Oxalic acid, H2C2O4. Acid principle of sorrel and other plants: prepared on large scale by action of caustic alkalies on sawdust.
1. REIL, aet. 29, in good health and of simple habits. Made concentrated solution of acid in distilled water at 60, it contained gr. 50 to 3viij. From this made dilutions with distilled water in proportion of 1 to 8.
1a. September 28th, 1849, took at 7:30 a. m., fasting, 20 drops of 2nd dil., and repeated dose in evening. Next day took 30 drops in morning and evening. None but slight effects resulted. 30th., morning and evening, 40 drops. October 1st, morning and evening, 50 drops; 2nd, morning, noon, and evening, 60 drops; 3rd, morning, noon, and evening 80 drops; 4th, morning noon, and evening 100 drops. On 30th had pressive frontal headache, eyes and forehead smarting as if coryza would set in (which it did not). This lessened on 1st and disappeared on 2nd, leaving only aversion to mental exertion. After doses from 40-60 drops much rumbling in belly and increased discharge of flatus. Stools absent or difficult throughout.
1b. Took 1st dil. from 5th to 9th inclusive, 20,40,60,80, and 100 drops on successive days, three times a day. On 5th, pain in sacrum all day, relieved after difficult evacuation. Distension of abdomen this day and next. No stool on 6th; on 7th abundant soft motion covered with mucus; preceded for some hour by frontal headache. Stool the same next day; on 9th, after previous rumbling in abdomen, copious pappy evacuation with cutting pains. On 8th, empty feeling in stomach; pain across kidneys; at night unpleasant pinching around umbilicus repeatedly waking him up. On 9th, feeling of lassitude all day.
1c. From 10th to 13th inclusive took repeated doses of concentrated solution, from 10 drops to 50, without effect save flatulence and loose stools, with painful griping and twisting in stomach. October 14th. – Took six doses of 100 drops each every 2 hours; appetite good in spite of increasing pains in stomach. At 7:30 p. m., on going out, very severe bellyache, as if diarrhoea would set in; no stool; great lassitude. The urine passed in morning of 3th after standing 36 hour in a warm room was still strongly acid, and a mass of crystals had deposited in it, which under microscope and by the murexide test were recognised as uric acid. Traces of oxalate of lime were seen as a milk-white precipitate. 15th. – A tablespoonful every 2 hours; soon after the first dose a pappy evacuation; all other symptoms as yesterday. Pains in stomach increase a while after eating, whilst formerly the vanished after eating. 3 p. m., an uncomfortable diarrhoeic evacuation, like wise at 7 p. m., though in smaller quantity. At 5, soon after food, pains in stomach were more troublesome than ever, and at same time nausea with inclination to vomit before food was present. 16th. – A tablespoonful every 2 hours. (= about 3 gr.); on awaking early difficulty of swallowing with scraping sensation; tonsils and velum palati slightly reddened and covered with adherent mucus which can only be detached by violent effort. During previous night frequent awaking from stomach and urging to pass water. After each meal more acute stomachache and stronger inclination to vomit. Appetite previously good, to-day absent, although gnawing sensation in stomach often simulates hunger; at midday could, however, hardly swallow a few bites. Warm soup afforded relief, but after swallowing a few spoonfuls great urging to stool set in, which was thin, yellowish, slimy, and serous, and accompanied with tenesmus. The difficulty in swallowing increased after each meal. At 3:30 p. m. occurred second evacuation of same consistency, without blood but with much tenesmus. Towards evening pain in stomach and bowels became more acute, and obliged me to sit doubled up. As I had already noticed on taking my sweetened morning and afternoon coffee, the sugar in my tea seemed to increase the pains in the stomach. The tongue, in spite of the great loss of appetite, remained clean, moist, and uncoated. Throat still more reddened than in morning. The morning’s urine was strongly acid, deposited uric acid spontaneously, and contained oxalate of lime. 17th. – Nothing taken. Throughout night was disturbed by pains in stomach and abdomen, and burning in rectum; before midnight and at 7:30 a. m. two serous stools with a few streaks of blood and much tenesmus. Great prostration with feeling as if spine were too weak to carry body. The symptoms of angina, subjective and objective, were the same as yesterday. Cafe au lait with sugar increased the persistent stomach. 11:30 a. m. another serious evacuation, mixed with some blood; tenesmus. At midday little appetite; I took only some gruel, which relieved the painful sensations. In afternoon repeated but fruitless attempts to empty the bowls. Tenesmus during whole time Climbing the stairs was especially troublesome. Head clear as heretofore. Character of urine same as yesterday. 18th. – Nothing taken. Sleep last night frequently disturbed by pains in anus; angina better; appetite also better, although food taken caused pains round and below navel, after a lapse of 2 hours, that is, during its passage through the jejunum and ileum. Towards midday an evacuation, not so serous but still tinged with bloody slime; tenesmus; lassitude; urine as yesterday, although the oxalate of lime is less. 19th. – Nothing taken. Sleep good; still some burning in anus. Angina slight. Appetite good; no pain after food or sugar. Urging to stool, but no evacuation. Lassitude improved. Urine still acid. Oxalate of lime can still be perceived. 20th. – Nothing taken. Condition nearly normal, only some lassitude still; appetite and digestion good; no stool. On following morning, however, it occurred in normal mass and quantity, although still with some pain in anus. On the following days this symptom also vanished.
Roughly speaking I had during the last six days taken 10.1/2 ounces of the concentrated solution of oxalic acid, containing 65 grains of pure oxalic acid. Altogether, including the 1st and 2nd dilutions, I must have taken about 70 grains. The largest dose was 3 grains, or 18 grains per diem. lk (Hom. Vierteljahrsch., ii, 340.)
2. A young physician to whom I gave some oxalic acid to prove, without his knowing what it was, experienced the following symptoms, which I give in his own words:- “The 2nd dilution taken every 2 hours caused no noticeable change, except that after a 50-drop dose I had a somewhat sluggish motion and passed water somewhat oftener but perhaps in smaller quantity. With doses of from 80-100 drops, however, this symptom vanished. “Of the concentrated solution I took doses three times a day only, and rose from 7 to 50 drops without detecting any change in my condition. Then the stools became more pappy and viscid, and called for longer and harder straining than usual. I remarked a weakness in the legs and increased transpiration all over the body, especially in the axilla. These symptoms remained the same up to doses of 80 drops, when there was a slight degree of qualmishness without inclination to vomit and a feeling of emptiness in the stomach. The latter was deceptively like hunger and often led me to eat, without being in the least changed by it. Beyond this the weakness, which I had previously remarked only in the legs, spread over the whole body, so that work usually light to me exhausted me very much and left behind no slight degree of muscular fatigue. With 90 drop doses the nausea and feeling of emptiness in the stomach increased, accompanied by an uneasiness of the whole body, so that I did not dare to increase the dose.” (Ibid.)
3a. Dr. HERING took, May 2nd, 1844, at 11 p. m., gr. 1/10 of lx trit. In 1/4 hour pain pressing inwardly between vertex and occiput, on spot not larger than dollar on middle line. Sensation of slight numbness in left arm. A very violent contracting pain in outer tendon of left knee. Long and sound sleep at night 3rd day. – In morning very bruised and stiff, cannot leave his bed till late. Had dreamt much which he could not remember. Bruised and stiff feeling in back on rising; but a chronic sore-throat and haemorrhoidal uneasiness better than usual. Sour taste on rinsing mouth. Bleeding of gums to unusual degree while brushing teeth. At 9:30 a. m. internal sensation of heat, especially in face; pulse 108; urinates less than usual. At 11 hiccup continuing for some time, though he had eaten nothing substantial; and recurring for some hour whenever he thought of it. Face redder than usual. After walking out pain in testicles and spermatic cord, more in latter and worse right side. While writing in forenoon violent jerking pain in lunar side of right arm near metacarpus. During speaking, much mucus in larynx, with hoarseness; he has to expectorate more than usual. Sensation of fulness in face and excitement, with disinclination to conversation. 12:45. Pulse 88. During hiccup stitching pressure over right hip. In anus pain, like a dull slow stitch, often returning. Painful but slight pressure in right temple, and soon after in hollow of right knee; pain is somewhat jerking. Great appetite for food at 2 p. m.; 30 minutes after pulse 96. A quick jerk in metacarpal joint of left index finger, soon also on ulnar side of hand, then on right side of head. After rising from recumbent posture, pain in right lumbar region between last rib and hip. Greater love of his children, in one in whom this feeling always predominated; a decidedly expressed and clearly distinguished symptom, it being not traceable to any other cause. In afternoon violent starting at slamming of doors, excitement seeming physical rather than mental. Occasionally a pain in depth of ear, as in Eustachian tube, near throat; worst on right side. In evening, while sitting down after walking, violent itching on small spot of neck, right side of hairy scalp, left side of trunk, &c. Unwonted hunger at 11 p. m. 4th. – Again profound and long sleep; on rising quite stupid, lay down again and slept another hour. Usual pain in sacrum is absent; instead thereof bruised sensation in back from loins to shoulders. Thought is effected slowly and with difficulty; is hardly able to answer questions proposed to him. Scanty urination. Indolence; he can scarcely sit up, but wishes to lie down; yet is not sleepy. Pulse quicker than usual. Some heat, at first in face, later in left leg, as from external warmth. In lying a movement in the upper body, especially the head, like a fine rippling as of a stream. It seems to observe a rhythm, but not that of the pulse, than which it is three times faster. It is as if the blood was streaming through the smallest vessels, from below upwards and from within outwards. This feeling becomes plainer the more the thoughts are directed to it. On lying down also vertigo, like a swimming in the head towards left. After a nap numbness in occiput and erections. He had dreamt of rapid sliding walking, and of water being poured over him. Some urging to urine and stool while lying: on rising violent tenesmus in upper rectum, not as in diarrhoea but painful, almost like knife-stabs. On sitting down to stool pressing cutting pain from right upper rectum to anus. Stool pappy, light brown, clay-like. Scanty clear urine. After stool undefinable sensation in anus for 1/2 hour. Some jerking in writing as on 3rd. While yawning a pressive stitch in right hip, taking away his breath. Pain in nose. Yesterday and to-day peculiar tightness a sort of weakness. During forenoon nap a decided sour taste in mouth. Then, moreover, and also while walking later, pain in heart, from behind and below forwards. At 1 sensation in fauces as if there were acidity in stomach. Pain in heart is very violent, as of electric flashes coming from within. In afternoon again passage from bowels, pappy, thick and short, with subsequent sensation in anus as yesterday. During passage violent stitches in ball of left thumb, like knife stabs. The anal pains have to-day same character, but are much worse. After stool a heavy rumbling in right side of abdomen (caecum) and noise from flatulency. A stitching pain between right scapula and spine. On two following days same symptoms as on 4th, but less pronounced. On 6th had red points on glans penis, without itching or other sensation. For 2 or 3 days on rising from sitting posture a sort of dizziness, as if senses would leave him, but without whirling round.
All the pains of oxalic acid seem to occupy only a small spot, 1/2 in to 1 in. in length. They recur especially when thinking of them.
3b. January 5, 1845, took a small quantity of an aqueous solution. After some hour, while walking in open air, a very violent pain in left eye, as it were on small short spaces. Towards evening violent pressive pain within middle of arm, as if in bone (just at insertion of deltoid), increased by movement or use of arm: it lasted all the evening, and slightly next morning. All afternoon and evening excessive fretfulness. Woke next morning with pain in left kidney; and that day and next at each micturition pain in front of glans penis, 6 or 7 jerks, not violent, but very disagreeable. In afternoon of 3rd days very bad temper. (Amer. Arzneiprufungen.)
4. Dr. NEIDHARD took 1x trit. before going to bed. Some minutes after pain in upper head. Thereupon contractive feeling, difficult breathing, at larynx a tightening with whistling breathing; then pressure on whole chest, especially right side; then again the narrowing in the trachea with oppression of lungs. With these sense of emptiness in head and faintness; it seemed as if all the blood had left the head, and caused anxiety. Being awaked by a noise could not sleep again for 2 hours. In morning, while in open air, tickling in throat causing frequent cough; larynx feels swollen; unwillingness to speak. At 11 a. m. pressure over eyes while walking; pulse quicker, fuller, and harder than ordinary. Drawing pain with feeling of stiffness in angle of lower jaw, lasting some time during rest. Stitches in left chest, more when walking; slight perspiration. At night distinct dreams of daggers: numbness of head and tickling with soreness in trachea.
During and after the 2nd trit. tickling cough with thick yellowish expectoration. (Ibid.) [ The above is described as “out of Neidhard’s day-book.” This physician’s symptoms however, as detailed in his schema in the Materia Medica of American Provings, are more numerous than those here given, and only in the tickling cough do they coincide with them. We have, therefore, reported the others in their own place. – EDS]
5a. Dr. KOCH. On 1st day, 3 minutes after taking a dose (quantity unknown) pulse fell from 70 to 65, and after 30 morning was 60 and irregular, thereafter more frequent and fuller. In 1/2 hour warmth in stomach; in 45 m. burning on left half of tongue, as from pepper; in 90 m. some tightness, with inclination to breathe deeply; in 2-3 hours power of apprehension failed when reading, and there was throbbing pain in forehead, and dull pain in middle of chest extending to scapula; in 5-6 hour (evening) vertigo on looking out of window, as if he should fall through, fine stitches in left ear, slight shooting pains in umbilicus, cough and tickling in throat, and sore feeling at praecordia, with heaviness of chest as in asthma or hydrothorax; in 8 hours griping in bowels. On 2nd days, at 7 a. m., great quantity of clayey faeces, preceded by fine thin violent cutting in bowels; then general malaise, urging to stool, and again a loose motion; in afternoon diarrhoea and constant desire for stool, with evacuations of undigested food taken an dinner, followed by chilliness; at night aching in chest as if ulcerated; in evening felt quite ill, and drank glass of wine, after which head was painfully confused; after supper severe cutting colicky pains, lasting all evening, with constant urging to stool; there was also burning pain deep behind scapula. During day pulse was 60, skin always dry, disposition irresolute with indisposition to work, the eyes weak, fine stitches in cardiac region. In evening slight burning pain through urethra to its orifice, as if a drop of acrid urine wanted to come out. On 3rd day, immediately on rising, violent colicky pains so that he must cry out loud, followed by very copious diarrhoea; this recurred at 9 a. m., with great weakness and prostration, then nausea, and cramp in calf; in afternoon again diarrhoea. Eyes were sunken, with blue rings, pulse 60, gullet dry, breathing tightened. At 2 p. m. pain in chest, like sore shooting extending backwards to between scapulae; after dinner immediately rumbling in belly; in evening taste in mouth like sorrel, feet cold. During day constant dry cough on active exertion, with (in evening) anxiety and tightness, and in right middle finger a penetrating, burning shooting pain, deep inside, most in last phalanx, like gout; at night undisturbed long sleep, quite unusual, with profuse night sweat; the wet nightshirt on waking feels disagreeably cold to him. On 4th day, after coffee for breakfast rumbling in belly, especially left side then diarrhoea, and later nausea; at night much discharge of flatus and rumbling. On 5th days nothing noted. On 6th firm stool with much mucus and some blood; at night violent burning when urinating, urine passing by drops. On 7th day after exerting head severe pain there, especially in forehead, with confusion; at night cutting pains in hollow molars. On 8th day, evening, severe pains in teeth, and gums are painful on various spots, as if vesicles were their; from 9th to 13th burning in gum of left lower incisor with pustules, surrounded by bright red areola and swelling.
5b. On another occasion, took gr. 1/2. In 4 hours general malaise, feeling as if hands and feet trembled. Next day, 1 hour after coffee at breakfast, quite sour eructation, and violent dry cough from tickling in throat, with severe pains in chest, lasting some time; nausea after eating during day, and no action of bowels. On 3rd day thin clayey stool in morning, and cutting in abdomen later.
5c. Another time took repeated doses of a solution. Stool was pappy and tenacious, requiring longer and stronger straining than usual; absent next day; and for 3-4 weeks bowels continued irregular, seldom acting oftener than every 3rd day.
5d. On another occasion, in morning on rising a vesicle in right nostril, shooting and burning when touched; alae nasi swollen, now right, now left most so. This recurred every 2nd or 3rd day for 2 weeks. On 11th day nose was very painful, shooting and burning, swollen and shiny red. No stool on 12th and 13th day. (Ibid.)
6. A man proved acid in doses of gr. 1/2-5 under Dr. Koch’s superintendence. No symptoms till 3rd day, when he had vertigo in morning with lassitude and thirst; after rising, toes of right foot spasmodically drawn downwards, without pain; this repeated at noon, after sitting for some time; in evening, empty deglutition painful; before going to sleep, rough voice. On 4th day, heat in face and hands; pale face, with sunken eyes; nausea and want of appetite; three watery stools; muscles of upper arm pain as if beaten; in evening, pain in swallowing food. On 5th day, complexion yellowish pale, eyes sunken; inflamed buccal cavity; pulse 105, hard and quick, at noon; all day chilliness, clayey diarrhoeic stools in 1/2 hour; three more at noon; at 8 p. m. another, violent pulsating headache. Next day from rising till noon three stools, but firmer, and without purging; violent pain on swallowing in morning, better at noon. On 7th and 8th day some scraping in throat; on former pulse 78 and small. (Ibid.)
7. Another man took unknown quantities. On 3rd day pressure in forehead on rising; during dinner, nausea, thought he must vomit, but did not; in evening, pain in hollow tooth. At other times, mucus in mouth and spitting, with clean tongue; violent shooting in whole abdomen, extending to region of spleen, then impelled to deep breathing, after which it went off; pulse somewhat frequent, morning. On 4th day, heaviness in left hand, fingers obey will only heavily and lowly, and draw inwards. On 4th and 5th day on rising, rough, scrappy throat, can only speak with effort; in evening, sour taste in whole mouth as if drug were still there. (Ibid.)
8. A woman; as last. On 3rd day, severe lateral headache, a cutting from right side of forehead to mastoid process; anxiety and dread, with vertigo; trembling of whole body, with exhaustion. Same symptoms next day, so bad that she could scarcely walk; headache causes closure of eyes; at 5 a. m. was waked by cutting in abdomen, which recurs periodically all day, with alternate chill and heat; pulse rather small; thirst, with nausea, tastelessness of food, and white-coated tongue; in evening, constant yawning, with flow of water into mouth and flat taste there, followed by violent rigor with small contracted pulse, red face, feeling of heat in head without actual warmth there, and icy cold hands as if dead. Next morning, same cutting in abdomen, with nausea. (Ibid.)
9. Dr. S. R. DUBS, aet. 33, sanguine temperament; disposed to stomach and bowel disorder, took February 16th, 1845, 3 gr. 1x trit. at 10 p. m. At 11 sharp shooting pain in right shoulder- joint, coming on suddenly, and lasting about 15 minutes. Slept very little through night, and when he did had constant dreams with starting, and then walking up with fright. The dreams were of an unpleasant character. Sharp pains in forehead and vertex, with feeling of lightness. Pain was more acute over left eye and in left temple. Several times raised himself up in bed in alarm, and looked around room; but on recollecting where he was, lay down again, to repeat same action in an hour or so after. 17th, 7 a. m., yellowish-white phlegm with a black lump in the centre the size of a pea. 8:30 a. m. Took same dose. Dull pain, with occasional sharp pains in forehead. Great increase of animation through the day with playfulness and mirthfulness, which had not of late years been natural to him. Soreness of fauces on swallowing for about 2 hours this morning, after which it gradually passed off. Dull aching pains of molar teeth of right and left upper jaw; worse in right Lasted nearly all day, but passed away towards evening. Bowels opened at 9 a. m. and again at 4 p. m. Slight colic pain in and around the umbilicus, just before afternoon evacuation. Natural in every other respect. tongue dry, sore, and excoriated, worse towards tip; continued so all day and evening. No thirst and rather a repugnance to water. 18th, 8 a. m., took same dose. Observed no particular symptoms in course of morning 4:30 p. m. Took 5 gr 1x trit. In 15 minutes felt dull pain in first molar tooth of right upper jaw, which is very distressing. Had now flushes of heat and perspiration all over the body, which he also had in morning and yesterday, but omitted to note it down. 5 p. m. Pain like a cramp, a little to left of umbilicus, and several minutes after colic-like pain in the right iliac region. Belching up of tasteless wind several times. Great disposition for play and mischief. Increase of pain in the right molar tooth. 5 to 9 p. m. Disposition to pass water every two hours and in large quantities. Uneasiness in limbs and feet, which he can keep quiet for only a few minutes at a time. 9 p. m. Distressed feeling around navel and through whole abdomen, with feeling of great debility therein. 10 p. m. Dull aching pains in abdomen, worse around umbilicus; occasionally aching pains in whole abdomen, like colic. 11:30 Sharp and constant pain in left iliac region. Great increase of sexual desire through night and in morning, with voluptuous dreams. This has been the effect the past three nights and mornings, the 16th, 17th, and 18th February. 19th, 8 a. m, took 5 gr. Had flush s of heat-and perspirations through the morning, with sharp pains in forehead and vertex which annoyed him very little as his spirits were so much elated. 4 p. m. Took 5 gr. more.10 Distressed feeling and great weakness in whole abdomen with flatulent colic. Aching pan in right ankle-joint, with feeling of swelling of this part and of whole right foot. Sexual excitement still. 20th. -Great flatulency the whole day with expulsion downwards of much wind. Swelling of abdomen, with dull colic-like pain occasionally in and around umbilicus, though worse in right iliac region. Itching at anus with crawling sensation as if from worms, which was relieved by rubbing parts for several minutes. It, however, returned several times through night 9 p. m. Sharp, shooting pain in left lung and heart, extending down to epigastrium, lasting for some seconds. Sharp, shooting pain, like neuralgia, on instep of right foot, lasting for 1/2 hour at intervals. Inclination to pass water every hour and in large quantities each time. Slight burning in passing the urine. It is clear and of a straw colour. 21st, afternoon, stitches several times in left lung. Eructation of wind (tasteless) after each meal. 8 p. m. Sharp pain in right instep lasting 5 minutes. Profuse flow of light coloured urine frequently through evening. Pain, colic-like, around umbilicus and in right iliac region. It came and went off frequently. Weakness in loins and hips extending down to lower extremities. Continual dull pain in forehead and vertex. At night and in morning excessive sexual desire, more so than he had experienced for some months previously. 22nd. – No symptoms sufficiently characteristic to note. 23rd. – Belching up of tasteless wind after each meal. Colic-like pains in and around the navel. E., belching up of wind tasting of food eaten. Sharp pain in right ankle-joint. Sharp, lancinating pain in left lung coming on so suddenly that it took his breath for several seconds, and then gradually subsided.24th, 5:30 a. m., felt perfectly well as he lay awake in bed. At 6 was suddenly seized with distressing feeling in whole abdomen, followed in several minutes by twisting (tormina) in and around the umbilicus. After this has continued a few minutes, was compelled to resort to the close stool. The faeces were hard, of a dark brown colour, and small in quantity. Again retired to bed; but at 6:15 pain and bearing down came on so violently that it caused him to use the chamber. The evacuation now was loose, though consistent, and of a muddy brown colour, accompanied by colic pains in navel and below this part, bearing-down and griping pains in anus. The latter were so severe as to produce severe nervous pains through whole head with heat in this organ. Retired to bed; but in about 5 minutes was compelled to get up again. Severe colic pains in navel preceded. When on the chamber, bearing down towards anus, with tormina and severe griping pains. Now copious evacuation of consistent, dark muddy-brown faeces. Went again to bed; but so soon as he had resumed the horizontal posture peculiar pain in navel again came on. Had some tormina nearly all day. Much better whilst up, and still better when moving about in the open air. The inclination to go to stool would invariably come on whilst sitting or reclining for a few morning Two doses of merc. solub. 2 were taken in course of day; otherwise he would have been unable to attend to his daily professional duties. In evening he was perfectly well. (Materia Medica of American Provings.) [ We are indebted to Dr. Neidhard for the original of this proving.-EDS.]