A case of CORYZA

case study

Miss E., aged 23, book-keeper, rather tall, thin, but counting herself in good health, complained of a single annoying symptom of long standing, as follows :

Since fourteenth year of age had suffered from attacks of sneezing and lachrymation. The slightest change in temperature, the most trivial irritation, would bring on violent paroxysms of sneezing, lachrymation and watery coryza going from one room to another, a draft, the opening of a door, the chilling of the hands or a bright light striking the eyes were any of them sufficient to precipitate an attack, and when such exciting causes appeared to be lacking occasional attacks would come on anyhow. There was no organic catarrh, no discharge (except at the time of the paroxysms), no symptoms of any kind left afterwards. No headache, no menstrual trouble, no pains, no aching, no modalities except as above mentioned in regard to the sneezing, Sabadilla 200, a few powders, cured completely and permanently.

This case was absolutely hopeless for a pathological prescriber or for an allopath. The pathology is not mysterious, almost anyone, if the knew enough, could talk learnedly about it.

It would be a description of how puerperal irritation, inconceivably slight, affected by branches of the sympathetic nerve and carried by paths and routes absolutely unknown to the mucous membrane of the nose, produced an undue afflux of blood, tumefaction and irritation of the Schneiderian membrane until another reflex was thereby started, setting up the whole complex mechanism of stimulation, there occurred a powerful, sudden contraction of the diaphragm, producing a friable expulsion of air through the nasal passages, accompanied by such a stimulation of the lachrymal apparatus as to produce copious tears, and also by such an activity of the nasal mucous membrane as to cause a profuse flow of watery secretion from the nose to the great detriment of many fine linen handkerchiefs. What is all this but words, vain words ? Miss Eberle could go through the process forty times while the pathologist was describing one sneeze. How could the most profound understanding of the pathological process show that Sabadilla was the remedy ?

I leave that problem to the prayerful attention of the devotees of pathology, Epsom salts, castor oil and calomel.

As to the remedy, sneezing, lachrymation and thin nasal discharge are characteristic. I count it a fault in our materia medica that it does not dwell with sufficient emphasis upon this important feature of Sabadilla. This drug in the days when the allopaths used Galenical medicines rather than coal tar products was of considerable prominence as an antiparasitic and vermifuge. Like nearly all the drugs of the old school, more than a year old, it has fallen into disuse, but was retained in the last pharmacopœia for the purpose of manufacturing the alkaloid veratrine of which it is the source. The present pharmacopœia drops it entirely, retaining its alkaloid only. I know by experience that it is impossible to powder Sabadilla seeds without taking precaution against the inhaling of the dust, as it is provocative of most powerful stimulation ; the alkaloid has the same property but in a milder degree.

It is said that the celebrated Schneeberger Schnupf-Taback owes its property of causing powerful nasal titillation to the presence of Sabadilla in its composition.

Sabadilla is almost a polychrest, and indicated probably twenty times where it is once used. I have no doubt that Ipecac., Pulsatilla and Lachesis are frequently useful to zig zag a case to health when Sabadilla would do more powerful and direct work than any of those mentioned. The resemblances and differences between it and Lachesis are worthy of careful study.

In the Materia Medica we find the following symptoms, showing its power in the direction of Miss E’s symptoms : “Lachrymation, worse when walking in the open air or looking at light ; sneezing, coughing or yawning, lachrymation as soon as the least pain is felt in some other part of the body, for instance, the hand.”

“Margins of the lids red.”

“Spasmodic sneezing ; fluent coryza.”

“Either nostril stuffed up ; itching nose.”

“Violent sneezing from time to time, shaking the abdomen, followed by lachrymation.”

“Coryza with savage frontal pains and redness of eyelids ; violent spasmodic sneezing, influenza and lachrymation on going into the open air. Cough with lachrymation.” (J. B. S. King.)

A case from the clinic of Dr. Nash