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Gastric and duodenic ulcers
THE
BRITISH
HOM(EOPATHIC
JOURNAL
39
GASTRIC AND D U O D E N I C ULCERS THERE is a special reason to report about such a well-known and common disease. During this war, and especially in its second half, we had the opportunity to see an immense number of such ulcers. So we were able not only to test the efficiency of our remedies--let me emphasize that, by this way, our treatment proved to be absolutely superior to the allopathic--but also to come to a thorough understanding of all that is going on here. Either disorders in the sympathetic nervous system or direct influence of bad food are supposed to be the primary cause of intestinal ulcers. Both opinions are supported by a lot of proof. There is no doubt about the food being bad during the war, it was not only insufficient but also extremely monotonous and contained too small a quantity of fat in spite of the black market. The only fat one was able to get in this country was an incredibly bad margarine. But on the other hand it was to be noticed t h a t everybody's nerves were incessantly strained to the very highest degree. Thus we raise the question by these phenomena. There is no need of scientific speculations for the Homceopathy in clearing up such questions. No case is treated schematically but always with regard to its individuality. And reviewing all remedies used during this period we can easily get the answer. For this reason first of all we let the cases speak for themselves. 1st Group : Anacardium orientale.
Drug picture : Marked irritability, disturbed by everything, irresolution, forgetfulness, hallucinations, internal anxiety, contradiction between will and 9 reason, fixed ideas, all seems to be a dream, the patient fears he is p u r s u e d - that is to characterize the mental state. The complaints are periodical ones. Skin eruptions dark, dusky, and of malignant type vesicles--itching and burning. (Anacard. or. is antidote to R h u s poisoning !) Cramps and pains in the s t o m a c h - - b e t t e r after eating for one to two hours--and from pressing (only nervous pains). All complaints grew worse from mental excitement, from cold and draught. Total number of cases: 42. Examples : (a) F. Ch., 41 years old. September 30th, 1943. For about three weeks " burning " i n the "region of the gall-bladder ", which begins two or three hours after he has eaten, and is stopped by eating again. The back of the tongue covered. No tenderness in the region of the gall-bladder--but very sensitive when the solar plexus is examined. X-rays : ulc. duoden. Therapy : Anacard. or. 200. October 20th, 1943. Better, but complains of smell hallucinations. Another dose of Anacard. or. 200. November 2nd, 1943. No complaints. X - r a y s : ulcer cured. (b) T.A., 47 years old. May 10th, 1944. Complaints about gastralgia for a couple of days. The pains grow better after eating, for about two hours. Examination: very irritable and nervous woman. Duodenum area aching. X - r a y s : ulc. duoden. T h e r a p y : Anacard. or. 200. May 19th, 1944. No compraints. May 25th, 1944. X-rays : ulcer cured. (c) M.O., 22 years old. July 31st, 1945. Lately, cramping in the stomach whenever the stomach is empty. Tongue clean, little ptosis, circumscribed sensibility. Anaemia. X-rays : ulc. duoden. Therapy : Anacard. or. 200. August 21st, 1945. No complaints. (d) O.W., 37 years old. September 25th, 1945. For the past six weeks cramps and pains whenever her stomach is empty. Nervous troubles (internal anxiety--fear for herself). Tongue clean, stomach contracted, vague tenderness. X-rays : ulc. duoden. Therapy : Anacard. or. 200. October 15th, 1945. No complaints.
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THE
BRITISH
HOM(EOPATHIC
JOURNAL
(e) E.P., 29 years old. February 4th, 1942. Duodenal ulcers for the last 289 years. Trcated w i t h Larostidin injections without any result. Pains grow better after eating, for two hours. Worse after anger and excitement. X-rays : ulc. duoden, chron. Therapy : A n a c a r d . ar. 200. March 23rd, 1942. No complaints. ( f ) L.S., 43 years old. In 1940 she had a duodenic ulcer and had been cured by Anacxerd. or. 4x. January 6th, 1943. From the autumn, again pains from the epigastrium through to the back, better after eating. Marked circumscribed tenderness. X-rays : ulc. duoden., cicatrices. Therapy : A n a c a r d . or. 200. January 26th, 1943. Still pains, though remarkably less than before. Another dosc of A n a c a r d . eyr. 200. March 2nd, ]943. A great deal better. May 4th, 1943. No pains " for a long thnc ". X-rays : only cicatrices. (g) M.S., 31 years old. April 1st, 1943. From her youth gastric pains which grow better after eating. Often headaches, " as if tied tip ". Tongue slightly covered. Stomach: vague sensitiveness. X-rays: ulc. duoden. chron., cicatrices. T h e r a p y : Anacx~rd. or. 200. April 22nd, ]943. No complaints. May 7th, 1943. X-rays : only cicatrices. (h) J.M., 31 years old. June 14th, 1945. During the past 2~ years from time to time pains in the stomach whenever it is empty, especially in spring andautumn. The back of the tongue covered. Distinctly marked sensitiveness. X-rays : gastroptosis, ulc. bulb. duoden. Therapy : A n a c a r d . or. 200. July 15th, 1945. No complaints. 2rid Group : 24ux vomica.
Drug picture: Over-scnsitiveness, irritability, hypochondria, egoism. Over-sensitive to light, noise, touch, odours. Consequences of abusing coffcc, tea, wine, tobacco and remedies.--grief, night-watches, mental fatigue--anger, (mania, sexual excesses. All this also aggravates the complaints. Headache relieved by quiet. Neuralgias. Tongue dry and white--thirsty. Bitter or sour taste, pyrosis. Flatulence, constipation or diarrhoea, tcncsmus. Stomach pains are cutting, spasmodic. Vomiting. Worse after caring, for one to two hours. Menses too soon and too long. Dysuria and renal colics. All complaints worse in thc morning, after cold air, sunshine, touch and eating (except breakfast !). Total number of cases: 37. Examples : (a) A. Sch., 52 years old. May 17th, 1943. For about four weeks cramps in his stomach, penetrating through to the back. Worse after eating for the first time. Slightly covcred and dry tongue. Circumscribed sensitiveness. X-rays : ulc. gastric cure. major. Therapy: N u x vom. 200. June 2nd, 1943. A great deal better. June 16th, 1943. No pains. X-rays : ulcer cured. (b) W.H., 41 years old. March 28th, 1944. In the past weeks from time to time cramps in his stomach, cspecially in the morning. A slight retching. Eating aggravates for the first hours, then better. A strong smoker. Tongue white. Bitter taste in the morning. Sympathicotonia. X-rays : ulc. prmpylor. Therapy : N u x vom. 200. May 15th, 1944. No complaints. (c) R.K., 40 years old. November 14th, 1945. For about a week, pains in the epigastrium. Worse after eating, for about two or three hours. Oppressive headaches. Tongue clean, dry. Sensitiveness on the curvatura major. X-rays : ulc. mediogastric. Therapy : ~\Tux yore. 200. November 29th, 1945. Better. January 2nd, 1946. All right. (d) A.P., 48 years old. December 3rd, 1943. For about 10 years, undefined pains in his stomach. Feels sickly after his meals. Latterly, often stitching pains in the stomach, diarrhoea with tenesmus. Tongue slightly covered. Vague sensitiveness. X-rays : ulc. duoden, chron., cicatrices. Therapy : N u x
GASTRIC
AND
DUODENIC
vom. 200. December 20th, 1943. Better. 1944. All right. X-rays : only cicatrices.
41
ULCERS
Bowels regular.
J a n u a r y 3rd,
3rd Group : Antimonium crudum.
Drug picture : " All the symptoms seem to centre about the stomach." No desire to live. Tongue covered with a milky-white coating. Nausea, feeling as if he had an overloaded stomach, vomiting, pyrosis. Violent pains, cramping, burning in the stomach. Diarrhoea, tenesmus. Worse after cold, (tamp weather, after cold bathing, after stimulants, after sour meals, after over-heating and radiated heat, and in a warm room. Better after a hot bath, after lying down quietly, in open air. Total number of cases : 11. Examples : (a) K.H., 53 years old. J a n u a r y 25th, 1943. For about a year, from time to time cramps and pains in his stomach. These complaints are not at all connected with his meals. Belching tastes of rotten eggs. Pyrosis at times. Tongue with a thick white coating. Only a slight sensitiveness. X-rays : ulc. pr~epyloric. T h e r a p y : Antim. crud. 200. February 9th, 1943. Better. March 9th, 1943. No complaints. (b) O.V., 65 years old. October 16th, 1943. For a long time vague pains in the stomach, flatulence, aversion to food, headache. Thc back of the tongue thickly covered with a white coating. Worse in a warm room, better in open air. Marked sensitivcness. X - r a y s : ulc. cure. rain. T h e r a p y : Antim. crud. 200. November 13th, 1943. Practically all right. November 27th, 1943. Worse after a gross mistake in diet. Another dose of AntDl~. crud. 200. December 22nd, 1943. No complaints. X4rays : ulcer cured. 4th Group : Other remedies, connected more with the metabolic processes.
(a) A.M., 35 years old. April 17th, 1943. During the past year pressing and permanent pains in the right epigastrium. Eating has no effect, except the fact t h a t milk aggravates her troubles. Dry constipation. Sensitiveness in the duodenic region. X-rays: ulc. duoden. T h e r a p y : Mag. mur. 200. May 29th, 1943. No complaints. X-rays : ulcer cured. Gastric symptoms of Magnesium muriaticum : Pains in the region of the liver. Tenderness in the region of the stomach. Ga,stralgia, worse in the evening. Hunger, but knows not for w h a t - - b u t every food causes distress, worst of all milk. Desire for sweets. Hard and dry constipation. Restlessness in bed (cannot close his eyes without becoming anxious). Sensitive to cold but prefers fresh a i r - - b u t his head must be covered. (b) lr 31 years old. J a n l l t h , 1944. Inclines to gastric troubles, on the whole. Now he has incessant cramping and burning pains in the right epigastrium, through to the back. Worse after eating. Frequent vomiting. Stretching relieves. Marked sensitiveness when the stomach is pressed. X-rays : ulc. duodcn. Therapy: Bismut. 200. February 2nd, 1944. No complaints. Gastric symptoms of B i s m u t u m : Vomiting immediately after eating. Burning and spasmodic pains in the gastric region, better when he bends backwards, worse after eating. Pressing pains between the shoulder blades. Flatulence, diarrhoea. Weakness, warm perspiration. (c) K.M., 50 years old. J a n u a r y 19th, 1944. Stitching pains in his stomach, unconnected with his meals. Sleepy after the meals. Intensive flatulence in the hypogastrium. Sometimes belching without any relief. X-rays : ulc. ventric. Therapy : Lycopod. 200. February 16th, 1944. No complaints. Gastric symptoms of Lycopodium : Sour or bitter taste, pyrosis. The patient is very hungry, but satisfied by a mouthful. E v e r y meal makes him sleepy. Gnawing pains in the stomach, nausea, vomiting of bile. And first of all flatulence, more in the hypogastrium, and belching without any relief. Worse after cold drinks, coffee, fruits--from 4 to 8 p . m . - - a f t e r warmth, quiet,
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THE
BRITISH
HOM(EOPATHIC
JOURNAL
pressure of clothes---in a warm room. In the beginning movement aggravates, but when continued ameliorates. Better after warm food, in open air. (d) J.T., 45 years old. February 29th, 1944. For 289 years, gastric troubles, cramps, vomiting. He feels a continual chill in his back. Better after eating. X-rays : ulc. ventrie. Therapy : Anacard. or. 200. March 20th, 1944. Condition unchanged. Mostly he vomits only " plenty of sour water " Therapy : Robinia 200. April 24th, 1944. No complaints. (e) J.J., 34 years old. September 21st, 1944. During 13 years, pyrosis, stitching pains in the stomach, vomiting. Better after eating. X-rays : ulcer. Therapy : Anacard. or. 200. Oct. 16th, 1944. On thewhole, condition unchanged, but no longer any amelioration after eating. Vomiting extremely sour. T h e r a p y : Robinia 200. November 3rd, 1944. No complaints. X-rays : no ~llcer. Gastric symptoms of Robinia (only a very small number is to be found) : Pyrosis, sour taste, sour belching, extremely sour vomiting. Flatulence, constipation. Headaches in the forehead. Better after eating. ( f ) J.C., 35 years old. October 3rd, 1944. For 10 years, gastric troubles. Has pains generally in the night and whenever his stomach is empty. Better after eating. X - r a y s : ulc. duoden. T h e r a p y : Anacard. or. 200. October 16th, 1944. First he felt better, then his condition became aggravated. Spasmodic vomiting of sour and undigested food one hour after eating. Nausea continues for some time after vomiting. Therapy : Kreosot. 200. November 1 ] th, 1944. No complaints. Gastric symptoms of Kreosotum : Face has a yellowish pallor. Thirsty. Bitter taste. Salivation. Burning pains in the stomach soon after eating, then nausea and vomiting of undigested, sour food, but the nausea continues. Quite frequently vomiting of blood. Worse after eating cold things--relief after warm diet. 5th Group : Other remedies, connected more with the sympathetic system.
(a) M.H., 34 years old. J a n u a r y 25th, 1943. For about a fortnight, pains in the stomach, and headaches. Sudden cramps in the stomach, better after bending backwards. Nausea, but cannot vomit. Circumscribed sensitiveness - - b u t very sensitive to every touch. X-rays : ulc. ventric, incip. Therapy : Belladonna 200. February 8th, 1943. No amelioration, but symptoms changed. Incessant feeling of pressure in the stomach. Cramps after excitation. Diarrhoea. T h e r a p y : Chamomilla 200. March 8th, 1943. No complaints. Gastric symptoms of Belladonna : Beginning inflammatory state in the stomach. Pains, burning, cramping--through to the spine. Better after bending backwards. When examining we find a very circumscribed point to be sensitive. Wants to vomit but without result. Worse after movement, bending forward, when touched, in the afternoon and evening. Gastric symptoms of Chamomilla : Bitter taste. Lack of appetite. Thirst for cold water. -Aversion to coffee. Pains in the stomach as if it would be pressed. Spasms everywhere. Vomiting of bile. Colic and diarrhoea {grass-green stool). Worse after anger and whenever excited. Great sensitiveness to every impression. Irritability. Capriciousness. (b) B.H., 53 years old. November 19th, 1943. Gastric pains during the past days, vomiting, flatulence. No appetite. Feels as if her head is swimming. White tongue. Vague sensitiveness. X - r a y s : ulc. ventric. Therapy : C h i n a 200. December 12th, 1943. X-rays : no ulcer. Gastric symptoms of China : Bitter taste, white covered tongue. Appetite diminished---or ravenous. Burning, cramping, pressure of the stomach. Feeling as if of a heavy weight in the stomach. Nausea after eating. Offensive flatulence. Worse after cold--nevertheless he desires cold drinks. Vertigo, headaches, noises in the ears.
GASTRIC
AND
DUODENIC
ULCERS
43
6th Group : A surgical case. J.K., 32 years old. October 17th, 1945. For 12 years gastric troubles. H a s incessant cramping that causes her to cry. Vomiting, diarrhoea. Belly very sensitive. This condition prohibits her from being X-rayed. In order to relieve the spasms one dose of Cupr. ars. 200. October 29th, 1945. Much better therefore X-rayed : bulbus duodeni contracted by cicatrices, incomplete evacuation of the stomach--ulcera duodeni--hernia epigastrica. The fixed contraction as well as the hernia indicate operation. November l l t h , 1945. Operation: resectio bulbi et GEA. S t a t e m e n t : irreparable cicatrice contraction, multiple ulcera going to penetrate, hernia epigastrica. J a n u a r y 23rd, 1946. Condition permanently " splendid " Altogether, the total number of cases treated during 1942 to 1945 was 99, the majority being recent ones which had got an ulcer for the first time. There was only one case that needed surgical treatment. Only one relapse could be noticed : in the case l ( f ) the first attack of which had been treated with a low potency. Of course, all cases got an adequate diet besides the internal therapy, especially in the beginning of the treatment. Unfortunately, for the shortage of all sorts of food, we were not able to prescribe a diet " lege artis ". Perhaps somebody will be interested in a description of the ways we had to take under these unavoidable circumstances. Fundamental prescription during the whole treatment : (1) No food that had been previously vomited. (2) All duodenic ulcer cases were recommended to eat every 189 hours. Detailed prescriptions : 1st week: stale rolls, rusks, butter (these patients got an extra ration of 2-3 oz. monthly), semolina, oatmeal porridge, milk (extra ration ~ pint daily), tea (if the patient had some reserve fund). 2nd week : in case of amelioration, a surplus : mashed carrots, mashed potatoes, a little bit of sugar, beaten eggs (ration 2-4 monthly). 3rd week: surplus: marmalade, fresh roils, mashed spinach, potatoes, vegetable soup, light puddings. 4th week : surplus : white meat, buns, light sweets. 5th and 6th weeks : slowly passing to a normal diet. The majority of all cases (81) responded to remedies which have a special connection with the activity of the sympathetic nervous system. Anacard. or. and N u x vom. were mostly indicated, but Chamom. and China belong to the same group. No theoretical considerations lead to them, the only reason for using them being the symptoms displayed by the illdividual patients. (In the above-mentioned examples I attempted to give a short description of the deciding symptoms.) J u s t for this reason retrospection enables us to conclude t h a t the primary cause in the majority of cases is to be seen in a disordered activity of the sympathetic nervous system. This fact is not surprising when we consider the circumstances of life during the war. Gestapo, persecution, executions, etc., did their best to trouble m a n ' s nervous system. The temporarily insufficient food and its bad quality (chemical substitutes, margarine from coal, etc.) is to be blamed for this primary cause being manifested in the digestive system. The remedies of the other 17. cases were Antim. cruel., Bismut., Lycopod., Maq. mur., Robinia, Kreosot. Antim. crud., is certainly a remedy all symptoms of which " seem to centre about the stomach ". The other remedies are characterized b y the fact that there is no primary connection with any tonus disorders in the sympathetic system. But they all, including Antim. cruel., have a very strong secondary connection with this system. So we are able to say t h a t every intestinal ulcer is connected with disorders of t h e tonus of the sympathetic system, even very bad food only producing the ulcer disease on this given base. P. DOSTAL (Prague).
BRITISH
HOM(EOPATHIC
JOURNAL
39
GASTRIC AND D U O D E N I C ULCERS THERE is a special reason to report about such a well-known and common disease. During this war, and especially in its second half, we had the opportunity to see an immense number of such ulcers. So we were able not only to test the efficiency of our remedies--let me emphasize that, by this way, our treatment proved to be absolutely superior to the allopathic--but also to come to a thorough understanding of all that is going on here. Either disorders in the sympathetic nervous system or direct influence of bad food are supposed to be the primary cause of intestinal ulcers. Both opinions are supported by a lot of proof. There is no doubt about the food being bad during the war, it was not only insufficient but also extremely monotonous and contained too small a quantity of fat in spite of the black market. The only fat one was able to get in this country was an incredibly bad margarine. But on the other hand it was to be noticed t h a t everybody's nerves were incessantly strained to the very highest degree. Thus we raise the question by these phenomena. There is no need of scientific speculations for the Homceopathy in clearing up such questions. No case is treated schematically but always with regard to its individuality. And reviewing all remedies used during this period we can easily get the answer. For this reason first of all we let the cases speak for themselves. 1st Group : Anacardium orientale.
Drug picture : Marked irritability, disturbed by everything, irresolution, forgetfulness, hallucinations, internal anxiety, contradiction between will and 9 reason, fixed ideas, all seems to be a dream, the patient fears he is p u r s u e d - that is to characterize the mental state. The complaints are periodical ones. Skin eruptions dark, dusky, and of malignant type vesicles--itching and burning. (Anacard. or. is antidote to R h u s poisoning !) Cramps and pains in the s t o m a c h - - b e t t e r after eating for one to two hours--and from pressing (only nervous pains). All complaints grew worse from mental excitement, from cold and draught. Total number of cases: 42. Examples : (a) F. Ch., 41 years old. September 30th, 1943. For about three weeks " burning " i n the "region of the gall-bladder ", which begins two or three hours after he has eaten, and is stopped by eating again. The back of the tongue covered. No tenderness in the region of the gall-bladder--but very sensitive when the solar plexus is examined. X-rays : ulc. duoden. Therapy : Anacard. or. 200. October 20th, 1943. Better, but complains of smell hallucinations. Another dose of Anacard. or. 200. November 2nd, 1943. No complaints. X - r a y s : ulcer cured. (b) T.A., 47 years old. May 10th, 1944. Complaints about gastralgia for a couple of days. The pains grow better after eating, for about two hours. Examination: very irritable and nervous woman. Duodenum area aching. X - r a y s : ulc. duoden. T h e r a p y : Anacard. or. 200. May 19th, 1944. No compraints. May 25th, 1944. X-rays : ulcer cured. (c) M.O., 22 years old. July 31st, 1945. Lately, cramping in the stomach whenever the stomach is empty. Tongue clean, little ptosis, circumscribed sensibility. Anaemia. X-rays : ulc. duoden. Therapy : Anacard. or. 200. August 21st, 1945. No complaints. (d) O.W., 37 years old. September 25th, 1945. For the past six weeks cramps and pains whenever her stomach is empty. Nervous troubles (internal anxiety--fear for herself). Tongue clean, stomach contracted, vague tenderness. X-rays : ulc. duoden. Therapy : Anacard. or. 200. October 15th, 1945. No complaints.
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THE
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(e) E.P., 29 years old. February 4th, 1942. Duodenal ulcers for the last 289 years. Trcated w i t h Larostidin injections without any result. Pains grow better after eating, for two hours. Worse after anger and excitement. X-rays : ulc. duoden, chron. Therapy : A n a c a r d . ar. 200. March 23rd, 1942. No complaints. ( f ) L.S., 43 years old. In 1940 she had a duodenic ulcer and had been cured by Anacxerd. or. 4x. January 6th, 1943. From the autumn, again pains from the epigastrium through to the back, better after eating. Marked circumscribed tenderness. X-rays : ulc. duoden., cicatrices. Therapy : A n a c a r d . or. 200. January 26th, 1943. Still pains, though remarkably less than before. Another dosc of A n a c a r d . eyr. 200. March 2nd, ]943. A great deal better. May 4th, 1943. No pains " for a long thnc ". X-rays : only cicatrices. (g) M.S., 31 years old. April 1st, 1943. From her youth gastric pains which grow better after eating. Often headaches, " as if tied tip ". Tongue slightly covered. Stomach: vague sensitiveness. X-rays: ulc. duoden. chron., cicatrices. T h e r a p y : Anacx~rd. or. 200. April 22nd, ]943. No complaints. May 7th, 1943. X-rays : only cicatrices. (h) J.M., 31 years old. June 14th, 1945. During the past 2~ years from time to time pains in the stomach whenever it is empty, especially in spring andautumn. The back of the tongue covered. Distinctly marked sensitiveness. X-rays : gastroptosis, ulc. bulb. duoden. Therapy : A n a c a r d . or. 200. July 15th, 1945. No complaints. 2rid Group : 24ux vomica.
Drug picture: Over-scnsitiveness, irritability, hypochondria, egoism. Over-sensitive to light, noise, touch, odours. Consequences of abusing coffcc, tea, wine, tobacco and remedies.--grief, night-watches, mental fatigue--anger, (mania, sexual excesses. All this also aggravates the complaints. Headache relieved by quiet. Neuralgias. Tongue dry and white--thirsty. Bitter or sour taste, pyrosis. Flatulence, constipation or diarrhoea, tcncsmus. Stomach pains are cutting, spasmodic. Vomiting. Worse after caring, for one to two hours. Menses too soon and too long. Dysuria and renal colics. All complaints worse in thc morning, after cold air, sunshine, touch and eating (except breakfast !). Total number of cases: 37. Examples : (a) A. Sch., 52 years old. May 17th, 1943. For about four weeks cramps in his stomach, penetrating through to the back. Worse after eating for the first time. Slightly covcred and dry tongue. Circumscribed sensitiveness. X-rays : ulc. gastric cure. major. Therapy: N u x vom. 200. June 2nd, 1943. A great deal better. June 16th, 1943. No pains. X-rays : ulcer cured. (b) W.H., 41 years old. March 28th, 1944. In the past weeks from time to time cramps in his stomach, cspecially in the morning. A slight retching. Eating aggravates for the first hours, then better. A strong smoker. Tongue white. Bitter taste in the morning. Sympathicotonia. X-rays : ulc. prmpylor. Therapy : N u x vom. 200. May 15th, 1944. No complaints. (c) R.K., 40 years old. November 14th, 1945. For about a week, pains in the epigastrium. Worse after eating, for about two or three hours. Oppressive headaches. Tongue clean, dry. Sensitiveness on the curvatura major. X-rays : ulc. mediogastric. Therapy : ~\Tux yore. 200. November 29th, 1945. Better. January 2nd, 1946. All right. (d) A.P., 48 years old. December 3rd, 1943. For about 10 years, undefined pains in his stomach. Feels sickly after his meals. Latterly, often stitching pains in the stomach, diarrhoea with tenesmus. Tongue slightly covered. Vague sensitiveness. X-rays : ulc. duoden, chron., cicatrices. Therapy : N u x
GASTRIC
AND
DUODENIC
vom. 200. December 20th, 1943. Better. 1944. All right. X-rays : only cicatrices.
41
ULCERS
Bowels regular.
J a n u a r y 3rd,
3rd Group : Antimonium crudum.
Drug picture : " All the symptoms seem to centre about the stomach." No desire to live. Tongue covered with a milky-white coating. Nausea, feeling as if he had an overloaded stomach, vomiting, pyrosis. Violent pains, cramping, burning in the stomach. Diarrhoea, tenesmus. Worse after cold, (tamp weather, after cold bathing, after stimulants, after sour meals, after over-heating and radiated heat, and in a warm room. Better after a hot bath, after lying down quietly, in open air. Total number of cases : 11. Examples : (a) K.H., 53 years old. J a n u a r y 25th, 1943. For about a year, from time to time cramps and pains in his stomach. These complaints are not at all connected with his meals. Belching tastes of rotten eggs. Pyrosis at times. Tongue with a thick white coating. Only a slight sensitiveness. X-rays : ulc. pr~epyloric. T h e r a p y : Antim. crud. 200. February 9th, 1943. Better. March 9th, 1943. No complaints. (b) O.V., 65 years old. October 16th, 1943. For a long time vague pains in the stomach, flatulence, aversion to food, headache. Thc back of the tongue thickly covered with a white coating. Worse in a warm room, better in open air. Marked sensitivcness. X - r a y s : ulc. cure. rain. T h e r a p y : Antim. crud. 200. November 13th, 1943. Practically all right. November 27th, 1943. Worse after a gross mistake in diet. Another dose of AntDl~. crud. 200. December 22nd, 1943. No complaints. X4rays : ulcer cured. 4th Group : Other remedies, connected more with the metabolic processes.
(a) A.M., 35 years old. April 17th, 1943. During the past year pressing and permanent pains in the right epigastrium. Eating has no effect, except the fact t h a t milk aggravates her troubles. Dry constipation. Sensitiveness in the duodenic region. X-rays: ulc. duoden. T h e r a p y : Mag. mur. 200. May 29th, 1943. No complaints. X-rays : ulcer cured. Gastric symptoms of Magnesium muriaticum : Pains in the region of the liver. Tenderness in the region of the stomach. Ga,stralgia, worse in the evening. Hunger, but knows not for w h a t - - b u t every food causes distress, worst of all milk. Desire for sweets. Hard and dry constipation. Restlessness in bed (cannot close his eyes without becoming anxious). Sensitive to cold but prefers fresh a i r - - b u t his head must be covered. (b) lr 31 years old. J a n l l t h , 1944. Inclines to gastric troubles, on the whole. Now he has incessant cramping and burning pains in the right epigastrium, through to the back. Worse after eating. Frequent vomiting. Stretching relieves. Marked sensitiveness when the stomach is pressed. X-rays : ulc. duodcn. Therapy: Bismut. 200. February 2nd, 1944. No complaints. Gastric symptoms of B i s m u t u m : Vomiting immediately after eating. Burning and spasmodic pains in the gastric region, better when he bends backwards, worse after eating. Pressing pains between the shoulder blades. Flatulence, diarrhoea. Weakness, warm perspiration. (c) K.M., 50 years old. J a n u a r y 19th, 1944. Stitching pains in his stomach, unconnected with his meals. Sleepy after the meals. Intensive flatulence in the hypogastrium. Sometimes belching without any relief. X-rays : ulc. ventric. Therapy : Lycopod. 200. February 16th, 1944. No complaints. Gastric symptoms of Lycopodium : Sour or bitter taste, pyrosis. The patient is very hungry, but satisfied by a mouthful. E v e r y meal makes him sleepy. Gnawing pains in the stomach, nausea, vomiting of bile. And first of all flatulence, more in the hypogastrium, and belching without any relief. Worse after cold drinks, coffee, fruits--from 4 to 8 p . m . - - a f t e r warmth, quiet,
42
THE
BRITISH
HOM(EOPATHIC
JOURNAL
pressure of clothes---in a warm room. In the beginning movement aggravates, but when continued ameliorates. Better after warm food, in open air. (d) J.T., 45 years old. February 29th, 1944. For 289 years, gastric troubles, cramps, vomiting. He feels a continual chill in his back. Better after eating. X-rays : ulc. ventrie. Therapy : Anacard. or. 200. March 20th, 1944. Condition unchanged. Mostly he vomits only " plenty of sour water " Therapy : Robinia 200. April 24th, 1944. No complaints. (e) J.J., 34 years old. September 21st, 1944. During 13 years, pyrosis, stitching pains in the stomach, vomiting. Better after eating. X-rays : ulcer. Therapy : Anacard. or. 200. Oct. 16th, 1944. On thewhole, condition unchanged, but no longer any amelioration after eating. Vomiting extremely sour. T h e r a p y : Robinia 200. November 3rd, 1944. No complaints. X-rays : no ~llcer. Gastric symptoms of Robinia (only a very small number is to be found) : Pyrosis, sour taste, sour belching, extremely sour vomiting. Flatulence, constipation. Headaches in the forehead. Better after eating. ( f ) J.C., 35 years old. October 3rd, 1944. For 10 years, gastric troubles. Has pains generally in the night and whenever his stomach is empty. Better after eating. X - r a y s : ulc. duoden. T h e r a p y : Anacard. or. 200. October 16th, 1944. First he felt better, then his condition became aggravated. Spasmodic vomiting of sour and undigested food one hour after eating. Nausea continues for some time after vomiting. Therapy : Kreosot. 200. November 1 ] th, 1944. No complaints. Gastric symptoms of Kreosotum : Face has a yellowish pallor. Thirsty. Bitter taste. Salivation. Burning pains in the stomach soon after eating, then nausea and vomiting of undigested, sour food, but the nausea continues. Quite frequently vomiting of blood. Worse after eating cold things--relief after warm diet. 5th Group : Other remedies, connected more with the sympathetic system.
(a) M.H., 34 years old. J a n u a r y 25th, 1943. For about a fortnight, pains in the stomach, and headaches. Sudden cramps in the stomach, better after bending backwards. Nausea, but cannot vomit. Circumscribed sensitiveness - - b u t very sensitive to every touch. X-rays : ulc. ventric, incip. Therapy : Belladonna 200. February 8th, 1943. No amelioration, but symptoms changed. Incessant feeling of pressure in the stomach. Cramps after excitation. Diarrhoea. T h e r a p y : Chamomilla 200. March 8th, 1943. No complaints. Gastric symptoms of Belladonna : Beginning inflammatory state in the stomach. Pains, burning, cramping--through to the spine. Better after bending backwards. When examining we find a very circumscribed point to be sensitive. Wants to vomit but without result. Worse after movement, bending forward, when touched, in the afternoon and evening. Gastric symptoms of Chamomilla : Bitter taste. Lack of appetite. Thirst for cold water. -Aversion to coffee. Pains in the stomach as if it would be pressed. Spasms everywhere. Vomiting of bile. Colic and diarrhoea {grass-green stool). Worse after anger and whenever excited. Great sensitiveness to every impression. Irritability. Capriciousness. (b) B.H., 53 years old. November 19th, 1943. Gastric pains during the past days, vomiting, flatulence. No appetite. Feels as if her head is swimming. White tongue. Vague sensitiveness. X - r a y s : ulc. ventric. Therapy : C h i n a 200. December 12th, 1943. X-rays : no ulcer. Gastric symptoms of China : Bitter taste, white covered tongue. Appetite diminished---or ravenous. Burning, cramping, pressure of the stomach. Feeling as if of a heavy weight in the stomach. Nausea after eating. Offensive flatulence. Worse after cold--nevertheless he desires cold drinks. Vertigo, headaches, noises in the ears.
GASTRIC
AND
DUODENIC
ULCERS
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6th Group : A surgical case. J.K., 32 years old. October 17th, 1945. For 12 years gastric troubles. H a s incessant cramping that causes her to cry. Vomiting, diarrhoea. Belly very sensitive. This condition prohibits her from being X-rayed. In order to relieve the spasms one dose of Cupr. ars. 200. October 29th, 1945. Much better therefore X-rayed : bulbus duodeni contracted by cicatrices, incomplete evacuation of the stomach--ulcera duodeni--hernia epigastrica. The fixed contraction as well as the hernia indicate operation. November l l t h , 1945. Operation: resectio bulbi et GEA. S t a t e m e n t : irreparable cicatrice contraction, multiple ulcera going to penetrate, hernia epigastrica. J a n u a r y 23rd, 1946. Condition permanently " splendid " Altogether, the total number of cases treated during 1942 to 1945 was 99, the majority being recent ones which had got an ulcer for the first time. There was only one case that needed surgical treatment. Only one relapse could be noticed : in the case l ( f ) the first attack of which had been treated with a low potency. Of course, all cases got an adequate diet besides the internal therapy, especially in the beginning of the treatment. Unfortunately, for the shortage of all sorts of food, we were not able to prescribe a diet " lege artis ". Perhaps somebody will be interested in a description of the ways we had to take under these unavoidable circumstances. Fundamental prescription during the whole treatment : (1) No food that had been previously vomited. (2) All duodenic ulcer cases were recommended to eat every 189 hours. Detailed prescriptions : 1st week: stale rolls, rusks, butter (these patients got an extra ration of 2-3 oz. monthly), semolina, oatmeal porridge, milk (extra ration ~ pint daily), tea (if the patient had some reserve fund). 2nd week : in case of amelioration, a surplus : mashed carrots, mashed potatoes, a little bit of sugar, beaten eggs (ration 2-4 monthly). 3rd week: surplus: marmalade, fresh roils, mashed spinach, potatoes, vegetable soup, light puddings. 4th week : surplus : white meat, buns, light sweets. 5th and 6th weeks : slowly passing to a normal diet. The majority of all cases (81) responded to remedies which have a special connection with the activity of the sympathetic nervous system. Anacard. or. and N u x vom. were mostly indicated, but Chamom. and China belong to the same group. No theoretical considerations lead to them, the only reason for using them being the symptoms displayed by the illdividual patients. (In the above-mentioned examples I attempted to give a short description of the deciding symptoms.) J u s t for this reason retrospection enables us to conclude t h a t the primary cause in the majority of cases is to be seen in a disordered activity of the sympathetic nervous system. This fact is not surprising when we consider the circumstances of life during the war. Gestapo, persecution, executions, etc., did their best to trouble m a n ' s nervous system. The temporarily insufficient food and its bad quality (chemical substitutes, margarine from coal, etc.) is to be blamed for this primary cause being manifested in the digestive system. The remedies of the other 17. cases were Antim. cruel., Bismut., Lycopod., Maq. mur., Robinia, Kreosot. Antim. crud., is certainly a remedy all symptoms of which " seem to centre about the stomach ". The other remedies are characterized b y the fact that there is no primary connection with any tonus disorders in the sympathetic system. But they all, including Antim. cruel., have a very strong secondary connection with this system. So we are able to say t h a t every intestinal ulcer is connected with disorders of t h e tonus of the sympathetic system, even very bad food only producing the ulcer disease on this given base. P. DOSTAL (Prague).