Brief contributed articles.

Treatment of Sydenham's Chorea.

JOHN W. KNOX, M. D.

While not of your school, yet I have profited by one of your articles, and wish to show my appreciation by the report of the case:

The patient, male, ten years of age, one of twins. He has had the diseases of childhood, but, apparently, always made complete recovery. Two months ago, a diagnosis of chorea was made, and Fowler's solution was pushed to the limit by two physicians but with no apparent benefit.

The child presented to me a typical case of Sydenham's chorea, with the irregular and incoordinate movements, insomnia, anaemia, speech impaired, and a general restlessness. The prepuce was slightly adherent, and the pupils and reflexes were sluggish, though I believe the literature says, unchanged. His parents stated that his disposition had changed. I could get no history whatever of rheumatism, not even of the so-called growing pains, yet endocarditis was markedly present.

Family history: No serious nervous diseases but a slightly neurotic tendency. One year ago, a sister, twelve years old, in three months passed through rheumatism, chorea, and cerebral meningitis, to a fatal termination.

As Fowler's solution had failed, I was at a loss for a treatment, when Dr. George Inglis, one of your readers, a man of wide experience and close observation and to whom I am indebted for many useful points, suggested "Macrotys," and, later, handed me your article.

The tincture only was available. I gave one teaspoonful three times a day, and, indeed, the result was amazing. In four days the chorea form movements had ceased and the patient was decidedly better. While I recognize the periodicity of the disease, yet I feel that macrotys was effective and regret that, according to some authors, it is not applicable to all cases.

Can you suggest an after treatment to prevent recurrence ?

COMMENT: Usually there is not a tendency for chorea, even of the severe type above described, to recur after it has once been cured with macrotys. However, it is necessary that the condition of general debility, the weakness of the nervous system and the character of the blood, be fully restored, after the involuntary movements have ceased. All anemia must be overcome, and the patient must be able to eat a full quantity of plain, nutritious food without disturbance of the digestive processes.

We are very glad to hear from the doctor with the above report. It may be as valuable to some of our other readers as the original suggestion for the use of this remedy has been to him. There are many of our practitioners who claim to have been successful in all their cases with macrotys. Others have used the remedy in conjunction with scullcap, both in large doses with excellent results.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.