I have selected for our study today a member of the leguminous plants, BAPTISIA TINCTORIA, or the wild indigo. It is a drug which has a short history, but one that is exceedingly interesting. Our journals are replete with glowing accounts of cures of typhoid conditions made with it. Baptisia causes, in general, the changes in the blood, both quantitative and qualitative, which are exhibited in typhoid fever. The offensive exhalations, the mental and nervous phenomena which it develops, are characteristic of this disease. Baptisia is suitable to all stages of typhoid, early or late. Its symptoms I will divide into two classes: those which would indicate the remedy early in typhoid affections, and, secondly, those which call for it late. Of course, it is not necessary that all the following symptoms be present in any one case, to make the drug the remedy. I am about to give you the characteristic symptoms of the remedy; without several of these be present it would not be proper to give Baptisia. These symptoms are as follows: Excitement of the brain, just such as precedes delirium; wild, wandering feeling, patient cannot confine his mind to any one subject; restlessness, constant desire to move from place to place, and disturbed sleep. The patient awakens at two or three o'clock in the morning and then is so restless that he tosses about, uuable to sleep any longer. During sleep his dreams are of the most extravagant character. He dreams that he is chained to the bed, or that he is swimming a river or undergoing some such ordeal as makes a great demand on his strength. He may suffer from nightmare, from which he awakens with a sensation as though the room was insufferably hot, making breathing almost impossible. If he still has strength he goes to the open window to get air. Now this is not a true asthma; it is not due to a spasmodic contraction of the bronchioles or air-cells. There is a fulness of the chest, giving this oppressed feeling. One prover described the symptom not as a true difficulty of breathing, but as a feeling as though he had not strength to lift his chest. The patient makes frequent errors as to his own person, supposing at times that he is double or that his body is scattered about, and that he must toss about the bed to collect the pieces. Now these evidences of nervous excitement are accompanied by excessive prostration; the back and limbs ache; the back feels stiff; the patient feels tired and bruised all over; he complains of the bed feeling too hard; this makes him restless, and he tosses about the bed to find a softer spot; weakness progresses so far that he becomes unable to walk; he suffers from an indescribable weak or faint feeling, with or without vertigo; the face is hot and flushed and has a heavy, besotted look, as in the case of one intoxicated. The eyes, also, are heavy and stupid in appearance. The tongue is at first white or slightly yellowish ; frequently, too, the papillae are raised and project through this whitish or yellow coating. The edges of the tongue are of a deep red color; there is a dull, heavy headache, with the sensation as if the head would be pressed in ; sometimes the pressure in the forehead seems to go down into the root of the nose. Again, the patient complains of a sensation which he describes "as though the skin of the forehead were being pulled back towards the occiput." This is evidently due to tonic contraction of the occipito-frontalis muscle. At other times the patient simply describes the sensation as though the skin of the forehead were tense, or tight, or drawn. These symptoms of the head are often accompanied with numb, tingling feeling in the forehead or scalp. At other times the head feels enormously large. The typhoid fever is very characteristic of Baptisia, it being one of the few remedies which actually produce this type of fever. There is always an increase of temperature. The pulse is usually accelerated in direct proportion to the intensity of the fever. Even in the early stages of typhoid fever, you may find Baptisia indicated by the abdominal symptoms, slight sensitiveness in the ileo-caecal region, and yellow putrescent stools. These then are the symptoms calling for the early exhibition of Baptisia in typhoid fever. I can say confidently that if you select the drug on its homeopathic indications as just outlined you will succeed in aborting a large percentage of typhoid states. I say this despite the assertions of many other physicians who have argued to the contrary. The properly selected drug WILL abort typhoid fever. The disease need not run its course, as prominent old school authorities claim it must necessarily do. You recognize that Baptisia is suited to true typhoid fever, particularly when associated with nervous phenomena.
Later in the course of the disease, during the second or third week, you will find Baptisia indicated when the prostration is profound.. The patient is in a stupor. He'falls asleep while answering questions. His face is now dark red in color and has, more marked than ever, this heavy, dark, besotted look. The tongue has changed its yellow or white coating to one which has a brown streak down the centre, the edges of the organ still remaining red. All the exhalations and discharges from the patient are exceedingly offensive. The teeth are covered with sordes having an offensive odor. The breath is fetid. The stools are yellowish or dark, and are horribly putrid. The urine and sweat are both offensive. So you see Baptisia applies to cases in which there is an evident decomposition of vital fluids and rapid disintegration of tissue.
To give Baptisia its legitimate position among other typhoid remedies, it will be necessary to compare it with those nearest like it in symptomatology. The first of these remedies to which I shall call your attention is GELSEMIUM. This usually precedes Baptisia when there are malaise, and muscular soreness, and the patient suffers from chills and crawls, which go down the back. This is on the first day, remember. In the afternoon comes the fever with accelerated pulse, this pulse being full and flowing, not tense and not resisting as under Aconite. The fever is usually associated with drowsiness; the face is uniformly suffused red, and there may even be prostration thus early in the case. Gelsemium causes pains of the motor nerves, hence there must be weakness of the muscles. By the next afternoon you may change to Baptisia, if the fever rises in the afternoon, despite Gelsemium, and when the above-mentioned symptoms of Baptisia develop. The reason why I dwell on the relations of the two drugs is because of the great similarity in their symptoms. Both of them have this intense muscular soreness and prostration ; both have drowsiness and nervous excitement, with prostration ; both of them have this feeling of expansion, as though the head or some part of the body were enormously enlarged; and both of them have the afternoon exacerbation of the fever. The relation between the two drugs is one of degree, one of intensity. Gelsemium is the milder acting drug of the two.
Another remedy which is not unlike Baptisia is RHUS TOX. Like Baptisia, Rhus has restlessness, brown tongue and soreness of the muscles. I must confess that the distinction between the two remedies is not always easy. Formerly Rhus held undisputed sway in almost all. diseases which threatened to assume a typhoid type, whether the disease was diphtheria, scarlatina, peritonitis or pneumonia. Now this honor is shared with Baptisia. The main differences between the drugs, briefly given, are these : Rhus has restlessness, caused more by rheumatoid pains than by muscular soreness alone. The tongue, under Rhus, has a red, triangular tip, which is not noticed under Baptisia. Delirium is of a muttering character under Rhus, unaccompanied, so far as I know, by these delusions respecting personal identity. Neither are the putrid discharges of Rhus tox. quite so offensive as those of Baptisia. If diarrhoea progresses to a severe type under Rhus the stools are watery, sometimes bloody, and involuutary. The pneumonic symptoms which often complicate typhoid fever are more prominent under Rhus.
ARNICA claims a relationship to Baptisia. It is similar to the latter remedy in the stupor, in the intolerance of the bed (the patient complaining that it feels too hard), and in the falling asleep while answering questions. Arnica, I think, suits more when there is tendency to apoplectic congestion, when the stupor is so profound that both stool and urine are passed involuntarily. The intensity of the involvement of the brain is shown by the loud, snoring respiration. Then, too, in Arnica we find suggillations, sometimes called ecchymoses.
LACHESIS also comes forward as similar to Baptisia. You will recognize the resemblances between the remedies in the offensiveness of the discharges, in the putridity of the exhalations and in the excessive prostration. I think I have seen apparently hopeless cases react under the benign influence of this remedy. As an animal poison I think it is a deeper penetrating remedy than Baptisia, and, in consequence, should be called for in worse cases. It may be distinguished by the following symptoms: Trembling of the tongue when attempting to protrude it, or it catches on the teeth during the act. When he succeeds in getting it out it hangs there tremblingly, and he may not even have sense enough to take it in again. Haemorrhages are frequent in the Lachesis patient. Blood may escape from almost every orifice of the body. The lips crack and ooze a dark or blackish blood. Dark blood escapes from the bowels. This, after standing awhile, deposits a sediment which looks like charred straw. In severe cases there is marked intolerance to light pressure. Even when the sensorium appears to be perfectly benumbed the patient resists the slightest touch about the neck. In still worse cases, you have to separate it from Baptisia when there is approaching cerebral paralysis, dropping of the lower jaw and involuntary putrid discharges.
MURIATIC ACID bears some resemblance to Baptisia in the great prostration, in the decomposition of fluids and in the low form of delirium. But it seems to me that the general character of its symptoms is not sufficiently similar to those of the other remedy to make a distinction difficult. The Muriatic acid weakness is so great that the patient is unable to make the slight exertion required to maintain the head on the pillow, he therefore slides down to the foot of the bed.
Now a word about Baptisia in other diseases than typhoid fevers. In such affections it is indicated by the symptoms already mentioned. In dysentery you will give it when the discharges are offensive, and contain blood, and are attended by tenesmus, but with a significant absence of pain, showing an alarming depression of vitality.
Baptisia has proved itself one of our best remedies in diphtheria, when it has assumed a typhoid type. Some of the symptoms already mentioned will be present. The mouth is excessively putrid. The membrane is dark and exhibits a gangrenous tendency. Sometimes, early in the disease, you will observe this characteristic: The patient can only swallow liquids. Give him milk and he will drink it. Give him solid food and he rejects it at once.
AILANTHUS is to be compared with Baptisia in typhoid conditions, scarlatina and diphtheria. It produces an even more profound stupor than the latter remedy. There is a well-marked, excoriating, watery discharge from the nose, making the upper lip sore. The rash, if any exist, is of a livid purplish hue, thus denoting the poisoned state of the blood.
I hope now with this lecture you may be able to properly place Gelsemium, Baptisia, Rhus tox. and Lachesis in your mind as so many distinct pictures, which are to be brought up in times of necessity to be. used according to their symptoms and their applications.