At the annual meeting of the International Hahnemannian Association in 1888, William P. Wesselhœft presented a paper entitled Aloe Socotrina, an Anti-psoric Remedy.[1] This paper (which is recommended reading) can be found in the Homœopathic Physician section of ReferenceWorks and starts with the following sentence from Hering: “Aloes has many symptoms like Sulphur and is equally important in chronic diseases with abdominal plethora.” In it Wesselhœft reports the cure of a number of patients with chronic diseases following the administration of Aloe, which was selected on account of the chronic intestinal or hemorrhoidal complaints. The interesting aspect of these cases is the reappearance of a previously suppressed skin eruption. Despite of being relatively well proven, Wesselhœft noticed that Aloe will “clear away a number of other psoric symptoms not yet contained in its pathogenesis.”
Two years later there appeared another most interesting paper on Aloe by Dr. Jekyll entitled Aloes.[2] To quote:
For a long time I have considered that Aloes was the most valuable remedy in the whole materia medica with which to commence the treatment of most of the chronic diseases that come into our hands, and especially those that came from the hands of the “regulars,” where a wholesale drugging had taken place and the symptoms were so obscured that it was impossible to separate the disease symptoms from those of the drugs that had been already administered; or in those cases, where the disease had been suppressed by improper doses, or by the profuse use of external applications.
Some thirty years since in a conversation with several physicians, whose names I cannot now recall (and perhaps it would be improper to give them if I could), I made the above remarks, and I well remember that my assertions were well poohed at by them and that I held my peace for the time being; but I still continued to watch the action of the drug, and let me here say that it has seldom disappointed me when administered in any of such of the above cases.
If you will carefully go over the symptoms of Aloes you will find that it has a vast number of symptoms in common with almost every drug in the Materia Medica; besides many that it has cured that are not recorded in any Materia Medica that I have seen, and I have examined everyone that has been published in the English language; or at least have tried to do so.
Where or when this idea fastened itself upon me is more than I can now tell, and it has been acted upon accordingly, to the best of my ability.
In the examination of cases where eruptions have been suppressed or driven from the surface by improper dosing or the use of external applications, you will find many Aloes symptoms are produced, and if Aloes be administered, it will cause to assume, more or less, its original form and can then be treated as the original; or it will so far clear up the case and symptoms, so that the proper simillimum may be selected for the complete cure. In other words it will relieve the oppressed vital organs, so that they can rally and throw off, to a certain extent, the oppression, which had taken possession of the vitality of the patient, together with the drug symptoms, and clear up the case, so that the proper simillimum may be selected for the complete cure of the case, which would have been impossible to have done in the first place, on account of the then muddled up condition of the drug and disease symptoms which could have been elicited from the patient.
Perhaps I could not better illustrate the matter than to give a few of the cases that have come into my hands for treatment.
Jekyll goes on to describe three instances where Aloe cleared up the case for another remedy. To quote one of his cases:
Some ten years ago, Mr. ___ came to me; he was about twenty years of age, rather tall and slim, light complexion, light brown hair; had an old look; poor and scrawny; was cross and snappish; complained of great lassitude, hard work to move; ill humored, dissatisfied with himself and everything around him; vertigo, especially when looking up, as if everything was in a whirl; dull, heavy, stupid headache, more in the forehead and over the eyes; dimness and flittering before the eyes, very sensitive to any noise, the hearing of music, the play of children, the talking of persons would almost set him wild; very gloomy and despondent, thought that life was hardly worth living; metallic, sticky taste in the mouth; yellowish ulcers on the tongue and in bucal cavity; no appetite except for fruits or knick-knacks, which caused an oppression of the stomach, with acrid, bitter belching of gas from the stomach, loose acrid stool with the passage of large quantity of gas soon after eating, with urging; restless sleep with vivid, frightful dreams; offensive sweat under the arms, in the groins and about the genitals; a hoarse, husky voice; chilly feeling in the open air; cutting pains in the upper portion of the right lung and in the lower portion of the left, with a gripping sensation in the region of the spleen; enlargement of the joints, very painful at the change of the weather, especially if damp, which made him very despondent and gloomy; said that he felt that he was certain to hear some bad news; scary and fearful, did not like to be left alone for fear that something dreadful would happen to him; skin was dry and harsh; a slight bruise or scratch would take a long time to heal, and if of any size was sure to ulcerate, with fearful itching and burning; lips, face and hands chap and the skin cracks as soon as cold weather sets in, with fearful smarting and burning – a sensation which covered all of the exposed parts of the body.
I soon elicited that when about six years old, he had a very bad case of itch, which was treated with large doses of sulphur; sulphur and molasses internally, a teaspoonful twice a day, and sulphur and lard as an ointment, which was applied every other day, or rather at night; this was kept up until some time after the eruption had all disappeared.
He said that he had never been well since he had the itch, that he had been in the hands of a great many physicians and none of them had done him the least good; in fact, his mother said that he was getting worse every day, could anyone wonder at it?
I gave him seven doses of Aloes 1 M, to be taken one dose just before bedtime, and to report as soon as the powders were all used. He returned in a week. There was but very little change except that his mother said that she believed that he had a little better appetite. He got seven doses of Sacarrhum lactis and to report when used. At the third call there were symptoms of the eruption making its appearance.
Another seven powders of Saccharum lactis was given, and upon the fourth call he had as nice a case of itch as you would wish to see; he said that he itched from head to foot; that he could not keep still one moment, and the more he scratched the worse he was. Otherwise his health was better; had a very good appetite; did not feel so gloomy; felt more like living if he could get rid of that infernal itching.
He now got one dose of Sulphur 1 M, and Saccharum lactis to last him for one month. Before that time the eruption had all disappeared. He then got one dose of Sulphur 10 M and Saccharum lactis for another month. This was all the medicine he got, and in about one year he had entirely recovered his health, and has remained well from that time to this.
Dr. Jekyll proceeds with two similar cases and ends his articles by saying, “I think that these cases are sufficient to establish the values of Aloes; if not, I can give any number of a like character.” The main difference between the cases of Drs. Wesselhœft and Jekyll is that Jekyll completed the cure of his patients by prescribing another remedy after the appearance of the skin eruptions. It was Sulphur in the first case and Pulsatilla and Nitricum acidum for his second and third cases, respectively. On the other hand, Wesselhœft often noticed that no other remedy than Aloe was necessary to complete the cure even after the appearance of the previously suppressed skin eruptions. A case by Dr. L. Whiting illustrates Wesselhœft’s point, that when Aloe is indicated in an acute or subacute complaint, which often happens to be diarrhea, it will often also be the chronic remedy: “Mrs. ____, age forty. Morning diarrhea for many years past, comes on every morning after arising and continuing till 10 A.M. Stools yellowish, thin, fecal, accompanied by much flatus, and an immediate irrepressible desire for stool; can not delay one minute. Aloe 30 was prescribed for the case, a powder dry on tongue night and morning. Having taken only four doses of the Aloe, the stool became of normal consistency, and the case became one of scabies over the entire body. Upon enquiry it was ascertained that she had the itch when about ten years of age, and that it was treated by inunction of sulphur and lard, and she was of the opinion that the diarrhea had been her constant companion since about that time, a period of thirty years. She received no further medicine and in three days time the power of the drug that had produced the scabies had also effected a cure of the same, with no return of diarrhea.”[3]
However no routine assumption should replace careful observation and strict individualization. Whether the case should be cured with Aloe alone or with the help of a complementary remedy, as illustrated in the following case of Wesselhœft presented two years after his original paper, cannot be a routine decision:
H. B. A., aged twenty-seven. Blonde, thin, active. For a year troubled with diarrhea. Always has a loose, watery stool at seven A.M. A second stool may follow any time during the day—early evening, forenoon, or afternoon. The stools are very urgent, often nothing but a little sputter with much flatus; is obliged to run to the closet as soon as he feels the desire, as he has but little power to retain stool.
Much rumbling of wind in abdomen after going to bed. Usually awakens an hour after going to bed with palpitation of heart; after passing flatus goes to sleep and rests easily the remainder of the night. At night he can pass flatus with confidence, which he could not do during the day. All the flatus he passes is hot.
Free discharge of prostatic fluid after stool. Constant sensation of soreness in lower abdomen, over os pubis, not sensitive to pressure. Tongue clean, appetite very good.
He affirms that he has been well all his life up to a year ago. When a boy he had tinea ciliaris.
Now, what bothered this young man more than anything was the discharge of prostatic fluid after the stool, and that is what he came to be “doctored for.” We all know that such a solitary symptom will give us no indication for a remedy, and if I had known as much as I do now about this symptom thirty years ago it would have saved me much trouble and often anxiety. In every instance I should have made this symptom a secondary and not a primary indication, no matter what the wishes of my patients might have been. Instead of trying all the remedies enumerated under the head of discharge of prostatic fluid during stool, I should have worked at other more important features of the case. But how often is the young physician misled by the patient’s mind, and especially if he comes with a diagnosis already concocted by some celebrity which aids and abets the fears of the patient?
The diarrhea with the characteristic weakness of the sphincter, which would not allow him at any time, except in the night, to pass flatus, the flatus always being hot when passed; the clean tongue and good appetite led me to give him a dose of Aloes CM.
In a fortnight he came back with the following story:
One formed stool a day for the last ten days. No urgency. Passes flatus with confidence and is not hot. Has slept well every night, no palpitation. Very little prostatic fluid has passed.
Reappearance of sick headaches, of which he had two violent ones during the fortnight. These have been absent for over a year and were treated by Bromo-caffeine.
Now consider for a moment my astonishment when my patient told me that he has always suffered from sick headaches up to the time his other troubles commenced! I gave Sacarrhum lactis.
A fortnight later came the following report:
Stools have remained perfectly normal. No discharge of prostatic fluid for two weeks. Soreness in lower abdomen over region of bladder entirely gone. During the fortnight has had four severe headaches with nausea but no vomiting. Gets very faint at stomach every morning about ten o’clock—another old symptom which accompanied his former sick headaches. Just forty days after the dose of Aloes he received a dose of Sulphur CM.
Three weeks later he reports:
No headache to speak of. One or two attempts at one, but not severe enough to keep him from work. His stools remain normal. Is troubled a little with flatulence that has easy and confident egress [exit]. Has gained four pounds during the last three weeks. Is discharged cured.[4]
Now let’s examine a few more cases.
An Autistic Child with Recurrent Diarrhea
I will present this case in full detail and with most of the follow-up visits, as the evolution of its cure is a very interesting one. This is the case of M. D., a mentally retarded 9 1/2-year-old boy, whom I first saw on May 14, 1997. The chief complaint was chronic diarrhea. M. D. was born with complete agenesis of the corpus callosum, one of only two cases ever diagnosed in Canada. There was no given prognosis. He also had severe dysmorphic myopia (-21 diopters), strabismus, hyperflexibility of his ligaments, cryptorchidism and cardiac malformation with aortic regurgitation (Marfan’s syndrome which is also very rare as he was one of two cases with this type of cardiac anomalies to be diagnosed in Canada). He was completely limp at birth.
M. D. had been completely absorbed within himself. He never answered any questions. It was impossible to know anything such as emotions, feelings or what he experienced except for the basic needs of life. He showed almost complete lack of reaction to his surroundings, including situations that would cause pain. He had cried fewer than 20 times in his life and only in situations where there was an incredible amount of pain. He blocked his ears and closed his eyes when spoken to. He always spoke with a very low voice, almost like whispering. He was totally obstinate. He would do nothing unless it was what he wanted to do. He was mentally retarded except for auditory and visual memory for which he was two years ahead of his age group. He learned how to read and calculate in a few days when he was 9 years old. He stopped growing on three different occasions. He had not grown in 1 1/2 years when I saw him and was three years behind on the growth chart.
He had been having 6-8 episodes of diarrhea per day. The diarrhea started 10 months after the parents separated two years ago. It was more severe at first, with 12-14 episodes per day. He tested negative for celiac disease and for the presence of blood. Psychiatrists treated him to no avail. Dietary changes helped at first, but benefits lasted only 3-4 weeks. He often became dehydrated. The diarrhea was only by day, worse from 11 A.M. to 3 P.M. (1) and especially worse between 12:30 P.M. and 1:45 P.M. (2). It was always the same: a watery, yellow brown, offensive diarrhea followed by albuminous mucous (like the white of an egg). It was so explosive that it hit the walls and the ceiling of the bathroom. It sputtered out by little shots of gas. Just prior to an episode he became totally distended (3) “like a child with marasmus” with a round hard abdomen and gurgling (2). He had to be in diapers as he had involuntary stools on a daily basis. It was a very offensive diarrhea (3). There seemed to be no other circumstances that would trigger the diarrhea except stress.
His parents separated in July of 1994 due to the father’s having an affair. M. D. didn’t show any reaction to the separation. From December of 1994 until March of 1995 the father threatened the family and pursued them “like in the movies,” which ended with the intervention of police who arrested him in March of 1995. The entire family lived in fear for their lives; policemen would accompany them on outings. M. D. developed diarrhea in April of 1995, which was worse on school days and much worse during hot weather (3). He had had diarrhea during hot weather since birth. The diarrhea was also worse after corn (3), wheat (2) and broccoli (1). It was unknown whether the diarrhea was painful.
M. D. had no physical or mental endurance. He became tired very easily from slight physical exertion such as walking. He was often found resting, lying on his abdomen with his two hands between his thighs and in the last 6 months, he preferred to lie on his back with his hands under his head and knees bent. He was restless while sitting. He preferred to raise his legs if sitting or even kneel on the chair if he could, which calmed him down. When tired, he became pale and rubbed his forehead. He also became very tired with any mental effort (3).
M. D. had many peculiar idiosyncrasies. He always wanted to be first: to enter the car, to climb the stairs, to enter school. He had an aversion to having his head washed. In fact, he would not let his head be washed. He also had a great fear of having his hair cut. Eventually, when his hair really needed to be cut, he would develop diarrhea. For the past two years, he couldn’t have his penis touched, even by himself. He didn’t laughed until he was about 6 years old. From infancy, the palms of his hands would peel for a period of two weeks, then there would be a pause of one or two weeks, then it would start again. He had an aversion to round food: grapes, round candies, etc. He rolled paper a lot. He had been falling asleep with the blanket over his head for the last year. He loved animals. He startled easily (2, and sensitive to sharp and low noise. If angry, which happened 3-4 times in his life, he would grind his teeth and pinch, but could not express a word. He rarely experienced pain. He very much needed routine (3): i.e., if a toy was used it needed to go back to where it belonged, or if a little box was used to put horses in, it could not be used for other animals. For general orderliness he was, however, normal. On the other hand, he was very meticulous in many other things: i.e., he had difficulty writing anything and then erased it 10-20 times; if one of his socks fell down, he had to lift it to where it belonged; he had to wear a T-shirt under his shirt. He had a history of having nightmares that were always related to the ocean and waves. He had never had a cold, flu or any other common infection except for one episode of otitis media two years ago. When pregnant with him, his mother was sure that something was not normal in his head.
The family’s life was completely compromised. Because of M. D.’s diarrhea the family could not leave the house for common outings.
Generalities:
Temperature: If he overdressed in the morning and the day became warm, he would not remove his clothes. He couldn’t breath in cold air (2) or if there was wind (3), even in summer. He got frostbite easily. He did not react to hot and cold water when being washed. He had an aversion to the sun (2), which tired him. He always sought the shade. He had an aversion to the heat of the summer, spending his time in the basement. His neck and head perspired during the entire night, but he never perspired while awake, even if it was very hot. Only his ears became red.
Energy: He was more tired after lunch, around 1-2 P.M. (2).
Sleep: He went to bed at 7:30 P.M. and slept until 5:45 A.M. He was very restless in his sleep, and would grind his teeth almost every night for the last 4 or 5 years. He never uncovered himself in sleep.
Appetite: He had a poor appetite. There were only a few foods that he would eat: pasta, chocolate, sweets, ice cream and cheese. Other foods he liked a lot were eggs, cucumber and soups. Thirst: he used to be a big drinker before the diarrhea. He preferred his drinks at room temperature.
Personality: He feared wolves and heights (3), after going up three steps he would panic. He feared going downhill (2). He was claustrophobic (2). He had an aversion to being touched (1), to being caressed (1), to being massaged (1), to being buckled in the car (1) and of crowds. He was very sensitive to admonition. If scolded, he would punish his mother by saying “no.” If he was sad he would not accept consolation. He was mildly jealous. He had never been violent or destructive. He was sympathetic (2): he seemed to suffer more than the ones that were hurt. He was very sensitive to the emotions of others (2).
Objective symptoms: M. D. was completely different from any child I had ever seen. He walked, moved and acted as if from another world. He wore thick glasses. He acted as if I was not present. He repeated many times during the interview “go.” His mother would say, “When the doctor is finished asking questions we will go home.” He would again say, “go.” He was lean and had a very enlarged, round and hard abdomen like a balloon (3). He couldn’t protrude his tongue and couldn’t lick. Every 4-6 months, plugs of wax had to be removed from his ears. Ht.: 130.5 cm (51.5 “). Wt.: 26.25 kg (57.75 lb.). He was very hairy, especially on his back. On auscultation of his heart, we could hear a distinct double S2 every fourth beat.
Current medication: M. D. had been slightly better since taking China 30 CH once a day for the last month, which another practitioner had prescribed.
Case analysis: We had a 9 1/2-year-old boy born with many congenital anomalies and a type of autism with many idiosyncrasies. What was most characteristic was the recurrent diarrhea that he had since birth and which was much worse during hot weather. Other characteristic symptoms were the perspiration of the cervical area and head all night, every night of his life, and his difficulty breathing in the wind—which I somewhat downplayed as it could have been related to his physical anomalies. Other peculiar symptoms that he had were the grinding teeth in sleep, amelioration from raising his legs, his weak and cautious nature, fear in high places, emaciation with an enlarged abdomen, his stubbornness and his food desires for ice cream and cheese. All these add up to a very good indication for Calcarea carbonica—better than any other remedy as the simillimum.
Plan: As the child had been under the care of another practitioner prior to our visit and had been taking until then China 30 C once a day, I decided to stop the China and wait until there was no further change. The mother would then give him one dose of Calcarea carbonica 10 M (Hahnemann Pharmacy).
June 2, 1997: He took the remedy at 8 A.M. on May 24. By 2 P.M. he had an aggravation of the diarrhea. He was passing transparent gelatinous stool with much white froth (ROS)* for the first 3 days, followed by his typical diarrhea. The following four days he woke at 5:15 A.M. with abdominal pain, urging for stool and passing only gas. On the third day after the remedy he became more affectionate; he started inquiring about the well-being of others for the first time in his life. The day before, he developed a coryza for the first time of his life. A colleague at the office saw him and on examination found bilateral otitis media. He had the exact same manifestation of otitis media two years ago. During the exam of his ears he said “Ouch!” (Such reaction to this level of pain was new). He also cooperated during the exam, which was new. He had a 99.6 °F temperature. His forehead was warm with cold hands and feet. His face was red and congested. His eyes were half closed and injected. He was very quiet.
Assessment: The initial reaction to the remedy seemed favorable as there was an aggravation of the diarrhea, a return of old symptoms, an improvement in his general disposition and the appearance of a first coryza. The picture of the acute condition was clearly indicating Belladonna with the characteristic symptoms of a congested face, hot head and cold extremities, quiet disposition with the eyes half open and injected.
Plan: My colleague prescribed Belladonna 200 D (Dunham) two doses: one now and one at bedtime.
June 4, 1997: By the next morning he was mostly recovered. His ears, appetite, energy and color were back to normal.
Assessment: Favorable reaction to Belladonna.
Plan: Wait.
July 2, 1997: On June 5 the coryza returned without any fever and lasted for 4-5 days. The diarrhea and bloating disappeared completely from June 7-17 and then relapsed exactly like before. He had changed overall. After Calcarea carbonica, he improved mentally until about two weeks ago. He was now stable. He now was calmer and happier, “quite remarkably.” He inquired about death every day in the last week for the first time in his life. He developed growing pains in the last week (his sister was also subject to growing pains). For the last three weeks, he complained of headaches for the first time in his life, as the temperature had been warmer—in the mid 80’s. The most we could get from him was that he felt them in his forehead and they were worse from light. Since Calcarea carbonica he had started to bend double during stools with both hands on the floor, moaning. The incontinence of stool happened about three times a day. Since one week he had been hiding from strangers. Since Calcarea carbonica his nose was itchy up to 25-30 times per day and he was sneezing for the first time in his life, around 3:30-4 P.M. everyday. He insisted that all windows and doors be closed, and panicked with open windows in the car. He wanted to hide more. He covered his head more, i.e., if he went to the pool he put a towel over his head. He let other people touch him (new). The peeling of his hands, perspiration at night, stubbornness, low voice, being startled at noise, teeth grinding in sleep, and perfectionism were unchanged. A few days before he got his hand caught in a door and didn’t complain of any pain, although he should have. He grew 5/8 of an inch since the first visit, which was the first sign of growth in over 1 1/2 years.
Assessment: The reaction to the remedy was good, not great. However, there were enough good changes, especially on the mental/emotional level, but also with the return of old conditions (the white frothy mucous and the ear infection) and increased stature, to warrant another dose of the remedy. One thing was clear: M. D. was sensitive to remedies. So far he had received three different remedies (China, Calcarea carbonica and Belladonna) and had responded positively to all three of them. This enhanced his prognosis but was also a signal that he would likely respond to any remedy with a certain degree of similarity to his case. Therefore, one had to pay great attention to the direction of cure to assure that the remedy to which he was responding had a high degree of similarity.
Plan: Another dose of Calcarea carbonica 10 M was prescribed.
August 5, 1997: The diarrhea got worse after the remedy like after the first dose, but it was a bit different: “It comes out in one shot: like a cork.” Since July 23 he asked for the first time to take a bath and let his hair be washed. He stopped inquiring about death. For the first time in his life he was willful. Since the very hot weather the diarrhea had been much worse. He still had loud rumbling before stool. The sneezing, peeling of the hands and perfectionism were gone. The grinding of the teeth was worse. The headaches, perspiration at night, itching nose, startling easily were unchanged. He cried loudly for the first time in his life.
Assessment: Calcarea carbonica was not the best remedy in this case even though the child made some progress on the mental level. The fact that the diarrhea in hot weather not only did not improve, but got worse under Calcarea carbonica, was a sign that its degree of similarity was not high enough. I started to look for a remedy with a higher level of similarity and studied the case anew.
While taking the initial case I had considered Aloe as it covered so well the picture of the diarrhea, but dropped it as it didn’t cover the rest of the case—especially some of the very peculiar symptoms mentioned earlier which indicated Calcarea carbonica. But, as the diarrhea was now clearly worse and aggravated in hot weather and characterized by this loud rumbling prior to the stool I again strongly considered Aloe. Moreover, after the first dose of Calcarea carbonica there was a return of the transparent gelatinous stool with much white froth which is very similar to frog spawn found under Aloe. At that point two prior cases of Aloe which I had successfully treated came to mind and I became convinced that Aloe had to the simillimum of the case.
To illustrate, I will temporarily interrupt M. D.’s case to present these two other cases. The first one is not complete in all its detail, as his file could not be retrieved. It was the case of young man about 18 years old whom I saw about ten years prior to M. D. He had a history of cryptorchidism and came to me after having been treated about 18 months previously with surgery and chemotherapy for testicular carcinoma. He had had diarrhea ever since chemotherapy. He presented the typical diarrhea of Aloe, which resolved it quickly. Following Aloe, I treated him successfully with Argentum nitricum for his chronic state. But the most interesting aspect of this case, which I recalled when considering a better remedy for M. D., was that this patient had a long history of great need for routine with aversion to change as well as cycles of fixations. For instance, when he was a child, he ate the same food three times per day for long periods of time and nothing else. Then, he would switch to another food three times per day and leave aside completely the previous one. If he had a project he would focus obsessively on it to the exclusion of almost everything else, until it would be replaced by another project. He was also overly meticulous in every minute aspect of his projects.
The second case which came to mind when I was considering a better remedy for M. D. follows in greater detail. In August of 1993, a homeopath called me from a hospital where T. P., her 20-year-old son, was being treated with chemotherapy for testicular carcinoma. Her son had been very sick since receiving chemotherapy, and after trying different remedies she was seeking my help. The history of T. P. was as follows: About five weeks earlier, T. P. started experiencing pain in his left testicle and kidney area. In the second week of July he noticed that his left testicle was enlarged and had hardened. T. P. also had a history of cryptorchidism. On July 27 he was operated on and was diagnosed with embryonic testicular carcinoma, which had already spread to the abdominal lymph nodes and the lungs. He started to receive chemotherapy on August 4. He got progressively sicker after the first chemotherapy, experiencing nausea, vomiting, weakness, diarrhea, faintness and abdominal cramping.
The presenting symptoms were burning and heat from the mouth to the rectum. His mouth was completely covered with Candida albicans. He had a fever of 101.7° F (38.7° C) and a pulse rate of 100. He experienced great weakness. He was not thirsty (usually he was very thirsty). He had been having diarrhea every 1/2-1 hour. His abdomen became hot and gurgled with cramps before each stool, which was a watery, yellow brown, lienteric diarrhea with “a sweet and sour smell (like a baby diarrhea).” The cramps, heat and gurgling in the abdomen were relieved by stool or flatus. He passed a great quantity of sputtering gas during each stool, and felt weak afterwards. Sometimes he did not recognize that he was passing a stool. He constantly felt a small ball in the rectum, and had a small hemorrhoid. He was chilly (1), his lips were chapped (2) and his mouth was dry (2) with a bitter taste. His tongue had a thick white coating. He had had no appetite for four days. His skin was sore (2). He was cool to the touch with the fever (2), and his face was cold and clammy (2). He was hypersensitive to jar (2) and to noise (2), which created “an electric shock” throughout his body. In general, he felt better in the morning and after 10:30-11 P.M. (1). He felt worse from 4-11 P.M. (2). He was intolerant of people especially if they made noise or jarred his bed. He never wants any visitors (previously he was very gregarious). He turned his head away when his girlfriend picked up his hand or if his mother wanted to kiss him. His oncologist and gastroenterologist thought that he had developed an intestinal infection, but all the cultures had been negative. T. P.’s mother had typhoid fever when she was eight months pregnant and T. P. was treated for active typhoid soon after birth with the antibiotic Chloromycetin. He had developed mycotic infections everywhere on his skin, mouth and throat.
Case analysis: T. P. was presenting a perfect picture of Aloe with heat and gurgling before stool, sputtering of the flatus, unconscious passing of stool, ball in the rectum and especially his tendency to “repel everyone.”
Plan: Aloe 200 C one dose.
1 P.M. or two hours after the remedy: T.P. felt better. He experienced a sense of well being very soon after taking the remedy that descended from above down. Since the remedy, T. P. had one small semi-solid stool and no diarrhea. The cramps were much less. He was very hungry. He was irritable and had a headache from hunger, which was common for him. His energy was better, 1-2 (0). He was not permitted to eat.
Assessment: He had a very good reaction to Aloe. The new symptoms of irritability and headache with hunger are characteristic of Sulphur, the only known complementary remedy of Aloe.
Plan: Sulphur 200 C.
August 12, 1993 at 4 P.M.: His headache and the burning in the abdomen got worse immediately after the remedy. Then he felt better. The headache disappeared. His energy was up to 5. He had not eaten yet. He had four small stools since the remedy. The gurgling and the flatus were much less. The burning from the mouth to the rectum was reduced by 20 %. The abdomen was not hot anymore. He had been very thirsty since the Sulphur. The hemorrhoid was better.
Assessment: He had a favorable reaction to Sulphur, with an immediate aggravation followed by a good improvement.
Plan: Wait.
August 12 at 7 P.M.: He had four large, watery stools in 2 hours. He was weak again, down to 2. There was a lot of gas. The hunger disappeared. His palate and throat were dry without thirst (2). The hemorrhoid began to bleed.
Assessment: Relapse of the original condition.
Plan: Aloe 200 C.
August 12 at 9 P.M.: He fell asleep soon after taking the remedy and had no stool afterwards.
Assessment: Good reaction to the remedy.
Plan: Wait and repeat the remedy at the first sign of a relapse.
August 13 at 10:30 A.M.: During the night he experienced diarrhea at 2:30 A.M. and three more times after waking up at 7:30 A.M. He took one dose of the remedy after each diarrhea. He had almost no pain or gurgling. He felt quite well.
August 13 at 4 P.M.: He passed a small, formed stool at 12 noon. His energy was up to 7. He had no headache. The temperature was normal. He had been eating well since that morning. The gastroenterologist did not know what happened; he planned to do a sigmoidoscopy but upon finding that his patient was so improved, he cancelled it. T. P. told him that he had taken some homeopathic remedies. The gastroenterologist wanted to know the name of the remedy, and was essentially relieved to know that his patient was better. In the afternoon, the chemotherapy was resumed.
August 14 at 10 P.M.: The Candida albicans came back right away after the chemotherapy (part of it was Bleomycin, which is a powerful antibiotic). He had a fever of 100.8 F° (38.2° C). His eyes burned (2) each time he experienced the fever. He had no diarrhea but a formed stool about every 6 hours. He was very thirsty for cold drinks. Before the fever he experienced chills going down his back. His energy was good (6-7) but he became very weak within a minute after standing up (3).
Assessment: The burning eyes with the fever, weakness worse standing, the return of the thirst and the descending chills indicated Sulphur.
Plan: Sulphur 200 C.
He responded well to Sulphur and continued to do so for several months afterwards. The interesting aspect of these two Aloe cases is that both of them had a history of cryptorchidism, testicular carcinoma and both had developed a similar severe diarrheal reaction to chemotherapy, which clearly indicated Aloe. Now, when looking at M. D.’s case and acknowledging that Calcarea carbonica was not his remedy, I wondered, could this be a case of Aloe? With the history of cryptorchidism of M. D., the typical Aloe diarrhea and the need for routine, I sensed that Aloe was not only the acute but also the chronic remedy for M. D. I therefore prescribed Aloe 1 M (Borneman) to M. D. on August 5, 1997 and was looking forward to his reaction to the remedy.
August 13, 1997: After the remedy he was happier. This stool became dramatically better the next day for three days. Then he developed a flu for the first time in his life. He had a relapse of the diarrhea and another dose of the remedy was given on August 9 which had no effect, except for a large evacuation of white froth.
Assessment: The fact that he relapsed so quickly and that there were no changes with the second dose would typically not be seen as a favorable response. However, remembering the cases of Jekyll where he repeated Aloe 1 M several times before he open them, I still felt that Aloe was the most similar remedy and I needed to persist.
Plan: Repeat Aloe 1 M up to three times within the next twenty-four hours. If there is an obvious reaction to the first or second dose do not give the subsequent dose(s).
August 26, 1997: Three doses of the remedy were given. He became very tired for the first 6 days after the last dose. The mother said that she had forgotten to mention that at least once a day the gurgling prior to stools was so intense that it made a similar sound as the drain of a very noisy toilet bowl and since the first dose of Aloe it had happened only three times. He was even happier than before. His energy returned to his usual low normal. He stopped being startled at noise. He felt pain and really cried on one occasion.
Assessment: A clear aggravation followed by an improvement on the mental/emotional level was a good sign.
Plan: Wait.
September 16, 1997: He did very well until 6 days ago when school started; he refused to go and once he cried in his mother’s arms. The diarrhea with the bloating, involuntary stools and abdominal pain completely relapsed. He did not want to get dressed anymore.
Assessment: Relapse with the stress of returning to school.
Plan: Repeat Aloe 1 M now and at the first sign of relapse.
September 24, 1997: He was dramatically better. The diarrhea stopped right away. His energy was much better after September 17. On September 18, he developed another cold with much discharge and sneezing, day and night. The foam reappeared again for one day. Personality-wise, he opened up. He began addressing others spontaneously. He was less self-absorbed. He was more demanding about his needs. He was more present. He stopped grinding his teeth and sweating at night for the first time. The bloating was gone.
Assessment: Excellent reaction to the remedy.
Plan: Wait. Repeat Aloe 1 M as needed.
November 19, 1997: On October 1, he had a relapse of the diarrhea, self-absorbed personality, bloating, peeling of the hands, covering his head, grinding his teeth, loud gurgling before stools, refusal to dress or go to school. He became silent. He didn’t want to talk or eat. The remedy was repeated on October 3. The next day he developed a cold with much discharge and sneezing which lasted only 24 hours. Again, he had the white frothy mucous in his stool on the first day. Then he was much better. The stool became formed and only once a day. His appetite returned. He was able to eat any food, even milk, without problems. He was much more expressive and was 50 % less self-absorbed. He asked to go play outside (never before) and laughed regularly with other kids (also never before). His self-confidence was much better. He was crying 2-3 times a week. It was only since the summer that he had really started to cry. He was fine in crowds. The fear of going down hill was gone. His hair could be cut without any fuss. He could be touched except in the genital area. He stopped being willful. He had no headaches. He had the coryza with sneezing at least once per week. He wrote better, but reading was still difficult. He still had poor stamina and resistance. He was stressed the week of November 8 at school and relapsed. He started again to sleep on his abdomen with his hands between his thighs.
Assessment: The fact that the response to the same potency is better with each subsequent dose is a sign that the degree of similarity is high.
Plan: Aloe 1 M now and repeat after 3-4 days of relapse, or if he is stable for 1-2 weeks.
January 19, 1998: He received six more doses of Aloe 1 M. He developed a cold and passed white foam for one day after each dose. Within 12 hours his stools became normal, his energy picked up and he became more like a normal child, e.g., wanting to play outside. If stressed, he regressed and if the mother waited before repeating the remedy, he continued to regress further. In general, he was much happier. He slept well from 8:30 P.M. until 8:30 A.M. (7:30 P.M. – 5:45 A.M., before). He became more independent. For the first time in his life, he used a public washroom by himself. He had only one normally formed stool per day unless he had a relapse. He accomplished all his chores perfectly. He never complained of headaches. He had coryza even more often than before, which excoriated his lips. He touched his penis after a bath the day after a dose on November 19. His mother still could not touch him there. The peeling of his hands relapsed only with the diarrhea. The white foam was present only if he took the remedy. He had no sweat at night. He slept again on his back with his hands under his head, knees flexed. He wept and laughed loudly quite often. Routine was less important. His lack of stamina was gone and he had the energy of a normal child. He spoke in sentences. During the year prior to the treatment, he would say “that” or “milk,” after the treatment he would say, “Can I have some milk, please?” He was 70 % less self-absorbed. He was reading and writing better. He did not grind his teeth anymore. He reacted normally to hot and cold. Wt.: 61 (57.75) lb. Ht.: 52 3/4 (51.5) inches.
Assessment: Same.
Plan: Continue the same.
March 16, 1998: On February 3 he had a relapse. He took the remedy. He had the coryza, then recovered and was well for only five days. The mother gave him by mistake Calcarea 10 M. It was interesting to note that there was absolutely no reaction or change following the Calcarea carbonica with the exception of chewing in his sleep (new). She waited one week, repeated Aloe 1 M and he was better again. His personality and intellectual skills improved further. He did not cry much anymore but became angry instead and expressed it spontaneously. Wt.: 63 lb. Ht.: 53 1/8.
Assessment: Chewing in sleep is a symptom of Calcarea carbonica.Despite continued improvement with Aloe 1 M, I wanted to seeif he would makea quantum leap with a higher potency.
Plan: Aloe 10 M (Boiron) as needed with the diarrhea.
May 11, 1998: He received one dose of the remedy. He started kissing his mother spontaneously. He was very polite and considerate of others. He played like a normal child. He was less self-absorbed. Routine was not important anymore. He chewed less in sleep. He was stronger physically. He appeared like a normal boy of his age. He had more self-confidence. The perspiration on his head and cervical region at night had returned in the last two weeks. He had a mild relapse in the last three days. His hair became fuller—it used to be very thin and fine. Wt: 62 lb. Ht.: 53 3/4.
Assessment: The fact that he reacted so well and so long to the higher potency was another sign that Aloe had a high degree of similarity.
Plan: One dose of Aloe 10 M.
Summary of the Case from May 1998 until March 2000: This summary was obtained by phone from the mother on March 28, 2000. She reported that M. D. was given three more doses of Aloe 10 M, followed by about eight doses of Aloe 50 M potency (Homeoden) from the end of 1998 until September 1999. At this time he changed schools and started to relapse. He was given four doses of the CM potency (Homeoden), viz., in September, October and December 1999 and the last dose on January 23, 2000. The remedy was given at the first sign of relapse, which was the reappearance of flatulence, abdominal pain and incontinence of mucus from the rectum. He had been very good over this period. His mother noticed that with the first sign of a relapse he asked for pasta, cereals, sweets, milk or chocolate. In 1998, he cried a lot but starting the summer of 1999 he was always happy, rarely sad, played like other kids outside, was very stable emotionally, expressed his needs appropriately, had no more fixations, ate everything, laughed a lot and made others laugh, was more present with other people, e.g., inquiring about others. Overall, his mother said that he was developing normally.
June 12, 2000:
I saw him in the office for the first time since May 1998. This time he shook my hand when I greeted them in the waiting room. He walked into my office asking me questions about myself.
I found out that with no apparent stress he had stool incontinence on March 30. He received another dose of Aloe CM and recovered the next day. On April 11, he was stressed. He became tired, developed a coryza and redness around the lips. His mother gave him another dose of CM. He recovered again within a day. On May 30 he was greatly stressed. He immediately developed frothy stools, with much crying and coryza. He received another dose of CM. He cried for three more days and his stools returned to normal within three days. He was now back to normal according to his mother.
I reviewed the case with the mother. The ability to touch his penis was mostly normal. The need for routine was gone, except for breakfast when he wanted the TV on. He was more talkative. He slept from 7:30 P.M. until 5:30-6:00 A.M. She said that his energy was better but still not as much as his peers. She put it at 6 on a scale of 0-10. The mother noticed that as soon as he relapsed he would sleep on his abdomen with his hands between his thighs, or on his back with his hands under or above his head, and with his head covered. Before homeopathic treatment he was at about a 2. He still tended to be lethargic, but had more stamina. He could walk up to 10-15 minutes before needing to sit. His abdomen was not enlarged unless he was stressed. He was doing very well in school.
He recently developed a new symptom. He had become a perfectionist in making sure that chairs and other such pieces of furniture were in their place, or that doors of closets, cabinets or rooms were closed.
Assessment: He was much better but his energy was still too low. He would likely benefit from the DM potency. As we did not have it, I decided to continue with the CM potency.
Plan: Aloe CM at the first signs of relapse such as fatigue with the return of the above food cravings, or changes in sleep position.
August 2, 2000:
He took three more doses of Aloe CM, June 12, July 7 and 14. His stools remained normal and never relapsed. He stayed up longer and slept more normal hours, viz., 8:45 P.M. until 6:45 A.M. For the first time, he had started to be jealous and possessive. For instance, he refused to share his toys and would cry if asked to. His energy was the same at 6 out of 10 but his stamina was better as he could walk 25-30 minutes. He was still lethargic. He was less cooperative. The perfectionism had become much worse. Instead of doing closing doors and replacing chairs 25 times a day it was up to 100 times a day.
Assessment: He stopped progressing with the CM.
Plan: Aloe DM (Homeoden) now and no repetition.
August 30, 2000:
There were no apparent changes until August 7 through August 9. During these three days he had an aversion to water. He craved milk “all day” and drank up to two liters per day. On August 8, he had a sore abdomen for 45 minutes followed by one bout of diarrhea. On August 9, he was better in general but had one episode of involuntary urination. From then on he started to improve.
The perfectionism regarding chairs and doors was much reduced, down to approximately 10 from a 100 times each day. He had two nights (August 14 and 28) with no sleep (return of an old symptom). The most dramatic improvement with this dose was the change in his speech. He spoke much more. For the first time he called his mother “Mama.” His voice was warmer and more emotional, which was new. His energy was much better. His lethargy was gone. His stools were normal with the exception of that one occasion. His jealousy and possessiveness stopped about two weeks after the remedy. He had had a bicycle for three years but never wanted to ride it. For the first time, he spontaneously decided to ride it. Also, two weeks after the remedy he became much more cooperative. And for the first time he looked forward to going to school in September. He had developed a new behavior by refusing to wear pyjamas to sleep.
Assessment: Excellent reaction with an aggravation followed by great improvement.
Plan: Wait and repeat only with a clear and prolonged relapse.
December 20, 2000:
He had not needed any more remedy. Around November 20 he had a bad cold and a mini relapse of his symptoms but recovered quickly without a dose of the remedy. He had no diarrhea despite a major stress during the previous two weeks; his brother had been hospitalized which created a lot of change in the family routine.
He became much more social. He went to a winter camp, which went very well. He made a friend for the first time and they played together on a regular basis. He had a period in November where he was stammering but it had disappeared. The perfectionism with furniture and doors was almost all gone. He agreed to wear his pajamas to sleep. However, he had had five nights without sleep since the last visit. He had not been lethargic. He could walk for two hours. His bedtime hours remained normal. He continued bicycling. For years he craved pasta. It was now gone for the first time, for a month. His teachers were very positive about his progress in school. They said that he had improved in mathematics. In October he developed a new behavior; when disappointed, he pulled on others’ clothes. He had no skin peeling of his extremities.
He was checked three times that year for his cardiac anomaly (Marfan’s syndrome). The cardiologists were surprised at how stable he was and how much slower the progress of the heart deterioration was in his case. A psychiatrist who specialized in autism evaluated him; M. D. was definitively diagnosed as being autistic. The mother was told that M. D. had a phenomenal memory. He was slow in certain faculties but faster in others. She was told that he was highly skilled in drawing and painting in spite of his visual handicap. He was scheduled to receive a more complete evaluation the next summer.
I reviewed with the mother some of the original symptoms. The shortness of breath when walking in the wind had been gone for at least one year. The nightmare with water and waves had not returned since the first year of treatment; however, M. D. had a great fear of drowning (3) while taking swimming lessons. The tendency towards frostbite had been gone for about two years. The fear of heights had been gone for about nine months. His aversion to being touched or massaged was less. His sensitivity to the sun had been gone since at least last summer. He was still sensitive to the heat of the summer, but much less so than before. He still had headaches on hot summer days, but fewer and less troublesome than before. He would still rub his forehead and become lethargic, and could not do much intellectual work with these headaches. He had been accepting consolation for over one year, but recently cried when consoled. He had had no problem using public washrooms for at least one year. His sympathy for the suffering of others was unchanged. The wax in his ears had been much less.
Objective symptoms: Ht: 58″ (147 1/2 cm) Weight 81 3/4 lbs. (37.15 kg). During these 3 1/2 years, he grew 6 1/2 inches or 16 cm and gained 24 pounds or 10.9 kg.
Assessment: He was still improving.
Plan: Wait and repeat only if there is a clear and prolonged relapse or if he stops improving for two or three weeks in a row.
Overall assessment:
From the use of Aloe over a period of about 3 1/2 years this boy has developed into a new state of health in all respects. This case confirms the deep “action” of Aloe as mentioned earlier by Hering, Wesselhœft and Jekyll. Even though some cases of Aloe need to be followed by a complementary remedy as in my previous cases or in the cases of Dr. Jekyll, it is warranted to better understand the chronic and often more obscure symptoms of Aloe to know when Aloe would indeed cover the entire case. Regarding the acute bilateral ear infection he developed after the first dose of Calcarea carbonica, in hindsight, it is very likely that it also would have been cured by Aloe. In the provings, we find all the symptoms of acute otitis media. I have since seen a few more cases where Aloe has demonstrated the same depth of “action” and I will summarize two of these cases help solidify the picture of Aloe in the mind of the reader.
Two More Cases of Aloe Characterized by Fixations
The first one is the case of S. P., a 22-year-old woman, suffering from many complaints including severe allergies since the age of ten, and depression. S. P. had also been diagnosed with chronic fatigue syndrome (CFS) and attention deficit disorder (ADD). I saw S. P. on July 4, 1998. She reacted to many foods such as dairy, wheat, corn, rice, shellfish and eggs, and to preservatives and dyes. Within 1/2 hour of eating an allergen she would become physically tired, very lethargic, irritable, annoying and sleepy. She would develop a headache and her nose became obstructed and would run. An allergic reaction would last about 24 hours. Soon after eating the allergen she felt so sleepy that she had to go to sleep. She then slept easily 12 hours straight, woke up and felt tired for another 1/2 day. These allergic reactions were worse in rainy weather (1) and much worse if exposed to molds (2) like during fall and spring. Since 1993, she had hay fever with asthma worse from spring to fall. Her nose was obstructed especially on waking (2), her nose would run, her eyes were red and would lachrymate and she had swelling under her eyes. The allergies were worse if she did not receive her desensitizing injections on a weekly to every-other week basis.
She felt depleted of energy in the morning upon waking and then she had low periods at 12 P.M. (1), 4 P.M. (3), and 7 P.M. (1). She got a “second wind” between 8:30 P.M. and bedtime. When tired she had to take a two-hour nap and would wake up still tired.
In 1995, she was doing poorly in college; a peer gave her some Ritalin and she improved dramatically. She took Ritalin (20 mg per day) on school days ever since. Without Ritalin she was more loquacious, more nervous, more irritable, (“really impatient: I can’t wait at a red light”), more tired, more lethargic, with a poor attention span and more hyperactivity. “I lose interest very easily because of my impatience. I have played piano for 18 years but I can’t sit down to practice more than 45 minutes. On the other hand I tend to be very patient with people and children. I can also be very intolerant of certain people.” She did everything fast. “I walk fast. I drive fast. I talk fast (2) worse without Ritalin. I stutter when tired.”
She had been very depressed for a long time, but it had been much worse in the last two years. “I just sit by myself and I don’t want to do anything and see anyone. I am not thinking about anything. I just shut down as if asleep but I am aware.” The depression came periodically about every other month and lasted about three weeks. Whether she took Ritalin or not made no difference. She didn’t like changes. “I feel more comfortable when things don’t change. At 10 years old I didn’t want to move. I was adamant about not moving. For example, now I don’t want to go home from college because I don’t want to deal with new things. I am scared of new things. I can obsess about things. I can listen to the same movie (The Sound of Music) or read the same book (Little Women) 15 to 30 times. I go through phases where I love to read books. Then I will switch to watching movies all day.”
For many years, she had the tendency to eat the same food 2-3 times a day for 3 consecutive weeks, then would switch to another food and so on. For instance, she would eat only Chinese food for 3 weeks, then she would only eat chicken wings for three weeks, then switch to deli, then to hot dogs, etc. “I do the same thing with my friends. I hang out with a certain girl everyday for three weeks then I change to someone else. I also like to wear the same clothes everyday for a long time. I have been wearing black clothes all the time for the last 10 years. I can do research, or play on the computer, or search the Internet for hours on end. I am very particular about TV programs; I just like certain ones. I still suck my thumb. I don’t like reality very much. I don’t like confrontation. I can’t deal with it. I would rather walk away than argue. I am very irresponsible about bills. I am too lazy to balance my checkbook. I want instant gratification. I enjoy food, cars, clothes and vacation. I am stressed all the time. I am very tense about being clean, with my hands, with my apartment. I take a shower twice a day. I vacuum my apartment once during the day and once at night at 3 A.M. before going to bed. I can’t stand looking at a mess. I can’t study in a room that is not perfectly clean. Inside the drawers it is a mess but I am too lazy to deal with that. When the place is a mess it makes me feel not clean and the apartment not clean. I always lived in very clean places. I tend to be very lazy. I tend to procrastinate and lie about it. It is easier to say that I have already done it and not do it. When I play tennis I don’t run for the ball, I let the ball come to me. I like to put things off till the last minute. I am always late. I work better under the crunch. I can only do things under pressure. The only reason I do things is because I am pushed to do things.” Indolence (3).
She also complained about having a problem with money. “If I want something I just buy it. I have no self control.” In general, she enjoyed her friends but when she experienced bad moods she preferred to avoid them. “I don’t want to interact with others. It is rude.” She did not trust people easily. “I was told that I was a snob.” She liked to talk on the phone. She liked gadgets, such as computers. “I like to know about everything, for instance, what is a good play in New York City.” She had a very good memory. “I can remember in detail, like I can picture circumstances that happened when I was five years old. I also remember a lot of stupid facts, i.e., a movie. As a kid I used to memorize commercials on TV. I also remember license plates without trying.”
“I am a control freak. I don’t go on roller coasters because I am not in control. For the same reason I don’t roller blade. I would never eat anything from a street vendor.” She was afraid of the dark until she was 18 years old. “I must sleep with the closets closed. I can’t watch anything scary (2).” She was afraid of germs (2). “I can’t share an apartment because roommates are not careful. When I leave home I always bring my own blankets. I hate sleeping in hotels because of the dirtiness of the blankets. It used to be worse.” She had never slept outside in a tent. She had never had a baby doll. She liked to take pictures. She liked to cook. She played with her hair or her mother’s hair since childhood. She tended to overpack when she left the house. “I bring something for every type of weather, yet I wear the same thing when I go away.”
Generalities:
Temperature: She felt hot all the time. She was hot and sweaty when nobody else felt so. She felt better in colder weather and worse in warm, wet weather (2). When hot, her forehead and feet would sweat, but nothing in between. She had more difficulty waking up in the morning if it was cloudy outside. She loved the sun. If she was not too impatient she could sit in it for a long time, even all day long, especially with music, but only if she was on vacation.
Energy: 3-4. Her energy increased after 8:30 PM.
Sleep: She could only sleep in a very cold room but with a lot of blankets. She would sleep long: from 3 A.M. until 4 P.M. If she was a passenger in a car she always slept from the moment she got in. She tended to talk and grind her teeth in sleep (2). She would sweat on her neck and whole head every time she took a nap. She slept with lots of covers. Her dreams continued from one night to the next.
Appetite: She could eat constantly or not eat at all. It went in cycles. The craving for food also came in cycles. When she craved a certain food she would wake up in the morning wanting that food and she would eat it at every meal for the next 2-3 weeks. The food cravings always changed. She was worse from beer (2). She became full and bloated and had eructations from it. She was usually constipated unless she took Ritalin. But if she ate dairy or fast foods she developed a liquid diarrhea within 1/2-1 hour. It first started as a pain in the right side and was quickly followed by a watery, yellow brown diarrhea. At home she got it about 1-2 times per week and in college about 4 times per week.
Thirst: She was always thirsty. As a teenager she drank only Coke, then for years she switched to Sprite. Now she only drank water. Each time she ate she needed to drink. She drank 3-4 glasses of liquid with each meal or snack.
Menses: Her menses were regular every five weeks, with cramps the first day only. She described herself as being prudish in terms of sexual behavior as compared to her friends.
Sensitivities: She loved all types of music, from opera to rap. She said she was not touchy in her feelings like her friends. She did not cry at movies when others cried. She felt indifferent when someone suffered, except those close to her. She hated horror movies.
Fears and anxieties: She said that she had a lot of fears and phobias. She said that she was very attached to her parents. “I cry every time my parents travel because I have fear of the plane. I always have the feeling I am going to die in the plane. I have a lot of fears.” She was afraid of heights (2), even climbing a small ladder. After cutting herself at 11 years of age, she had fear of knives for the following 6 years. She worried a lot about the future (3). “I feel very insecure. I always worry about what people think of me. I don’t want to do things because I don’t want to fail.” Her self-confidence went up and down. She had to sleep with the doors locked. She feared that the stove was not off if she was the last one to leave the house. When she left the house she would unplug every apparatus, check that all doors and windows were closed, that the stove was off and that the garage door was locked. She feared that the house would burn when she left. At 3 A.M. she would get up and check again that everything was locked. “I check that the car is locked. It is always locked. I have to check otherwise I can’t sleep. I need to be in control.” She would not swim in the ocean, as she feared the fish in it. “I think it is dirty.” She feared loosing her parents. “They have cared for me.”
Trauma: The most traumatic event in her life was moving at 10 years of age. “Ever since I have done poorly. I was used to certain things and everything changed.”
Stress: As college was about to finish and she had only one semester to complete, she needed to find a job and an apartment, but felt too lazy to do it.
Medications: She took Claritin for her allergies, Ritalin while in school, Motrin for menstrual cramps and weekly desensitizing injections.
Objective symptoms: Her skin was slightly oily. She had acne along the jaw line, which was worse before her menses and after eating sweets. Her hands were hot to the touch. She said that they were swollen in the morning. Her eyes were injected.
Her parents described her as introverted. She avoided emotional communication even with her mother. She tended to be addicted to a certain stereotypic repetition of activity. They said that S. was a very bright person and used to have high grades in school until the age of 10, when she began receiving low grades in school. She was a very happy child until she was 10 years old, when her mother started to work at her father’s office. She was transferred to a private school, which was full of mold. That was when she developed the allergies and her many other symptoms started. Her sleep had always been very light. Before falling asleep she would twirl her hair and before she would twirl her mother’s hair. She still sucked her thumb in sleep. She often complained of headaches, which grew worse from strong odors and tobacco. She was indecisive: she wanted others to make decisions for her. All her fears were minimized when her parents were nearby. Insect bites produced great swelling and inflammation for many days. Since infancy she would fall asleep while riding in a car. She had frequent nosebleeds. She had diarrhea when she started eating solid food at 7 months old.
Assessment: This case was not difficult to diagnose with the great number of characteristic symptoms pointing to Aloe. We had a hot patient who was aggravated from heat and preferred cold weather with great laziness alternating with activity, aversion to change, fixations in cycles, watery, yellow-brownish diarrhea, great thirst during meals and worse from beer and cloudy weather.
Plan: Aloe 200 C (Borneman).
She took seven doses of Aloe 200 C (Borneman), six doses of 10 M, one dose of 50 M and two doses of CM over a period of about 1 1/2 years. She would first experience an aggravation of most of her symptoms after a dose, especially at first, which was followed by an improvement. Her energy became normal at a steady 9 all day. The anxiety, depression and ADD disappeared very quickly, as did the food cravings, asthma, epitaxis, headaches, warm hands, feeling too hot, procrastination and fixations. The difficulty waking on cloudy days disappeared. The bowel movements became normal. Only the allergies did not resolve but the patient stopped her homeopathic treatment with me after postponing her scheduled appointment on three different occasions. She said that she was doing well and would eventually do an appointment. Her father was an allergist who was practicing homeopathy. She would also consult him. What is important to note in this case is that the rare. peculiar and unusual symptoms of the aversion to change with cycles of fixations, the great laziness alternating with activity and the heat are again being confirmed under Aloe.
Now let’s look at the case of B.M., a seven year old boy with Duchenne muscular dystrophy whom I saw on May 3, 2000. B. M.’s most peculiar symptom was a great aversion to change and the desire for routine. Things had to be done always in the same order. For instance, activity during the day had to follow the same order. If he undressed, clothes always had to be removed in the same order. Foods always had to be presented in the same way, i.e., if the cheese was not cut in a certain way he would have a fit. Other characteristic symptoms were perfectionism, i.e., he explained everything in the most minute detail, great tiredness and lethargy from waking until 11 A.M. but increased energy in the evening, sighing all the time as if everything was an effort, great irresolution about trifles, great heat and aversion to and aggravation from heat, aversion to bathing, great desire for fruits and apple juice, daily loose diarrhea, stubbornness, offended easily, overly sensitive to pain, tendency to be too affectionate, sensitivity to admonition and the desire for being fanned. In a period of 10 months B.M. received three doses of Aloe 200 C (Borneman), four doses of Aloe 1 M (Standard) and seven doses of Aloe 10 M (Standard). The aversion to change, perfectionism, lethargy, fatigue in the morning, diarrhea, sighing, aversion to bathing, irresolution, heat, being too affectionate and desire for fruits all disappeared. He eventually stopped falling when previously he would fall 2-3 times per week. He walked and ran better and longer, and climbed stairs better. The aversion to change, lethargy and heat were again confirmations for and characteristic indications of Aloe.
The Materia Medica of Aloe
Aloe socotrina grows naturally on the shores of the Island of Socotra located in the Indian Ocean south of the Arabian Peninsula. It was known in ancient times as a holy medicament against melancholy. Alexander the Great sent colonists to the Island of Socotra just to cultivate the plant. It was a so rare and precious plant that it was given as a present from sultans to kings. The part used as a medicine is the resin that freely flows out of its leaf when cut. It is recognized not only by its color but also by its sweet smell and very bitter taste. Hering told the story of how he obtained a “stolen” piece of Aloe for his proving: “I went to a druggist in Philadelphia by the name of Morris to buy some Aloes. He showed me two kinds. I told him that both of them were adulterations. He sent his boy out to all the drug stores in town for more samples. An immense heap of Aloes was collected, all of them bogus. The druggist was chagrined. He sent to New York for more samples. I came to examine this large assortment but did not find a single genuine specimen among them. At last I noticed that the druggist held back a small package, carefully wrapped in paper, which he did not seem willing to show me. I asked to see it. He handed it over, smiled as I said: ‘This is genuine Aloes. Where did you get it?’ He confessed that he had stolen it from a collection in the Academy of Pharmacy, of which he was a trustee. The sample had been brought into the country by an expedition that had sailed around the world and had received the specimen from the Sultan of Muscat, who grew the plant from which the substance is derived. When you break a piece of Aloes the fracture must show a fiery red, almost purplish, golden tint, almost transparent. The adulterated specimens were boiled in certain oils to such a degree that they made the paper, in which they came, greasy.”[5]
Aloe was first proven by German homeopaths in the early 1820’s and 1830’s and one of them was under the guidance of Hahnemann. Hering and other American physicians completed its proving in the 1840’s and 1850’s. Hering first published the materia medica of Aloe in 1857 in the Amerikanische Arzneiprufungen (American Provings) which was translated by T. F. Allen and published in the American Homœopathic Review in 1863 and reprinted in ReferenceWorks.
There is an interesting anecdote from Edmund Carleton recalling his first meeting with Hering who prescribed him Aloe: “I remember, as if it were but yesterday, the first time we met. It was in his office as physician and patient. He stood and looked at me calmly, while I related my symptoms. Then, silently turning to his desk, he prepared three powders and handed them to me, with directions. I left him in wonder, for my case had troubled the physician who had sent me, and I had expected a long search. The remedy produced a violent aggravation, and I recollect that wonder temporarily gave place to a state of mind akin to resentment. Recovery followed, and so did my promised report to the doctor. The recital of the success of his prescription caused his face to smile all over, which ended with a hearty, genial laugh, and he said, ‘that was A-lo-es; it was low; it was the five hundredth.’ Then seating himself and motioning me to a chair, he went on to relate how he had suffered similarly when proving the drug, and made me promise to write out and give to him a history of the case, which I afterwards did, and informed me that the medicine had been potentized for him by Doctor Fincke, from a choice bit of crude material furnished by himself.”[6]
The main known effect of Aloe is on the intestines and rectum and characterized by its profuse, watery, gushing diarrhea. Diarrhea will often be the chief presenting complaint of the patient and its characteristic symptoms will lead the conscientious prescriber to study Aloe.
Now, let’s first describe the characteristic symptoms of the diarrhea of Aloe: Typically, it is a profuse, yellow brownish, watery diarrhea containing lumps; it can be lumps with mucus or lumps of mucus jelly. It can look like frog spawn, or it can be mixed with blood and typically associated with great rumbling, gurgling and passing of a large quantity of loud sputtering gas.
The diarrhea can be felt coming minutes or even hours before. There is a great rumbling before. At times patients can feel the bolus traveling in the guts and then eventually filling the rectum. The rectum seems full of liquid, which feels as if it would fall out. That is when they develop their most peculiar symptom, which consists of insecurity of the rectum; they don’t feel that they will be able to contain the diarrhea. The rectum seems full of liquid, which feels heavy, as if it would fall out. In old books, we can find the expression, “Want of confidence in sphincter ani.” P. P. Wells wrote about this symptom that “it is oftener then otherwise described, by those who suffer it, as a feeling of ‘uncertainty’—meaning that they are not sure they shall not be attacked by diarrhea any minute—and that they feel just as though they would be.”[7] They cannot pass gas or urinate without stool escaping. The stool can also be passed unnoticed.
At times they can also have a great urge for stool but only flatus is emitted. As Dunham well said, Aloe “strikes the patient equally between wind and water.” The flatus tends to be hot, offensive and with heat and burning of the rectum. At first they will have to hurry to the toilet especially immediately on eating or drinking, but eventually they will lose control. The stool will pass when walking or standing, especially after eating. Involuntary stool can go unnoticed, or there can be an involuntary stool at night in bed in a constipated person; even in children you will find a large solid stool. A hard stool can drop out without causing the least sensation.
Other characteristics are that before the stool there is a great amount of distention, gurgling and heat in the abdomen. The heat is both subjective and objective and feels like the pelvis is filled with hot water. It can also be accompanied by pain before and during stool. The pain is a pinching, cutting, twisting and gripping type of pain, forcing the patient to sit bent, which relieves. It is worse from jarring when sitting in a chair or lying in bed, and is relieved by stool.
During the stool the patient feels a violent tenesmus and there is much flatulency which is offensive smelling, and burning with heat of the rectum and anus especially if there is a hemorrhoid. The abdomen is relieved but the patient feels an extreme weakness, prostration and faintness with clamminess or even profuse perspiration.
Let’s look at its most characteristic modalities of the diarrhea, which could help to confirm Aloe:
The diarrhea is worse:
. As soon as he eats or drinks anything (he must hurry to the bathroom).
. Rising from lying.
. Standing.
. Motion.
. Walking.
. Morning: driving out of bed in the early morning, 5- 10 a.m.
. Evening.
. Becoming overheated.
. Hot weather.
. Damp weather: both hot humid and cold damp (also mentally worse in cloudy weather).
. Acidic foods, fruits and milk.
. After chagrin (anger).
. From suppressed skin eruptions.
. From chemotherapy.
As the diarrhea becomes more chronic the patient will develop hemorrhoids which will protrude like a bundle of grapes after the stool. These hemorrhoids will create a constant bearing down in the rectum. They tend to bleed and be sore and are characteristically better with cold water and very sore upon wiping after stool. There is a tendency for the rectum to constantly secrete mucus, which escapes from the anus. There may be a peculiar sensation in the pelvis, a feeling as if a plug was wedged between the symphysis pubis and coccyx, which becomes worse with urging for stool. This sensation could be related to an affection of the prostate gland.
Let’s now go over some of the other symptoms of Aloe. Most important is its mental picture. In the acute state, the patient tends to be very sick and what is most remarkable is that it is not pleasant to be in his presence. Like Chamomilla, he is hard to please, becomes angry at nothing, and throws things when contradicted. He has “disgust with everything, dissatisfied and angry with himself, capricious, discouraged about his success. He is impatient and irritable. He curses, quarrels with everyone who contradicts him. He has aversion to company, cannot endure the visit of people. They are repugnant to him to the point of repelling everyone.” You will find this symptom under “hatred, repels everyone,” like one of the above-mentioned patients who turned his head away when his girlfriend picked up his hand or when his mother wanted to kiss him. Fear of men, anthropophobia.
Another very characteristic mental symptom of Aloe is its great laziness: “Disinclination to move. Disinclination to go into the open air, though there is relief from it. Indolence; at noon. Disinclination to mental labor. Speedy fatigue from mental labor. Incapacity for labor, with peevish restlessness, disinclination to mental labor.” He sits still, silent. A characteristic of this laziness is the possible alternation with great activity, as in one of the above patients. In the proving it is found under “Exhaustion alternating with activity.” Or it could be the opposite, such as excitement or the tendency to overwork. These are found in the proving under “Inclination to labor. Much inclination for continued labor. Especially inclined to mechanical labor. At an early hour, quick, complete awakening, with inclination for mental labor, good appetite. In the forenoon, he is much excited, works hastily and yet well. In the afternoon he works with a will, without a midday nap. Excited at night. Great restlessness and excitement. Inner restlessness and excitement. Excitement of mind and body.” The Aloe patient tends to get exhausted easily. He tires quickly. The mental symptoms are clearly worse during cloudy weather.
Another characteristic mental symptom is the aversion to change and the tendency for fixation and obsession as seen in three of the above cases. There is a monomania, which can last for some time and be replaced by another one. Cycles of fixations.
In terms of sensitivity he is very sensitive to jar especially with colic as seen in T. P.’s case. There is also a special sensitivity to noise or music. He can hate music and noise, which can set him off in a tremor, or he can feel it travelling his body like a shock wave (trembling from musical sound and noise) as seen in T. P.’s case. There can be great liking for music as in S. P.’s case. M. D. was startled at noise.
Another important characteristic symptom of Aloe is the heavy, confused dullness felt in the forehead associated with difficulty in thinking. It is worth reciting Dunham’s experience with Aloe. He reported that:
Among the remedies of which provings have been published within the last five years, none has seemed to me more deserving of attention than Aloes.
Among the symptoms of the head I am inclined to regard as characteristic of Aloes those which describe a heavy, confused dullness in the front part of the head extending to the root of the nose, with inability to think; a pain in the forehead which compels the patient to close the eyes, or, if he wishes to look at anything, to constringe the eyes, making the aperture of the lids very small. It must be admitted, however, that symptoms so similar to these are found under other remedies, that these symptoms alone could not be regarded as a sure indication for Aloes.
The following case will show how I have prescribed Aloes, and will suggest some reflections upon the mode of selecting remedies in practice.
During the winter season a gentleman, about seventy years of age, applied for relief from a dull, heavy frontal headache, which incapacitated him from mental labor. He could give me no more definite or characteristic description of his ailment. It was felt as soon as he waked, and lasted all day. From such a description as the above, it would be impossible to prescribe with any certainty of selecting the right remedy. I set myself therefore to investigate the patient’s previous history, in the hope of getting some help from the Anamnesis, to which Hahnemann and Boenninghausen attach so much importance. I learned that this headache was no new affliction. It had for years annoyed this gentleman, rather more during the winter season, whereas during the summer he was comparatively free from it. No peculiarity of diet or regimen could explain this fact.
On the other hand, I learned that during the summer season my patient was very frequently attacked with diarrhea, the disease coming on suddenly, waking him at two AM, with a pinching flatulent colic, and so urgent a call to evacuate the bowels that he would be compelled to seek the water-closet instantly, experiencing meanwhile the greatest difficulty in retaining the feces. From this time till ten AM he would have four or five stools, pappy, copious, light yellow, great difficulty in retaining the feces for even a moment after the desire for stool was first experienced. Desire for stool provoked by eating, so that he was compelled to leave the breakfast table. Involuntary stool when straining to pass water. When comparatively free from headache, he was inclined to diarrhea, and vice versa.
I have long been persuaded that a most important condition of success in the treatment of chronic diseases consists in the practitioner taking such a view of the case as shall combine the various ailments of which a chronic patient may complain at different periods of time and in different organs, even though these periods and organs be remote from each other and apparently disconnected. In no other way, it has sometimes seemed to me, could the characteristic indications of the remedy for such a case be found.
Acting upon this persuasion in the case in question, I regarded the headaches which predominated in winter and the diarrheas which predominated in summer as, in some sort, complementary series of symptoms, and as making up, both together, the “totality of symptoms” for which I was to seek, in the Materia Medica, the simillimum.
The symptoms of the headache—indeed of the entire winter affection— presented nothing that was characteristic of any one remedy to the exclusion of all others. Carbo vegetabilis, Sabadilla, Sulphur, Aloes, Nux vomica, and several others might be regarded as about equally well indicated.
When, however, to the head symptoms of the winter, I came to add the diarrhea symptoms of the summer, regarding the sum total as one disease, it was then impossible to avoid perceiving that the diarrhea symptoms were strikingly characteristic of Aloes, and could not indicate any other remedy. This furnished the clue to the prescription. On studying the head symptoms of Aloes, it was seen that they corresponded to the head symptoms of my patient quite as well as the symptoms of any other drug. Aloes 200 was given and it afforded a relief, which my patient had sought in vain from other remedies taken on the strength of the head symptoms alone. The headache returned a few times afterward with very much diminished severity, but yielded at once to Aloes. Lately my patient has been entirely free from it, nor did the diarrhea return as it used formerly to do whenever the headache ceased to prevail.[8]
About the heavy confused dullness, P. P. Wells wrote:
This drug has been found effectual repeatedly in removing a peculiar heavy, dull, pressing pain in the forehead, of no great severity, but which indisposes to, or even incapacitates for all exertion, especially for intellectual labor. This state of the head has appeared in the person of the writer, every year for the last ten or twelve, on the blossoming of the Ailanthus. He found no remedy for it, till he received the proving of Aloes, in Hering’s Amerikanische Arzneiprufungen.[9]
Other characteristic symptoms are dry mouth and dry, red lips usually without thirst, the desire for fruits especially apples or apple juice, juice or juicy foods, refreshing foods, beer, farinaceous foods, milk, stimulants, bitter, and salt.
Aloe will be indicated in uterine hemorrhage with a feeling of great heaviness in the pelvis (like the plug we referred to); the uterus always feels too heavy and engorged as if a hemorrhage would take place at any time. This feeling of heaviness of the pelvis can also be an indication for Aloe in a constipated subject. The same state occurs with the sphincter of the bladder as with the sphincter ani: on rising he is obliged to run quickly to urinate and can hardly retain the urine.
Some important generalities are: the sensation of heat worse from warmth, worse in warm wet weather, better from cool or cold weather, better cold application (head and anus), better open air, ailments from suppression and effects of drugs (it is interesting to note that Wells mentioned that Aloe is indicated in “hospital diarrhea”), worse in the morning and better in the evening, especially the energy and moods. It is interesting to read the abstract of the mental symptoms written by Hering in 1857 and realize how reliable the original provers of Aloe were: “Anguish and ebullition of the blood, vertigo, startings up, restlessness, fear, misanthropic, ill-humor, morose in cloudy weather, peevish toward himself, worse with pains, with suppression of the stool—better in the open air. Disinclined to labor, lassitude alternating with activity; good natured, self-contented; prattling and laughing children.”[10]
Differential Materia Medica
In acute cases of diarrhea, the remedy that will most often need to be differentiated from Aloe is Podophyllum, and often it will be very difficult to differentiate between these two remedies. It is therefore necessary to study carefully their similarities and differences.
Both have heat in the abdomen with full, bloated feeling, distention and the soreness of the abdomen, which are all relieved after stool. Both have a pressing out feeling. Podophyllum feels that the uterus will come out while urinating and that during a stool, all the internal organs will come out. Both can have prolapse of the rectum with diarrhea, however, it is more common with Podophyllum. Both can have involuntary stool in sleep or when passing flatus. Both have aggravation from motion, summer heat and after eating or drinking. Both can have profuse, watery, yellowish, gushing diarrhea. Podophyllum has a gush as from a fire hydrant. Both can have prostration after stool, though often more pronounced with Podophyllum as it can feel a profound prostration. The Podophyllum child can have a deathly look, very pale, as if he is going to die. Both can develop hemorrhoids with the diarrhea. Both can have offensive diarrhea. With Podophyllum it can smell like carrion. Both can have a morning aggravation, worse 5 A.M., and both can be driven out of bed. Both can have alternation of complaints like diarrhea alternating with headaches. Aloe has alternation of lassitude with great activity.
What are the main differences?
Aloe: Prominent with Aloe is the insecurity of the sphincter of the rectum. The bolus moves with great rumbling and when it reaches the rectum a weakness is felt. There is a feeling of not being able to hold the stool. The haste to go is therefore more prominent with Aloe because of this weakness. Aloe will also have a greater tendency to lose control and have involuntary stools, which is worse after soon eating or while walking. Aloe commonly has involuntary stool while urinating like Muriatic acid. The involuntary stools of Aloe can even happen with hard-formed stools and can even be unnoticed.
Another good differentiating symptom is the amount of flatus during diarrhea, which is definitely more pronounced in Aloe where it is characterized by a loud sputtering. Loud gurgling, as of water running out of a bottle, prior to passing stool or large amounts of gas is more characteristic of Aloe. The Aloe patient will characteristically pass hot flatus. Jelly-like stool is more characteristic of Aloe while Podophyllum’s is generally watery. It is more characteristic of Aloe for the diarrhea to be worse standing and/or walking. Aloe will tend to be hungry after every stool like Veratrum album while Podophyllum tends to have no appetite with the diarrhea.
Above all, the Aloe patient is a more unpleasant patient when acutely sick. Podophyllum is more depressed, he thinks he is going to die.
Podophyllum: The most characteristic symptom of the Podophyllum diarrhea is how profuse it is. You wonder where so much can come from. The profuse gushing stool of Podophyllum tends to be more changeable, in terms of the color. It can be yellow, green, white or black. It is changeable also in terms of the consistency. It can be watery, slimy, gelatinous, lienteric, bloody, pasty or naturally formed. The very offensive stool like carrion belongs to Podophyllum. Podophyllum can have empty retching with the diarrhea. The diarrhea of Podophyllum is worse during dentition, which is not found in Aloe. In this condition there is a desire to press the gums or teeth together. The sleep of Podophyllum tends to be more restless. He sleeps with his eyes half open, whining, moaning and rolling the head from side to side. However, both grind their teeth in sleep. The painless stool is more characteristic of Podophyllum. The hot flatus is not characteristic of Podophyllum, but instead it passes hot eructations.
Another remedy often needing to be differentiated from Aloe and Podophyllum in cases of acute diarrhea is Croton tiglium, which shares with them many characteristic symptoms such as the loud gurgling before the diarrhea followed by a profuse, yellow, watery stool which is aggravated by drinking, eating and motion. The most characteristic aspect of the stool of Croton tiglium is the explosiveness. It comes out like a sudden explosion, in like a shot all at once, in one violent gush like water from a hydrant. The aggravation of drinking (nursing in an infant) and eating is more intense in Croton tiglium and more characteristic of it. The gurgling before the stool can sound like a loud swashing of water. The diarrhea tends to be more painful in Croton tiglium, more griping pain and tenesmus. Other characteristic symptoms of Croton tiglium are the great pallor and weakness associated with faintness, vertigo, nausea, vomiting, dimness of vision, perspiration and coldness. Podophyllum can have vomiting preceding its diarrhea. The time aggravation is not very prominent in Croton tiglium. Aloe has most prominently the urgency with insecurity of the rectum, Podophyllum has the great quantity of stool and Croton tiglium has the explosiveness of its stool. Only Aloe, among these three remedies, will pass stool without noticing it.
The third remedy, which often must be differentiated with Aloe, is Sulphur but this time it is on the chronic level. Both share hundreds of similar symptoms. Both are hot remedies but Aloe is more intolerant of the heat. For instance, the diarrhea of Aloe is aggravated in the heat of the summer, which is not characteristic of Sulphur. However the great heat of the feet and the desire to uncover them especially at night is more characteristic of Sulphur. Both are driven out of bed in the morning 5 A.M. but it is more striking for Sulphur and less for Aloe. Both will desire apples, beer, farinaceous foods and salt but Sulphur will also tend to desire spices and sweets more prominently. The 11 A.M. aggravation is more characteristic of Sulphur. The aversion to change and the cycles of fixations are characteristic of Aloe. The great indolence and lassitude alternating with activity is also more characteristic of Aloe. Sulphur tends to be often hungry during the day and especially at 11 A.M., while Aloe tends to be most hungry after stool, as illustrated by the following case:
“Mary H., twenty-three years old, applied for treatment because she had a movement of the bowels after every meal. The trouble had existed for about six weeks. The stools were nearly normal in consistency and looked well digested. Always after eating and drinking, she must go to stool in hurry. She had no bowel movements, except immediately after eating and drinking. She suffered from an empty feeling after stool, and soon became hungry; but if food were eaten, she would be compelled in a few minutes to go to the closet.
Her tongue was a little narrow and covered with a light gray coat. Menses were regular and lasted five days, with backache and pain in the uterine region the first day.
She had lost considerable flesh and was getting uneasy, as the difficulty seemed persistent.
Two symptoms especially called my attention to Aloe; one was stool after eating and drinking, and the other was the desire to go to stool in a hurry. Desire for stool after each meal is especially found under Arsenicum album, China, Lycopodium, Podophyllum and Trombidium.
Under Aloe in the Guiding Symptoms, I found the following: “Hungry during the diarrhea; hungry after the morning stool” “As soon as he eats anything, he must go to stool” “Has to hurry to the closet immediately after eating and drinking.” Although hunger occurred in this case after every stool instead of after the morning stool only, I gave her on January 22, 1908, Aloe 1M, dry on the tongue, every night for a week.
Feb. 5, Reported that she was much better in every way. She did not feel so empty after stool and the hunger was nearly gone. As the case seemed at a standstill, the same medicine in the same potency was again prescribed, and in a short time all the symptoms disappeared, and she has not had any trouble since.”[11]
In Hering’s American Provings, Aloe contains over 1640 symptoms which the conscientious prescriber will profit from reviewing when the consideration of Aloe comes up in a case, as many characteristic symptoms not present in the above cases will be found there (see ReferenceWorks under American Homœopathic Review). Aloe calls to be rediscovered but also uncovered by continued clinical use. Many of the above cases have confirmed Hering’s, Wesselhœft’s and Jekyll’s observations, who have said, respectively, that “Aloes has many symptoms like Sulphur and is equally important in chronic diseases . . .,” Aloe will “clear away a number of other psoric symptoms not yet contained in its pathogenesis,” and “Aloes has cured many symptoms that are not recorded in any Materia Medica that I have seen.” Many other characteristic aspects of Aloe have been discovered clinically like the retention of the stool as in the following case of Butler:
In January 1885, Mrs. G. ___ a brunette 26 years of age, of plump figure, firm muscular fiber and nervo-bilious temperament, consulted me for constipation of many years standing. She received Sulphur without benefit.
February 1, I gave her Bryonia, also without benefit. Dissatisfied with not having been helped she discontinued treatment, saying that she never had received more than temporary relief from my medicine and was disgusted with drugs and with doctors.
In October, however, she came to me again, as the constipated condition was worse than ever and “something must be done”. At this time she presented the following condition.
Her general health was excellent. Careful enquiry failed to find any aches, pains, or abnormalities, except those about to be recorded. Her bowels moved once in four or five days, usually without cathartics or enemata; if, however, there was no disposition for stool after this length of time she would take licorice powder, but this was seldom resorted to. For two or three days preceding the movement of the bowels she had a feeling of heaviness through the entire pelvic region “as if the lower part of the abdomen were made of lead” which sensation was relieved by an evacuation of the bowels just in proportion to its completeness. The stool itself was natural in color, large, hard and dry. On account of its size it was voided only by great exertion and even the most persistent straining was not always effectual until after repeated attempts. There was no actual pain with the stool, but after it she had a sense of great soreness about the anus, well up within the rectum, and especially, in the perineum; so severe was it that the ordinary means of cleansing were too painful and she was obliged to use a soft sponge and water for this purpose. This soreness continued for several hours after an evacuation.
The heaviness in the pelvic region and the great soreness after stool called my attention to Aloe and although this drug produces looseness of the bowels as its most usual effect, and in the few cases of retarded action of the bowels recorded under it in Allen’s Cyclopedia, the character of the fecal accumulation is not given, it more nearly covered the totality of the symptoms than any remedy that I knew. I gave it in a Fincke potency (the 45m graft) a dose in water, each night until the bowel moved- then to report for further advice.
On the second morning (i.e. after the second dose) she reported that the bowels had moved and more freely and naturally than for months; that meantime the heaviness in the abdomen, and the soreness after stool were very much better although not well.
The medicine was now discontinued and she was directed to report again when her constipation returned. Up to this time, now more than six months, she has required no more medicine for this condition, her bowels continuing to move naturally and regularly.”[12]
In the proving, we find that the “secondary effect” of Aloe is stool retention. This retention of stool in children for fear of pain is not that uncommon and had been confirmed by Nash some years earlier.
Here is his most interesting case: “Master P. ___ aged three years, light hair, complexion and eyes, had been troubled with constipation since birth. At times he was worse than at others, and it was often almost impossible to get an evacuation even with repeated injections of water. The feces were in lumps, very large and light colored; there was so much pain attending efforts at stool that he screamed and was covered with sweat, and the mother was often obliged to pick away the hard lumps. He seemed afraid, and avoided letting his parents know, of a desire for stool, as long as possible. After treating him during several of these attacks with Bryonia, Sulphur, Nux vomica, Veratrum album, Calcarea carbonica, and Sepia, with indifferent success I found that he oftentimes passed large, hard lumps of fecal matter involuntary and apparently unconsciously. Aloes 200th cured and there has been no return of the trouble for two years.[13]
This symptom had also been reported by Guernsey in the following case: “A little girl was first taken with a bad, nervous, shattering cough; then fever; pain in her stomach; loss of appetite; constipation; could not sit up, or hold up her head even, so completely had she lost the muscular power of her neck and spine. She had a great variety of symptoms, but it was quite impossible to name her disease. Most of her symptoms seemed to belong to a great variety of medicines; only one seemed peculiar, and to belong especially to Aloes. The symptom in her case that characterized it from all other symptoms was an involuntary, unnoticed hard stool. The little girl knew nothing of it. Now, it was found on careful comparison, that Aloes had all her symptoms, and the golden rule is, give the smallest dose that will cure. My choice was Aloes 50 M, one single dose only. In three days she made rapid recovery.”[14]
That would also apply to the symptom observed in many individuals by C. Carleton Smith who reported during one of the Lippe Society meetings that during “the epidemic of cholera that occurred in Chicago while he was practicing there. Patients would come into his office holding the hands upon the abdomen and fearing they would have an attack of diarrhea immediately. They could not trust their bowels. Aloes would relieve all such cases, and they escaped the cholera afterward.”[15]
Or, in the following case of appendicitis:
April 24, 1903, I was called to see a little schoolgirl, aged about twelve years. She complained of pain in the right side, in a central spot. She had slight fever, some thirst, and was restless and nervous. I could not get much in the way of symptoms from the child, but as she lived with her aunt and did as she pleased. I came to the conclusion that her trouble resulted from getting her feet wet on her way from school the day before, though I could get no positive proof going to confirm my suspicions. However, I prescribed Rhus 200.
Called the 25th and found a slight improvement, when I told the aunt what my suspicious were in regard to the case. The child’s father was sent for, and, like many anxious fathers, felt that he must do all that could be done under the mistaken notion that good would result from doing everything that can be done, whether it has any particular reference to the good of the patient or not, and as the child had not eaten anything for forty-eight hours he gave her a pint of strong beef broth, with some bread in it. Of course, he soon heard from it, and I did also.
I found her with a temperature of 103, trying to vomit, bowels bloated and so tender that she could not bear the slightest touch. Her pulse was 130, weak and thread-like, and the pain in the abdomen caused the child to scream whenever she was touched or moved in the bed. She was called to the chamber as often as every half-hour to pass a clear, thick jelly-like substance, which was preceded by pain and relieved by the discharge. No pain during nor after the discharge. She got Aloes 200. I repeated the dose three times during the next ten days; always after I noticed the symptoms did not improve during the preceding twenty-four hours.[16]
Review of the Characteristic Symptoms of Aloe Needing to be Added or Upgraded in the Repertory
As many characteristic symptoms of Aloe are being clinically cured but often not found or fully developed in its proving, Wesselhœft legitimately asked the question, “Are we authorized to add to the pathogenesis of Aloe those symptoms which were cured in this case? . . . I think we are fully authorized to do so and in this way enrich still further this splendid proving.” We must be careful not to add just any symptom to the materia medica of a remedy because it has disappeared under treatment. However, symptoms, which have clearly and repeatedly disappeared following the administration of a remedy should be included.
A *(star) following a symptom indicates that it needs to be added to or upgraded in the repertory. If in bold it should be in Italics in the repertory. If in bold underlined it should be bold in the repertory. The letter “p” after a symptom means that the symptom is found in the proving, the letter “v” means that it has been verified clinically and the letter “c” means that the symptom was cured under Aloe, but not found in the proving. The letters “p + v” means the symptoms were proved and verified clinically. When there are no letters it means that the origin of the symptom, whether from a proving or clinical, is not known.
Absorbed. (p + v) *
Reserved. (p + v)*
Obstinate. (p + v)*
A certain anxiety after one scruple. (p + v)*
Fastidious. (p + v)*
Obsessions and cycles of fixations. (c)
Needs routine or aversion to change. (c)*
Anguish in the abdomen. (p + v)
Great anxiety, timorousness, restlessness, dread of death, great anguish so that she cannot stay anywhere. (p + v)
Anticipation, anxiety about the future. (v)*
Fear of heights and going downhill. (c)*
When sick the patient is not pleasant to be with. He is hard to please. He has disgust with everything. Dissatisfied and angry with himself. (p + v)
Irritable, he cannot endure the visit of many people, they are repugnant to him. (p + v)
Unfriendly and unfeeling. (c)*
Hates people; repels every one. (p + v)*
Aversion to being spoken to. (c)*
Ill humor, peevishness and anthropophobia, with cuttings in the abdomen. (p)
Weeps easily.* Weeps with consolation.* Dissatisfied and angry with himself. Revengeful. (p)
Impatient and in a hurry. (p + v)*
Indisposed to go outdoors, but the pain in the abdomen is thereby relieved. (p)
Irritable, quarrelsome with every one who contradicts him; it seems he would rather be torn to pieces, sooner than give up his will. (p)
Throws things when contradicted. (c)*
The weather is cloudy, cold, rainy (in December), and his humor morose, thoughtful, discontented. (P + v)
Ill humor; peevish about himself, so that he insults* and blasphemes; worse afternoon. Peevish towards himself without reason. (p)
Little inclination for labor, discouraged, apprehensive about his success. (p + v)
Indolence; if he sits he deliberates about standing up. Can be associated with great fatigue, confusion, desultory thinking which can all alternate with activity. (p + v)
Mental condition improves by exercise in the open air. (p + v)*
Much inclination to continued labor. (p)
Especially inclined to mechanical labor. (p)
In the forenoon, he is much excited, works hastily and yet well. (p + v)
Excited at night* with warmth and redness of the face. (p + v)
Lassitude alternating with great mental activity. (p + v)*
After a meal no sleepiness but a forbidding and unconcerned humor; about half past three he is better and is much inclined to joke, continually mocking the remarks of others; in the evening he is inclined to work. (p + v)*
Immediately after a meal a sluggish sleepy mood, he sat down by himself without speaking, without any desire for mental or physical exertion, meditating, wrapped up in himself, as after a sickness, or a fit of anger, which still gnaws internally, which one cannot express. Nothing can engage his attention; he is averse to and disgusted with everything. From one till after four, in the evening, already an opposite condition sets in; he is not at all angered about an accident which otherwise probably would have angered him. (p + v)
Sits still, silent. (p + v)*
Very discouraged and unhappy mood, since the forenoon, with confused head and lack of inclination to labor; better in the evening. (p)
Contented, happy humor in the evening* as well as all the following day. (p)
Contented with his station in life; it involuntary occurs to him that he is really much better off than many other people. (p)
Towards evening uncommonly aroused by spirited joyful news. (p)
Merry, self-contented, fraternized to the whole world. (p + c)*
Sympathetic. (c)*
Too affectionate. (c)*
At evening, in a happy mood, he feels completely happy and contented. (p)
Great serenity and good humor; in a patient. (p)
The child is very much enlivened and vivacious, it plays and prattles uncommonly with much mischievousness and laughter; from sucking Aloes. (p)
Lack of self-confidence. (c)*
Doubtful. (c)*
Will not use a public washroom. (c)*
Sensitive to admonition. (c)*
Aversion to consolation. (p + v)*
Sensitive to noise. (p + v)*
Startling easily, at noise.*Easily frightened at slight noise. (p + v)
Painlessness. (c)*
Lack of irritability. (c)*
Never cries. (c)*
Never laughs. (c)*
Slow learning to talk. (c)*
Low, whispering voice. (c)*
Aversion to being touched, being massaged. (p + v)*
Grinds his teeth with anger. (c)*
Heaviness in the forehead with confusion and aversion to mental labor. (p)
Headaches worse in the summer and from light. Compelled to make the eyes small. (v)*
Rubs his forehead. (c)*
Heat of face with excitement, headaches. (v)
Headaches better cold and passing flatus.*
Headaches worse rising,*
Congestion of the head in lunatics. (p)*
Hair falling in lumps, leaves bare patches. (c) **
Noise in ear when moving the jaw. (p)*
Deafness, left then right side. (p)*
Ear pain, left then the right side. (p)
Earwax increased. (c)*
Cracking of the jaw. (p + v)
The nose is very red, without redness of the face, in cold open air. (p)*
Epitaxis on the right side,* in the morning in bed shortly after waking. (p)
Sneezing and with watery fluent coryza. (p)*
Husky voice during coryza. (p)*
Black comedone on edge of the upper lip. (p)*
Red and dry lips. (p + v)*
Dry mouth without thirst. (p + v)*
Dry mouth with thirst. (p)*
Salivation with hunger. (p)*
Cold sensation of the left side of the tongue. (p)*
Stitches under the tongue. (p)*
Pappy taste. (p)*
Grinding teeth when angry. (c)*
Grinding teeth in sleep. (c)*
Sore throat after stool. (c)*
Constriction of the throat. (p)*
Raw throat worse in the cold open air. (p)*
Sore throat worse at night, yawning, on opening the mouth, in the evening, on waking at night or in the morning, and better on swallowing food. (p)*
Thirstlessness during diarrhea. (c)*
Thirsty during meals. (v)*
Desire for fruits, especially apples and apple juice, and juicy food, refreshing foods, beer, salt, , stimulants, farinaceous foods, bread, meat, milk, bitter and cold sour drinks. (p + v)*
Aversion to fruits and meat.
Worse from alcohol, beer, fruits, milk and vinegar.
Better from beer, cold drinks and tea.
Increased appetite. (p)*
Hunger with diarrhea, hunger after morning stool or any stool. (v)*
Nausea and vomiting better sitting still. (p)*
Appendicitis with acute pain in the right lower quadrant worse from movement and touch. (c)*
Stitches in the umbilical region on sneezing. (p)*
Enlarged abdomen especially in children. (c)*
Pain in the abdomen better lying bent and pressure. (p)*
Diarrhea:
Profuse, watery, yellow brown diarrhea, containing lumps with mucus. It can be lumps of jelly mucus, like jellyfish. It can look like frog spawn, green or white. It can be mixed with blood. (v)
Heaviness, pressure downwards. Feeling as if a plug were wedged in between the symphysis pubis and the os coccygis. (p)
Very active bowels before stools: noisy (as if fluid was swashing), hot, distended, painful (cutting, gripping), sensitive. They can feel the diarrhea coming minutes or even hours before. At times they can feel the bolus travelling in the guts and then eventually filling the rectum. The rectum seems full of fluid as if it would fall out. (That is when they have the above feeling of a plug ) (v)
It comes out with force with lots of gas, loud sputtering. Forcible, can come out like a cork. Theevacuation takes place without any exertion on the part of the patient; it seems, as it were, to fall out of the rectum. (v)
Lack of confidence in the sphincter ani. Involuntary stools when passing flatus, when urinating, when standing, when rising.* Fear to urinate less stool should escape. (p + v)
Holds the hands on the abdomen and fearing he would have an attack of diarrhea. (c)*
Diarrhea worse from anxiety, excitement. (c)*
Continual urging for stool. (p)*
Stool comes out unnoticed, “the stool falls out.” (p + v)*
Albuminous white or clear frothy mucus, mucus in globs like jelly-fish. (v)*
Painful or painless.
Worse being overheated, hot weather, must hurry to the closet immediately while or right after eating or drinking, after breakfast, 2 A.M. to 9-10 A.M., worse around 5 A.M., rushing out of bed, worse moving around, rising from lying, standing, excitement, anticipation, fruits, milk. (v)*
Diarrhea from suppressed skin eruptions. (c)*
Passage of much flatus after each meal; offensive, hot, and burning with relief. (p)
The rectum constantly secretes mucus, which escapes from anus, even with attempts at defecation.
Great weakness and faintness after stools. (v)*
Cold clammy to profuse perspiration after stool. (c)*
Hemorrhoids, protrude like a bunch of grapes, better cold water, worse on wiping after stool.
Anal pain better from beer. (p)*
Urine is saffron, offensive with sediments.
Urine frothy. (c)*
Similar frequency and urgency of the desire to pass urine, with a certain uncertainty in the tenure of that excretion. (p + v)
Enuresis. (c)
Involuntary urination in old men with enlarged prostate. (v)
Affection of the prostate gland.
Cannot hold the urine when the urging comes. (c)
On rising he was obliged to run quickly to urinate. (p + v)*
At stool urination; when urinating desire for stool.
Increased sexual desire after eating, after stool, in the evening. (p)*
High sexual desire especially in children. (c)*
Free discharge of prostatic fluid after stool. (c)*
Quick ejaculation, emission during siesta.*
Testicles cold; right feels cool at night; penis small; scrotum relaxed. (p)
Epididymis sensitive to touch and while walking. (p)*
Offensive perspiration of genitals.
Fullness and heaviness in the region of the uterus. Pressing down in the rectum during menses. Uterine hemorrhage with great heaviness. The uterus always feels too heavy and engorged, as if the hemorrhage would take place at any time. This heaviness can be seen in a constipated person. Menses early and profuse. Pains worse when standing. (p)
Shortness of breath in cold air or when walking against the wind. (c)*
Dorsal pain as from prolonged stooping. (p)*
Low back pain worse lying on the back, better after rising. (p)*
Stiffness in the sacral area after sitting, worse rising. (p)*
Pain in the coccyx as if he had fallen on it. (p)*
Pain in extremities as if sprained. (p)
Pain in the right upper arm worse motion. (p)*
Pain in left thumb, as if sprained. (p)*
Chilblains. (c)*
Desquamation of palms of hands. (c)*
Numbness of the extremities while lying after eating.
Sleep:
Lays on the abdomen especially children. (v)*
Lies on the abdomen with hands between the thighs. (c)*
Lies on back with knees bent and hands above or under the head. (c)*
Sleeps with the head covered. (c)*
Cold hands and feet in bed. (p)
Enuresis. (c)
Moans in sleep. (v)
Perspiration profuse in sleep. Head and neck. (c)*
Dreams: animals of all sorts, danger, monsters, cannot cry out, of being crazy and being watched, having a stool, waves and water.* (p)
Chills extending down the back. (p)*
Worse spicy foods. (p)*
All the symptoms are better with exercise in the open air. (p)*
Generalities:
Poor stamina and low resistance to effort. Indolence.
Worse mental and physical exertion. (p + v)
Polarity: overly sensitive/insensitive to pain, cries easily/never cries, sympathetic/unfeeling, friendly/unfriendly, hatred/affectionate, sluggish/vivacious, great thirst during a meal/thirstlessness during diarrhea, desire for meat/great aversion to meat. (v)
Alternating states : Indolence/great activity. Alternating moods. Low back pains alternating with headaches. Cold hands alternating with cold feet. Constipation alternating with diarrhea. Diarrhea alternating with headaches. (p + c)
Warm-blooded but chilly during acute state. (v)*
Worse warmth. (v)*
Aversion to the sun. (c)*
Weakness from the heat of the summer. (v)
Worse hot damp weather, worse being in the Sun.* (v)
Worse cloudy weather (moods: sad and morose). (v)*
Better in the evening: energy, inclination to work, moods, chilliness, increased sexual desire. (v)*
Better cold (headaches, hemorrhoids, general). (v)
All symptoms better exercise in the open air. (p)*
Worse jarring when sitting in a chair or lying in bed. (v)*
Aversion to bathing. (c)*
Aversion to having his hair being cut. (c)*
Better kneeling. (c)*
Sensitive to music: he hates musical sound and noise. It sets him all in a tremor, or he fees it travelling his body like a shock wave. Trembling from music or noise. (v)*
Development arrested. (c)*
Ailments from suppression or the effects of drugs (“hospital diarrhea”). (c)
Key or Guiding Symptoms of Aloe
When encountering a case of a warm-blooded person who becomes chillier during acute states (like Pulsatilla) and is aggravated by heat and better by coolness, worse in the morning and better in the evening, better in open air, sensitive to cloudy weather and especially, but not necessarily, with a history of diarrhea, Aloe should be considered. If there are other bonus symptoms such as cycles of obsession, indolence alternating with great activity or involuntary stools then the choice becomes easier. The following key symptoms when appearing during case taking should alert the prescriber to consider Aloe :
Great impatience and hurriedness.
Indolence, which can alternate with activity.
Low stamina.
Hates people; repels every one.
Aversion to change. Tendency for fixation and obsession.
Startles easily.
Worse cloudy weather.
Worse hot weather.
Worse heat, better cold.
Better open air, better exercise in the open air.
Worse in the morning, better in the evening: energy, moods, indolence, control of sphincter ani. Tired in the morning and the rest of the day but the fatigue vanishes in the evening; a crowd of thoughts busy him, cannot get to sleep for a long time.
Better passing stool or flatus: abdominal or rectalpain, heaviness, palpitation, and headaches.
Chronic or recurrent diarrhea.
Involuntary stools. Stool unnoticed.
Ailments from suppressed skin eruptions, headaches, and diarrhea, and ailments from drugs.
Conclusion: I hope this presentation will help my colleagues to better grasp the broad indications of Aloe, stimulate a more detailed study of its materia medica and encourage them to report their cured cases to further complete the picture of Aloe, thereby continuing the great work begun by Hahnemann.
* ROS: Stands for the return of old symptom(s).
[1] William P. Wesselhœft. Aloe socotrina, an anti-psoric remedy. Proceedings of the International Hahnemannian Association 1888: 188-193
[2] Jekyll. Aloes. The Journal of Homœopathics. 1890; 2: 296-299.
[3] L. Whiting. Cases from note book. Proceedings of the International Hahnemannian Association 1890 : 365.
[4] Wm. P. Wesselhœft. A case read at the meeting of the Organon Society of Boston, December 28th. Homœopathic Physician 1890 ; 10 : 10-13.
[5] Constantine Hering. Life of Hering. Calvin B. Knerr. Philadelphia: The Magie Press, 1940, 9.
[6] Edmund Carleton. In A Memorial of Constantine Hering. Philadelphia, N.p.n.d., 185-186.
[7] P. P. Wells. Aloes. American Homœopathic Review 1866; 6 : 268-270.
[8] Carroll Dunham. Remarks on Aloes. Medical Investigator 1868; 5 : 143144.
[9] P. P. Wells. Aloes. American Homœopathic Review 1866; 6 : 268-270.
[10] Constantine Hering. Aloes. Translated by T. F. Allen from Americanische Arzneiprufungen. American Homœopathic Review 1866; 6 : 49.
[11] Thomas G. Roberts. Experience with Aloe. Proceedings of the International Hahnemannian Association 1909 : 252-253.
[12] Clarence Willard Butler. An Aloe constipation. Medical Advance 1887; 19 : 389-391.
[13] E. B. Nash. Aloes—Constipation. Homœopathic Physician 1881; 1 : 153.
[14] H. N. Guernsey. In Clinical Therapeutics. Volume 2. T. S. Hoyne. Chicago : Duncan Brothers, Printers. 1880 : 363.
[15] C. Carleton Smith. Discussion. Proceedings of the Lippe Society. Homœopathic Physician 1890; 10 : 117.
[16] I. Denver. Two cases of appendicitis. Medical Advance 1903; 41 : 611-612.