Chorea.
H. L. HENDERSON, M. D., ASTORIA, OREGON.
Anent the several articles and reports on the above subject recently appearing in THE THERAPEUTIST, I desire to report the following:
About twenty years ago, I was occupying a position in one of our medical colleges, the duties of which required me to demonstrate the various clinical cases presented before the class. On one occasion, a sister of one of the students appeared before the class, suffering with a well marked case of chorea major. I carefully excluded everything that could be a causative factor in producing the disease, such as gastro-intestinal diseases, genito-urinary disorders, menstrual derangements, etc. I then proceeded to impress upon my class, the tediousness, and oftimes uncertainty of our treatment in such cases, and pointed out the indications, in the given case being unquestionably toward macrotys and hyoscyamus.
Just then one of the students in the class, an old practitioner who was attending a post graduate course, said to me in a whisper, "Professor, if you will let me prescribe for that case, I will cure the case in forty-eight hours, and will then tell you what medicine I use." I readily consented, and directed him to go into the dispensary and procure whatever medicines he might require. He came from the dispensary holding in his hand a half ounce bottle containing a straw colored liquid. He directed that the patient should take thirty drops of the liquid in a full glass of water, immediately after each meal, and that the patient should again appear at the clinic rooms on the second day following, without fail.
On the second day following, when I entered the clinic room, there sat the chorea patient, as quiet as a statue, and reported that the improvement began immediately after the first dose of medicine, being so marked that she slept well the first night, and after about the fourth dose of medicine, she had almost perfect control of all muscles. The student then confided to me that the medicine used, was Fowler's solution of arsenic. I am free to say that I was absolutely dumbfounded! The student assured me that he had been using the remedy, in the dose mentioned, for many years and had never known it to fail to cure the case, nor had he ever seen it cause any trouble.
From that day to this, I have used the remedy mentioned, in the dose given, and I do not remember a single case that has failed to yield in from one to five days. I have never known a stomach to reject the medicine, nor have I ever seen a case with puffy eyelids. I will modify the first, by saying, that on one occasion the patient took the medicine straight, and then took a glass of water following it. and in that case there was vomiting which subsided immediately, when the medicine was mixed with a full glass of water.
I believe as strongly in specific medication as does any one, and I do not believe in giving a medicine because a given disease exists; but in this case, twenty years and numerous cases have convinced me that thirty drops of Fowler's solution in a full glass of water, taken immediately after each meal, will cure the idiopathic case of chorea, with as much certainty as will castor oil produce an evacuation of the bowels. I don't know the indications in this case, nor do I care for the indications, but I do know what result will follow.
COMMENT:—The suggestion made by Dr. Henderson for the use of Fowler's solution in the treatment of chorea is by no means a new one. It is the classic method of the old school. It is the first suggestion made by all their medical writers. It is their principal dependence in all cases. Unfortunately, they make but few suggestions for medical treatment beyond this. The doctor has been very fortunate in having a class of cases that were cured by this remedy, as the reports from the general use of this agent do not show nearly as good results, in fact many who have depended upon this remedy for years, administer it with doubt and fear, in each new case, hoping that it will be beneficial, but feeling by no means confident.
Another undesirable feature connected with the use of this remedy is, that while with our remedies the patient's general condition improves all the time, with this remedy if the chorea is cured, the condition of the patient is such with anemia, disordered stomach, disordered glandular action and general debility, that it takes a long time with the best of other remedies to restore him to health.
It is but justice to the doctor to state that the dose that he advises may have had something to do with the promptness of his results, as this is a larger dose than is usually advised. Both Hare and Anders advise from two to five drops with children, given three or four times a day. Carefully increased doses are given adults, but thirty drop doses I am not able to find in any of their works, as it is certainly a dangerous dose to be continued. Carr advises in young people that twenty drops may be given with caution three times a day, but claims that if no other toxic symptoms appear, arsenical neuritis is apt to be produced.
Perhaps Dr. Henderson expects of this very large dose that it will accomplish its results in from three to five days and can be discontinued before serious results appear.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.
