosphorus w h a t n e x t ? Should t h e p a t i e n t h a v e been given a nosode or w h a t should h a v e been t h e further line of t r e a t m e n t . Pho,,phorusm e t his case considerably, b u t was there a n y chance of doing a b i t more t h a n t h e Phosphorus h a d done ! Dr. QU~NTON said there were two points which occurred to him, one was t h a t in Dr. Mitchell's case where i n s t a b i l i t y ws so m a r k e d he t h o u g h t Ignatia was indicated. I n Dr. Mason's case h e t h o u g h t t h e c o n s t i t u t i o n a l r e m e d y should be given before t h e nosode. Dr. MCCRAE said t h a t he was m o s t i n t e r e s t e d in t h e cases which Dr. K e n y o n described as s y m p t o m l e s s . This was a t y p e of case which reveals t h e value of w o r k w i t h the e m a n o m e t e r . Through electro-physical indications it was possible to arrive a t a r e m e d y when other m e t h o d s failed. I n this m a n n e r one f r e q u e n t l y came across u n u s u a l medicines a n d it revealed t h e necess i t y to persevere with more a n d more provings. There were now sufficient i n s t r u m e n t s of scientific precision a n d m e t h o d s of l a b o r a t o r y technique to e x t e n d the value of our provings. Because of this we m i g h t v e r y well find t h a t some provings will d e m o n s t r a t e t h e a p p e a r a n c e of glycosuria or even a rise of blood sugar w i t h o u t a n y n o t a b l e s y m p t o m s in t h e p r o v e r s . T h a t would be something of g r e a t value to a d d to our m a t e r i a medica. Through such m e t h o d s of l a b o r a t o r y control we would possess a guide as to the limits we could go in safely pushing our provings w i t h o u t d e t r i m e n t to t h e prover's health. Dr. SUNDEI~ said t h a t t h e p a p e r was v e r y s t i m u l a t i n g a n d he would like t i m e to t h i n k a b o u t it. H e was p a r t i c u l a r l y interested to h e a r t h a t Dr. K e n y o n gave some of his p a t i e n t s Tuberculinum, a n d would like t o ~ whether he h a d h a d experience of this t y p e of case. H e himseff could t h i n k of two, first a medical m a n who was a ship's surgeon a n d who d e v e l o p e d tuberculosis a n d came into the s a n a t o r i u m where artificial p n e u m o t h o r a x was carried o u t over a period of five years. The p a t i e n t also had diabetes to a v e r y severe extent. His insulin r e q u i r e m e n t was 140 units per d a y a n d on t h a t a n d his p n e u m o t h o r a x he k e p t e x t r e m e l y well. I f t h e insulin was r e d u c e d he got into trouble. H e w o n d e r e d w h e t h e r Dr. K e n y o n could t h r o w a n y light on t h e reason w h y t h e t u b e r c u l a r p a t i e n t should be so resistant to t r e a t m e n t . H e was speaking as an allopath. A n o t h e r p a t i e n t in t h e s a n a t o r i u m a t t h e present t i m e h a d been worked on for weeks to find the r i g h t dose. H e was given 70 units a n d got hypoglycsemia, he h a d 60 a n d g o t hyperglycmmia, a n d he was also a case of t u b e r culosis. T h e r e s i s t a n t cases h a d been t h e t u b e r c u l a r cases. One m o r e p o i n t was t h e influence of fear. The t r a n s i e n t influence of fear m i g h t be enough to bring on glycosuria. W a s it well recognized t h a t fear, t h e cause for which h a d ceased, would produce a glycosuria several years afterw a r d s ~. T h a t was an i m p o r t a n t p o i n t a n d he would like Dr. K e n y o n ' s considered r e p l y to t h a t . Dr. FERCIE WOODS said t h a t d i a b e t e s i n t e r e s t e d him v e r y much. H e h a d been in practice almost f o r t y years a n d supposed he h a d seen an average n u m b e r of diabetic p a t i e n t s and h a d never once given insulin. H e did n o t s a y t h a t he h a d cured t h e p a t i e n t s , b u t he found t h a t with homceopathic remedies, plus a certain a m o u n t of dieting, one could keep a diabetic p a t i e n t in good h e a l t h a n d a c t i v i t y y e a r after y e a r for a n a l m o s t indefinite period w i t h o u t a n y insulin. This was an a d v a n t a g e because one h a d to a d m i t t h a t insulin h a d its risk. I t was also i n c o n v e n i e n t a n d t h e diet h a d to be v e r y s t r i c t l y controlled. H e found t h a t diabetic p a t i e n t s u n d e r homceopathic t r e a t m e n t could usually eat o r d i n a r y wholemeal b r e a d a n d c a r r y on a n o r m a l life w i t h o u t a n y fear of complications. H e h a d never seen a complication y e t in a n y of his diabetic patients. The t y p e of p a t i e n t which developed diabetes was usually the m e n t a l t y p e r a t h e r t h a n the m a t e r i a l t y p e which m i g h t explain w h y Lycopodium
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and Phos. avid wcrc common remedies in this condition. Szdphur, hc agreed, was useful when there were very few symptoms to go on. He looked upon one of the chief symptoms of Sulphur to be lack of symptoms, but most of the patients he had had, had done well on Phos. a~id and Lycopodium. Dr. A. MO~qCRIEFFsaid that she had had very slight experience of diabetic cases and what patients she had had showed the best results with Sulphur. She had rather explained it on the grounds that diabetic patients, on the whole, fell into Dr. Kenyon's class of not many symptoms and she agreed that one of the great points of Sulphur was that very often there were very few symptoms. A patient she had at out-patients two or three years before the war was a woman of 50 who told her that she had her husband, brother-in-law and five sons for whom she had to cook, wash and do everything for. She had marked glycosuria, the blood sugar was 300, and she did her best to persuade her to go into hospital. The patient felt that she was quite indispen~ble, so she was threatened with immediate death but was given Sulphur 10m. The patient came ba~ck in a month, and her blood sugar was practically normal. Quite often pregnant women developed a certain amount of glycosuria, she never worried about it. She thought it was recognized that it had to do with thc alteration of the metabolism during pregnancy. She wondered, however, if the element of fear had anything to do with it. Many patients were afraid of labour. Did Dr. Kenyon think that that might have something to do with the temporary glycosuria which cleared up when the baby arrived. Dr. Foubister seemed to think they should limit their cases to those which Homoeopathy could help. She disagreed. She did not think there was a limit to the cases which could be helped by Homceopathy. I f all the islets of Langcrhans were destroyed they could not be replaced, but all the ductless glands interconnected with each other and it was possible by stimulating the other glands to enable the patient to carry on with less insulin than would be necessary if one did not give homceopathic treatment. Dr. MITCHELLasked Dr. Kenyon's opinion as to the effect of using insulin along with Homceopathy. Did the use of insulin damp down the effect of the homocopathic remedy ? This was a question which would apply to all deficiency disea~ses, and was one about which it was difficult to make up one's mind. He wondered whether Dr. McCrae could help on this point. I f one test were taken before and another after the administration of insulin would these tests show different reactions.on the emanometer ? Dr. MCLMAE : I could not answer that. Dr. CHAND said that he had not practised for long in homceopathy and he could not give any definite idea as to the degree of diabetes in India or the eastern countries. It was common, but he did not know the difference between the incidence in the eastern and European countries. Dr. TEMPLETON said that it was quoted as being very common in India and Ceylon. Dr. SU-~DELL said that there was one race which was liable to get it and that was the Hebrew race. Would that not be due to the easier reaction to fear and the adrenal stimulus .~ Dr. TEMPLETON thought Dr. Kenyon was to be congratulated not so much on his cases, but on tackling the subject at all. Most of them fought shy of diabetes, at least of talking about it, because of an inferiority complex. They were not as shy as Dr. Quinton who handed his cases on to another physician to treat, but if there was anything which the discussion had shown it was the variability of diabetes. The number of cases which had reacted to the different remedies made it almost certain that diabetes was not a disease in the true sense of the word. He had hoped to hear something about heredity. Diabetes mellitus was supposed to be hereditary, 48 per cent. of the age group 25 to 45 inherited the condition. He believed that Mr. MacDonagh had said that we could never touch heredity. He wondered if any of them thought t h a t
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t h e y were touching h e r e d i t y in a n y w a y a t all ? W h e n one t h o u g h t of t h e p a u c i t y of i n f o r m a t i o n which t h e o r t h o d o x books gave o n the mtiology of d i a b e t e s t h e homceopathic p h y s i c i a n h a d no reason to be a s h a m e d of his a p p r o a c h . H e r e d i t y was a m o s t interesting p r o b l e m to us. Of the exciting causes mentioned, t h a t which i n t e r e s t e d him m o s t was a n x i e t y , a n d t h a t was where t h e homceopathic physician came into his own. I n t h e ~etiology it was t h e a n x i e t y or its effects which we could t r e a t more successfully t h a n most. Then, he t h o u g h t , Dr. K e n y o n was to be c o n g r a t u l a t e d in t a c k l i n g these cases as successfully as he h a d . B u t h a d he a definite m e t h o d of stabilizing t h e p a t i e n t first a n d t h e n giving t h e r e m e d y ? D i d he do t h a t as a rule ? T h a t seemed to be t h e b e s t m e t h o d b u t it was difficult to stabilize under some conditions. W h a t was one to do, i f one could n o t get t h e m stabilized a t all ? One m u s t then, of course, t r y t h e r e m e d y to see if a result could be achieved b y t h a t means. W i t h r e g a r d to t h e case which was q u o t e d where i n s t a b i l i t y was so m a r k e d he w o u l d have t h o u g h t of Pul~satilla r a t h e r t h a n Ignatia. Dr. Q u i n t o n ment i o n e d giving t h e nosode first, t h e n t h e c o n s t i t u t i o n a l r e m e d y . W h y d i d he give a nosode first ? Dr. K e n y o n m i g h t know s o m e t h i n g a b o u t w h a t was in his m i n d in t h a t p a r t i c u l a r m a t t e r . H e w o n d e r e d if Dr. Sundell could h a v e given t h e m some idea if t h e r e was a large p r o p o r t i o n of people on diet a n d stabilized who u l t i m a t e l y r e d u c e d their insulin a n d even if t h e r e was a proportion of cures. W e r e a n y of these figures a v a i l a b l e ? Each case was different : t h e y r e a l l y could n o t be classified into percentages a n d so forth. The other p o i n t which s t r u c k him was w h e t h e r t h e n u m b e r of d i a b e t i c s was known. T h e y were said to be increasing e v e r y d a y . W h y ? Because the diabetics lived longer a n d p r o d u c e d children ? T h a t would p r o v e the heredit a r y factor. Quoting o d d cases was no use. H e k n e w of a y o u n g m a n who was rejected for t h e A r m y , he was investigated, g a v e a d i a b e t i c curve, a n d w i t h i n a m o n t h w i t h o u t t r e a t m e n t he h a d no sugar a t all in his urine. H e was n o t frightened, he was anxious t o join t h e A r m y , and he was a c c e p t e d on his second a t t e m p t , a n d r e m a i n e d in the services.* Re Dr. F o u b i s t e r ' s case, one would h a v e t h o u g h t t h a t t h e carbuncle was a c o m p l i c a t i o n of diabetes, n o t t h e cause of t h e diabetes. Could Dr. Fergie W o o d s h o n e s t l y s a y t h a t no d i a b e t i c p a t i e n t w h o m he h a d t r e a t e d h a d d e v e l o p e d complications ? N o c a t a r a c t ? .No gangrene ~. H o w d i d these cases s u r v i v e if t h e y a t e e v e r y t h i n g a n d a n y t h i n g ? D i d t h e insulindiet t r e a t m e n t p r e v e n t t h e onset of c a t a r a c t and retinitis ? Some people said " N o ", b u t he would like to k n o w more a b o u t t h a t . P r o b a b l y m o r e t h a n m o s t diseases d i a b e t e s was an i n d i v i d u a l p r o b l e m a n d t h a t was true of its homceopathic t r e a t m e n t as had been shown b y Dr. K e n y o n to-day. Dr. KEn'YON, r e p l y i n g to t h e discussion, said t h a t w h a t he claimed was t h a t a homceopathic r e m e d y could speed recovery of t h e p a t i e n t in a g r e a t m a n y cases. W i t h r e g a r d to t h e p o i n t raised a b o u t t h e r e l a t i o n b e t w e e n d i a b e t e s a n d infections such as carbuncles, he considered t h a t while t h e d i a b e t i c was more prone to such infections, nevertheless n o n - d i a b e t i c persons suffering from carbuncles sometimes d e v e l o p e d a t e m p o r a r y hyperglycsemia which d i s a p p e a r e d when t h e infection cleared up. Dr. Sundell h a d s t a t e d t h a t he was innocent of the homceopathic t r e a t m e n t of diabetes. This was a gross u n d c r s t a t e m e n t as a c t u a l l y Dr. Sundell was m o s t successful in dealing w i t h this disease homceopathically. H e h a d only h a d experience of one t u b e r c u l a r p a t i e n t who h a d d e v e l o p e d d i a b e t e s a n d this p a t i e n t r e q u i r e d v e r y large doses of insulin. As infections block t h e action of insulin, he a s s u m e d t h a t this was t h e reason for the large dose required. * This case after demobilization
has again shown signs of a mild diabetes.
THE
HOM(EOPATHIC
TREATMENT
OF
DIABETES
189
Dr. Kenyon said t h a t Dr. Fergie Woods had certainly been more successful than he had beenin treating all cases of diabetes without having to resort to insulin. With regard to the question about giving the nosode in a tubercular diabetic, he would give the nosode (or an intestinal non-lactose fermenting potency) provided the patient's tubercular condition was not advanced. He quite agreed with Dr. Templeton that instability of symptoms would direct one's thoughts to Pulsatilla. He had treated a man who was practically homceopathically symptomless and suggested Sulphur, to which drug he had not responded. His hyperglyc~emia and glycosuria were so variable and inexplicable in point of time that Pulsatilla was given with definite benefit. Dr. MASON said that a friend of hers, a doctor, was taken prisoner at Singapore. While in captivity the diet was very low and he said that diabetics did very well on a low diet. Dr. KENYON said that the line he usually followed was firstly to stabilize the patient on diet (and insulin if required) keeping a slight glycosuria present in order to judge the effect of the remedy.