Prescribing on the basis of Ladder Like Symptoms

By Dr. J.C Brunette

I cannot subscribe to the generally accepted view that when you have covered all the symptoms of a case you will necessarily work a real cure; you may do so or you may only palliate the case; certainly this kind of palliation is scientific and beneficial, but palliation it is and palliation it remains, e.g., Gall stones are not gone, when you have laboriously covered the symptoms and thoroughly cured them. And so on.

To cure a disease by remedies, the remedies must stand in some relationship to the disease process itself no matter whether the symptoms reveal the process or not. If the symptoms spell out the morbid process the symptom suffice.

To me the physician who never gets beyond the symptoms is like a reader who in order to read is always obliged to spelt his words.

In the graver forms of disease the only bodies that I am acquainted with which have a range of action coincident with the disease processes themselves are of zoic nature and frequently those, which are causal or constituent of these, same processes.

The Disease-processes are in quality zoic; the remedies to have a range of action equal to the disease-processes must be like zoic (like in quality), The zoic remedies constitute the field of promise; for the further development of progressive scientific homoeopathy. I am beginning to see, though only through the gate ajar, but I live in hope of more light. Here let me just say that where zoic remedies are named in this work they were chosen on a tentative workable hypothesis of my own, and that although they are often so chosen purely hypothetically, they are no more and no less than homoeopathic remedies, pointing to a great advance in homoeopathy.

Some Hahnemannian reviewers of certain of my writings have said hard things about me, possibly with the good intentions of stifling a new heresy. I have nothing to do with any man's subjective opinions; the future of medicine belongs to homoeopathic pathologist, and to really cure the great diseases (with a pathologico-anatomical basis) we must have remedies homoeopathic to such morbid anatomy, at any rate in its earlier states.

No drug is capable of curing a morbid state homeopathically, unless it is capable of producing one like it.

I am quite prepared to grant, indeed I quite believe, that every morbid state or process might be cured from the symptoms alone as a guide, provided such states and processes had been actually produced patho-genetically in healthy human beings, and the symptoms produced had been duly noted during the days, weeks, months, and years (and perhaps lives and generations of lives), wherein such processes are being evolved. But that is not, and in the nature of things to a very large extent, never can be.

To speak of the "all-sufficiency of symptoms" is to mislead some, to disgust others; and in general it effectively dams the stream of homoeopathic progress.

As we have already seen, it is not very often that we can, cure a tumor with one medicine, and here I must explain, and for this purpose I cannot possibly do better than quote from "Fifty Reasons" page 123:

You take exception to the number of remedies used in my last case, and want to know "which cured the case?''

Will you get a long ladder and put it up against the side of your house, and mount it so as to get into your house by the top window; and when you have safely performed the feat, write and tell me which rang of that ladder enabled you to do it.

I sympathize with your objection, because it was once my own great stumbling block in accepting the results of homoeopathic treatment; it may perhaps be adequately explained somewhere in the vast literature of the homoeopathic fraternity, but I have never come across such an explanation, and hence have had to work it out for myself, I will put it to you thus: - In difficult, chronic, complicated cases of disease you require not a remedy but a ladder (series) of remedies, not one of which can of itself effect the cure, but each of which works cure-wards, their cumulative action eventuating in a cure. That is how I cure cataract, and many other diseases that are currently held to be incurable by most of men of all shades of therapeutic opinion. I regard this power of utilizing a long series of remedies for the cure of difficult chronic cases as only second in importance to the law of cure itself. I originally learned the thing in conversation with Dr. Drysdale of Liverpool; though not formulated by him, and I doubt it if Dr.Drysdale ever did formulate it. In my own mind I call it the ladder of remedies plan. It is, what I often heard Dr. Dcysdale call "a course of medicines" I often compare the course of a difficult case of disease to a game of chess in which you have King, Queen, Bishops, Knights, Rooks, and Pawns, the various powers of which you must learn before you can play chess."

On November 17, 1887, I was requested to see a gentleman resident of London, who was said to have a very large tumor in the abdomen and no efforts to cure it had been spared, but they were quite unavailing. As six medical men-including the consulting surgeon and the consulting physician at Guy's Hospital had seen him and done their best to no purpose, I did not much care to go as a seventh medical man, merely to say ditto to the dictum of the other six. There seemed no chance of a cure, and an operation had been declared to be impossible, evidently because of the position and size of the tumor, and its probable adhesions to adjacent parts and organs. The tumor presumably had its origin in a fall, then eight years ago, on the left side, which fractured the ribs; that is to say, the side had never been comfortable since and for many months this large mass had been growing larger and larger, at first in commoding locomotion and finally rendering it impossible. Patient was not only bedridden, but was not even able to turn over in bed; partly from weakness and partly because of the bulking mass. And patient being a long way past sixty years of age did not make the prospect any brighter.

However, two days later, I did go to see the patient, and found a slender-built man crouched up on his back and a little to the right. As he could not turn over himself his wife and I had to aid him for the purposes of a proper physical examination, which disclosed a huge mass in his left side almost from the nipple to the Pelvic rim. There were prown patches on the skin of abdomen, and inside of the left Poupart's ligament were a number of lumps to be felt like little potatoes, presumably indurate and hypertrophied lymphatic glands. Add to this a quite cachectic look and rather severe adynamia, and the picture of hopeless malignant disease is complete.

I made close enquiry as to the opinions of my six doctorial predecessors in regard to the seat of origin of the tumor, and found that their two family advisers (the same firm) had always held it be connected with the left kidney. And when they failed to do it any good they called in a physician of repute who thought it could be cured, but when his efforts had also failed; a good surgeon was called and he thought it quite incurable. Then came a consulting physician and surgeon respectively from Guy's, and the final outcome of all the deliberations was that it was cancer, or at any rate a tumor connected with the spleen which was or had become malignant in its nature, and that the result must necessarily be fatal; a mere matter of time, in fact. The most careful examination did not enable me to say whether it was connected with spleen or kidney or with both: the tumor practically occupied the left half of the abdomen, and, not considering its history, was apparently connected with the spleen.

Was there any chance of cure? There had been quite enough diagnosing from the stand-point of mere diagnostics, but I found the medicinal treatment had been confined to general tonic and quasi-absorbent measures, probably quinine, iron, mercury arid certainly iodine.

I think any practical physician or surgeon will concede that a more hopeless case to cure by medicines is hardly to be found.

To begin with, how are we to choose medicines for such a case allopathically, homeopathically, or anyhow?

My own plan in difficult cases that seem so hopeless is to lay firmly hold of some point that may serve as a reasonable therapeutic starting point whence to carry out a cure.

As a start there is here the traumatic element in the case, that is positive, and my own favorite and well-tried anti-traumatic is Bellis per; then the proving of this drug, communicated by myself, shows a decided affinity for the left hypochondrium, and finally Bellis has already in my hands cured a few tumors.

This plan in the face of desperate odds, to lay hold of any help promising remedy, is at least a stay for further reflection. Bellis per as an anti-traumatic and also Ceanothus Americanus as a splenic, presented themselves to my mind, but which? Candidly confessed I thought the good man doomed, but determined to try and save him, and not knowing of my two remedies was the more likely to do something quickly, (for the case was urgent-patient's friends had already taken a last look at him as they thought). I gave the two in alternation, and much did I subsequently regret this double shot, for the use of two medicines at one time teaches next to nothing. 

However Bellis and Ceanothus 1X were given in five drop doses every four hours in alternation; this was on November 12, 1887, I find, and not the 17th, which was the date of my second visit.

The results of this medication was that after a while patient could turn over in bed, then he could get in and out of bed by himself, and in 17 days from the beginning of the medicine, viz: on November 29, patient came to my Westend rooms in a cab with his wife.

The effect of medicines were great diminution in the swelling, (patient had lost much flesh and was still loosing flesh), the passage of vast quantities of urine-"it literally pours from me", the skin of palms of his hands is black but the lines strikingly white in contrast. And the tumor itself was not only much smaller, but more defined. But patient's weakness was terrible; evidently his coming to me was partly braver and more an effort of will than real physical power. I, therefore stopped the two remedies and gave Nux V 1X and Calc Hypophos 3X as an indicated all-round pick-me-up.

December 6th- He is much stronger; can walk up stairs, but his tumor is not quite so well. The skin of his hands, etc., is peeling off. Ur. sp. gr. 15, containing mucus in great quantities.

Repeat the first prescription.

December 16th- He is still getting thinner but he is stronger, tongue very much coated; has to strain much at stool; eats well, he has walked here from the end of the street. Has a cold on the chest and cough, and this shakes him and hurts his side very much.

Bryonia Alb 1X and Phos 3X in alt.

December 27th- The cough is worse on going to bed and seems to be spleen-cough.

Squilla Marit. Five drops in water three times a day. He did not need subsequent treatment and he came to say goodbye on January 24th, 1888. He had lost his tumor and enlargement and indurations of the lymphatic in the left side, and he was rapidly gaining flesh and strength.

All things considered, it was clearly a tumor of spleen, and I am disposed to think the lymphatic were irritated to enlargement either by iodic and other irritant topics that had been applied, or else by the pressure of the tumor.

Still, the entire case remains a little puzzling, and others being in possession of its main features can judge as well as myself. At least it teaches- nil desperandum!

The cure was complete and permanent, which I know, patients turns up in my rooms every few months for his own and my satisfaction. Such a case is an oasis in the desert of physician's hard life.

Updated on: 01 Feb 2010