TABLE OF CONTENTS

CHAPTER I

My First Lesson

Case 1: Abscesses in Armpit Dispersed without Operation

It is one of the canons of old school medicine that as soon as matter or pus has undoubtedly formed in an inflamed part, there is nothing for it but to let the matter out. There is no possibility, it is taught, of causing absorption of matter : when once formed and abscess must be opened. That impression is so firmly drilled into students in the ordinary schools, that two years of homeopathic practice had failed to get it out of my mind. The preceptor who finally cured me of it was a very humble person - a hawker who came to consult me at the Homoeopathic Dispensary in Ipswich, where I was then practicing, for a swelling under her arm. On examining the part I found the whole armpit converted into a bag of pus. I said to her that it was an abscess, and would have to be opened, and I proceeded to make arrangements for the little operation. But I had reckoned without my patient. An operation of even that trifling nature she sturdily refused to agree to. I felt that the dignity of the whole profession was outraged in my person by this rejection of my advice, but I pocketed my pride for the time being and prescribed Hepar sulph. 6. one pilule three or four times a day. On her return the following week I expected to find that the abscess had opened itself in a very unscientific way, after causing much needless suffering to the patient. In this I was disappointed; she had gauged my therapeutical powers better than I had been able to do myself - the swelling was very much less! No opening had taken place, the patient was feeling much better, and the pus was nearly all absorbed. In a short time all fluid had gone, and an agglomerated mass of glands was left. The glands soon separated and then resumed their ordinary state, the patient recovering perfectly with a whole skin!

From that patient's "obstinacy", as I regarded it at the time, I learned a lesson which has been of the greatest service to me ever since. Matter can be absorbed, and its absorption can be promoted, by homoeopathic medicines. When matter is absorbed in this way, it is dealt with as the organism deals with all waste tissues, and is not "dispersed" into the circulation to poison other parts. When matter can be thus dealt with, by putting the organism into a more wholesome condition, it is infinitely better for the patient to avoid any operative interference.

CHAPTER 2: Anatomy and Physiology of The Glands

In ordinary language a "gland" means a gland of the lymphatic system. It is in this sense that I use the term in the present treatise. Anatomically speaking, all the organs of the body which secrete definite fluids, such as the liver, the kidneys, the salivary glands, the sweat and sebaceous glands of the skin, and also some organs which have no known secretion, as the pineal and thyroid bodies, are glands. But when the word gland is used absolutely, it is the lymphatic glands which are understood to be meant.

The lymphatic glands are little bodies varying in size from a lentil to an almond, and are very widely distributed over the body. they are like so many "locks" on the system of lymph canals, which form a network of vessels spread over the whole of the soft tissues. The office of these vessels is to take up the used-up materials of the body, pass them on to the lymphatic glands, which so act on them as to make them again fit to be poured into the current of the blood.

In the ordinary course of events the glands are very well able to discharge their functions, but at times extra pressure is put upon them. When one has a gathered finger, instead of the ordinary amount of waste products of the part, there is a great increase, and some of them are of a highly irritating character. In consequence of this we often find a red streak running up the arm from the injured finger to the armpit, and in the armpit one or more enlarged and painful glands. This means that the irritating matters are being dealt with by the glands. These may prove equal to the strain put on them, or they may inflame and suppurate themselves.

On dissection the lymphatic glands are found to consist of a capsule, and an internal portion composed of pouches communicating with each other, and richly supplied with blood-vessels and nerves. The pouches contain "a molecular fluid in which numerous nuclei and a few cells may be found in all stages of development" - (Bennett). There are lymphatic vessels leading into the glands and others leading away from the glands. The lymphatic vessels are provided with valves which only permit the fluid they contain to travel in one direction, away from the surface in the direction of the heart. Those vessels which enter a gland open into the lymph spaces of the outer portion of the gland; those which leave it are connected with the internal portion.

The distribution of the glands is very extensive. The chief localities n which they are found are the neck, the armpits, and the groins externally, and internally under the lining membrane of the abdominal cavity (peritoneum), and in the folds of it, where it where it forms the band of attachment for the bowels (mesentery), and in the chest along the larger bronchial tubes, at the root of the lungs, and at the base of the heart.

It will easily be understood that the function of this system of glands and vessels is of very great importance. The apparently solid tissues of the body are in a constant state of flux, of building up and of decay, and on the regular discharge of this process of interchange (metabolism, the scientific call it) the health of the body depends. It is one function of the lymphatics to take up the waste materials of the tissues and re-organise them, so far as they are capable of it, for the rebuilding of the same or other tissues. If they act too sluggishly the tissues become thick and unhealthy, and a state of obesity, either local or general, may result; if they act too energetically the opposite condition of wasting will ensue.

But they have another function of enormous importance in the economy. I have spoken of the familiar instance of glands inflaming in the armpit when there is inflammation of some part of the arm or hand. The lymphatics, therefore not only deal with the waste of the body, they attack the products of diseased action, and, so far s they can, destroy the virus of disease.

I will not rest content with my own authority on this point. The Lancet of May 12, 1894, reports a discussion on a paper by Dr. Walter Carr, entitled "The Starting-points of Tubercular Diseases in Children." In the report of the discussion which followed I find the following :-

"Dr Routh pointed out the value of the lymphatic glands as a means of arresting the disease, in the same way that the poison of syphilis or of a dissection wound was arrested".

Dr. Carr, in reply, said . . . he believed that the glands were usually infected near the primary source of infection. He had no doubt that the lymphatic glands did act as fillers and arrested the disease."

Closely allied with the lymphatics are the tonsils, which are looked upon by many surgeons as useless encumbrances (from the patient's point of view), liable to become enlarged from the slightest provocation, and good for nothing except for providing the surgeon with the work of cutting them out. But even in regard to the tonsils some authorities in the old school are waking up to the fact that they may have been put where they are for some useful purpose, and not solely for the surgeon's benefit. I quote the following from the Homoeopathic World of April 1893 :-

The Tonsils

In the Revue Homoeopathique Belge of December 1892, Dr. Martiny adduces weighty reasons against excising or even cauterising the tonsils. He quotes from a work (Etudes Générales et Pratiques sur la Phthisie) by Dr. Pidoux, which was accorded by the Faculty of Medicine the prize of 10,000 fr. founded by Dr. Lacaye, and in which facts were adduced to show that in phthisical patients the excision of the tonsils materially increased the predisposition to the disease. Says Pidoux :-

"I act in regard to the follicular angina of phthisis as with hypertrophied tonsils, which I never excise, no more than I do the uvula in phthisics or in those who appear to me threatened with becoming such; as also with anal fistula, skin affections, pains, leucorrhea, and c., and c."

And further on he says :-

"Now it is quite certain hypertrophy of the tonsils is one of the most benign and most natural expressions of non-degenerated struma (des strumes non dégénérées). It is often such with all the other characters of simple and nascent scrofula, in infants and strong adolescents, well formed, of healthy colour, with the aspect a little humid and full of juices. It must be feared, then, that the violent suppression of this primitive affection may be followed, in a predisposed subject, with pulmonary manifestations of catarrhal pus and still more retrogressive ultimates."

Dr. Martiny adds that the above entirely agrees with his opinion. For a long time he has advised neither removal nor cauterisation of the tonsils, for he has discovered, on inquiring into the antecedents of consumptive patients, that a large number had formerly submitted to excision of the tonsils. For many years he has not met with a case of enlargement of tonsils that did not improve so much under treatment as to render their removal unnecessary.

Dr Martiny maintains that though nobody knows exactly what part the tonsils play as glands in the economy, this is no reason for concluding that they are useless; and that "to excise, to lacerate, to cauterise deeply an organ which exists normally in the human species and in a large number of animals", has always appeared to him the reverse of prudent.

CHAPTER 3: Surgical Interference

From what I have said above, the rashness of surgery in interfering with these vitally important organs when they are doing their office of destroyers and filters of disease, will have became apparent to my readers. In the process of "arresting and filtering "disease, the glands sometimes become over-burdened, and inflammation and abscess takes place. But they are discharging their functions all the time. If they cannot arrest disease without becoming inflamed, the next best thing is for them to do it by suppuration. By homeopathic treatment, as my first case showed me, and as I shall prove by other cases later on, it is possible to so assist them in their operations as to prevent the necessity of suppuration, and even to enable them to remove the products of suppuration without opening externally; but even without homoeopathic treatment it is far kinder to the patient to let the glands take their course and leave their own scars, than to cut them out and leave only the neat scar of the surgeon. How often do we not see in phthisical families that those who have on their necks the marks of old abscesses have lived and become strong, whilst others who have not had this disease-filtering and disease-arresting process have succumbed?

It is not always possible to trace the remote results of surgical interference. After the operation the patient is often temporarily relieved, and is to all appearance quite well; and when the diseases comes back again it is in such a different form that its connection is easily over-looked. I think, however, in the two cases now to be narrated the connection is obvious.

Case :: Tubercular meningitis and death following removal of strumous glands of the neck

Ronald P., aged 4, was admitted to the London Homoeopathic Hospital on Feb. 10th, 1892, with the following history. Some time before (the exact date is note stated in the notes), he had had strumous glands removed from the neck by operation. Two days before admission he began to be fretful, crying for no apparent reason. In the afternoon of the same day he complained of irritation in the back, and a rash came out in the form of a group of pustules which quickly burst, being very irritable. The morning before admission he woke up and found he could not stand. This lasted some hours and was accompanied by complete loss of sensation. The power and sensation gradually returned, and he found he could stand but not walk well. On admission he had an unhealthy appearance, but was not wasted. There was an eczematous eruption on the left shoulder, running and irritable. There was no pain in the back and no curvature. There was much loss of power, and defective sensation in the legs. When he walked he trod on the outer sides of his feet, and kept the toes raised. The superficial reflexes were less than normal; the knee-jerk about normal. His temperature was 100°. Passed water in bed at times.

Under Calcarea he seemed to make some progress, but on Feb. 22nd sickness set in, and on the 24th there was commencing optic neuritis. After this there were fluctuations.

March 3 rd. - Very drowsy; semi-comatose; screams out when moved; no sickness; bowels constipated; marked tâche cérébrale; keeps perfectly still; pupils dilated, react to light. From this time he gradually sank, and died on March 8th - Cheyne-Stokes respirations setting in before the end. From the beginning of this seizure on February. 8th, the boy, in my opinion, had not a chance. It is, of course, impossible to say that he would not have had this illness in any case, but my own belief is that he would not. If the neck glands had been left to do their work, unsightly though they may have been, they would in all probability have "filtered and arrested" the disease, which was undoubtedly tubercular. Possibly it would have taken them years to have done it; but as it was, they were taken ruthlessly away in the midst of their restorative work. No doubt the patient was very efficiently "cleaned up". The ugly sores were all removed, and he was made quite presentable once more. But he was not cured of his tubercle - surgery never can do that. It developed again, and this time attacked a part much more dangerous than the first, and the organism, being deprived of the eliminative powers of the removed glands, was unable to withstand the attack. The common notion about the danger of driving in a disease has a very substantial foundation in fact.

The next case is one of a different kind.

Case :: Tubercular disease of nasal bones and valvular disease of the heart following removal of glands of the neck

At the beginning of the winter of 1893 I was consulted by a lady, Mrs W., 56 who gave me the following history. She came of a very tuberculous family. When very young she had sore eyes. She had all her life been liable to rheumatism of the limbs. In 1870 she began to suffer from lupus of the nose. This was treated surgically and "cured". The following year it recurred, and was again treated in the same way. Afterwards she had polypus, and this was removed. Volkmann treated her in 1872. Seven years later the nose began to fall in from disease of the bones, and she had been under treatment ever since.

In 1886, as the result of a cold, she had enlargement of the glands on the right side of the neck. A year after, these glands were removed and were pronounced tuberculous by the surgeon who performed the operation. For a time she felt much better, but then the nose became more troublesome, and in 1890 she had to undergo a very severe operation, bone having to be chiseled away to open a breathing passage. When she consulted me she was complaining of nervousness and irritability, with attacks of palpitation. She was less able to walk or bear fatigue than she had been formerly. When I came to examine the chest I found the cause of the trouble in disease of the aortic valve.

In this case the sequence and consequence of the events are, perhaps, not as clear as in the first; but, at any rate, there was a history of a surgical "cleaning up" of the outer structures, followed by an attack on deeper ones, ones, and to my mind it is clear that if for the skin and gland affections the patient had been treated medically instead of surgically from the first, she would have been spared the attack on the bones of the nose and the last development of all, disease of the heart.

I am confirmed in my opinion by a discussion on the subject held at the meeting of the British Medical Association at Newcastle-o,-Tune in August 1893, and reported in the British Medical Journal of Nov. 25 of the same year. Mr Pridgin Teale of Leeds, on the suggestion of Dr. Clifford Alibutt, first performed the operation of excising scrofulous glands in the year 1881. Their guiding principle in this operation was - "that, where-ever septic material is contained in the system, we rest not until it is expelled and its burros are laid open and disinfected". At the meeting above referred to, Mr Teale spoke, and among other points referred to the ultimate effect of the operation upon health. In 23 cases he made enquiries into the subsequent history of the patients. Twelve of these were in very good health; three were in "fair health", which means indifferent health; five failed to report; three had died. Now these deaths are remarkable. One died of tuberculosis of the lungs; one died suddenly of heart disease, and one died of abdominal cancer. This was thought by those present to be a very excellent balance-sheet. This only shows how very modest are the expectations of old-school surgeons and physicians. Most of the surgeons who spoke dwelt on the encouraging fact that they had lost no patient as a consequence of the operation. In addition to the three cases of death in Mr Teale's practice, Dr Ashley Cummins of Cork mentioned two cases in which extensive operations on the neck and axilla had been followed by acute consumption, and Mr Wm. Thomas of Birmingham quoted a case of removal of "a large glandular mass which necessitated the division of the sterno-mastoid muscle, and drawing up some glands from the thorax. The wound healed favourably, but the patient died fifteen months after from extension of the disease to the bronchial glands". Mr T. Barlow of London, president of the meeting, summed up the belief of the speakers on the question of medicines as follows : - "Drugs were of use for improving the general nutrition, but had little caseous material". However, he was not so enthusiastically in favour of operating as most of the speakers. "There was little doubt as to the right treatment of glands which were actually suppurating". - the old fallacy of which my hawker patient cured me - "but there were many borderland cases of enlarged glands in which one hesitated about immediate surgery".

This madness for operating (furor operativus, as it is called) is by no means confined to the operation for removal of glands. An eminent French surgeon not long ago entered a protest against it. "We operate too much", he said, "and it would be a good thing if we listened more to the protestations of our patients. Quite recently three severe cases have occurred to myself in which I was convinced that nothing but an operation could do any good. The patients, however, insisted on being treated medically. I told them that it was sheer waste of time; but they remained firm, and were rewarded by being perfectly cured without operation".

It is notorious that many needless operations are performed on women. Dr Routh (Medical Press, May 9, 1894) mentions an instance in point. An eminent operating surgeon paid a visit to one of his disciples, who "triumphantly brought out two dozen specimens, which he had removed from women, in bottles, which in almost every instance were free from guide". That is to say, perfectly sound organs have been removed, on the supposition that they were diseased.

The poverty of the physicians department is not a little to blame for this state of affairs. It is not at all uncommon to heart medical students say, "Oh! I shall go in for surgery, there is something to be done in that; in medicine nobody knows what he is doing - it is all conjecture". This is quite true of allopathic medicine; but the Faculty ought to take shame to itself that it is true. Medicine is the frontier line of defense; to abandon medicine for surgery is as bad as for a general to give up all his outlying strongholds without a blow, and give the enemy a free march on the capital. The object of the general (and of the medical man) is to keep the enemy away from the center, and avert the risk of dismemberment, by all the means in his power. This, as I shall show, is what homeopathy can do in a very large proportion of cases.

But it is not always the operating surgeon who is to blame. Such is the effect of modern doctrines, that some patients actually demand an operation when there is no excuse for it. They have a kind of weakness for being operated upon (furor operativus in a passive sense). Some months ago quite a list of cases of the kind were recorded in one of the medical journals. A number of patients insisted on having operations performed, and they were successful in finding surgeons obliging enough to comply. One man was so convinced that he had a tumour in his stomach that nothing would satisfy him but that a surgeon should open him and see; This was done, and nothing abnormal was found. But even this did not satisfy him. He was sure the surgeon did not look properly, and insisted on having it done over again. One woman was insatiable : she had no less than seven unnecessary and unjustifiable operations performed on her.