DISEASES OF THE SPLEEN
AND THEIR
REMEDIES CLINICALLY ILLUSTRATED








DISEASES OF THE SPLEEN
AND) THEIR
REMEDIES CLINICALLY ILLUSTRATED.
BY
J. COMPTON BURNETT, M.D.,
Auzthor of "Diseases of the Veins, more especially of Venosity,
Varicocele, Hremozorrhoids, and Varicose Veins," " Valvular
Disease of the Heart fromn a New Standhoint,"
Etc., Etc.
" Les 6tats pathologiques des organes doivent &tre d'abord isolement
etudies et ensuite simultan/ment considiris,....   car
souvent on est forcd d'attaquer les organopathies cons/cutives
sans pouvoir atteindre l'etat morbide primitif qui les cause."
PIORRY.
EN 6-L AND:
LONDON: JAMES EPPS & CO.,
170 PICCADILLY AND 48 THREADNEEDLE STREET.
1 8 8 7.




PRINTED BY OLIVER AND BOYD, EDINBURGH.




PREFACE.
THE strength of a chain is equal to that of
its weakest link, and similarly the value of a
person's life may be equal to that of his
weakest vital organ:  here  the  particular
organ is equal in importance to that of the
entire organism.
Even where the tissue state of the entire
organism is everywhere equally bad, it may
be a life-saving act to relieve the particular
organ that first gives way, so that time may
be gained to alter the entire crasis or the
quality of the stroma.
Death itself is often at the start in a
particular organ, i.e., local, and if the part be
saved in time life may be preserved. In the
acute processes the value of a particular
organ strikes one often very forcibly, there
may be no need of any constitutional treatment; the one suffering part may be the




vi              Preface.
whole case. And in many chronic cases
certain organs claim, and must have, special
attention.  This is my standpoint in the
following pages on DISEASES OF THE SPLEEN.
As Forget says, " Entre la nature mztdicatrice
et la nature homicide, il n'y a souvent que
l'epaisseur d'une aponevrose."
I deem it necessary to guard myself
against misapprehension in one or two
particulars. In the first place, I understand
by organ-remedy not a drug that is topically
applied to a suffering organ for its physical
or chemical effects, but a remedy that has an
elective affinity for such organ, by reason of
which it will find the organ itself through the
blood. For instance, an astringent applied
to a mucous surface to get rid of a catarrh
is no organ-remedy in my meaning, it is no
example of Rademacher's organopathy.
Then I do not put forward organopathy
as an idea of my own, or as something new,
but as that of Hohenheim, and of his codoctrinaries, as resuscitated, extended, elaborated, and systematized by Rademacher,




Preface.             vii
in the early part of this century. Honour to
whom honour is due; poor Hohenheim has
been maliciously befouled and meanly robbed
long enough, and it is high time he should
have the credit of his own genius, as well as
of his own folly.
The modern father of organopathy is
Johann Gottfried Rademacher, who was
born on the 4th of August I772, and died
on the 9th of February I850. His great
life-work bears this title: " RECHTFERTIGUNG
der  von  den  Gelehrten  misskannten
verstandesrechten ERFAHRUNGSHEILLEHRE
der ALTEN SCHEIDEKUNSTIGEN GEHEIMAERZTE, und treue Mittheilung desErgebnisses
einer 25-jahrigen Erprobung dieser Lehre
am Krankenbette, von Johann Gottfried
Rademacher." The preface to the Ist edition
is dated ist April I84I.
This is the work I so often refer to herein,
and from which I translate the part on
diseases of the spleen, though slightly condensed.
Further, I do not regard organopathy as




viii           Preface.
something outside homceopathy, but as being
embraced by and included in it, though not
identical or co-extensive with it. I would
say - Organojathy  is homtzopathy in the
first degree. And, finally, I would emphasise the fact, that where the homceopathic
simillimal agent covering the totality of the
symptoms, and also the underlying ppathologic
pr-ocess causing such symptomrs, can be found,
there organopathy either has no raison d'`tre
at all, or it is of only temporary service to
ease an organ in distress.
J. COMPTON BURNETT.
2 FINSBURY CIRCUS,
LONDON, E.C.
A ugust 6, 8 8 7.




Some of t/Ze Litera/ure relating to
Organoopa/zhy  which  I have consulted.
I. "Der Biicher und Schriften des Edlen
Hochgelehrten unnd Bewehrten Philosophi
unnd Medici Philippi Theophrasti Bombast
von Hohenheim Paracelsi genannt: jetzt
auffs new auss den Originalien und Theophrasti eygener Handtschrifft so viel derselbigen zu bekommen gewesen auffs trewlichst
und fleissigst an Tag gegeben: Durch Joannim Huserum Brisgoium, churfiirstlichen
Cilnischen Raht und Medicum."  In 2 vols.
Franckfort, Anno MDCIII.
2. Numerous writings of the ParacelsistsCrollius, etc.
3. Rademacher's Work.
4. "Zeitschrift fuir Erfahrungsheilkunst."
Von Dr A. Bernhardi und Dr F. Lbffler.
1847-48.




x             Lizeralure.
5. " De la ge'neralite et de l'unite' de la
maladie."   Par le Professeur  Forget de
Strasbourg.  Reprint from L' Union Medicale,
December 25, 27, 29, I8556. "De la Doctrine des Etats Organopathiques; de la nomenclature organopathologique." Par M. Piorry. Paris, I855.
7. "De L'Element Specificite en Therapeutique."  Par le Professeur Forget. Paris,
I858.
8. "De l'autonomie ou Independance de
la Medecine.  Ce qu'il faut entendre par
Doctrine Holopathique." Par M. Marchal,
de Calvi. Paris, I86o.
9. " Holo-iatrie et topo-iatrie. Discussion
entre MM. Fleury et Marchal (de Calvi)."
Paris, i86o.
Io. " Discours sur Organicisme, le vitalisme
et le psychisme." Par M. P. A. Piorry.
Paris, I860.
I. "Continuation de 1'histoire et de la
critique du localicisme ou topo-iatrie." Par
le  Docteur  Marchal,  de  Calvi.  Pinel.
Paris, i86I.




Lilerature.            xi
I2. s" Die direkte Kunstheilung der Pneumonieen." Von Dr Carl Kissel. Eilenburg,
I852.
I3. 1" Handbuch der physiologischen Arzneiwirkungslehre."  Von Dr Carl Kissel.
Tiibingen, I856.
4. " Handbuch der speciellen Pathologie
und Therapie." Von Dr Carl Kissel. Erlangen, I863.
I5. "Dreissig Jahre Praxis. Erfahrungen
am Krankenbett und im iirztlichen Kabinet
mitgetheilt von H. L. von Guttceit."  2
vols. Wien, 1873.








ERRATA.
Page 103, line 7, for "dripping" read "dropping.",,  I04, line 9, for "Crollins" read " Crollius."
1, 104, line I5, for " Crollins " read " Crollius.",, 107, line  I9, for "Vennua cardui" read
" Semina Cardui. ",, IO8, line 2, for " Manxe semmia" read
"Mariae semina."








Diseases of the Spleen.
FROM  the time of Morgagni's
De Sedibus etc., but more
particularly with the introduction
and generalization of physical and
regional diagnosis by Auenbrugger,
Laennec, Skoda, Piorry, and the
mighty host of their disciples,
practical medical men have been
led to consider each organ by
itself much more than ever before,
and this often apart from medical
doctrines. We may say the first
half of this century thoroughly
P,




2     Diseases of Ite Spleen
established the absolute essentiality
of regional diagnosis. This separatist practice has gone so far that
the organism has not unfrequently
been lost sight of altogether.
Piorry in his Traile de Plessirmelrie  et de' Organogray5hisme,
etc. (I827 to  185I), very justly
remarks: "Le pathonomisme n'a
donc ete possible qu'a cause de la
doctrine sur laquelle il est fonde."
With the direct diagnostic delimitations of the various organs by
palpation, percussion, and auscultation came the coining of the words
organopathy, organogeny, organography, and such like terms, which,
we must say, are both sensible and
useful, though organopathy had with
and ever since Hohenheim consti



Clinically Illusiraled.  3
tuted the backbone of the medical
practice of certain, in their days
mostly heterodox, practitioners, and
some of them great masters of healing.
If it be asked, What is here meant
by ORGANOPATHY? my reply is, that
organopathy is the specific local
action of drugs on particular parts
or organs, as first systematized by
Rademacher in the early part of
this century.  It is, thus, a very
convenient term in therapeutics as
well as in aetiology and pathology.
In pathology the term organopathy
has long been in general use, particularly on the Continent of Europe.
The French understand by Organopalhie an organ disease, and as such
it is an accepted term in pathology.




4    Diseases of the Spleen
The same is true of Oisganleiden
in the German language. All this
by the way.
In this little work, therefore, the
word organopathy is used as a technical term of drug therapeutics, it
was copied in this country some
years ago from Rademacher, and
from the Rademacherian writers
of Germany, without a single word
of acknowledgment. But the real
father of organopathy in essence
and substance is Hohenheim, an
eminent and learned physician
commonly called Paracelsus, for
proof of which see his works, and
hereafter in this little volume on
Diseases of the Spleen, if space
permits.  Organopathy is included
in the wider generalization known




Clizically zllustraled.    5
as homceopathy; for whereas organopathy claims only that certain
drugs affect certain parts curatively,
preferentially, or specifically, as, for
instance, digitalis the heart (therapeutic organopathy), homceopathy
claims that not only does digitalis,
e.g., affect the heart specifically
(therapeutic organopathy), but to
be curative the natural disease of
the organ (nosological organopathy)
must be like in expression to the
therapeutic organopathy or drugaction.
Homceopathy may be said to be
based upon organopathy, for a drug
to cure the heart of its disease specifically must necessarily affect the
heart in some manner.   But the
homceopath specializes, and says




6    Diseases of the Spleen
further: The drug that is to cure
the heart must affect the heart, certainly-that is one of the foundations of our whole therapeutic
edifice, but that is not enough; the
nosological organopathy and the
therapeutic organopathy must be
and -are similar.  And inasmuch
as we can know disease only by
its subjective and objective symptoms (its language), it follows that
the two organopathies must be
symptomatically alike, though possibly antipathic in their mode of
action as against one another.
My reason for considering Diseases of the Spleen from the organopathic standpoint lies not only in the
fact that I already worked on the
same subject ten years ago, but be



Clinically IllustIrated.  7
cause I believe my experience in
this field is somewhat unusual, and
likely to be instructive to my readers;
and incidentally I wish particularly
to emphasize the fact that organopathy was a well-established system
of medicine long years ago, and is
no child of our time.
No doubt it wants precisionizing
and developing, and I trust this
little volume will work a little in
this direction; but for any man to
come forward nowadays and pose
as the discoverer of organopathy,
in either name or substance, presupposes an amount of ignorance
that makes one fairly stagger with
amazement. I am not maintaining
that treating an organ affection by
an organ remedy, after the manner




8     Diseases of the Spleen
of Hohenheim, Rademacher, and
their  respective  co - doctrinaires,
will stand as a medical system
sufficient in itself, but that it is
eminently workable, and is largely
of the nature of elementary homceopathy, is, in fact, specificity of seat.
Neither am I unmindful of the
part played by the universalia in
Hohenheimic medicine, or of the
g-enius  epidemicus  morborum.   I
leave them here largely out of
consideration, on the principle of
doing one thing at a time.
Finally, I am very far from supposing that in the vast majority of
cases an organ disease exists primarily and permanently by itself independently of the organism; on the
contrary, I know well from close




Clinically Illustratecd. 
observation of nature that the part
and the whole are commonly qualitatively the same. The organ which,
to my mind, is the most systemic is
the skin; * and, on the other hand,
the spleen has clearly a very distinct
life of its own, and its own sufferings
may be, and are well pronounced.
Whether any particular value is
to be attached to the doctrine lately
proclaimed by certain clear-seeing
people that the spleen is the storehouse of vital energy I am unable
to say; but I am much struck with
the teaching of Rademacher, that a
very large percentage of dropsies
are curable by spleen remedies.
I beg no one of my readers will
* See my Diseases of the Skin from the
Organismic Slandpoint. London, I886.




Io    Diseases of the Spleen
confound what I here say with local
treatment of disease. I am thinking and writing about self-elective
specific treatment, not local treatment.
The whole organism may suffer,
or a part of it, and when such part
or organ is wrong in its life and
being, it generally speaks and lets
its owner know, and that in its own
way.  The altered  state of the
organ sometimes produces a sense
of tightness, or fulness, or pain in
its own immediate vicinity; at other
times, it expresses itself vicariously
through another neighbouring or
distant organ.   First come first
served is a good maxim, and is
generally acted upon also in diagnostics. If a man coughs, his lungs




Clinically zllustratecd.     I
are wrong; if he gets palpitation,
his heart is at fault, always to the
extent of being the seat of the
symptom, though not necessarily
its primary one, for the symptom
COUGH, PALPITATION, may arise from
the prompting of another organ or
part either near or distant. In other
words, an organ may speak out
complainingly, either because it is
wrong itself-organopathically; or
it may be moved to express itself
on behalf, or at the instigation, of
another   organ - synorganopatzically, or of the entire organismholopaliaically.
Thus I desire to approach the
subject of Diseases of the Spleen
from the standpoint of organopatky.
From the earliest childhood of




I2    Diseases of th/e Spleen
healing it has always been more or
less known that, e.g., to cure a liver
disease you will want a liver medicine, the organ suffering being the
organopathy.
But, as I have already said, we
must ascribe to Hohenheim the
honour of a real practical organopathy; * that is to say, that certain
internal organs of the body seem at
times to be afflicted by themselves
primarily, as it were, on their own
account organopalhically, whereby
the very existence of the organism
itself may be threatened, other organs or parts being, or not being,
consecutively involved synorgano-.pathically,' and that there are in
nature certain remedies that have
" See Rademacher.




Chizzzcally fllustrated.   I3
a more or less pronounced elective
affinity for these self-same organs
or parts which, indeed, have long
borne the name of organ remedies.
But of this more further on. To
Rademacher himself, as we have
just seen, is due the formulation
and actual clinical demonstration
of this organopathy, for which see
his work published some sixty odd
years ago. Rademacher began to
investigate organopathy in the year
1815, and practised organopathically
with immense success for about thirty
years and to the end of his life.
Rademacher had a number of
disciples who followed him in practising, developing, and defending organopathy. These disciples
formed a school, and are known




I4    Diseases of tIe Spleen
in literature as Rademacheriansat least that is what I call themfor it were almost more in accordance with fact to say that literature
has misunderstood or ignored them,
though here and there a literary
freebooter has " discovered" from
their storehouse. For a time these
disciples of Rademacher held together, and published a journal
entitled Zez'tschrft f ir Erfahrungsheiikunst, which began in
I847 at Eilenburg, being edited by
Drs A. Bernhardi and F. L6ffler,
and carrying as motto-" Medicina
ars expverimentalis "-which is very
old, very hackneyed, and still as
true as ever! I do not know how
many years it ran, but not many,
for as soon as the Rademacherians




Clinically Illustrated.   15
began to try to gain fixity for their
indications they wandered off into
the field of experimental pharmacology, but found it already occupied
by-whom? by the homceopaths!
and as in the case of so many
wanderings, the wanderers never
came back, but remained in the
field of provings side by side with
the followers of Hahnemann. Of
course before Hahnemann's time
no arrangement of drugs based on
provings could be made.
Hohenheim's organopathy, as interpreted by Rademacher, differs
therefore somewhat from the organopathy of Rademacher's followers, inasmuch as these practically
gave up the idea that remedies are
per se friendly to the organs, and




i6    Diseases of the Spleen
brought into their organopathy the
Hahnemannic proving of drugs on
the healthy, and this being done, the
organopaths (Rademacherians) and
the homceopaths marched side by
side, the former giving up their
journal.
Rademacher's work has been
both ignored and criticised, but it
remains classic for all time; I
believe his direct art-cures of
disease are unsurpassed, nay, never
equalled, in the written history of
medicine so far as the same is
known to me.
I sometimes regret that the
disciples of Hahnemann and those
of Rademacher became so closely
assimilated, for it seems to me that
drug provings are not everything,




Clinically Illustrated.    17
and I cannot help thinking that
had the Rademacherians kept by
themselves, they would have taught
us much of the higher physiology
of the various organs that we still
have to learn. And I am bound
to say that some of the organ
remedies of Rademacher possess a
direct healing power over organ
diseases that their provings in no
way  explain.   Perhaps  further
knowledge will throw light on this;
we must accept the fact, and wait
for the explanation.
In daily life we make certain
acquaintances with our fellowbeings, and some of these pass out
of sight for a time, or for ever.
Months or years roll by, and we
meet with some of them again, and
c




i8   Diseases of the Spleen
as So-and-so is with us, we introduce our friend to him, remarking
that we have known him ever
since a certain memorable event.
We find that with a physician
diseases and drugs stand out as so
many individual acquaintances along
the path of his professional life; if
he meet a congenial brother chip
he will very soon run off the first
subject of conversation and begin
to "talk shop." Most people will
join in a very hearty condemnation
of " talking shop," but, nevertheless,
the genuine man will not be long
with you before you can form  a
pretty correct opinion of his walk
in life. Let two medicoes meet for
a little social chat, and you will not
have to wait long for the sign of the




Clinizcally Illustrated.    I 9
leech. And why should it be otherwise? Do we really expect a plantloving botanist to prefer astronomy
as a subject of conversation?
Some time since I was casually
sitting in a pretty garden with a
gentleman. Left a few moments
together we began to chat, and the
gentleman asked if I could discern
a bar across the attic window. No,
was my reply. "I can," said he,
and almost immediately he inquired
whether I had been to the Academy. No, I had not. And then
in a twinkling he exclaimed-" Oh,
what lovely tints, just look at the
shade of the plum-tree across, the
path, and that green, I mean there
just by the nut-tree."  Need I say
he is an artist?




20   Diseases of the Spleen
I had not noticed any of the
pretty things to which he called my
attention, but I had seen a small
issue-a tiny aperture in his skin
covering his larynx.
As a striking clinical acquaintance, there stands out in my professional path a remedy called
Ceanolihus Americanus, which acquaintance has increased with years,
till it and I have become fast
friends, to the advantage of not a
few. Through my clinical friend
Ceanothus Amesricanus, I have perhaps paid much more attention to
the spleen than I otherwise should,
and it is of the spleen that I am
about to discourse.
As an introduction to " Diseases
of the Spleen," I cannot do better




Clinically Illustrated.    2 
than reproduce a portion of what I
wrote on the subject of this Ceanothus Americanus in I879.*
ON Ceanothus Americanus IN
ITS RELATIONS TO DISEASES OF
TIHE SPLEEN.
For several years I have been in
the habit of using this drug in true
Rademacherian fashion as an organ
remedy.  The perusal of Rademacher's Magnum Opus is one of
the greatest literary treats that ever
fell to my lot; based on Hohenheimian bizarries, avowedly and
obviously merely an attempt at
reducing his genial erratic Jretended
mysticism to the concrete form of a
Aionthly Homeoapath/c Review, March
I879.




22   Dziseases of tie Spleen
practice of medicine, by depolarizing it, if I may so speak, it is
nevertheless the most genial and
most original production it is
possible to find in medical literature.
It is the most bare-boned, lawless
empiricism that one can conceive,
and yet there are two leading ideas
running through the entire work,
and these are the genius epidemicus
morborum  and organopathy; and,
considered from  the pharmacological side, the other two ideas of
universal (general) and particular
medicines.  For Paracelsus there
were only three universal remedies,
and so also for Rademacher and for
their followers.  Hahnemann has
but three fundamental morbid
states-psora, syphilis, and sycosis.




ClGnically Ilusstrated.    23
Von Grauvogl has but three constitutions of the body-they might
have all been working out the
fatherlandish proverb, Aller gulen
Dinge sind drei /
The genius epidemicus morborum
is beyond question a fact in nature,
but it is dreadfully eel-like, hard to
get a grip of. The same may be said
of Hahnemann's tripartite pathology
and of Grauvogl's three constitutional states.
Rademacher's organopathy (that
an otherwise able modern writer
appropriates with child-like nazvete')
is no more and no less than the
homceopathic specificity of seat,
with just a dash of a mystic psychic
something in the several organs;
if we set aside this little particular




24   Diseases of the Spleen
soul for each organ, it is only local
affinity, or elective affinity.  And
it is quite true in nature, and the
mind that cannot, or will not,
recognise it, is wanting in catholicity
of perception; and inpractice will
often go a mile when three paces
would have reached the goal. Whatever else  Cantharis may  be, it
is first and foremost a kidney
medicine; whatever else Difgitalis
may be, it is primarily a heart
medicine; and let Belladonna be
what it may, it is before all things
an artery medicine, and just in this
sense Ceanothus Americanus is a
spleen medicine.
The spleen constitutes a dark
corner in the human economy,
whether considered physiologically




Clinically Illustrated.    25
or therapeutically.* I have heard
it professorially very ably argued
that the spleen is the principal
manufactory of our blood corpuscles.  I have heard that theory
equally ably and professorially refuted, and in its stead the thesis
set up that the spleen is, as it
were, the ullimum refugium of
the old and effete blood corpuscles, wherein they are broken
up, and their debris sent off again
into  the circulating  medium.   A
third argued that all this was
veritable nonsense, as the spleen
had nothing whatever to do with
* "Qu'est-ce que la rate?  Telle est la
question, assez &trange, posee depuis trois
mille ans dans la science, et dont, apres trois
mille ans, la science a jusqu'a ce jour,
vainement attendu la solution."-Bourgery.




26   Diseases of the Spleen
either making leucocytes or breaking up their reddened descendants,
that in fact the spleen had no other
function than to act as a reservoir
for the blood-being, indeed, a kind
of living sac in the side, to swell or
shrink according as the circulation
required more or less of the circulating fluid.
I fondle this latter theory myself,
and like to call it mine; whose it
really is I do not know. Perhaps
some of my readers will be
able to say what they think
the spleen  is good  for beyond
serving as the anatomical whereabouts of that enigmatical something that supposedly sends our
dear fellow-countrymen in shoals off




Clinically Illustrated.   27
London Bridge into the Thames on
a rainy or foggy day-I mean, of
course, le spleen! This great bugbear of our Gallic and Germanic
brethren-as applied to ourselves
bien en/endu! for they consider it
essentially a morbus Anglicus, just
as we like to think it is principally
those naughty French who commit
suicide-is really only another name
for being "hipped," or suffering
from an attack of hypochondriasis,
and there cannot be any sound
reason for refusing it a habitat
under the left ribs, since so many
have welcomed it under the right
ones.
My first and only literary acquaintance with Ceano/hus Americanus




28    Diseases of the Spleen
is the very short empirical account
of it in Hale's New Remedies, which
I read some five or six years ago.
Previously I had frequently felt a
difficulty in treating a pain in the
left side, having its seat, apparently,
in the spleen.  Myrtis communis
has a pain in the left side, but that
is high up under the clavicle; the
pain that is a little lower is the
property of Sumbul; still lower of
Acidum fluoricum; a little further
to the left of Acidum  oxalicum;n,
more to the right of Aurum; right
under the left breast of Cimiczfiuga
rac.
These remedies promptly do their
work when these left-sided pains are
a part of the disease-picture, but
they will not touch the pain that is




Clinically Illustrated.    29
deep in behind the ribs of the left
side; more superficially Bryonia has
it; a little deeper than Bryonia,
Pulsatilla nut/al will touch it; and
so will 7uglans regia, which poor
Clothar Miller proved as a student.
But the real splenitic stitch requires
China, Chelidoniumn, Berberis, Chininurn  sulphuricum  or Conium, or
Ceanothus Americanus.
Some years since I treated a lady
for "violent vomiting, pain all up
the left side, cough with expectoration, profuse perspiration, and
fever." She was not a native of
the place, but came only for a short
visit, and took lodgings in a small
house facing a meadow on the banks
of the river; the locality was at one
time a part of the port, but was many




30   Diseases of the Spleen
years ago reclaimed. At my first
visit she told me she often got
inflammations on the chest with
cough, and finding considerable
fever, cough, pain in left side, and
dulness on percussion of the same
side, I quickly ticketed it pleuropneumonia sinistra, and gave Acidum  oxalicum, which seemed to
cover all the symptoms, and to
correspond also to the supposed
pathological state within.  Oxalic
aczid somewhat relieved the vomiting, but nothing more, and I then
gave various remedies, such as
Aconite, Bryonia, Phos., Ipec., and
thus elapsed about three weeks, but
patient remained as ill as ever.
Then I went into the case with
very great care, and examined my




Clinically Illustrated.    3 I
patient very thoroughly, and, see,
there  was  inflammation  of the
spleen.   I  gave  her Ceanoltus
Americanus in a low dilution, and
all the symptoms, subjective and
objective, disappeared right off, and
my previously ill -treated patient
was sitting up in a week, and quite
well in a few more days.  I had
never before met with splenitis in
the acute form, and, indeed, it is
a very rare disease in this country.
Cases of chronic pains in the
spleen occurred subsequently in my
practice, and they rapidly yielded
to Ceanothus, one of which I well
remember; it is this:Chronic Splenills.-A young lady
of about 26 consulted me for a chronic
swelling in the left side under the




32   Diseases of the Spleen
ribs, with considerable cutting pain
in it. She stated that it was worse
in cold damp weather, and she always felt chilly; the chilliness was
so severe and long lasting that she
had spent the greater part of her
time during the previous winter
sitting at the fireside, and now she
was looking forward to the winter
with perfect dread. In the summer
she had felt nearly well, but the lump
and the chilliness and pain nevertheless persisted, but it being warm,
she did not heed it much, it being
quite bearable.
Ceanothus A mericanus quite cured
her of all her symptoms, and subsequent observation proved its permanency. Often during the following winter she called my attention




Clinically Illustrated.   33
to the fact that she was not chilly
and felt well.
Another case which I treated at a
later date was that of a young man
somewhat similarly suffering.
Chronic Splenitis.-This young
man had been sent to my dispensary, and was occupied in the postoffice in some light but ill -paid
employment.  His whole trouble
consisted in severe pain in the left
side in the region of the spleen, and
he had long vainly sought relief
of many, probably at dispensaries.
He therefore put in an early appearance at my new dispensary to try
the new doctor, probably on the
well-known principle of the new
broom. He had become quite lowspirited and began to fear he would
D




34   Diseases of the Spleen
become totally unfit for work, and
naturally that was a very serious
matter for a young married man.
He told me he had formerly helped
his wife in her household matters,
doing the heavy rough work, but
the pain in his side had now become
so bad that he could not carry a
bucket of water into the house or
even sweep up their little yard, as
handling the broom pained him so
dreadfully.  I was pressed for time,
and prescribed Ceanothus Americanus in pilules of a low dilution,
and promised to go into his case
that day week, meaning to percuss
the part and ascertain whether the
spleen was enlarged. He returned
that day week almost well, and the
following week was quite well. At




Clinically Illizs/raed.    3 5
my request he again reported himself some time afterwards, and he
still continued well.
I resolved to begin my next case
with a physical examination. My
next case was thisChronic.Hypertrophy  of  the
Spleen. A middle-aged lady consulted me, shortly after the above
case, for a severe pain in the left
side and a large swelling in the
same position.  Remembering the
last case, I said I must examine
the side. She objected, so I declined to treat her; then she said
she would think about it and consult with her husband on the subject.  In a fortnight or so  she
returned (driven by the severe
pain in the side), and I examined




36   Diseases of tze Spleen
the side and found an enormous
spleen occupying the entire left
hypochondrium, and reaching inferiorly to about an inch above
the crest of the ilium; it bulged
towards the median line and ran
off to an angle laterally.  It was
of long standing.
Gave Ceanothus Amerzcanus in a
low dilution.
This lady being very intelligent
I begged she would allow me to
examine the side again after I had
finished the treatment.  She promised to comply.
Fourteen days after this she came
full of gratitude, and reported that
the swelling was smaller and the
pain considerably less.
To continue the medicine. She




Clinically I/lustrated.    3 7
never consulted me again, but as
she was a near neighbour of mine
I often saw her, and somewhat six
months afterwards she called to pay
my fee, and then informed me that
she had soon got rid of the pain
entirely and the swelling was much
smaller, so she had discontinued
the medicine altogether, and did
not deem it needful to trouble me
again.
This is the usual thing. People
will not be at the trouble of seeing
the doctor as soon as they are better,
they seem not to understand any interest one feels in the case. We can
only make periodical reliable examinations of patients in a hospital; in
private practice it is extremely difficult, as all practitioners know to




38   Diseases of the Spleen
their chagrin. Still, fau/e de mieux,
we must put up with these fragments.  This patient has had no
children, and had a very fresh complexion.
My next case is also one of
Chronic Hyperlrojhy of ihe Spleen,
though only about half the size of
the one just narrated. Subject: a
poor woman of about 30 or 32 years
of age, whom I was requested to
see by a very kind-hearted benevolent lay minister well known in
the neighbourhood.  She is the
mother of several children, very
poor, ill-fed, and over-worked, but
withal a good, respectable woman,
and very clean.  She had a considerable and very painful swelling




Clinically Illustrated.    39
in the left side under the ribs, that
had been there for some time, and
latterly she could not get up on
account of the severe pain. I carefully examined the tumour and satisfied myself that it was a very much
swelled spleen, and the pain seemed
to me to be due to its pressing
against the ribs. I marked its size
on the skin with ink, made her engage not to wash off the ink mark,
and promised her I would call in a
week, having first prescribed Ceanothus as in, the other cases.  But the
fates were against my laudable plan,
for I received a message, the day
before my next visit was due, to
the effect that Mrs    felt herself
so much better that she was up at
her housework, and begged me not




40   Diseases of the Spleen
to call again, as she thought it unnecessary.
Since then I have at times had
cases of deep-seated pain in the left
side to treat, and have mostly found
it yield to Ceanothus, though not
always.  In one case in which it
failed the pain was cured with Berberis vulgaris.
In one case of jaundice, characterized by very severe pain in the left
side, I gave Ceanothus, with very
prompt relief of the pain only;
Myrica cerifera then finished the
icterus. Before giving the Ceanothus  I had  given  Chelidonium
mlajus.
In one case of severe metrorrhagia, characterized by pain in
the left hypochondrium, Ceanothus




Clinically Illustraled.    41
gave instant relief to the pain, and
checked the hzemorrhage. It failed
me in a subsequent similar attack in
the same person, when Conium was
effective.
Chronic Splenitis, Chills, and
Leucorrhwa. - Some four years
since, perhaps a little more, I
treated a lady of about 55. She
complained of rigors at frequent
intervals, and pain in left side,
both of long standing.
The leucorrhcea had lasted some
twenty years, and was profuse, thick,
and yellow. She had been for years
under the best allopathic physicians
of her native city, and finally given
up as beyond the reach of medical
art, evidently on Moliere's principle
that "Nul n'aura de I'esprit que




42   Diseases of the Spleen
nous et nos amis."  Nevertheless,
the patient bethought her of homceopathy, and came under my care.
Her last physician had finally suspected cerebro-spinal mischief, and
hinted at incipient paralysis.
The pain in the side was the
most prominent and distressing
symptom, and for this I prescribed
Ceanolhus.  In a month the pain
was entirely cured, and also the
leucorrhxa, while the cold feeling
was very much diminished, but not
quite cured.  I have also never
succeeded in quite curing it with
any  subsequent  treatment.   I
watched the case for nearly four
years, and am thus enabled to
state that the pain in the side
and the leucorrhcea never returned,




Clinically Illustrated.   43
and the chilliness never again became very bad, but still she had it
a little when I saw her last.
I wrote the foregoing at the
beginning of 1879, and since then
have found a good many chronic
cases of spleen affections, and those
for the most part previously unrecognised.
CASES OF ENLARGED SPLEEN MISTAKEN FOR HEART DISEASE.
A few years ago I was attending
some of the members of a family of
position in London, and at my
various visits I occasionally heard
of an invalid daughter of the family
suffering from a hopelessly incurable disease of the heart, for which
she was said to be under a West



44   Diseases of the Spleenz
End physician, who was thought
to devote himself especially to
diseases of the heart. The heart
was said to be enormously enlarged,
and patient had had to give up
first dancing and then hurrying, and
finally she was only allowed to
walk very slowly and carefully, lest
the hugely enlarged heart should
rupture.  Several physicians had
examined the case, and all were
agreed as to its cardiac nature.  I
had never seen the young lady, and
took no particular interest in the
frequent narrations of her heart
troubles: they are common enough.
Time went by, and the mother
used to speak of her " poor invalid
daughter" with increasing despondency, finishing up one day with




Clinically zIllusraled    45
the remark that the unfortunate girl
was no longer allowed even to
walk, as the doctor considered even
that now fraught with danger. " Is
it'not sad?" said she.  "Would
you like to see her?"  I declined,
saying, I never cared about seeing
other physicians' patients.
More time elapsed, and finally
I was requested to take the case in
hand.  I demurred at first, because
such hopeless cases are as unsatisfactory as they are painful.
At last I consented to take over
the case, and I appointed a time to
call and examine the patient.
During all my professional life, I
have rarely been more taken aback
than I was after I had made my
examination of the patient, for I




46   Diseases of the Spleen
found the heart not only not enlarged, but of the two rather abnormally small, although apparently
the cardiac dulness extended a foot
down the left side. But this dulness
on percussion was due to an enlarged
spleen which pushed up the diaphragm and left lung by its bulk, till
the heart and the spleen gave one
continuous dull percussion note.
Patient had many genuine symptoms of real heartdisease-dyspncea,
palpitations, inability to lie on the
left side, faintness-but these were
due to the mechanical hindrance to
the heart's action produced by the
spleen bulking upward so much.
That young lady I met three
weeks ago looking blooming, and
as agile as possible, and she has




Clinically Muluzstrated.   47
done her share of dancing, tennis,
etc., for some years.
Ceano/hus Americanus cured the
enlargement of the spleen for the
most part, though it swelled again
two or thrce times at some months'
intervals, and FerriPhosph., Coniumn,
Tihuja, Besrberis, and other splenics,
came into play before patient was
really well. Looking at the case
now with the advantage of wider
experience  and  more  matured
views of biopathology, and with the
patient fully six years under my
observation, I regard the affection
as a primary disease of the leucocytes due to vaccinial infection,
the spleen being disturbed secondarily, and then the heart mechanically. I am confirmed in this view




48   Diseases of the Spleen
by the fact that the spleen would
not leave off swelling up at certain
times till I had cured the vaccinosis.
That prince of splenics, Ceanothus
Americanus,  readily  cured  the
splenic engorgement, but did not
touch the blood disease which
caused it.  This is the inherent
defect of organopathy, that it is not
sufficiently radical in its inceptive
action, but the like remark applies
to every other pathy more or less,
because the primordial cause is
more or less elusive, and generally
quite beyond positive science, which
only admits of what it knows, and
will not seek to encompass the
unknown by the processes of
thinking and reasoning. Because
in former times philosophy made




Clinically I/zustira/ed.    49
science impossible, the votaries of
science now round upon philosophy, and sneer it out of view.
To trace back proximate effects to
remote causes is now ridiculed in
medicine because mere science is
productive of a gross-mindedness,
incapable of following the fine
threads of the higher perception.
It was also about the same
time that I was at the house of a
patient in London, the wife of a
general officer, and the conversation fell upon the general's heart
affection, and also upon that of
their charwoman.  I learned that
the lady of the house took a
certain interest in her charwoman
because she had seen better days,
E




5o   Diseases of Mte Spleen
and had an invalid husband depending upon her labour more or less.
This charwoman was, it was said,
suffering from an incurable disease
of the heart, causing her terrible
distress; on rising in the morning
she would have to fight for her
breath, so that it would take her
often three-quarters of an hour to
get dressed, having to pause and
rest, from the dyspncea and its
effects.   Nevertheless  she  persisted in thus getting up and dressing, and did as much charing as
she could get. Her pride would
not allow her to beg of her friends.
Such was the story, and I really felt
curious to see the charwoman, and
promised to do what I could, though
from the account given me by the




Clinically Illustrated.   5i
general's wife, I certainly thought
it quite a hopeless case.
Calling a few days later, I saw
the lady and the charwoman, and
having duly examined the latter,
I promised to cure her! She was
to come to my city rooms, and report
herself every fortnight. On returning from the bedroom to the drawing room, the general's wife accused
me of cruelty in thus raising the
poor old woman's hopes "when,"
exclaimed she, "you must know it
is impossible." I tried to explain
that it was a case of enlarged spleen,
and not heart disease at all, that the
charwoman was suffering from, and
that the palpitations and fightings for
breath were the mechanical sequels
of the splenic engorgement, but my




52   Diseases of the Spleen
patient evidently did not believe it,
for she wound up by saying, " As you
will treat her for nothing, I hope you
may succeed, and it is very kind of
you, but you must know that the
poor woman has been under various
doctors, and all have declared it
incurable heart disease, and I merely
wanted you to tell me of something
to relieve and ease the poor old
thing."
This was towards the middle of
October I879. A careful physical
examination showed that the heartsounds were normal, but there was
much beating visible in the neck,
and the heart's action was laboured.
In the left hypochondrium  there
was a mass corresponding to the
position of the spleen, and a dull




Clinically Illustrated.    53
percussion note was elicited not
only in the left hypochondrium,
but also in the right, and all across
the epigastrium, or pit of the stomach,
from side to side.
The following notes were put
down at the time:- " Heart-sounds,
normal; apex beat, exaggerated;
splenetic dulness extending up to
the left mamma; the whole region
very tender, so much so that she
cannot bear her clothes or any other
pressure."  The prescription was:
CeanoIhus Americanus Ix 3ij., five
drops in water three times a day.
November I4.-Has been  taking the Ceanothus five weeks today, and has taken altogether three
bottles of it, viz., 3vj. It has nearly
stopped the pain in the left side,




54   Diseases of the Spleen
wzeich had lasted for quite twenlyfive years.  This pain came on
suddenly, especially if she drank
anything cold. She would get an
indescribable pain under the left
ribs, and she would have to fight
for breath, and the dyspncea would
be so severe that it could be heard
in the next room, frightening everybody. She had ague thirty years
ago in Northamptonshire. Repeat.
November 29.-Not much pain
left; the cold feeling still there, but
nothing as it was. Repeat.
December 20. Has the pain in
the left side, but very little; has not
had any of those at/acks of fighting
for breath', she can walk better,
and the side is much smaller, which
she knows from her dress. In her




Clinically Illustrated.    55
own opinion she is less in the waist
by two inches. Before taking the
medicine, for very many years she
was compelled to pause in the morning when dressing, and lie down on
account of the beating of the heart,
but this has all gone; on examining
by palpation and percussion I find
the dulness diminished by four inches
in the perpendicular, and by about
the same from side to side. However, there is still some tenderness on
pressure, and the swelled spleen can
still be felt towards the mesian line
and inferiorly. She can now do her
work (charing) very much better.
1~ Tc. Ceanoth/.-Am. I, four drops
in water three times a day.
January Io, I88o.-The pain is
gone; has now no pain in walking,




56   Diseases of lie Spleen
and she is a great deal stronger and
better. The coldness in the pit of
the stomach has gone. Repeat.
February 7.-In the left hypochondrium there is now nothing
abnormal; the old ague-cake has
disappeared, there being no dull
percussion note.  Her own conception of the size of that portion
of the enlarged spleen that used to
stretch across the pit of the stomach
to the liver is thus expressed by
her:-" I used to say it was as big
as a half-quartern loaf." Not only
is the lump gone, but she is much
stronger; she now wears stays again,
and fastens her clothes with comfort.
She again gets some cold feeling in
the pit of the stomach, but not much.
Her liver seems considerably en



Clinically Illustrated.   57
larged, and there is still too much
beating of the bloodvessels (veins)
in the neck.  In my opinion the
condition of the bloodvessels calls
for Ferrum 6, which I now  prescribe, and when that has done its
duty-as it surely will-the liver
will call for attention. But what I
wanted to bring out was the specific
affinity of Ceanolhus Americanus
for the spleen, and its consequent
brilliant effects, as the simile only
grounded on the homceopathic
specificity of seat, which some say
has no existence.
This poor woman thus took Ceanothus during about four months in
small appreciable doses: at first the
Ix and then the I centesimal.
The existence of the hypertrophy




58   Diseases of the Spleen
was ascertained by percussion and
palpation; and subsequently I ascertained by the same means that it had
ceased to exist. Although patient
took the drug for four months I
could not find that it affected any
other organ-liver, kidney, bowelsave and except the spleen.
The dyspnoea and palpitation
were cured certainly, but these
arose, I submit, from the engorged
condition of the spleen itself.
As far as I could ascertain, the
secretions and excretions were not
affected in the least degree; the
remedial action must therefore be
considered specific.  My conception of the cure is simply this, that
the specific Ceanothus stimulus persistently applied restored the spleen




Clinically Illustrated.   59
tissue to the normal. This homcceopathic specificity of seat suffices only
in simple local disturbance; it is
only a simile, not a simillimum.
The latter would, I apprehend, have
affected the liver also and the right
heart, and I should then not have
needed further detail treatment.
This charwoman continued to attend at my rooms for some months,
and CeanoIhus Americanus and other
indicated remedies cured her of her
"incurable heart disease;" and I
saw no more of her for some time,
when one day she was ushered into
my consulting room. She came up
to where I was sitting, told me she
was perfectly well, could do any
work with ease, and-then occurred
one of the sweetest things of my




60   Diseases of the SpZeen
whole professional life-the old lady
(and what a lady!) put a tiny packet
on my desk, tried to say something,
burst into tears, and rushed out!
I never saw her again, and have
often since wished I had kept that
particular sovereign and had it set
in diamonds.
SUPPOSED CONSUMPTION:
CHRONICALLY ENLARGED SPLEEN.
The case I am about to relate is
not without practical interest. The
subject is a fine young AngloIndian of about 2  or 22 years
of age, who, a couple of years
since, commenced preparing for the
study of medicine in London. His
father was my patient, and told me,
as he left for the East, that one of




Clinically Illustraterd.   6 i
his boys, whom I had casually seen,
was going to remain in London to
study medicine as a profession, rather
than as a hobby, as said father has
done for many years.
Two years elapsed, and then my
patient returned from the East, and
came to see me on his own account,
and I incidentally inquired about the
medical student. " Ah! he is better
now, but he had to give up the study
of medicine, as the professors said he
was going into consumption. He
had spitting of blood, and they sent
him to America. He has returned,
and is better; but I am still anxious
about him, as his breath is very short.
He looks very well."
The young man came in due course,
and a very careful percussion and




62   Diseases of the Spleen
auscultation of the chest revealed
nothing but a very large spleen filling up the left hypochondrium, and
clearly impeding both lungs and
heart in their action.
I ordered Ceanothus Am. I in five
drop doses. He took the drops for
a month or so, and came again on
the I6th February i887, telling me
he breathed easily and comfortably,
and demonstrated to me that he
was inches smaller round the body,
by showing me his waistcoat and
trousers that were previously tight,
but now uncomfortably loose, so
much so that he laughed at their
bagging. Evidently his pulmonary
symptoms had never been phthisical
at all, but were merely mechanical
from the engorgement of the spleen.




Clinically Illus/traed.   63
SPLENALGIA.
A lady came to me complaining
of the following series of symptoms
Pain in the left side corresponding to the region of the spleen,
so bad that she cannot lie on the
left side; with this pain in the side
there are two other disturbances,
indicating that a kind of vascular
turgescence - an orgasmus humorum - underlies the whole, viz.,
palpitation of the heart and piles.
With these also some indigestion,
and a feeling as if the visceral
contents of the abdomen were
being pulled down.
W1  Tc. Ceanothi A4mericani 3x
3iv.  Three drops in water three
times a day.




64   Diseases of lhe Spleen
She came from the country, so
I did not see her again, but as I
asked for a report in a fortnight,
her husband wrote at the end of
that period to say that she was well
and needed no further attention.
The case of this lady rather interested me, as some six years
previously she came under my care
for chronic headaches that seemed
climacteric; I treated her for these
headaches, but could not make any
impression upon them, and then on
going over the various organs I
found that the urine contained a
small quantity of albumen.  This
our ordinary remedies removed in
about two months, and the headaches disappeared. About a year
later the albuminuria again returned




Clinically Illusstraled.   65
in a very slight degree, and with it
some cephalalgia, both yielded at
once to the same remedies, and she
had remained well till she came
with  the splenalgia and haemorrhoids.  I suspect, therefore, that
the old albuminuria was not due
to any kidney  mischief, but to
venous congestion of the kidneys.
PAINFUL ENGORGEMENT OF SPLEEN,
WITH VARICOSIS.
Some cases of varicosis will not
get well till you cure the spleen of
its, perhaps slight, enlargement.
Thus, a hale gentleman of 70 odd
consulted me early in I887 for
varicose veins, particularly below
the knees. The veins on the surface of all four extremities get knotty
F




66   Diseases of tIe Spleen
and painful. There is a pain under
the left ribs, which is worse when
he has urinary urging. The splenalgia he has had these ten years.
I prescribed  Ceanothus I.  It
cured the splenalgia and painful
vein-knots in a few weeks.  He
is now comfortable under left ribs
for the first time for ten years. He
is also not so short of breath. The
stricture of the urethra of which he
also suffers was not affected by the
Ceanolth/s, and he remains under
my care to see if the stricture will
also yield to treatment.
CHRONIC ENLARGEMENT OF SPLEEN,
WITH HEAIT SYMPTOMS.
An unmarried lady of 49 came
to me in January I887 for a sup



Clinically Illustrated.   67
posed affection of the heart. Being
rather stout, she was thought to have
a fatty heart.  She complained of
numbness and heaviness down the
left arm for a considerable time,
also of a pain under her left ribs at
times ever since her childhood, and
over which part she had had blisters
and poultices from most of her many
physicians, generally with relief for
the time being. An'examination
showed the heart to be normal,
but disclosed an enlargement of
the spleen.  Patient has suffered
from whites all her life.
She took Ceanolhus Americanus
I, five drops in water night and
morning, for two months: I had
ordered it for one month only, but
she found herself so much better




68   Diseases of the Spleen
from the medicine that she got a
second bottle of it on her own
account, and continued taking it
for just two months, when she came
to inform me that she felt quite
well, and percussion showed that
the spleen had returned to its normal size.  The leucorrhcea was a
trifle better, but not much, and for
this affection she remained under
treatment.  The spleen engorgement had been cured by the spleen
remedy, but the constitutional state
had remained unaltered; but with
this I am here not concerned.
VOMITING-CHRONIC AND SEVERE
HYPERTROPHY OF SPLEEN.
On June I6, 188i, an unmarried
lady, of 23 years of age, residing on




Clinically Izlustirated.   69
high ground in London, came to me
saying she suffered from chronic
and severe vomiting, debility, and
emaciation.  The vomiting began
about Midsummer i88o, at first
once or twice a week, and it has
been gradually getting worse, so
that she now vomits generally about
half an hour after every meal, though
occasionally she will miss a meal and
not vomit. She has lost I3 lbs. in
weight since January last. Menses
are getting scant. There is a very
considerable area of dulness on percussion in the left hypochondrium,
and when she is sick she feels pain
under the left ribs. She often gets
caught with a pain under left ribs;
and, besides this left hypochondriac
pain, she gets a clawing pain in the pit




70   Diseases of the Spleen
of the stomach, not seemingly connected with it, and apt to last the
whole of the day. Lifting her arms
seems to pull her stomach, and hurt
in the middle. Cannot wear stays,
because their pressure hurts; she
dons them, but is compelled to put
them off every few hours. There
is a clear space of about an inch
between the area of dulness on
percussion of liver and spleen respectively.  She flushes at times.
She is generally chilly, sitting by
the fire when others do not, and
she goes to sit by the kitchen fire
when there is no fire anywhere
else in the house.  Cannot walk
up stairs other than very slowly
because of dyspncea.  The vomit
is sometimes nearly black, as if she




Clinically Illustrated.   7i
had been drinking coffee; at times
it is watery, at others just the food.
1U Tc. Ceanokhus Am. I, 3iv. Five
drops in water three times a day.
She took no other remedy, and
was discharged cured in about seven
weeks. The patient had previously
been under an able homceopathic
practitioner, who had treated the
case purely symptomatically, and
thus failed, for the very sufficient
reason, that the symptoms which
he treated were secondary to the
engorgement of the spleen, and so
his remedies all failed. God forbid
that I should say one disparaging
word about symptomatic treatment
as such, for we but too often have
only the subjective symptoms to go
by, but where an exhaustive physi



72    Diseases of the Spleen
cal diagnosis is possible, it should
always be made, and should stand
in importance far before merely
subjective symptoms, as these may
be, and often are, consecutive and
secondary, and consequently in this
sense delusive.
For, as in this case, it must be
manifest that vomiting due to an
enlarged spleen can never be cured
by remedies that physiologically produce vomiting, but by such as will
bring a large spleen back to the
normal.
ENLARGEMENT OF SPLEEN-AGUECAKE.
In November i886 a poitrinaire
lady of 29 came under my observation complaining of indigestion,




Clinically Illustrated.   73
flatulence, and palpitation, with
cough and considerable debility.
The flatulence is worse in the evening. The right lung gives a dull
percussion note almost all over the
front aspect.  There is an endocardial bruit, best heard at midsternum. The spleen fills the entire left hypochondrium, while in the
right side the hepatic dulness runs
up, seemingly almost to the nipple.
There is slight increase of vocal
resonance on the right side of thorax.
The skin across the epigastrium is
very brown. Had a cough ever
since she had fever in Malta three
years ago; also frontal neuralgia.
Chezidonium I cured the swelling of the liver, and reduced the
spleen a trifle. Ceanotzhus Ameri



74    Diseases of the Spleen
canus I restored the spleen to the
normal, but did  not touch  the
neuralgia.   Thuja occidentalis 30
cured the neuralgia, and I am now
endeavouring to go deeper into the
case to find out the etiologicx of
her.constitution, which causes me
to state that she is poilrinaire, the
anatomic basis of which is a sodden,
phlegmy, bronchial lining; but what
is the etiologic moment thereof?
This case also illustrates both the
insufficiency of the organopathic
conception and also its practical
utility.
QUASI-HEART DISEASE.
A city gentleman between 30 and
40 came to see me on November
25, 1885, for heart disease, from




Clinically Illustrated.   75
which he had suffered for fifteen
years. He has been under quite a
number of eminent physicians, tried
changes to spas, and been for
climatic benefits east, west, north,
and south, at all times and seasons.
Cruising about in a yacht does him
most good. For the past several
years he has been under Sirfor his heart.
I find his heart rather small, its
action irregular, an endocardial
bruit most audible below and to the
left of the left mammilla. He gets
very chilly, and his fingers often go
dead in the early morning: the socalled "poor circulation" so  frequently accused. He is languid,
anaemic, seemingly barely able to
rise in the morning. Has been vac



76    Diseases of Ahe Spleen
cinated three times, but only took
very slightly the first time.
The lungs are flat; the spleen
notably enlarged.
The most distressing symptom is
his nocturnal palpitation.
I$ Ceanothus Am. I. Five drops
in water three times a day.
After taking the Ceanothus thus
for a fortnight, the cardiac and
splenic dulness no longer ran into
one another, and the palpitation and
numbness were much better.
Regarding the case causally. as
partly from vaccinosis, I gave
Thuia 30 infrequently, which did
him so much good that he
stayed away for a month. But a
very ugly patch of eczema had come
out in the rzght axilla / and he




Clinically Illustrated.   77
subsequently got shingles on left
thigh.
The quasi-heart disease was gone,
and has not returned, and the further course of the case presents
no relevancy to my present thesis.
Strange to say, the endocardial
bruit had also quite disappeared.
The foregoing being entirely chips
from my own workshop, I think it
would be well to give an example
of what Rademacher's organopathy
really is, by reproducing in rough
and ready translation the bulk of his
chapter on Diseases of the Spleen
from his great life-work the Rechtferligung, already referred to.




78     Diseases of Ike Spleen
RADEMACHER'S EXPERIENCE OF DIsEASES OF THE SPLEEN, BASED ON
HOHENHEIM'S ORGANOPATHY. *
Spleen Medicines.
It is difficult to find good spleen
remedies, because the spleen, as
compared with the liver, is seldom
painfully affected in its substance.
When it pains, the pain is most
commonly at the margin of the epigastric and left hypochondriac
region rather than in the hypochondrium itself. But, alas! just at
I Abbreviated from - RECHTFERTIGUNG
der von den Gelehrten misskannten, VERSTANDESRECHTEN  ERFAHRUNGSHEILLEHRE der alten scheidekiinstigen Geheimaerzte, etc., von Johann  Gottfried
Rademaczer.  Erster Band.  4th Edition.
Berlin, 8 5 1.




Chizically I/lustrated.   79
this very spot liver affections also
often express themselves, so this
symptom is uncertain. The com.
fortable lying on the left side, and
the impossibility of lying without
distress on the right side, certainly
speaks for a spleen affection, provided always that the left lung be
not affected.  So it is very well to
pay attention to this symptom, but
it is an uncertain  one.   People
whose  spleen  is  much  affected
like to lie on their backs, just as
do those who have the right lobe
of the liver much  enlarged, and
neither can lie comfortably on their
sides. When we further bear in
mind that the spleen (so far as we
know at present) is neither an
excretory nor a secretory organ,




80   Diseases of the Spleen
it follows that we cannot have
any symptoms indicating a disturbance of such-like functions. When
we further consider that the gall
ducts are sometimes sympathetically
affected in spleen complaints, with
the urine discoloured as in gall affections-that, in fact, the mensirua
dzgestionis in general are qualitatively altered; and that to fill the cup
of difficulties to overfilling, abdominal plethora will simulate painful
spleen disease; it is easy to see
that the finding of good spleen medicines is, indeed, a very difficult affair.
The states and symptoms that,
during my medical career, I have
known to arise more or less frequently from spleen affections are
the following:



Clinically Illustraled.   8 
Pain in the stomach (often).
Cough, and that oft, violent, and
suffocative.
Bellyache (at times).
Chronic diarrhcea, and rather
more frequently,
Constipation.
Asthma (seldom).
Disturbed renal functions and
their consequent dropsy.
And with regard to such dropsies,
in so far as they are not due to
organismic affections, I ascribe,
according to a rough calculation,
about one-third to the spleen.
In women the spleen affects the
womb and the vagina, causing
emansion, or excess of the flow,
and leucorrhcea. [This I (Burnett)
have myself observed very freG




82   Diseases of She Spleen
quently, and also a very distinct
sympathy between the male urethra
and the spleen, which Rademacher
does not appear to have noticed,
since probably peccant urethrorrhceae were not very common in a
place like Goch.]
Not a few acute fevers of a
secondary nature (Consensueller
Art-synorganismie) and agues are
the mere concomitants of spleen
disease.  When abdominal affections are prevalent, we at times
meet with splenic fever. But in
this one year differs from another.
At one time, when liver affections
were prevailing, I have not had to
treat a single case of spleen fever in
a whole year, and at other times,
liver affections still prevailing, I




Clinically I/lustrazed.   83
have had here and there an intercurrent case or two of spleen fever.
Brain affections, such as mania
and melancholia, eye diseases, such
as diplopia, amblyopia, chronic
inflammations, I have seen arise
from the liver, but thus far not from
the spleen.  If I had ever witnessed
an epidemic of spleen affections, I
should know more about the organ.
As it is, what I have to say about
spleen medicines can only be imperfect.
CARBO VEGETABILIS.
Rademacher speaks of the difficulty of really diagnosing a primary
spleen disorder, and then says:Continuous asthma, worse at night,
is not a common complaint. It may




84   Diseases of the Spleen
be, like the cough, of a synorganic
(consensueller) nature, and depending
upon a spleen affection. Not long
since I witnessed an instructive case
of the kind. A man who, in his
youth, had had a moist eruption all
over his body, which eruption was
fruitlessly treated with medicines,
but went away of itself in adult life,
but left behind an ugly fish-skinlike epidermis, began to complain
of tension in the left hypochondrium,
becoming at times a little painful.
He did not, however, consult me
for this, but for shortness of breath.
I soon ascertained that he had had
the tension in the hypochondrium
much longer than the asthma, and
so thought he was suffering from
a disease of the spleen, and which




Clinically Zllustrated.   85
I thought the more likely, as he
had never had the least the matter
with his lungs.  Well, I did not
give this man Carcbo, but another
remedy, and the complaint got visibly better. When it had reached
a certain stage of improvement, he
was hard hit by a then prevailing
liver fever, which in his case implicated the chest. This chest affection, however, did not consist in the
previous asthmatic attacks, but in
pain in the side, with cough and
bloody  expectoration.   He  got
well, but hardly was he able to
be up all day when the old asthma
came back worse than ever. Thinking the liver complaint might not be
quite cured, I gave him a good
hepatic, but the asthma remained.




86   Diseases of the Spleen
Here I gave him the spleen remedy
-the splenic-which had done him
so much good before the acute
affection came on. The man asked
for it himself, but it did no good at
all. Asthma and cough remained,
and instead of picking up after his
acute disease with good nights' rest,
the asthma drove him every night
out of bed. I now gave him Carbo,
which soon altered the face of things.
Cough and asthma lessened; the
latter soon disappeared altogether,
so that the man was able to make
the hour and a half walk home to
his friends, who had given him up.
But not every case of asthma,
due to the spleen, will yield to
Carbo. Those stomach pains that,
as they pass off, lose themselves in




Clinically Il/ustra/ed.   87
the left hypochondrium, and which
I put down to the spleen, I have at
times cured with Carbo, more frequently, however, with other spleen
remedies.
Kidney affections, with dropsy,
due to primary spleen disease, I
have never tried to cure with Carbo,
because I thus far have managed to
cure them with other remedies, and
I do not hold it to be right to try
experiments from mere curiosity.
SCILLA MARITIMA.
In my youth I used Scilla, like
so many other physicians, as a pectoral and diuretic.  But finding it
thus used so little helpful, I gave it
up in contempt. During the last
twenty years, in which I have taken




88   Diseases of the Spleen
more interest in the affections of
single organs, I came to recognise
the necessity of finding out good
and reliable remedies proper to the
various organs, and as I had indeed
such a very poor stock of spleen
medicines, I read one day in an
old Galenic author (I really don't
remember now in which) that Scilla
was a very good splenic.  Dioscorides also reckons it to the spleen
medicines, but he has put down so
many drugs as organ remedies that
one's whole life would not suffice to
try half of them. All things considered, I thought the old Galenic's
idea not a bad one, and from that
time on I have used Scilla as a
spleen remedy, and I have never
given it up since.




Clinically Mflustraled.   89
Although I may be in some doubt
as to whether Carbo veg. really acts
healingly upon a diseased spleen, I
am, on the contrary, very sure about
Scilla.  I have found it quickly and
surely helpful in such painful spleen
diseases-affections painful and beyond any doubt in and of the spleen.
In those dull pains on the border
of the left hypochondriac and epigastric regions, there being no signs
of any liver affection (a rather uncertain and negative sign), I have
used Scila as a remedy with advantage.
I have also used Scilla with
very striking results in those socalled stomach pains that are made
so much better by lying on the left
side, and which in all probability




90   Diseases of tle Spleen
depend upon a primary affection of
the spleen.
Finally, I have used it with good
results in one case of continuous
asthma from a spleen affection, with
nocturnal exacerbation, and in which
Carbo had been used in vain, but
in this case the spleen engorgement
was of such long standing that I
hardly believe in its being radically
cured.
As to the dropsy that depends
upon a diseased spleen, I no doubt
gave it in former years in such also,
for I daresay I gave squills to nearly
all my dropsical patients; and that
may account for my having found
it so useful in dropsy, but I am not
so very sure.  But since I have had
the habit of trying to find out in all




Clinically Illustrated.   9I
diseases the primarily affected organ
(provided the to-be-cured disease be
not a primary one of the whole
economy) I have not used it, for
the very sufficient reason that I
have not needed it, but of which
more anon.
The preparation I prefer is the
tincture I 5 to 30 drops, five times a
day.  In cases where it caused
diarrheea in these doses, I have had
to come down to 5 drops three times
a day.
AQUA VEL TINCT. GLANDIUM
QUERCUS.
I became acquainted with this
remedy in a wonderful way. Many
years ago (I do not remember the
exact time) a working carpenter,




92   Diseases of the Spleen
who had previously lived in Crefeld,
came to seek my advice for his
bellyache, which was of long standing. According to his own statement, he had long been under
Sanitary Councillor Schneider in
Crefeld, who was not able to help
him, and so sent him to Professor
GUnther in Duisberg. Ten journeys
thither were likewise in vain.
I tried my usual remedies for
seemingly such cases, but to no
good; and as I noticed he was a
good cabinetmaker, and dabbled a
bit in upholstery, I told him it
would be a good plan if he were to
hire himself out to a country squire
as joiner, thinking that the food
of the servants' hall would suit his
sick stomach better than the beans,




Clinically Illus;rated.   93
black bread, and potatoes of the
master carpenter. The good fellow
followed my advice, and lived with
a squire for many years; and I
heard nothing more about him.
Finally, he married the parlourmaid, and settled here in this town
as a joiner. One day when visiting his sick wife I remembered the
old story of his bellyache, and wanted
to know how it then was.  "All
right," said he, " I have not had it
for years."  It seems that a local
surgeon, being one day at the
squire's, told him to get some
acorns, and scrape them With a
knife, and then put the scrapings
into brandy, and leave them to
draw for a day, and then to drink
a small glass of this spirit several




94   Diseases of the Spleen
times a day. He did as he was
advised, and was forthwith relieved,
and very soon entirely freed from
his old trouble.
From what I knew of the surgeon, I was very sure he could not
give me any intelligent reason for
his prescription.  I should  only
have heard that acorn scrapings in
brandy were good for the bellyache,
or, at the most, I may have ascertained from what doctor, or peasant,
or old wife he had got the tip.
But this would have done me but
poor service; and as I had in the
meantime become much more cunning, I questioned the joiner himself
afresh as to the kind of his old pain,
particularly as to the part of the
belly where the pain was last felt




Cnizically Izuls/rated.   95
when he had had a bad attack.
He was in no doubt about it, but
at once pointed to the part of the
belly nearest the left hypochondrium.
So I very shrewdly suspected that
the abdominal pains were really
owing to a primary affection of
the spleen, in which notion I was
strengthened by remembering that
the best pain-killing hepatic and
enteric remedies had done him no
good.
To get as soon as possible to the
bottom of the thing, I set about
preparing a tincture of acorns, and
gave a teaspoonful five times a day
in water to an old brandy drunkard,
who was sick unto death, and of
whom I knew that he had suffered
from the spleen for a very long




96   Diseases of the Spleen
time, the spleen being from time to
time  painful.   He had  likewise
ascites, and his legs were dropsical
as far as the knees.  It occurred to
me that if the acorn tincture were
to act curatively on the spleen the
consensual kidney affection and its
dependent dropsy would mend. I
soon saw that I had reckoned
rightly. The urinary secretion was
at once augmented, but the patient
complained that each time after
taking the medicine he felt a constriction of the chest.  I ascribed
this to the astringent matter of the
acorns, and thinking the really curative principle thereof would most
likely be volatile, I caused the tincture to be distilled.  This acorn
spirit caused no further constriction,




Clinically Illustrated.   97
and the urinary secretion was still
more markedly increased, the tension in the praecordia became less
and less, and this hopelessly incurable drunkard got quite well,
much to the surprise of all who
knew him, and, honestly speaking,
much to my own surprise also.
Having thus put the spirit of
acorns to such a severe test, and
that in a case that I already knew
so well, in which it was impossible
to make a mistake as to the primary
affection, I went further, and used
it by degrees in all sorts of spleen
affections, and that not only in
painful ones, but in painless ones,
in the evident ones, and in those of
a more problematical kind. Gradually I became convinced that it is a
H




98   Diseases of Mte Spleen
remedy, the place of which no other
can take. More particularly is it
of great, nay, of inestimable value in
spleen-dropsy. Later on, I found
that the volatile curative principle
of acorns may be still better extracted with water with the addition
of alcohol.  [The aqua glandium
is thus prepared,-One pound of
peeled and crushed acorns to the
pound of destillate.] Perhaps water
alone might extract the healing
principle, but it would thus not
keep, and so the cures would be
uncertain, not to mention the fact
that such-like decaying medicines
are a great trouble to the chemists.
The dose of the spirituous acornwater (the only preparation I have
used of late years) is half a table



Clinically Illustra/ed.    99
spoonful in water four times a day.
It has not much taste; some would
even say it has none, but the doubter
may make a solution of alcohol and
water in the same proportions, and
he will soon find that it has quite a
taste of its own.
I must make mention of two of
its peculiar effects.  Certain few
people feel, as soon as they have
taken it, a peculiar sensation in the
head, lasting hardly a minute or two,
which they say is like being drunk.
With a few people, particularly
with those who have suffered from
old spleen engorgements, diarrheea
sets in after using it for two or three
weeks that makes them feel better.
It seldom lasts more than a day,
and is not weakening, but moderate.




I00  Diseases of tle Spleen
Hence it is not needful either to
stop the acorn water, or to lessen
the dose.
I could add many instructive cases
of spleen-dropsies and other spleen
affections, in which the volatile
principle of acorns proved curative,
but as I have so much more to say
on other subjects, I dare not be too
discursive on this one point; besides,
what I have already said will suffice
for common-sense physicians. Still
I cannot forbear noticing a few
bagatelles. For instance, I have
found that the acute spleen fevers
that occur intercurrently with epidemic liver fevers, are best cured
with aquaglandium-at least that
is my experience.
Furthermore, I am of opinion




Clinically Illustraledt.  loI
that the three splenics of which I
have made mention are curative of
three different morbid states of the
spleen, and I know well from my
own experience that acorns are
indicated in the most common spleen
affections; and, finally, I am not
acquainted with any positive signs
whereby those three separate morbid states of spleen can with certainty be differentiated from one
another.
There are other spleen remedies
to which I must allow a curative
action in diseases of the spleen, but
I have not used them so often as
those, because the morbid states of
which they have been more particularly curative have not occurred
so often to me.




I02  Diseases of the Spleen
Those I have tried are-Galiofsisgrandiflora, a celebrated spleen
remedy of the old time, and not to
be despised; and Rubza linctoria,
which is also undoubtedly justly
credited with being a splenic, but I
have not used it often enough
myself to be able to say anything
satisfactory about it.
BACCAE JUNIPERI.
These berries are a good spleen
medicine which I have often ordered
for the poor, and sometimes with
good effect. The berries must be
crushed, and a handful left a long
time to draw in four cupfuls of
boiling water if you want to see any
effect from them. I do not think it
is the xetherial oil, but a non-volatile




Clinically Ilzustrated.  Io03
principle of the berries, that acts as
a splenic.
OLEUM SUCCINI NON RECTIFICATUM.
This is a good spleen remedy.
It must be given in small doses,
and as people often make a mess of
the dripping, it is best to give it in
some other fluid.  I order it in
acorn water, and formerly in acorn
spirit. To six ounces of acorn water
I add half a scruple or a whole
scruple of the oil. They do not mix
chemically, but if the mixture be
well shaken our object is attained;
the patient does not get more into
his stomach than we intend. The
giving them together contains no
virtue; at least I have no reason to
think so. The Oleum Succini does




Io4  Diseases of Mte Spleen
good service in painful spleen affections wherewith there are convulsive
attacks, such as the hysterical and
hypochondriacal often have. Only
once did I observe its smell cause
hysterical convulsions in a woman,
but that is a very rare exception to
the rule.
Oswald Crollins lays great stress
on the importance of rectifying the
oil of amber, but what he says
therein is not true. The rectified
oil is nothing like so serviceable
as the  unrectified.  In  general,
Crollins is the most honourable and
the most straightforward of all the
jatro-chemists, but a man of but
small understanding.




Clinically Illustraled.  I05
CONIUM MACULATUM.
The late Professor GUnther, of
Duisberg, used to give for chronic
cough a powder composed of one
grain of Conium and ten grains or
a scruple of acorn mistletoe. He
had once cured an old gentleman
with it. A colleague of mine, an
out-and-out sceptic, who had in vain
patched away at the old gentleman,
did not deny the cure, but ascribed
it to chance, to the particular faith
the patient had in GUnther, and not
to the action of the powder. But I
could in no wise agree with his
opinion, for although I had at the
time but very little (kxperience of
Coniurn, still I knew Giinther was
a sensible physician, who wrote




i o6 Diseases of the Spleen
simple prescriptions, and so must
have understood the curative action
of his medicines. I once met G'unther over a patient, about whom
there was little to say, as he was
evidently dying. In the course of
our conversation, I begged him to
tell me what he thought about
Coniumn. He was willing, but, being
interrupted by the anxious friends
of the patient, I only gathered that
he set great store by it.  I had
several times easily cured patients
of his of liver coughs, and to whom
he had in vain given Coniurm, as I
saw from the prescriptions of his
that they brought with them; from
which I concluded that it was not
a sure liver remedy. I had before
fruitlessly used Conjiur in painful




Clinically Illustrated.  I07
spleen affections, and hence too
hastily concluded, because I was
still stupid, that it was not a spleen
remedy. Now that I had become
wiser, and understood that nature
could produce different sorts of
spleen affections, I began also to
see that while Conium  might be
quite useless in one kind of spleen
affections, it might nevertheless be
remarkably - curative in another
kind of spleen disease.  Thus I
once used it in a case of consensual
cough arising from a primary spleen
disease. This is hard to cure; all
the lung medicines do no good. Of
the belly medicines, the only one
that would occasionally be of any
service was the Vennua cardui.  I
now put Coniure to a very severe




Io8  Ditseases of the Spleen
test, that is to say, I gave it in cases
in which the Cardui Mane semmia
failed me, and lo! and behold! I
saw the most beautiful and most
astonishing curative action from it.
Since then I have never given it
up, and as I make no unreasonable
demands upon it, it has never disappointed me.  I stated earlier on
that Giinther gave it in combination
with oak mistletoe, but there is
nothing in that; I have found it
just as active with sugar of milk or
sweetwood, as when triturated with
oak mistletoe.
MAGNESIA TARTARICA.
My readers will not much care to
learn how I became acquainted with
this remedy. So I may just say




Clinically Illustrated.   I09
that I neither stole it from a brother
brush, nor did one very kindly communicate it to me, neither did I
find it in a book. Still it is manifestly a remedy with which a spleen
affection may be ousted.  I confess,
however, that I knew nothing of it
till four years ago, and, from want
of opportunity, have not used it
much. But as I have got rid of
painful spleen disease with its aid,
and that such as would not obey
other remedies, I am bound to conclude that there must be a spleen
affection in nature which is peculiarly subject to the healing power
of this remedy. It does not follow
that because this particular disease
has come comparatively seldom
under my observation that this




IIO  Diseases of the Spleen
will necessarily be the case in the
future.
I have not yet given this remedy
in those spleen diseases that are
evidenced by consecutive cough or
dropsy, for the very good reason
that other and twice better known
remedies sufficed. I never try experiments with new remedies until
the old ones leave me in the lurch.
The average dose of the remedy
is one scruple four or five times a
day.  In this dose it has no laxative
action. Should one, however, meet
with very sensitive bowels, whose
movements are increased by this
dose, less must be given, for I have
observed that the laxative action
does not hasten the healing.
Rademacher also favourably men



Clinically  llus/rated.   I I I
tions Cicuta and Acidum pyrolignosumn as topic splenics.
There is not much to be learned
in any English works that I have
read on spleen medicines. I, personally, know nothing ofLUFFA ECHINATA.
Moore (Diseases of India, 2nd
edition, p. 527) narrates that Dr
Dickinson (Bengal Service) had
some years ago recommended the
Bindaal Rerula, or Luffa echinala,
an indigenous plant of the N. O.
Cucurbitacese, as a remedy in spleen
disease, and says that he himself
had used it in dispensary practice
with apparently good results.
I may now refer to a little of my




I I2  Diseases of the Spleen
own clinical experience with Rademacher's spleen remedies, and particularly as to the Oleum Succinalum
non rectiftcatunm, which has rendered
me brilliant service, as my readers
will see.
CHRONIC  ENLARGEMENT  OF THE
SPLEEN,  WITH   HEMIHYPERAESTHESIA, CEPHALALGIA, DYSPNCEA,  ORTHOPNCEA,  CONVULSIONS.
A more remarkable case of its
kind I never observed. Subject:
A young lady towards the end of
her teens, of good family, and at a
finishing school in London. Had
been treated at home for hysteria
of a severe type both homceopathically and hydropathically, the




Clinically Illustrated.  I 13
latter consisting of the cold douche
when a convulsive attack was on.
The cold douche was only once
applied, and nearly killed the patient.
Many months after it was applied,
when the patient was in a state of
what seemed to be approaching
death from exhaustion with violent
delirium, she literally yelled at
what she imagined was some one
approaching the bed to throw water
on her. It would fill a little book
to give a complete history of her
case; so I will summarize it as
briefly as may be.
At first, and for a year or two,
I treated her for attacks.  Said
"attacks" I had never seen, but I
put them down as a form of epileptoid seizure, though it was disI




II4  Diseases of ihe Spleen
tinctly stated that the convulsions
were mostly left-sided. Sometimes
violent palpitation of the heart was
essentially the attack;  at other
times dyspncea, orthopncea; and
always a pain in the left side under
the ribs, going up and down; and
patient, no matter how violent the
convulsive attacks, was never quite
unconscious. I was not able to see
an attack, and could never get a
really clear description of them.
" Dreadful fighting for breath"
coming on in attacks, with pain in
the left side, was the essence of all
the descriptions given to me.  I
treated the case, but without doing
any real good, and finally she was
seized with an attack so violent
that the parents telegraphed from




Clinically Illustrated.  Ir5
the country to me to know what to
do, and I felt it too serious a case
to be treated by me at a distance,
and so I wired back that I resigned
the case to their family physician,
himself an eminent homceopathic
practitioner, who also had formerly
tried his hand at the case, but in
vain.
Many months elapsed, and I
heard only indirectly about the
case; and then the friends, in sheer
despair and disgust at the obstinacy
of the attacks of what their family
physician said was a severe form of
hysteria that would not go away for
good, but ever and anon came like
a domestic explosion, creating unrest
and tension, brought her to reside
near me in the neighbourhood of




I I6  Diseases of the S5leen
London, and this was at the beginning of the winter of 1886-87.
The attacks soon came, and I had
the opportunity of observing them.
On entering the room I thought I
heard steam coming out in short,
sharp " whists" from a kettle-spout,
but I found it was patient's expiratory efforts.  The dyspncea was
very great, and the convulsions
most violent, being always confined
to one side-the left but varying
as to position on the trunk, being
at times in the nape, then on a
level with the nipple, then in the
lumbar region, sometimes so bad
that the body would be bent like a
hoop, and the movements very often
sent patient flying either against
the bedstead, over on to the next




Clinically illustraled.  I I 7
bed, or on to the floor; and hence
we had to pad all hard objects.
Some of the convulsive contortions
were awful to behold, and most of
her friends devoutly hoped and
prayed that she might die.  For
some weeks I was the only one
who believed recovery possible, so
long, so violent, and so exhausting
were the convulsive attacks. Myself, I only lost heart once, and that
was after a series of attacks of
convulsions lasting for hours, and
leaving only short intervals. Her
friends several times fetched me in
the night, believing patient to be
dying.
The thing went on for months,
and I was able to get slowly at
some constant characteristics.




II8  Diseases of the Spleen
I. When out of the attacks
patient was comparatively well in
herself, and looked well, only as
time went on, and the attacks lasted
for hours with great violence (relays
of two, and sometimes three persons being required to hold her
down), she became very weak from
exhaustion.
2. The appetite was poor, the
tongue coated, the bowels obstinately confined.
3. The left side of the body
(trunk) was so tender that she could
not bear the least pressure. Touching it gently with one finger even
made her wince.
4. The spleen was considerably
enlarged, and the whole region
excessively tender.




Clinically Zllustrated.   I 19
5. She had a constant fixed pain
in the left half of skull, worst about
midway between ear and the sagittal
suture, and she usually held her
head in left palm.
6. Warmth was agreeable, and
cold aggravated very distinctly, and
particularly frost and snow; violent
attacks always came on whenever
it froze.  "Thunder has always
tried me."
7. There was pronounced periodicity, sometimes irregular, but also at
times and for weeks together as regular as a clock, there being two, three,
or four attacks in twenty-four hours.
I could not agree that the case
was one of hysteria, as the family
physician thought.  In  the  very
early part of the treatment I treated




120   Diseases of the Spleen
her for epilepsy, but did her no
good. Then, in view of the enlarged spleen, I gave  Ceano/tus
Am. and other spleen  remedies,
but in vain.
She was at times feverish, and had
Aconitum; very flushed in the face,
and I ordered at first Belladonna,
and then Lachesis, but in vain.
PhospSorus, Gelsemium, Zincum,
Cuprum, Ignatia, Nux, Puls., and
many such, were equally useless.
Aranea diadema, Cicuta, were no
better.
Sulphur and Plumbum did a little
temporary good, and we thought
Cup rum and Acid. hydrocyanic eased
the convulsions a little, and also
Mikania guaco.  Essentially they
did no real good.




Clinically Illustraed.   1 2 1
The fixed, constant, and often
severe pain in the left side of the
head at last compelled me to assume
the presence of a tumour in the
brain, perhaps of a vascular nature.
Silicea and a number of other
remedies were given on this hypothesis, but the patient seemed practically uninfluenced by them.
Heretofore I had treated the case
from the particular standpoint,- as
well as from that of the entire
organism, and had failed, so I
thought over the case afresh, and
came to the conclusion that Rademacher's account of the action of
Oleum Succini made that drug appear
a likely remedy. I therefore prescribed the non-rectified oil in fivedrop doses three times a day. That




122  Diseases of the Spleen
was early in March....  In
forty-eight hours the convulsive
attacks ceased, and in three weeks
the hemihyperaesthesia. The pain
in the head  in fact, the whole
series of morbid phenomena-slowly
disappeared. So I am now disposed to regard the case as a
primary disease of the spleen from
the very beginning, the convulsions
and head pain being consecutive
thereto. This is the kind of cure
one meets with in Rademacher,
and which gave the tone to his life
and practice.
When I say kind of cure, I mean
an obviously bad case of disease not
mending of itself, and cured straight
off - generally  jugulated.   Evidently, too, Hohenheim used his




Clinically Illustrated.  123
organ-remedies, so that he effected
striking cures; any wonder that
he became overbearing and arrogant?
After taking the Oleum Suc. for
six weeks, I very carefully percussed
and palpated the left hypochondrium,
which was no longer tender, and
the enlargement of the spleen had
quite disappeared, though patient
said the side was at times tender
still, and the pain in the head still
persisted a very little.  No convulsion since the second day of taking
the 01. Succini.
LEUCOCYTHAEMIA SPLENICA.
There is nothing quite certain
about this disease-form, except that
scholastic medicine defends it as a




I24   Diseases of tMe Spleen
distinct morbid species, and thendeclares it to be incurable.
A consideration of it in brief will
not be out of place in a treatise on
Diseases of the Spleen. That there
are cases answering to the ordinary
description of splenic leucocythaxmia
is quite certain; several such cases
have come under my observation,
two of which are now under my
care and are getting better-incurability notwithstanding.
Splenic leucocythxemia has been
defined as hypertrophy of the spleen,
with an alteration of the blood consisting in a considerable augmentation of the number of the white
corpuscles. Virchow called this disease Leukaimie (from XevK0v, white,
&a4Aa, blood), because of the altera



Clinically Illustrated.   125
tion in the blood. Now that the
white blood corpuscles are often
called  leucocytes  (XevK,5,  white,
KUVTO9, cells), Bennett's name of
leucocythaemia (splenica) is likely
to carry the day as against Virchow's leukaimie, though, perhaps,
not in Germany.
The disease is variously called a
cachexia, a diathesis. The first case
recorded is that of Dr Craigie (184 I),
and then Hughes Bennett and Virchow run neck and neck in their
claims for priority; and, I think, to
Bennett belongs the honour. The
year i845 may be accepted as the
year of the recognition of the new
disease; and for years medical
literature gave it a front place, but
of late one sees but a very occa



126   Diseases of the Spleen
sional note on the subject. Whether
leucocythxamia splenica is essentially
different from other varieties of
leucocytosis remains to be investigated; and whether common anzemia and it are degrees of the same
is also very much an open question.
Perhaps future progress in our knowledge of hzematology may show us
as very numerous diseases, the one
anemzia, that "calls for iron."  For
I apprehend that if the spleen be
the breeding-place of some of the
leucocytes, and the lymphatic glands
and the bone-marrow the breedingplaces of other leucocytes, we shall
necessarily have three varieties of
anaemia, namely, the splenic, the
lymphatic,  and  the  medullarycausally, perhaps very different.




Clznically Izllustraled.   I27
Then the spleen is said to be the
place where some of the red blood
corpuscles  are  broken  up  and
destroyed.  If this be true, then
there must in all probability be
two distinct forms of leucocythaemia splenica-the one due to
formative lack, and the other due
to undue splenic destructiveness.
The probability of the truth of
this speculative theory is greatly
enhanced by the absolute uselessness of the ferric medication in
some cases of anaemia; whereas
in others the striking, nay, almost
startling, curative results following
the same treatment surely characterize it as different.
Clearly, the anaemia which yields
to iron must be very different




128  Diseases of the Spleein
from that which does not yield
to it.
I have found Oleum Succini non
rectz/fcalum,  Sfpiritus  glandium
Quercus, Thuja 30, M/Ianigan acel.
i, and Natruim sul. of positively
curative effect in leucocythzemia
splenica.
Beyond any question there is a
form of leucocytosis that is surely
and rapidly cured by iron, a remedy
which the Paracelsists considered
universal, i.e., affecting that which
is common to the whole economy
(the microcosm), and not having
any particular affinity for any one
of the organs of the body above
another.  It  follows, therefore,
that from Hohenheim's standpoint
iron would be no remedy for




Clinically Illustrated.   I29
leucocythaemia splenica unless the
disease was one of the entire
organism (or its blood), and, indeed, iron is no remedy in leucocythaemia splenica; and I regard the
therapeutic uselessness of iron in
a bad form of anaemia as a first
step to the diagnostic differentiation of the kind of leucocytosis
one is dealing with.  Nevertheless,
good authorities claim that iron will
reduce the spleen, but this may be
by reason of its unquestioned action
on the blood.
I have found it of considerable
therapeutic advantage to regard
leucocythxamia as being causally
connected (often remotely) with
vaccinosis and gonorrhcea-to me
a great clinical fact, but on which
K




I30 Diseases of t/e Spleen.
I have here nothing further to say.
And, indeed, cui bono? The world
that would not listen to Autenrieth,
Hahnemann, Grauvogl, Wolff, H.
Goullon, and others, would also not
listen to me.
Well, we can wait; and since the
spleen, on which I have been here
already too discursive, is the organon
risus of the ancients, I must keep
my own functionally intact, and
hence will close with their old
distichCor sentit, pulmo loquitur, fel continet iras,
Splen ridere facit, cogit amare jecur.
PRINTED BY OLIVER AND BOYD, EDINBURGH.




WORKS BY DR BURNETT,
Second Edition, Foolscap 8vo, Cloth.  2s. 6d.
THE MEDICINAL TREATMENT
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MIORE ESPECIALLY OF
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