DISEASE CLASSIFICATION: THE SYPHILITIC STIGMA, Continued by H.A. Roberts
Disease classification the Syphilitic Stigma Continued…
***IT has been said that the patient afflicted with the syphilitic taint suffers from structural changes; yet the emotional sphere in the purely syphilitic patient is not seriously affected. For this reason, in the syphilitic patient we find less subjective symptoms; there is little of the supersensitiveness, and less desires, cravings and longings than in the psoric patient. The syphilitic patient actually suffers much less than the psoric; the mental sphere has not been so much invaded, for the syphilitic stigma is not so thoroughly established through untold centuries of time as the psoric, and because it is not so thoroughly a part of the very essence of man’s spirit we have a far better chance to eradicate the dyscrasia.
The very earmarks of the various stigmata show their respective character. The psoric itches, and appears unclean, unwashed. The syphilitic ulcerate and the bony structure is changed. The sycotic infiltrates and is corroded by its discharges.
Psora is the stigma which shows little on the side of objective symptoms, but expresses itself through the mental and emotional reactions. For this reason the patient of a tubercular diathesis reflects many subjective symptoms in comparison with the purely syphilitic for, as has been pointed out before, the tubercular is the combination of the psoric and syphilitic. In this combination we find all the mental and emotional reactions, the subjective symptoms, of the predominant parent, psora, and the pathological and destructive changes of the younger parent, syphilis.
Syphilis alone has few cravings in the way of food; it is averse to meats, but aside from that negative symptom there is little that we note in the way of appetite. Compare that state with the tubercular cravings, which were pointed out in the last chapter.
The frequent, unsatisfied hunger; the craving for meat and potatoes when nothing else will satisfy; the craving for salt; craving for indigestible things; the inability to assimilate much starch; these marked symptoms of appetite show the psoric parentage of the tubercular diathesis.
In the syphilitic-psoric type we find the changes in the chest wall, which are structural changes is the bone contours. The chest wall is narrow and may be more shallow than normal; even the action of the diaphragm is limited. While there may be no structural changes in the lung itself, there is less air capacity and less residual air in the lung. The very structural changes eventually bring about occlusion of the air cells and the formation of foci, for these people are very poor breathers; the pumping power is so cramped that they are incapable of supplying sufficient oxygen for the body needs. This is shown in the anaemic and chlorotic conditions, as well as in the tubercular. The tuberculosis produces its destruction by first cramping the aeration of the red blood cell through the formation of the bony structure. Because breathing is a difficult process they become averse to fresh air, and will survive for a long time in a close, breathed-over atmosphere.
Long before tuberculosis develops, sometimes even years before, you may notice a symptom of the latent diathesis: on the least exposure to cold the patient develops a deep, hoarse cough. This will be repeated many, many times before there is actual development of the tuberculosis. The purely syphilitic patient has a short, barking cough; this is sometimes true of the early tubercular stages.
The tubercular expectoration is purulent, greenish yellow, often offensive; usually sweetish or salty to his taste. We can usually depend upon the salty or sweetish taste as being a characteristic of this dyscrasia.
There is the everlastingly tired feeling of the tubercular type; (the psoric is always ready to lie down); the tubercular patient is better in the daytime and worse as night comes on, showing the syphilitic influence. The syphilitic patients should be sun- worshippers in type, for they are always better during the daylight hours, and all conditions are worse at night. The tubercular people suffer from neuralgias, prosopalgias, sciaticas, insomnias, hysterias, and all the nervous symptoms peculiar to the diathesis. They may have for years persistent headaches; this may precede the actual tubercular development. Hysterical and other nervous symptoms often precede the tubercular manifestation, and when the lung condition improves the hysteria will return; when the hysteria improves the lung condition takes on renewed activity. Often a severe dysmenorrhoea will stay for a time the disease progress in the lung itself. In other words, the pre-tubercular manifestations are more psoric than syphilitic; but the structure predisposing to develop the lung condition is syphilitic.
When children cry out in their sleep we may take this to be an indication of the tubercular diathesis, which may take on a meningeal form when it develops. Look carefully to all night aggravations, especially in children, to see if they are not pre- tubercular indications.
The tubercular diathesis has many heart symptoms, showing the psoric parentage. There is much palpitation. In the psoric this is due to uterine or gastric irritations and disturbances; in the sycotic patients the heart manifestations are reflexes of rheumatic conditions. In the syphilitic and sycotic stigmata we find little mental disturbance accompanying the heart conditions, even when the conditions are critical; it is the psoric patient who worries about his heart condition and rarely succumbs to it. It is the syphilitic or sycotic patient who may have for years a slight dyspnoea and occasionally slight pains, or perhaps no symptoms at all, but they die suddenly and without warning.
In the tubercular, as in the psoric heart conditions, the patients want to keep still; they are much worse by higher altitudes; cannot climb stairs or ascend hiss; cannot breathe well on ascending; have not the proper amount of room for air. They have difficulty in descending. With this heart condition there is a cyanosis that is often painful. There is a gradual falling away in flesh in these conditions. The syphilitic dropsies and anasarcas are greater than the sycotic.
Lymphatic involvement of the abdomen is of tubercular origin, as are the hernias; the muscles lack tone.
Hereditary syphilitic troubles in children sometimes produce a very watery discharges that almost completely drains the system of its vital fluids and unless promptly corrected death ensues. The cholera infantum types of diarrhoea are syphilitic; we often find tubercular diarrhoeas which simulate the cholera infantum, but they do not as rapidly drain the system. In the tubercular diarrhoeas we find the worse in the night or the early morning, driving the patient out of bed, and worse by cold, showing the syphilitic relationship. The tubercular child often cannot assimilate cows’ milk in any form; the casein has to be modified before it can be digested at all. These are the children who have undigested curds in the loose stool.
There is a close relationship between the ability to take the lime salts from food and these diarrhoea of tubercular children; this is the reason for the difficult and irregular dentition and the craving for the elements which the body needs; they cannot assimilate the necessary elements from their food. The diarrhoeas of the syphilitic child who is strongly tainted with sycosis will probably call for some such remedy as Croton tig. or Sarsaparilla.
The tubercular stool is apt to be slimy, bloody, with a musty, mouldy smell; nausea and gagging before stools and prostration with a desire to be left alone after stools. Haemorrhages from the rectum are signposts of tuberculosis, although there are bleeding haemorrhoids in sycosis. Tubercular patients are troubled alternation of symptoms in the tubercular patient may be noted in the alternation of rectal diseases with heart, chest or lung troubles, especially in asthma or respiratory difficulties. Very often, operated or suppressed haemorrhoids will be followed by asthmatic manifestations, often accompanied by heart troubles.
In the rectum, strictures, sinuses, fistulas and pockets are all of tubercular origin, but these conditions are much more frequent and in much aggravated form when combined with the sycotic stigma. Cancerous manifestations of the rectum are a combination of the tubercular and sycotic; in other words, they are a manifestation of the combined destructive force of the three stigmata. Psora alone never reaches to pathological changes; yet without the psoric element malignancies will never develop.
In the urinary tract all of the stigmata may manifest themselves, but most frequently these manifestations are psoric and sycotic; here also the combined assault of all three stigmata are represented in the malignancies. The diabetic patient is as a rule strongly tubercular; sometimes in these conditions there is a strong taint of the sycotic, which makes the condition much more malignant. We never see marked tissue changes or fibrous growths without the presence of the three stigmata, although the tubercular and sycotic are represented in the majority of cases of Bright’s disease. While the psoric element is present in these conditions, it is not in as marked degree as the syphilitic and sycotic.
Nocturnal enuresis, with the worse during sleep and soon after falling asleep, are tubercular; and nightly emissions also are a combination of the syphilitic and psoric taints. Usually prostatic troubles may be classed under the union of these two stigmata.
Syphilis seldom attacks the ovaries or the uterus. In pathological conditions we occasionally find a manifestation of the tubercular diathesis, but this is because of the psoric affinity for functional and emotional disturbances and not because the syphilitic influence toward these organs.
The syphilitic stigma attacks the long bones; the growing pains of children are syphilitic, especially when worse at night, worse in storms or on change of weather. This stigma causes destruction of tissue partly because it hampers assimilation of the necessary elements, and we see the result in rickets of children; they cannot assimilate from their food what they require to make the bones sufficiently hard to support their weight without bending.
The nails of these patients are characteristic, being paper- thin, spoon-shaped and bending and tearing easily. Where the nails are irregular, brittle, break and split easily, and with many hangnails, this is an unfailing sign of the tubercular; these nails are also spotted, or with white specks, and scalloped edges. Felons about the nail are a manifestation of the combined effects of syphilis and psora, as are all periosteal affections.
The psoric-syphilitic patients cannot endure much cold, yet they cannot endure much heat; the heat from the stove may drive them from the room.
Chilblains are a combination of all the stigmata. Anyone who has endured the torments of this affliction can readily understand how willing these sufferers are to accept any from of treatment which promises some relief; yet a suppression of this manifestation brings in its train a succession of all sorts of nervous diseases and many other serious conditions, even to malignancies.
Corns and like hypertrophies are tubercular manifestations. Boils are usually psoric, but when there is much suppuration and pain it is usually a combination of the psoric and syphilitic manifestations. It is characteristic or psoric eruptions that they tend to dry down and scale off rather than to suppurate. However, the appearance of boils after the administration of the antipsoric remedy is a welcome and encouraging indication.
Children who have weak wrist and ankle joints, who have difficulty in holding on objects, who drop things easily, who are clumsy in getting about and stumble over a straw, are manifesting the effects of the combined syphilis and psora, for this combination affects the tendons about the joints by weakening them so that they will not stand the strain of much use.
As we naturally expect, there are a great many skin manifestations with the syphilitic miasms and in the tubercular dyscrasia. There are pustular eruptions which suppurate, and eruptions occur especially about the joints or in the flexures of the body. These eruptions are quite prone to arrange themselves in crescentic formation. In colour they are coppery or brownish, but sometime very red at the base of the pustules. The most striking characteristic of these syphilitic eruptions is that they do not itch, and there is very little soreness. If these eruptions progress to scaling and crusts, as they usually do, these are very thick and occur in patches or circumstances spots.
The gangrenes of the skin and dry gangrenes show the destructiveness of the syphilitic stigma.
Skin affections with glandular involvement are frequent.
Occasionally psoriasis shows itself. Psoriasis has been called the marriage of all the miasms, or stigmata, but its characteristics are predominantly psoric and sycotic. Another type of eruption where all the stigmata are present is the fishscale eruption. In this condition we have the dryness of psora, the squamous character of the syphilitic eruption and the moles and warts of sycosis.
Varicose veins are of tubercular origin. Varicose ulcers are the last destructive manifestation on the skin of the syphilitic taint. In this stigma, too, we see the ecchymoses and haemorrhagic conditions into the skin; purpureal conditions are all manifestations of the syphilitic taint.
Erysipelatous and carcinomatous conditions, epithelioma and lupus, are all manifestations of the union of the three stigmata. In acute exanthematous diseases we see the tubercular diathesis. These conditions show the psora in the severity of the attack, but the profound prostration from the lowered vitality is the mark of the syphilitic taint. Urticarias occur in the tubercular diathesis. Marked freckling is also a manifestation of the tubercular diathesis; this has the clear, almost transparent skin of the tubercular patient, with the pigmentation of the psoric. Impetigo will readily develop in the combination of the psoric and syphilitic stigmata, while those without this dyscrasia will not become infected.
We often find patients with slight wounds that heal very slowly or not at all; this condition is due to the union of the syphilitic and psoric influences. In this same category we may place the stitch abscesses which occur following operative measures, in hospitals and under the best of sanitary conditions.
We have spoken a great deal of the tubercular diathesis as being a combination of the syphilitic and psoric stigmata. The scrofulous diathesis is also a combination of these two stigmata, but it differs in the proportionate degree of the presence of the taints, and is further influence by the suppressive measures of crude drugging. Probably environment and circumstances have some bearing on it also. However, the suppression is a strong factor in its individual expression, because this has buried it deeper in the system.
The scrofulous diathesis manifests itself largely by the involvement of the glandular system, particularly the lymphatics. While many authorities have classed scrofula as psoric, its relation may be traced by its manifestations. Psora has no glandular involvement, by syphilis has a particular affinity for glandular tissue. Scrofula has many symptoms in common with psora, but it has the same tendency to ulceration as syphilis; the relationship may be seen also in the purulent discharges and decomposition of the exudations. Scrofula has the same tendency as syphilis to locate in the organs of the special senses, such as the eyes, ears, nose, lips, etc. The pernicious anaemia of the scrofulous patient resembles very closely the syphilitic parent, and shows its kinship to the tubercular diathesis.