Trinitro-carbolic acid. (C6 H6 (NO2)3 OH). Trituration. Solution in Alcohol. Picric acid is the product of nitric acid on several substances, ex. gr. carbolic acid and salicin. It is sparingly soluble in water, and therefore the lower attenuations are made with absolute alcohol.
PATHOGENESIS.
PICRIC ACID is an irritant to the skin and mucous membranes, it causes in them a yellow coloration which is not jaundice but is a staining by the drug. It is excreted in the urine as picric or picramic acid and causes irritation of the kidneys and the production in the urine of casts, albumin and a little sugar, but no bile. Violent poisoning causes nephritis and anuria, but smaller doses an increase in the quantity of urine, an increase in the uric acid and phosphates and a decrease in the sulphates and chlorides. There is burning in the urethra during and after micturition, and weakness of the bladder with dribbling of urine. In the blood there is destruction of red blood-corpuscles and a state of suboxidation is produced.
Nervous System.-The chief stress of picric acid is on the nervous system. In poisoning of animals the cerebellum, medulla oblongata and upper part of the cord are completely disorganized, soft and pulpy, and this condition extends in a less degree forwards over the brain and backwards to the lower portion of the cord. Entire anaesthesia and analgesia of the lower extremities and paralysis are present and also tonic and clonic spasms resembling those produced by strychnine.
These extreme results have not been seen in man, but the provings demonstrate that the same parts of the nervous system are affected though in a less degree. They show great weakness, especially of the lower extremities; fatigue going on towards actual paralysis; burning heat in the spine from mental and physical exertion; twitching of the muscles, asleep or awake, soreness of the muscles and joints.
Severe headaches are produced, which begin in the occiput and extend forwards over the head to the eyes and downward to the spine. They are brought on by the slightest excitement or use of the brain, and are of bursting (*Gloninum) character, worse in a warm room and better from binding up the head tightly, from cool air and from sleep. Attempts to study, cause burning along the spine with great weakness of the back and legs. Numbness and itching of various parts and the sensation of a band constricting the limbs and the chest are experienced.
Mentally there is a tired-out worked-out feeling want of will power he must give in but there is not anxiety, the patient’s mind is profoundly calm; he is quite indifferent to everything; he cannot bear the least mental effort all mental exertion makes him worse. There are sleepiness in the daytime and sleeplessness at night, especially after mental labour; and amorous fancies.
Sexual Organs- Picric acid strongly affects the sexual organs due no doubt to its influence on the spinal cord. It causes violent erections (*Cantharis, *Graphites, *Hyoscyamus, *phos., *Sil) which are long lasting and uncontrollable; priapism and profuse emissions; great sexual desire with emissions. In the female there is great exhaustion during menses, or leucorrhoea instead of the menses, and voluptuous pruritus in bed at night before menses.
Digestive system.- The symptoms produced by picric acid in the alimentary canal are slight and unimportant. They are anorexia with thirst, sensation of a plug in the throat on empty swallowing better from eating; bitter taste in the mouth; eructations, abortive or sour; sometimes vomiting nausea in the morning on rising rumbling in the abdomen and a yellow oily diarrhoea. Great weakness is felt after stool.
Before the eyes are sparks fog or mist a whirling round of objects. There may be a feeling of sand or sticks in the eyes acrid tears dilated pupils. The pain in the eyes is worse from any strong light light and from moving the eyes. Reading fine print will bring on a headache.
Chronic deafness may be produced, buzzing and whistling in the ears. Boils occur in the auditory meatus.
In the skin small, painful reddish elevations like furuncles come on the face and go on to the pustulation. Erythema and pruritus of the abdomen and feet, and a cachectic appearance of the skin are sometimes present.
Fever.- Slow poisoning sets up an intermittent fever of quotidian type; the extremities are cold chilliness predominates with cold, clammy sweats.
THERAPEUTICS.
Mind.- The use of picric acid in disease exactly corresponds to the pathological findings. It is in states of prostration mental exhaustion and brain fag that it has gained its laurels. It is most useful for cases in which there is entire disinclination and disability for metal prostration after reading or writing ever so little inability to collect thoughts or to concentrate, lack of will power. These conditions are common in students, teachers, professional men and overworked and over- anxious business men.
Head.- With the prostration there are often headaches, which usually begin in the occiput and extend over the head to the eyes, and perhaps down the back of the neck. They are of a bursting” character and are relieved by pressure such as binding the head up tightly (mag. mur., sil), are worse from movement stooping, from a warm room and a bright light, and wrapping up, and better in cool, open air. With the headache there is aversion to any talking the patient wants to lie down and be quiet. Sometimes the headache is a sharp, shooting or cutting pain in the temple or supra-orbital ridges, or a sensation of weight in the bridge of the nose.
Locomotion.- Picric acid is of great service for the symptoms of weakness and semi-paralysis that may or may not accompany mental exhaustion for the general weakness of limbs that are hardly able to support the body. The legs feels heavy as lead and are cold. These symptoms of the limbs are worse from mental exertion which causes burning down the spine in connection with them. Sweating of the hands occurs. The drug has been employed successfully in myelitis with weak limbs and a sensation as if the body and limbs were constricted or bandaged, and with numbness of the legs and feet; also in locomotor ataxia where there co-existed tormenting erections and emissions as soon as – – the patient fell asleep. It is a remedy for all cases of spinal exhaustion following acute disease, and also when the exhaustion comes on from prolonged over-use as is illustrated by a case of writer’s camp that was cured by it in a stenographer and typist who had overworked.
Sexual.- In accordance with its influence on the sexual organs, picric acid is a remedy for sexual weakness with seminal emissions; for satyriasis; for spermatorrhoea with the resulting impotence, and for sexual neurasthenia.
In the female it is useful for prostration the result of too profuse menses and for vulvar pruritus preceding menses. It has cured warts on the genitals.
Picric acid is efficacious in nephritis, chronic or subacute, with dragging-down pain in the region of the kidneys, dark, scanty urine and prostration. The dimness of sight and hardness of hearing for which it is useful are those accompanying or the result of the brain fag and nervous prostration, which are the main sphere of action of the drug. It is useful for ophthalmia, which is relieved by cold bathing and cold air, if part of a neurasthenia complex.
Skin.-In the skin it is remedy for furunculosis especially of the auditory meatus, in which it is specific. It is also good for pustular acne. Externally, picric acid is a valuable application for burns of the thirst and second degrees. A saturated solution (picric acid 90 gr. to alcohol 3oz.) dissolved in 1 quart of water is applied to the burnt surface by means of strips of sterilized gauze soaked in it, and retained by a bandage to be removed after three days, and re-applied till healing takes place, which quickly occurs with little or no pain.
LEADING INDICATIONS.
(1) Extreme mental and bodily prostration.
(2) Absence of mental anxiety with the symptoms.
(3) Uncontrollable erections and profuse emissions.
(4) Sensations of constriction.
(5) Burning and heat in the spine (*phos.)
(6) Lower limbs more affected by weakness than the upper.
(7) Boils in auditory meatus, pimples and boils on the face. Burns, locally applied.
(8) Dark complexioned persons, worn out, anaemic, cachectic.
AGGRAVATION:
BY noise, mental or bodily exertion, wet weather, warm rooms, wrapping up.
AMELIORATION:
By rest, lying down and sleep, open air and cold water and tightly binding the head (headache).
Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,