All acute inflammatory diseases present prominent head symptoms, pain, red puffed face, throbbing carotids and delirium, and spasms, or jerks and twitchings.
Eyes staring, red, blood-shot and pupils first contracted, then greatly dilated.
Mouth and throat very dry, red, sometimes greatly swollen; all mucous surfaces correspondingly dry and hot.
Pains appear suddenly, and after a while disappear as suddenly as they came.
Skin very red and hot, fairly radiates heat; burns the hand touching it, but sweats on covered parts.
Several inflammations which streak out in radii from a center.
Modalities: < after 3 P. M. or after midnight from uncovering, or draft of air, and lying down; > from covering and head high.
Great liability to take cold; sensitive to draft of air, especially when uncovering the head; from having the hair cut (Hep.); tonsils swell after riding in a cold wind (Acon.).
Imagines he sees ghosts, hideous faces, and various insects (Stram.); black animals, dogs and wolves.
Abdomen tender, distended < by least jar, even the bed; obliged to walk with great care for fear of a jar.
Pain in right ileo-cæcal region, < by slightest touch, even the bed covers.
Pressing downwards, as if the contents of abdomen would issue from the vulva; < standing and sitting erect; worse mornings (compare Lil., Mur., Sep.).
Tongue: Red and dry, with red edges and white coating in the middle; Papillæ bright and prominent, like scarlatina (Acon., Ant. t.), offensive, putrid taste in throat when eating or drinking, although food tastes natural.
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We now come to consider what I call the trio of delirium remedies -Belladonna, Hyoscyamus and Stramonium. Many other remedies have delirium, but these three deserve to head the list. Belladonna may also be called pre-eminently a head remedy. In most complaints where this remedy is indicated head symptoms preponderate. The blood all seems to be rushing to the head. (Amyl nitrite, Glonoine, Melilotus). The head is hot while the extremities are cool. The eyes are red and blood-shot. The face is also red, almost purple red. The carotid arteries throb so as to be plainly visible. There is either great pain, pressure or sense of fullness, or an almost stupid condition. The wild, terrible delirium, if present, may be found with pain, or even with no complaint of pain. In delirium the patient "imagines he sees ghosts, hideous faces and animals and insects." Fears all sorts of imaginary things and wants to run away from them; breaks out into fits of laughter or screams and gnashes his teeth; bites or strikes those around him; in short, Performs all sorts of violent acts and is controlled with great difficulty. No remedy has more presistently violent delirium than Belladonna. One of the characteristic features of Belladonna in delirium as compared with the other two remedies is the decided evidence already mentioned of a surcharge of blood in the brain. When the throbbing of the carotids, the heat, redness and congestion of face and conjunctiva go away, the delirium subsides in proportion. Belladonna may have delirium with pale face as its alternate, but it is the exception. Even the upper lip is congested and swollen.
In inflammations, which localize, Belladonna is in the first stage as often the leading remedy as any other. It does not make much difference where they localize, whether in head, throat, mammæ or elsewhere, if they come on suddenly, pursue a rapid course, are red, painful and especially throbbing. It is astonishing how many local inflammations, even a carbuncle or boil, will so disturb the general system and circulation, as to produce the general inflammatory fever, with the characteristic head symptoms calling for Belladonna, and no less astonishing how this remedy controls the whole condition, both local and general, when indicated. What! exclaims the believer in local applications, give Belladonna internally for a boil on the hand or foot? Yes, indeed, not only Belladonna, but Mercurius, Hepar Sulphuris, Tarantula Cubensis, and many others, and you will not have any need for local medication at all. It is only in the first or congestive or active inflammatory stage that this remedy is in place; but, if properly administered then, it will often abort the whole thing and never leave it to finish all its stages, or if not, so modify as to make it comparatively insignificant.
Belladonna is one of our best remedies in the diseases of children, even vieing with Chamomilla. They come suddenly, almost without warning. This sudden and intense onset of fever is sometimes duplicated in Cina cases, but there is helminthiasis in connection with it. Child is well one minute and sick the next, and one very characteristic symptom in these cases is, the child is very hot, with red face and semi-stupor, but every little while starts or jumps in sleep as if it might go into spasms. This condition is often found in children and then Belladonna is like "oil upon troubled waters." Remember Belladonna inflammations localize more than they do in Aconite. I drew the difference between these two remedies in inflammations and inflammatory fevers when writing upon Aconite. There is no use of confounding them. Some do so; but, in so doing, only exhibit their ignorance.
There are, in every remedy, symptoms of sensation, circumstance, constitution or modality which are peculiar both to diseases and remedies. These symptoms are not always easily accounted for. The attempt to explain them from a pathological standpoint is not always possible or even necessary were it possible. A simple acceptance of them as facts is often more sensible than to wait long to find the often unfindable. To act as a prescriber upon what we know is better than waiting, because we cannot explain or account for it. For instance, it is not easy to tell why "the pains of Belladonna appear suddenly and after a time disappear as suddenly as they come," while those of Stannum "gradually increase to a great height and as gradually decline," or Sulphuric acid "begin slowly and decline suddenly," or "gradually increase and suddenly cease" but so it is, and the acceptance of these facts enables the homopathic prescriber to cure his patient, whether he can explain them or not. Guernsey says -"This medicine is particularly applicable, and in fact takes the lead over all others in cases in which quickness or suddenness of either sensation or motion is predominant." To be sure all these symptoms have their pathological explanation if we could give it; but, acting on our law of Similia, we can cure our patients and are not left at sea, without chart or compass, because we cannot explain. We know that these symptoms are the natural outcry of the pathological state, and that the administration of a poison which is capable of setting up a similar outcry cures the patient. What else is necessary? Either this is true, or Homopathy is a humbug.
The simple fact, abundantly proven, that the remedy having the symptoms corresponding to the symptoms of the patient, cures him, no matter what the pathology, where a cure is at all possible, is one of the greatest discoveries of scientific investigation. Long live the name of Hahnemann the discoverer.
From out description thus far of this remedy you would expect it to be a good one for congestive headaches, and so it is, and not only so, but for neuralgic headaches. Throbbing pains, with the already described evidence of congestion of blood to the head. Belladonna headaches, whether congestive or neuralgic, are worse on stooping forward, bending downward, or lying down, anything that takes the patient out of the perpendicular. "Worse on lying down," in fact, seems to be a very reliable general characteristic. The elder Lippe once told me of a case of suspicious enlargement or swelling and pain of the breast of long standing, which, as he expressed it, seemed likely to prove a case for the surgeon (cancer), which was entirely cured by a few doses of Belladonna, to which he was guided by this symptom of the pains being so much worse on lying down. Since then I have observed and verified this symptom in many cases of different kinds. I will not stop to give all the symptoms that might be present in Belladonna headaches.
No remedy has greater affinity for the throat. The burning, dryness (Sabadilla), sense of constriction (constant desire to swallow to relieve the sense of dryness, Lyssin), with or without swelling of the palate and tonsils, is sometimes intense. I once witnessed a case of poisoning in which these symptoms were terribly distressing.
There are two very characteristic symptoms in the abdominal region, viz.: "Tenderness of the abdomen, aggravated by the least jar, in walking, or stepping, or even the bed or chair, upon which she sits or lies"; and "pressure downward as if the contents of the abdomen would issue through the vulva, < mornings." This last symptom is found under other remedies, notably Lilium tigrinum and Sepia. With Belladonna there is often associated with this pressure downward a pain in the back "as if it would break." "Starting and jumping," or "twitching in sleep," or on going to sleep is characteristic.
So also is "sleepy, but cannot sleep," and "moaning during sleep."
With Belladonna the head likes wrapping up or covering, takes cold when it is uncovered or from cutting the hair (Silicea). (Glonoine; can't bear hat on).
Uniform, smooth, shining, scarlet redness of the skin, so hot that it imparts a burning sensation to the hand of one who feels of it, is very characteristic (H. N. Guernsey).
Convulsions with other symptoms of Belladonna are very frequently found under this remedy.
I have here endeavoured to give an outline of this great remedy. A volume might be profitably written upon its virtues. No one remedy would be more greatly missed than this, if it were to be expunged from our great Materia Medica, but we must leave it here and proceed to notice.
High-grade delirium, similar to that of Stramonium and Belladonna; alternating with low-grade, delirium, with stupor, equal to that of Opium. Face pale.
Grasping at flocks, picking the bed clothes and subsultus tendinum.
Persistent cough, worse lying down, relieved on sitting up, especially in elderly people.
Dementia senilis; fears imaginary things, being poisoned, etc.; sees persons and things that are not present; foolish laughter.
General twitching of all the muscles of the body; in spasms or convulsions.
The mania often takes on the lascivious form. The patient uncovers and exposes himself, sings and talks amorously.
Fears being poisoned; Suspicious and jealous.
Constant staring at surrounding objects, self-forgetful (fevers). Pupils dilated; insensible; small objects seem very large. Sordes on teeth; grating the teeth. Alternates well with Rhus tox. (fevers).
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Hyoscyamus is as delirious as Belladonna, but the high grade of delirium alternates with the low. With Belladonna the violent form predominates, while the quiet or stupid form is the exception. With Hyoscyamus it is just the other way. The stupid muttering form predominates, with occasional outbreaks of the violent form. The face of the Belladonna patient is red, that of Hyoscyamus pale and sunken. The Hyoscyamus patient is weak and the weakness increases. His violent outbreaks of delirium cannot keep up long on account of weakness. This is not so much so with either Belladonna or Stramonium. The Hyoscyamus patients may begin with the violent form or outbreaks of delirium, but they grow more mild and less frequent, and the low or stupid form increases until there is total unconsciousness; so much so that it sometimes becomes difficult to choose between it and Opium.
The case takes on typhoid symptoms fast. The tongue gets dry and unwieldy, the sensorium so cloudy that even if you can arouse the patient to answer questions correctly he immediately lapses right into stupor again. This unconscious condition may continue even with the eyes wide open, staring around the room, but seeing nothing but flocks, at which the patient reaches and grasps; picks the bed clothes, indistinctly muttering, or not saying a word for hours. The teeth are covered with sordes; the lower jaw drops; stools and urine pass involuntarily; thus presenting the most complete picture of great prostration of mind and body. This is a picture of Hyoscyamus as we find it often in typhoid fever, or typhoid pneumonia (where it is the best remedy I know of), scarlatina and other diseases. It is a wonderful remedy, but not of wide range like Belladonna.
Hyoscyamus is not only a great remedy in the acute affections of which we have written, but it is also one of the most useful in chronic manias. If acute delirium passes on into the settled form, called mania, this remedy is still one of our chief reliances. It is much oftener of use here than Belladonna. Again, if the mania comes on after an acute disease it is still one of our leading remedies. In these forms of mania there are certain very marked symptoms calling for its use, such as, the patient is very suspicious; will not take the medicine because he thinks you are trying to poison him, or thinks some plot is being laid against him. He is jealous of others, or the first cause of the attack is jealousy. Again, the mania often takes on the lascivious form.
The patient uncovers and exposes himself, sings and talks amorously. Hyoscyamus leads all the remedies for this form of mania.
The patient, like the one in acute delirium of this remedy, is liable to alternate between the mild and violent manifestations; at one time so mild and timorous as to hide away from every one, and again so violent that she will attack, beat, fight. scratch, and try to injure anyone within reach.
The Hyoscyamus maniac is generally weak, and so this remedy is found particularly adapted to mania consequent upon the infirmities of age. Of course it is useful in all ages if indicated by the symptoms.
The nervous manifestations of this remedy are not confined to the cerebral symptoms; but seem to involve the whole system.
As H. N. Guernsey says: "Every muscle in the body twitches, from the eyes to the toes." This is one of his chief indications for its use in convulsions, whether epileptic or not. The spasms are generally of the clonic, not the tonic order, as in Nux vomica or Strychnia. Nor are they so violent as those under Cicuta virosa; but the general twitching is characteristic in convulsions, as is the subsultus tendinum in typhoids.
Hyoscyamus is very useful in a form of dry cough which is aggravated when lying down and relieved by sitting up. Here, too, it is particularly useful in old people. I have already referred to its great usefulness in pneumonia. I wish to emphasize it, and believe it to be the leading remedy in the typhoid form of the disease. At least it has performed wonders for me.
It is also very useful in scarlatina of the typhoid form, and is complementary to Rhus tox. in those cases. I never alternate the two, but if the depressed sensorium and delirium goes beyond the power of Rhus to control I suspend the Rhus for a day or two and give Hyoscyamus, which will so improve the case that Rhus may again come into use and carry it to a successful termination. This is the only alternation I am even guilty of. It is like that of Hahnemann when he alternated Bryonia and Rhus in fevers.
Wildly delirious, with red face and great loquacity. Loquacity.
Pupils widely dilated; wants light and company; fears to be alone; wants hand held.
One side paralyzed, the other convulsed.
Awakens with a shrinking look; frightened; afraid of the first object seen.
Painlessness with most complaints (Opium.) Jerks the head suddenly from pillow in spasms.
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The last of the trio is pre-eminently the high-grade delirium remedy, differs from the other two chiefly in the degree of intensity.
The raving is something awful singing, laughing, grinning; whistling, screaming, praying piteously or swearing hideously, and above all remedies loquacious. Again the patient throws himself into all shapes corresponding to his changeable delirium, crosswise, length-wise, rolled up like a ball, or stiffened out by turns, or, especially, repeatedly jerks up suddenly his head from the pillow. Things look crooked or oblique to him.
The whole inner mouth as if raw; the tongue after a while may become stiff or paralyzed. Stools loose blackish, smelling like carrion, or no stool or urine. Later there may be complete loss of sight, hearing, and speech with dilated, immovable pupils and drenching sweat which brings no relief, and death must soon close the scene unless Stramonium helps them out.
By way of still further comparison Stramonium is the most widely loquacious.
Hyoscyamus is the most insensibly stupid.
Belladonna in this respect stands half way between.
Stramonium, throws himself about, jerking head from pillow.
Hyoscyamus, twitches, picks and reaches, otherwise lying pretty still.
Belladonna, starts or jumps when falling into or awaking from sleep.
All have times of wanting to escape.
The same state of mind and sensorium is found in chronic and acute manias. I have cured several such cases. One was a lady about thirty years of age, who was overheated in the sun, on an excursion. She was a member in good standing in the Presbyterian church, but imagined herself lost and called me in six mornings in succession to see her die. Lost, lost, lost, eternally lost, was her theme, begging minister, doctor and everybody to pray for, and with her. Talked night and day about it. I had to shut her up in her room alone for she would not sleep a wink or let anyone else.
She imagined her head was as big as a bushel and had me examine her legs, which she insisted were as large as a church. After treating her several weeks with Glonoine, Lach., Natrum carb. and other remedies on the cause as the basis of the prescription, without the least amelioration of her condition, I gave her Stramonium, which covered her symptoms, and in twenty-four hours every vestige of that mania was gone.
But for the encouragement I gave the husband that I could cure her she would have been sent to the Utica Asylum, where her friends had been advised to send her by the allopaths. I gave her the sixth dilution or potency.
I cured a case just as bad since then with the C M. potency. I could relate other experience, just as remarkable, cured with this remedy, but why do so? Aside from the uses of the remedy, which are the main ones, I will mention now a few symptoms that have been found very reliable guides:
Staggers in the dark with eyes closed.
Eyes wide open; prominent, brilliant pupils widely dilated.
Desires light and company.
Face hot and red, cheeks circumscribed.
Convulsions, aggravated in bright light.
Mouth and throat dry. (Bell.)
Fear of water and aversion to all fluids.
Metrorrhagia, with characteristic mind symptoms.
Great pain in hip disease, or abscesses.
One side paralyzed, the other convulsed. (Bell.)
Entire absence of pain. (Opium)
Feels very sad and despondent, < after sleeping, or in the morning.
Enemy of all constriction; must loosen everything (neck, chest, throat, abdomen, etc.)
Left-sided affections generally, especially throat, chest, ovaries.
Inflamed parts very tender to touch and of bluish or dark color.
Great weakness and trembling; tongue trembles when protruding it; catches under the teeth (lower).
Blood decomposes, breaks down, hæmorrhages; blood uncoagulable; ulcers and even slight wounds bleed profusely.
Modalities: < at climacteric; touch, constriction or pressure, sun-heat, after sleeping; > after discharges (suppressed or delayed discharges).
Many complains connected with the menopause: hot flushes, hot sweats, burning vertex headaches, hæmorrhoids, hæmorrhages.
Great physical and mental exhaustion; trembling in whole body; would constantly sink from weakness.
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To Dr. Constantine Hering belongs the honor of introducing and developing the wonderful medicinal properties of this snake poison. If he had never done anything beside this for medicine, the world would owe him an everlasting debt of gratitude. It alone would immortalize him. All this, and more; notwithstanding, Chas. Hempel wrote in his first volume of Materia Medica: "In spite of every effort to the contrary, the conviction has gradually forced itself upon my mind that the pretended pathogenesis of Lachesis, which has emanated from Dr. Hering's otherwise meritorius and highly praiseworthy efforts, is a great delusion, and that with the exception of the poisonous effects with which this publication is abundantly mingled the balance of the symptoms are unreliable." Hempel modified his views somewhat, I think, in later editions.
Now, it is interesting to note that in Allen's Encyclopædia of Pure Materia Medica, the verified, and especially the black-typed symptoms, almost all of them, are verifications of provings made with the 30th potency. It is also significant that the provings of Hahnemann's polycrest remedies, mostly made with the potencies, are among the most useful and reliable we have to-day. Some have sought to destroy confidence in the provings of all remedies which are made with the 30th potencies and upwards; not only that, but in their power to cure even when the provings were made with cruder preparations. With us, who know the value of these potencies, all such efforts only excite pity. But many who do not know are misled and prejudiced so as to never dare to test for themselves. To all such we say take no man's ipse dixit, but prove all things, "hold fast that which is true."
Lachesis is a remedy of wide range of action. It has an alternate action on the mind and sensorium, that of excitation and depression. Illustrative of the former are the following symptoms: "Quick comprehension, mental activity with almost prophetic perception, ecstasy, a kind of trance. Exceptional loquacity, with rapid change of subjects; jumps abruptly from one idea to another." This kind of excitation may be found in acute chronic complaints; in the delirium of fevers, or in mania of a settled form. On the side of depression occur: "Weakness of memory; makes mistakes in writing; confusion as to time. Delirium at night; muttering; drowsy; red face; slow, difficult speech and dropped jaw. Feels extremely sad, depressed, unhappy and distressed in mind," and this condition is very apt to be worse on awaking in the morning, or indeed after any sleep, day or night. "Chronic complaints from depressing cause, like long-lasting grief or sorrow." This depressed side of the remedy may also be found in both acute and chronic complaints. Again these opposite conditions may be found alternating in the same person, and a notable fact is that the alternations are extreme. Of course the causes of these conditions of mind and sensorium are varied, but we will often find them in old topers, subjects of broken-down constitution, and in the troubles incident to the climacteric age. Such cases are subject to sudden attacks of giving away of strength, fainting, vertigo from rush of blood to the head causing apoplectic seizure, or opposite symptoms arising from sudden anæmia of the brain. In short, the circulation in Lachesis subjects is very uncertain. This is what makes it so valuable in sudden flushes during the climacteric period.
Lachesis has some prominent head symptoms where no other remedy can take its place. It is one of our best remedies for sun headaches; of course it does not compare with Glonoine for the immediate effects of sunstroke, but does come in well after the first effects are overcome by that remedy. The patient is troubled with headache every time he is exposed to the sun's heat, and the trouble has become chronic (Nat. carb.).
This is another characteristic symptom, namely weight or pressure on the vertex. (Cactus, Glonoine, Menyanthes). This is found mostly in women suffering at the menopause, and coupled with it in such cases there is sometimes burning on the vertex. Sulphur has this symptom, but if it occurred at the menopause the remedy would oftener be found in Lachesis, unless, indeed, there were some marked psoric complications. Lachesis has a variety of headaches, but I know of only two characteristics that have been of very much value to me in prescribing for them, namely, with then headache very pale face, and the patient sleeps into the headache; dreads to go to sleep because she awakens with such a distressing headache. These two are very valuable indications, otherwise I would expect to get my indications outside of the headache itself. "Headache extending into the nose, comes mostly in acute catarrh, especially when the discharge has been suppressed or stops after sleep. This kind of headache is often found in hay fever, with frequent and violent paroxysms of sneezing. Now if the hay fever paroxysms of sneezing are decidedly worse after sleeping, even in the daytime, Lachesis 2000th may stop the whole business for the season." Being an old hay fever subject myself, I am authority on that statement.
We now come to the action of Lachesis on the alimentary tract; first the gums are often swollen and spongy, easily bleeding; when this is found Lachesis often follows Mercury well. If the gums turn purple the indication is strengthened for Lachesis. One of the most characteristic symptoms of Lachesis is found in the tongue, especially in diseases of a typhoid type; namely, puts the tongue out with great difficulty; it is very dry; trembles and catches under lower teeth. The tongue trembles and is protruded with difficulty under Gelsemium, but it is not so dry as in Lachesis. This is a sign of great weakness, but in Gelsemium it occurs in the very beginning of the fever, while in Lachesis it comes later. There is bad odor from the mouth in Lachesis, and it may be very dry throughout; or there may be an abundant accumulation of tenacious mucus. Here it again resembles Mercury. Lachesis is one of our best remedies for sore mouth in the last stage of consumption. This is sometimes a very distressing symptom, and relief for it is often very difficult to find. If Lachesis should relieve it, my experience has been that the patients are also greatly relieved in other ways; so much so, indeed, that they think that they are, after all, going to get well. This brings me to notice what I believe I have not spoken of before, that where a cure is no longer possible, and temporary relief is the only thing left, we have the best means of giving it in the homopathically indicated remedy. Narcotics, counter irritants, so-called tonics, stimulants, etc., do not and cannot compare with the simillimum (if properly administered) in smoothing the pathway to the inevitable termination. Lachesis has won its chiefest laurels in affections of the throat.
"Throat and neck sensitive to slightest touch, or external pressure (Sepia); everything about throat distresses, even the weight of the bed covers." This is very characteristic. Another peculiarity is that empty swallowing, or swallowing of saliva or liquids, aggravates a great deal more than swallowing of solids. The pains in the throat run up into the ears. There is much mucus in fauces, with painful hawking. In tonsillitis and diphtheria, swelling of tonsils begins on left side and extends to the right (Sabadilla). The pains are aggravated by hot drinks (reverse, Sabadilla). All these symptoms are peculiar to Lachesis, and are all apt to be very much worse after sleep. In old quinsy subjects, where the trouble always began on the left side, I have often not only aborted the attack, but cured the predisposition thereto.
Sometimes the throat assumes a gangrenous appearance, but if the other indications are present it is an additional indication for its use. Lachesis is always one of the first remedies to be thought of in any disease, when it seems inclined to spend its main force in the throat, such as typhoid fever, pneumonia, scarlatina, etc.
If the skin turns purple or bluish, as if mortification were impending, there is no remedy like it. Not only is Lachesis an unusually efficacious remedy for these acute throat troubles, but for those of a chronic form, and the same symptoms are present, even in syphilitic throat troubles. We have placed great stress upon the great sensitiveness of the throat to all touch or pressure; but this does not end it, for, as Lilienthal expresses it, Lachesis is the great enemy of all constriction. "The pit of stomach sore to the touch, or even to pressure of clothes." "Cannot bear any pressure about the hypochondria." In the abdomen there is "Painful distention, flatulence, which is very annoying, can bear no pressure; the surface nerves are sensitive." "Is obliged to wear clothes, especially about stomach, very loose; they cause uneasiness; even in bed, obliged to loosen and pull up night dress to avoid pressure; dare not lay the arm across the abdomen on account of pressure." "Uterus does not bear contact; has to be relieved of all pressure; frequently lifts the clothes; they cause an uneasiness in the abdomen, even with no tenderness." "Larynx sensitive to least touch, which causes suffocation and feeling of lump in the throat." "During heat, as of an orgasm of blood, he is obliged to loosen clothes about the neck; sensation as though they hindered the circulation of blood, with a kind of suffocative feeling. "Intolerance of tight neck bands." I could no better express the value of this symptom, or great modality of Lachesis, aggravation from pressure or constrictions, than by quoting entire from Guiding Symptoms the above. It does nor seem, after such an array of oft-verified symptoms, that more need be said to impress this upon the memory and confidence of any physician. Now, the why of this almost invariable aggravation from pressure of Lachesis and almost as invariable amelioration from the same of Bryonia I leave for those to explain who pretend to be able to do so. It is, however, another proof of the value of modalities.
Lachesis has some peculiar symptoms of stool and anus. There is an urging, or rather a pressing down, in the rectum, but it is worse when he attempts a stool; hurts so that he must desist. It feels as if the anus were closed. This is somewhat like the constant or rather frequent, though ineffectual, urging to stool of Nux vomica; or like the painful constriction of Lycopodium, which either prevents stool, or follows after an incomplete and unsatisfactory one. Another marked symptom is that the stools are often very offensive, whether formed or not. Then, under Lachesis, we have hæmorrhages from the bowels, of decomposed blood, which occur mostly during the course of exhausting, acute diseases, like typhoid. Guernsey gave this: "Flakes of decomposed blood, having form and appearance of perfectly charred wheat straw, in larger or shorter flat pieces; portions more or less ground up." I have met such cases and Lachesis was very efficacious, not only in changing the character of the stool, but bringing about general improvement, ultimating in perfect recovery.
This remedy is often of great use in that very common malady, hæmorrhoids; and here you have the constricted feeling, whether the piles are external or blind, and sometime a beating or throbbing, or as the patient will perhaps express it, a sensation of "little hammers" beating in the rectum. All these symptoms and many more show the affinity of this remedy for the anus and rectum, as they do also its power over disease of the whole alimentary tract.
This is also one of our best remedies in diseases of the female generative organs. In the first place it is eminently an ovarian remedy, and seems to choose by preference the left ovary. It is of use in simple ovarian neuralgia, and from that to actual tumors or every cancer of the left ovary; or the trouble begins in the left and goes to right ovary. (Reverse, Lycopodium). But we may have neuralgia, swelling, induration, suppuration, tumors or cancer of one or both ovaries. Its action in uterine troubles is also very marked. Here is a condition, as expressed in Guiding Symptoms, that I have often verified during climaxis: "Pains in uterine region increase at times more and more till relieved by flow of blood from vagina; after a few hours or days, the same again, and so on."
In these cases you almost always have the intolerance of least contact or pressure over the uterine region so characteristic of this drug. The womb prolapses, is at times persistently congested, and obstinate uterine hæmorrhages repeatedly occur. There are hot flashes, hot vertex, pale face and fainting, uterine displacements of various kinds, and deranged capillary circulation, all so common in females at the menopause and especially hæmorrhages. (See also Crotalus and Kreosote). Probably there are not three remedies in the whole Materia Medica so often indicated in troubles connected with this period, as Lachesis. (Kreosote, post-climacteric diseases). It is often of great use in cancer of either the breasts or uterus. In either case the cancer puts on a bluish or purplish appearance, and if open or fungoid bleeds easily, a dark, decomposed blood. In case of bleeding, the pains and suffering, as in the case of uterine hæmorrhage, are temporarily relieved by it. We would be greatly crippled in the treatment of these various ovarian and uterine troubles without Lachesis.
The respiratory organs and chest also come under the influence of this drug. Paralysis of the vocal chords, causing loss of voice; larynx is sensitive to least touch; it causes suffocation; it is one of our best remedies in desperate cases of croup, where the child gets worse in sleep; seems to sleep into it. Spasm of the glottis; sensation of something running from neck to larynx, stopping the breath. It has great shortness of breath when walking, especially in old topers and in heart affections, when this condition is always the guide to its use. "The least thing coming near the mouth or nose interferes with breathing; tears off the collar or everything about the neck, throat or chest, because it suffocates." Asthma with the same symptoms, has sudden flushes of heat or orgasm of blood; must loosen clothes to prevent suffocation; threatened paralysis of the heart or lungs; dry hacking cough, aggravated by touching throat or larynx, also cough during sleep, without awakening or being conscious of it. Here it often cures very obstinate cases of cough after Chamomilla has failed, which also has this symptom. For the short dry cough sympathetic with heart troubles, Lachesis is often useful. Cough with pain in anus, or stitches in pile tumors. One of our best remedies in typhoid pneumonia or typhoid fever with lung complications.
Now look out for the Lachesis tongue in these cases. Lachesis is also one of our most useful remedies in heart troubles, acute or chronic, the peculiar suffocation, cough and aggravation from constrictions being the guiding symptoms.
No remedy more profoundly impresses the nervous system than this. In the first place it causes trembling, not from fright or excitement, but from extreme weakness. In this it resembles Gelsemium; both have great trembling of the tongue on trying to protrude it. With both remedies the whole body trembles; but with Lachesis she feels faint, as if she must sink right down. This great prostration is both mental and physical, and she does not improve from rest or sleep, but on the contrary is worse in the morning after sleeping. With this prostration there are often pain or other troubles with the heart; nausea, pale face and vertigo. Now if this thing goes on the next stage supervenes and paralysis is the end of it. The paralysis is generally left-sided, as are the majority of complaints of Lachesis, which is pre-eminently a left-sided remedy. This paralysis may come on as a result of apoplexy or cerebral exhaustion; if the latter, there is still great hope of a perfect cure by a judicious use of Lachesis. Of course if the lesion is too extensive in apoplexy, and the extravasation of blood too great, there is little hope; but some apparently most desperate cases do recover even then. It is recommended in epilepsy and locomotor ataxia, but I have never seen good effects from it.
There is, however, another place in which I have seen it accomplish much and that is in the languor, weariness and prostration from hot weather. The heat not only aches, but the whole body seems prostrated by sun heat. (Antim. crud., Gelsemium, Glonoine, Natrum Carb., Natrum m.)
Worse after sleep, or rather the patient sleeps into an aggravation, is a genuine characteristic of this remedy, no matter what the enemies of Lachesis say of it. On this line there is one particular symptom to which I wish to call attention, i. e., "As soon as the patient falls asleep, the breathing stops." This is as Hering expresses it. I have oftener found it this way; the patient cannot go clear off into sleep, because just on the verge of it the breath stops and he wakens catching for breath. This is often found in heart troubles, functional or organic, and is very distressing. Grindelia robusta has a similar symptom. (Also Digitalis).
I once had a case of very obstinate constipation in an old syphilitic case. He was at last taken with very severe attacks of colic. The pains seemed to extend all through the abdomen, and always came on at night. After trying various remedies until I was discouraged, for he "got no better fast," he let drop this expression, "Doctor, if I could only keep awake all the time, I would never have another attack." I looked askance at him. "I mean," said he, "that I sleep into the attack, and waken in it." I left a dose of Lachesis 200. He never had another attack of the pain, and his bowels became perfectly regular from that day and remained so. I could give more cases where this symptom has led me to the cure of ailments of different kinds. It is enough to say that I have no hesitation in adding my testimony to that of others as to the value of this symptom. I think I have said enough about the different symptoms of Lachesis to indicate that it is one of the most useful remedies in typhoid fever. I will only add here that it is generally in the second or third week of the disease that it is found indicated. This is one of the differences between it and Gelsemium. For the trembling and weakness of Gelsemium come early, and if recognized then Gelsemium can abort the disease at once. Of course the sensorium, tongue, mouth, throat, abdominal and stool symptoms already spoken of, especially the sleep symptom, help to decide the choice between Lachesis and other remedies.
Now upon the tissues. We have swelling on all parts of the body, and one of the most characteristic conditions is the color of them. They are bluish verging onto black. (Tarantula Cub., Anthracinum). I never see a swelling of that color but Lachesis immediately comes to my mind, and then if I find that they cannot bear to have them touched, they are so sensitive, even a poultice is unbearable, because it is so heavy, that settles it. I give Lachesis and am seldom disappointed. The blood decomposes, or, as is sometimes said, "breaks down," becomes uncoagulable. This often occurs in typhoid fever, and is of course very serious. The bleeding is easily started, and is very persistent. There seems to be a tendency to hæmorrhagic trouble, so we find Lachesis one of our best remedies in purpura hæmorrhagica. Ulcers and wounds bleed profusely; even "small wounds bleed much;" wounds easily become gangrenous. Here Lachesis is capable of doing great good. Cancers turned bluish or black, bleed much and often, and burn; blood appears in the urine in many affections, indicating its broken down condition.
We find ourselves drawn out to a greater length on this truly
remedy than we had anticipated when we began writing we have also found it a much more useful remedy than we had anticipated from our impressions of it when reading Charles Hempel (for whom we have great respect) in our studenthood. It wears well for those who use it in the 30th potency and upwards. Don't forget that Lachesis is preeminently a left-sided remedy, as Lycopodium is a right-sided one. Left-sided paralysis, ovarian affections, throat troubles, lung troubles, headaches, etc., all make us think of this remedy first because of its positiveness in this respect. Of course, if the other symptoms were present in right-sided affections we would not hesitate to use it. Lachesis is often a remedy of great value in skin affections; in scarlatina maligna, black measles, erysipelas, smallpox, malignant boils, furuncles, carbuncles, chronic ulcers, bed sores; fungus hæmatodes, etc. In all these and many other affections appearing upon the surface, the characteristic dark blue color is present, or we need not expect much from this remedy. So far as stages of life and constitution are concerned, I have found it efficacious in all ages and temperaments. But Perhaps oftener indicated in thin than in fat people.
Now we bid our old and tried friend an affectionate good-by for a time, and heartily recommend all who have not done so to seek his acquaintance.
Here is a blood relative of Lachesis, if serpent poisons may be called relatives, and according to the symptoms arising from the bite of the serpent it ought to be equally valuable as a curative, but it has not yet been found so. Why not? on referring to Allen's Encyclopædia we find twenty-nine provers, poisonings and all, for Lachesis, and forty-five for Naja. Of course, Lachesis has been longest in use; but has the difference in time been sufficient to account for the very great difference in utility? Another thing is noticeable; the provings of Lachesis were made mostly with potencies as high as the 30th, while those of Naja are almost all with the lowest preparation or the crude poison from the bite of the serpent. Does this account for it?
We also notice on referring to the same authority that all the most marked verifications are of symptoms produced by the provings of the 30th of Lachesis. Does this indicate that Naja must be proven in the potencies to develop its most efficient powers? Naja has been found of very decided use in affections of the heart, especially weak heart (Nux vomica, tired feeling); diphtheria, where there is impending heart failure or paralysis. Dyspna and prostration from weak heart, sympathetic cough in organic diseases with weak heart action. (Dry cough, sympathetic in heart affections, Spongia.) Palpitation and bad feeling in heart, < walking. In these troubles, as well as in chronic weakness of heart, there is no doubt of the value of Naja. Constantly dwells on suicide like Aurum. But further than this I do not know of very many marked successes from its use. Nevertheless, I feel convinced that with further proving and investigation, along the same line as Lachesis, it may rival if not outshine it.
Here is another snake poison which, although like Naja has been proven only in the low preparations, has a better clinical record. Yet it lacks the clear-cut indications of Lachesis. It has shown enough, however, to indicate that it is a remedy of great value. It seems, so far, to have shown its greatest usefulness in diseases which result in a decomposition of the blood of such a character as to cause hæmorrhages from every outlet of the body (Acetic acid); even the sweat is bloody. This occurs in the lower fevers of hot climates, such as the bilious remittent fevers, typhoids, and that dread scourge of tropical climates, yellow fever. It is also the chief remedy in diphtheria when the profuse epistaxis occurs which marks many cases of a malignant type. In hæmorrhages of the nose in an old man of broken down constitution, where none of the remedies usually applied did the least good, Crotalus acted promptly and no doubt saved the man's life. This was a patient of my own, and, although he had frequent attacks before, he never had another after the Crotalus. As would be expected with such a remedy, there is great prostration at such bleedings. Crotalus is right-sided.
Malignant jaundice is set down as an indication for Crotalus, but the yellowness of the skin, so characteristic of Crotalus, is after all, I imagine, more of hæmatic than hepatic origin; yet there may be an element of both, as hepatic troubles are so common in hot latitudes where Crotalus has gained its greatest laurels.
Crotalus richly deserves proving in the potencies in order to bring out its finer characteristics.
Stitching pains, very characteristic.
Pain in lower right chest through to back.
Anæmia with bloating, especially upper eyelids, which hang down like a bag of water.
Backache, sweat, weakness very great; drops down in chair.
Flatulence great; everything turns to gas.
Heart weak, irregular, intermits.
Modalities: < at 3 to 4 A. M.
After loss of fluids or of vitality, particularly in the anæmic.
Asthma, relieved when sitting up or bending forward, or by rocking (Ars.); worse from 2 to 4 A. M.
Backache, before and during menses.
Complementary to Carbo vegetabilis.
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This remedy, like some others, finds its leading symptom in the character of its pains. It leads all the remedies for stitching pains. Bryonia stands next, but there is a very marked difference. The stitching pains of Bryonia come on with every movement, and only exceptionally when quiet, while those of Kali carb. come on independently of movement. Again, the stitching pains of Bryonia are oftenest located in serous membranes, while those of Kali carb. are found anywhere and everywhere, and in almost every tissue, even to the teeth. One of the favorite localities, however, for this remedy is in the lower right chest. This sharp stitching pain is likely to run right through to the back. If in pneumonia or pleuro-pneumonia your Bryonia has failed when you thought it indicated, and further examination reveals that the stitching pains come on independently of the respiratory movement, Kali carb. often helps, and follows well after Bryonia. Often the fact is, that Kali carb. was all the time the remedy and ought to have been given first. Now, these stitching pains of Kali carb. are not by any means confined to the right chest, but we may find them in the left, especially in pleuro-pneumonia, peri- or endocarditis. Remember, also, Mercurius vivus in these lower right-chest pains. If there should be present at the same time sweat without relief, and the mercurial mouth and tongue, neither Bryonia nor Kali carb. are "in it."
Another kind of case in which this remedy has achieved signal success, being indicated by the stitching pains, is puerperal fever.
The pains are so sudden and so sharp as to make the patient cry out loudly, and then they are gone. Kali carb. has saved some desperate cases of this kind. But it makes no particular difference where the disease is located, if these stitching pains are present, Kali card should not be forgotten. We cannot too strongly emphasize this.
Kali carbonicum exerts a profound influence over the blood-making processes. The blood lacks red corpuscles. The patient is anæmic, with great debility, skin watery or milky white. This condition is often found with young ladies at the age of puberty. They do not seem to be able to menstruate because of the poor quality of blood and general weakness. They incline to bloat, particularly in face, around eyes and especially upper eyelids, and have much pain and weakness in the lumbar region as well as general weakness. Kali carb. is in such cases sometimes successful after Ferrum or Pulsatilla have been wrongly prescribed.
This anæmic condition is also found at the menopause, and in old age, when the same dropsical tendencies appear, and the same characteristic bag-like swelling, or rather bloating, in the upper eyelids appears. In all these cases you will generally, or often, at least, find what is called "weak heart." The heart action is irregular or intermittent from very weakness in correspondence with the general muscular weakness. One of the characteristic symptoms which makes us think of Kali carb. in these cases in the constant backache of such a nature that the patient feels all the time that the back and legs must give out. she drops into a chair or throws herself on the bed completely exhausted. This aching often extends into the hips and down into the gluteal muscles. Patient sweats easily. Farrington says: "This particular sweat, backache and weakness as a combination is not found under any other remedy."
I have already spoken of this remedy somewhat while writing of its stitching pains as an indication for its use in diseases of the chest, but I did not there do it full justice. It is not only a great remedy for pneumonia, pleurisy and heart troubles, as there spoken of, but goes much further and becomes very useful in incipient and even with advanced cases of phthisis pulmonalis. I have seen a case pronounced incurable by several old experienced and skillful physicians, Dr. T. L Brown among them, get well under a dose once in eight days of Kali carb. The disease was located mainly in the lower right lung, with profuse expectoration of matter of pus-like appearance, pulse 120, greatly emaciated, no appetite, and quite a large cavity in the lung. This man is still alive (twenty-five years later), hale and hearty. Such service from any remedy makes a man fall in love with it. There is a time characteristic for this remedy which is very valuable in chest affections, viz, aggravation at 3 A. M. It may be found in cough, consumption, hydrothorax, asthma, and dropsies attending heart disease The father-in-law of Dr. T.L. Brown, an anæmic old man, was apparently near his end with hydrothorax and general dropsy Dr Brown was a skillful Prescriber, but in this case had utterly failed to even relieve. In consultation with Dr. Sloan, after carefully reviewing the case, the fact appeared, through de daughter of the patient, who had been his nurse all the time, that all his symptoms were aggravated at 3 A. M. Now Kali Carb. 200 was given, and with such miraculous results that in an incredibly short time the old man was well and never had a return of that trouble. He lived for several years after, and, finally, did nor die of dropsy at all. The day of miracles is not past yet. Hahnemannian Homopathy performs them still.
I cannot persuade myself to have this remedy yet, although I have given its chief uses.
I must call attention still further, even at the risk of repearing somewhat, to some very important symptoms. In regard to the nervous system I have already spoken of the great debility which I have called muscular debility, but there is a weakened condition of the nerves which renders them very sensitive which is well described in the symptoms found in the Materia Medica. "Very easily frightened, shrieks abut imaginary appearances; cannot bear to be touched; starts when touched ever so lightly, especially on the feet" these are valuable indication for Kali carb. Then don't forget the "bag-like dematous swelling in the upper eyelids." It goes with many affections and is invaluable as a guiding symptom. "Sticking pain in the throat (pharynx), as if a fishbone were sticking in it" (see Hepar sulphur, Dolichos, Nitric acid and Argentum nitricum).
"Great sensitiveness of epigastric region, externally."
"Stomach distended, sensitive, feels as if it would burst."
"Excessive flatulency, everything he eats or drinks appears to be converted into gas."
"Fullness, heat and great distention in abdomen immediately after eating a little."
"Abdomen distended with wind after eating."
All these stomach and abdomen symptoms indicate the value of this remedy in dyspeptic conditions. They make us think of Carbo vegetabilis, China officinalis and Lycopodium clavatum, but remember Kali carb. and that it is especially adapted to broken down, aged people who are anæmic. "Sitting up, leaning forward, relieves in chest affections." The patient is also aggravated by lying on the affected side. Don't forget this, for it may enable you to choose between it and Bryonia, which has the reverse.
Now in what I hat written I do not pretend to have told all, and if I thought that any young physician would be led to rely alone upon this work of mine or be led away from thorough study of the Materia Medica instead of to it I would stop writing.
Affections of the mucous membranes with discharge of tough, stringy, adherent mucus, which can be drawn out into long strings.
Formation of jelly-like mucus on mucous membranes.
Round deep ulcers, as if cut out with a punch.
Diphtheritic membranes on mucous surfaces.
Migratory pains, which appear and disappear suddenly.
Pains appear in small spots, which can be covered by a silver dollar or the point of the finger, especially in the sick headache, which is preceded by blindness.
Yellow coating at base of the tongue; or dry, smooth, glazed, cracked tongue.
Rheumatism alternating with dysentery or diarrha.
Gastric complaints; bad effects of beer; loss of appetite; weight in pit of stomach; flatulence.
Nose; pressing pain in root of nose; discharge of "clinkers", plugs.
* * * * *
"Affections of any mucous membrane with discharges of tough, stringy, adherent mucus, which can be drawn out into long strings." No remedy has this more prominently than this one. Hydrastis comes near to it, and Lyssin may approach it when from the mouth or throat; also Iris versicolor.
But Kali bich. produces and cures this kind of discharge from nose, mouth, fauces, pharynx, larynx, trachea, bronchi, vagina and uterus.
And the action of the drug does not stop here but goes on to the formation of tough membrane, on the same surfaces. Again it causes and cures ulcerations of the mucous membranes. These ulcers are peculiar, "deep as if cut with a punch, edges regular." I remember one case of years ago in which such ulcers appeared in the throat of a woman. One had eaten up through the soft palate into the posterior nares, and the whole palate looked as though it would be destroyed by the ulcerative process if not speedily checked. The case had a syphilitic look to me and had been under the treatment of two old school physicians for a long time. I gave Kali bich. 30th, and to say that I was astonished at the effect (for it was in my early practice) is putting it mildly, for the ulcers healed so rapidly, and her general condition, which was very bad, correspondingly improved, that it three weeks from that time she was well to all appearance and never had any return of the trouble afterwards, or for years, at least as long as I knew her. I forgot to state that she also had the stringy discharge, though not so profuse as I have often seen in other cases.
I once cured a dog that had a sore mouth and throat, from which the saliva hung in strings, and dragged on the ground as he staggered along. People who saw him said he was mad, but I think not, as he did not snap or bite or have suffocating spasms.
Kali bichromicum is one of our sheet anchors in the treatment of disease of the mucous membrane of the nose. Not only in inflammations of an acute character, which are attended with stringy discharges, but also of a chronic kind known as "chronic catarrh." In these cases the patient often complains of much pressure at the root of the nose (Sticta pulm.), and especially if an habitual discharge becomes suddenly suppressed. Slugs and clinkers form in the nose, which form again and again after removal. Sometimes there discharge tough green masses or hard plugs. This process of chronic inflammation may go on from bad to worse, until ulceration sets in to such an extent that the whole septum may ulcerate away. I have known a case in which the apparently "punched out" ulcers ate a hole right through the septum. This may be syphilitic or not. If in syphilitic cases the destructive process should attack the bones, Kali bich. may still be of use, thigh I should expect to be obliged to resort to Aurum met. or some more deeply acting remedy.
I have likewise found in those troublesome cases of chronic post-nasal catarrh, where the dropping back into the throat is stringy, or those crusty or pluggy formations occur, this to be a good remedy, and it has gained me some fast friends.
In its formation of membranes in the throat it is as positive as any other remedy, and when the membrane extends downward into the larynx, causing membranous croup, I believe no remedy excels it. I have with it cured many cases of diphtheritic croup, and of late years never give it below the 30th Potency, because abundant experience has convinced me that it does better than the low triturations.
Kali bichromicum has been of use in the treatment of stomach troubles. The vomiting is often of the ropy character, and here also, as in nose, mouth and throat, we may have formed "round ulcers" But short of actual ulceration we have a form of dyspepsia, in which this remedy is very useful. It is often found in drunkards, especially beer drunkards. There is great weight in the stomach, fullness, a distress immediately after eating (like Nux moschata), but not like Nux vomica, which comes on two or three hours after, nor like Anacardium, which also comes on two or three hours after eating, and then the pain continues until he eats again, which relieves.
There are two appearances of the tongue which may be present in conjunction with these stomach troubles; one is a yellow coating at the base (Mercurius prot. and Natrum phos.), the other a dry smooth glazed or red cracked tongue. This latter tongue is found more often in connection with dysentery in which Kali bich. has sometimes done good service.
There is one kind of discharge which comes from mucous membranes of which I have not yet written, "jelly-like mucus." (Aloe socotrina). It may come from nose, posterior nares, vagina or anus. This is especially found in dysentery where the stools have by some other remedy changed from an appearance "like scrapings" to the jelly-like form. Of course leucorrhas of both the ropy and jelly-like variety come under this remedy and many fine cures have resulted from its use. It is no less so in affections of the respiratory organs, in coughs, croup, bronchitis, asthma, and even in consumption. The chromic acid element in this combination of Kali seems responsible for the ropy mucus, as no other Kali has it in any such degree.
There are a few more points about this remedy that ought not to be omitted. The pains are peculiar. They appear in small spots, which can be covered with the point of a finger. This is markedly so with the pains in the head. In sick headache often so. Farrington says: "There are quite a number of remedies having blind headache, but Kali bichromicum is the best of them." The blindness comes on before the headache; then, as the headache begins, the blindness disappears. (See Iris versicolor and Natrum mur.) Then the pain settles in a small spot, and is very intense. Again, the pains of Kali bichromicum appear and disappear suddenly. This is like Belladonna. Then, again, they fly from one place to another like Pulsatilla. There are five remedies having markedly wandering or erratic pains, viz.: Kali bichromicum, Kali sulphuricum, Pulsatilla, Lac caninum and Manganum aceticum. Kali bichromicum does not stay as long in a place as Pulsatilla does, nor is there so much disposition to swell. Kali sulphuricum is most like Pulsatilla in all its symptoms (see Boericke & Dewey's Twelve Tissue Remedies). The Manganum pains shift crosswise from joint to joint, while Lac caninum alternates sides, being worse on one side one day and on the other the next, etc. Then, again, Kali bichromicum alternates symptoms; for instance, rheumatic and dysenteric symptoms alternate. (Also, Abrotanum). Platina alternates back symptoms, with general mind and bodily symptoms.
Kali bichromicum is particularly adapted to fat, light-haired persons, or children disposed to catarrhal, croupy, scrofulous or syphilitic affections. Dr. Drysdale deserves much credit for what he has done for the profession by introducing this truly great remedy.
Cough with profuse, thick, green, salty expectoration, from deep down, as if from mid-sternum, with pain through to back; great weakness and night sweats.
Stitches through the lungs; in middle of sternum; through sternum to back or deep in chest; < walking.
Irresistible desire for open air; walking in open air does not fatigue; periosteal rheumatism.
Intolerable bone pain, especially at night; syphilitics.
Syphilitic affections, especially after the abuse of Mercury.
Glandular swellings; interstitial infiltration.
Hepar sulphur. antidotes its over-use.
* * * * *
This is one of the drugs so greatly abused by the old school that I confess to not having prescribed it much; in the first place, from my prejudice against it, and, in the second, because it never had so thorough a proving as did Kali carb. by Hahnemann.
There is one condition of the respiratory organs in which I have found it of great value. When after a hard cold a long-continued cough is the consequence, or it may be after an attack of pneumonia. The patient seems as if running into consumption. There is profuse expectoration from low down, deep in the chest, as if it came from mid sternum, with pain through to between the shoulders (Kali bichrom.) (Kali carb., lower right chest through to back), and there are exhausting night-sweats and great general weakness. I have repeatedly cured such cases where consumption seemed inevitable.
In the beginning of my practice I used to dissolve two to four grains of the crude salt in a four-ounce vial of water and direct to take a teaspoonful of this preparation three times a day, until it is half used, and then fill up with water and continue taking the same way until cured; filling up the vial every time it was half used. But several years ago, having a marked case of this description and feeling sure of my remedy, I gave it in the 200th potency as an experiment. This case also made fully as speedy a recovery as the others treated with the crude drug, so since then I often prescribe it in the potencies. There are two other remedies that may dispute the place with Kali hyd. in such cases, viz., Sanguinaria and Stannum. In all the expectoration is profuse and thick, but in Stannum the matter tastes sweet, in Sanguinaria the breath and sputa are very ftid, even to the patient (also Sepia and Psorinum), while in Kali hyd. it is salty to the taste (Sepia). With Kali hyd. and Stannum the expectoration is often thick, green; not so much so with Sanguinaria. Sometimes with the Kali hyd. there is a frothy or soap-suds-like appearance of the sputa, but the heavy, green, salty expectoration seems to me to be more characteristic. The frothy expectoration is found in dema of the lungs and may occur in Bright's disease. I have more than once gotten the reputation of curing consumption in such cases as I have been describing, and I don't know but I deserved it, at least I was never known to deny it.
Kali hydroiodicum as used by the old school is given either as a sort of specific against syphilis, or more often syphilis complicated by their abuse of mercury, or again as an alterative in scrofulous affections, without much reason. Now, what is an alterative? Here is the definition: "A medicine which gradually induces a change in the habit or constitution, and restores healthy functions without sensible evacuation." Isn't that rather sweeping? How is that for a school of medicine that claims to be the custodian of all medical science? Isn't that about what we would like to do in every case -restore healthy function, without sensible evacuation? How would Kali hydroiodicum do then for a panacea? There are, however, many so-called alteratives according to this definition; which shall we give? It is just here that we homopaths believe that such vague general terms as alterative, tonic, narcotic, etc., are too unmeaning for purposes of close prescribing, and therefore misleading. They allow the doctor to prescribe too loosely a class of remedies, instead of the particular remedy of that class best adapted to the individual case.
We claim, therefore, great superiority for our system of prescribing, which is based upon a system of close drug proving, which brings out the closest, finest shades of difference between remedies belonging to a class of remedies. There must be no substitution of one for the other, if we would do the finest prescribing possible.
It requires but little comparison between the Materia Medicas of the two schools to show the wide difference in this respect.
There is said to be a place for the use of this remedy in pneumonia. I have not had experience with it here, but on account of its reputation I give it, and may use it if occasion requires.
I give you Farrington's words for it: "Pneumonia, in which disease it is an excellent remedy when hepatization has commenced, when the disease localizes itself, and infiltration begins. In such cases, in the absence of other symptoms calling distinctively for Bryonia, Phosphorus or Sulphur, I would advise you to select Iodine or Iodide of Potassa. It is also called for when the hepatization is so extensive that we have cerebral congestion, or even an effusion into the brain as a result of this congestion." The symptoms are as follows in these cases:
"First they begin with a very red face, the pupils are more or less dilated, and the patient is drowsy; in fact, showing a picture very much like that of Belladonna. You will probably give that remedy, but it does no good. The patient becomes worse, breathes more heavy, and the pupils more inactive to the light, and you know then that you have serous effusion into the brain, which must be checked or the patient dies." So far good. But now even Farrington dulls -as great men sometimes do. He says, "why did not Belladonna cure?" "He who prescribes by the symptoms alone in this case would fail, because he has not taken the totality of the case." What does Farrington mean? Does he mean that in his picture of Belladonna he had the totality of the case without the hepatization, or does he mean that the hepatization was the totality without the other symptoms? Here are the two horns of his dilemma -which would he take? I contend that all the other symptoms of the case, without the hepatization, was not the totality of the case. The hepatization was one, and only one, of the totality of symptoms. Now he says -"Put your ear to the patient's chest, and you will find one or both lungs consolidated." Well, I should call that a very important objective symptom, and one that could not be left out of the totality of the case. Remember that both subjective and objective symptoms must enter into every case in order to make the totality complete.
So after all, in true Hahnemannian fashion, I claim that he who prescribes, being guided by all the symptoms, will not and cannot fail where a cure is at all possible. These are and must be our infallible guides, or Similia Similibus Curantur is not true. (see Kafka's case, Hom. Clinic, page 73, 1870).
Guiding Symptoms, Vol. VI, page 441, records this -"Distends all the tissues by interstitial infiltration; dema, enlarged glands, tophis exostoses; swelling of the bones." Then of course it cures such distentions of the tissues. Great mistakes and abuses of the remedy, and irreparable injury to the patient, often follow the use of remedies on such vague or single indications, that is of course if we prescribe on them alone. That would be like trying to prescribe for pneumonia from the single indication hepatization. This is only one symptom, and that one may occur under any remedies. If we say, or could say, interstitial distention of the tissues with certain other symptoms peculiar to that remedy, then could we differentiate between it and other remedies. But to use a remedy simply as an absorbent because it has secured absorption in some other case, is simply to fall back into the indiscriminate generalization and routinism of the old school. Kali iodatum is called an anti-syphilitic. So is mercury. Sulphur is called anti-psoric, and Thuja antisycotic. That is well to begin with, but the "end is not yet." There is a large class of remedies for each of these miasms and the one (indicated by all the symptoms or the characteristic symptoms) out of the class is the one to select for the cure of each individual patient.
The very fact that Kali iodatum has been too generally and indiscriminately used is the reason why it is a great question as to whether humanity has been most blessed or cursed by it. We homopaths have much to do in combating the evils produced by the abuse of both these drugs, and Hepar sulphur, is one of the best antidotes. Most of the reported cures with this remedy Kali iod. are made with the low or crude preparations of the drug. I think it can be used lower than most drugs without injury, and yet I believe we do not know half its remedial power as developed by our process of potentization.
Is one of the so-called "Bio-chemic" remedies, or one of the twelve tissue remedies, claimed by Schuessler to be able to cure all the ills that flesh is heir to. It has not been proven enough to know half its real value. Clinical use in the potencies, ranging from the 3d to the 30th, has proven. that it is a remedy of undoubted great value. It is of use in the second stage of inflammations or the stage of interstitial exudation in any part of the body, and here it is not, so far as yet known, attended with the danger of Kali hydroiodicum. If it had been used in the massive doses of the latter remedy, we might have had more deleterious results than we now know of. I have seen enlarged joints after acute rheumatism rapidly reduced to normal size under its action, sometimes after they had resisted other remedies a long time; but I do not know of any characteristic symptoms for its use in preference to other remedies. It is also a remedy for tonsillitis after the acute inflammatory symptoms have been checked by Aconite, Belladonna, or Ferrum phos. I have found it very efficacious in deafness from inflammation and closure of the Eustachian tube. I began using it in the 3d or 6th, but have better success with the 24th potency. A great many cases of chronic incurable deafness might have been cured by this remedy if used early. Mercurius dulcis may be mentioned in this connection, as it was not when we wrote of the Mercuries, as another remedy for these Eustachian troubles. Of course you would be apt to have some other mercurial symptoms which would perhaps enable you to choose between the two remedies. Kali mur. is likely to come into use more from a clinical introduction than from provings. That is what Hering used to call a remedy born by breech presentation. It is possible, but not right or natural.
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