Skin.-The discoloration is a mechanical process, but the irritation of the skin of the neck and in the margin of the hair is specific. Dermatitis in this region with redness, burning pustulation and itching, worse in the evenings, amounts almost to an eczema.
Head.-Pains in one side of the head and one eye; boring in forehead, worse on left side; headache relieved by binding it up tightly, and worse from violent movement such as dancing and from mental exertion-all are argent nit features.
Sleep.-Heavy sleep, or restless sleep, or wakefulness from strange or pleasing fancies in the early part of the night are common. Or sleep may be disturbed by colic, calls to stool, or by dreams-“monstrous,” amorous, or of snake, &c.
Chills, followed by heat and sweat, are caused by this drug. The chills spread from nape to coccyx-relieved by warmth, not affected by movement or open air; chills recur at midday.
THERAPEUTICS.
If above abstract were taken alone as a series of indications for the use of argentum nit. in the treatment of patients exhibiting similar symptoms, the result would show the drug to be a remedy of no small value. It was with such records, or less complete ones, that the pioneers of homoeopathy begin. Clinical experience with it has afforded other indications which enable the therapeutist to prescribe with great precision.
Argentum nit. is a deeply acting remedy but produces some of its result with rapidity. The wealth of material in the “Cyclopaedia of Drug Pathogenesy” shows that it quickly induces malnutrition, weakness and emaciation, consequently it should be considered in a thin, withered-looking subject, looking prematurely old. Whether this be a child suffering from congenital syphilis or other with malnutrition causing this dried-up appearance, whether the cause be identifiable or not, the remedy must receive careful consideration.
Digestive Sphere.-Argentum nit. is useful in gastralgia and dyspepsia, especially when there is great accumulation of wind in the stomach, which is eructated in bursts of explosive violence giving great relief; it is also very valuable for gastric and duodenal ulcers.
Diarrhoea in children (or adults) with some urgency, where the stool contains greenish, flaky mucus or specks of blood and is passed with a good deal of flatus-a noisy, spluttering evacuation-may be the cause of such emaciation as has diarrhoea and its results, especially where forcible eructations of gas and marked abdominal distension are present. If the patient is old enough to give evidences of desires, a craving for sugar, if very marked, would be a strong confirmation of the choice. Eating sugar, however, is said to cause or aggravate the diarrhoea in such patients. The Diarrhoea may be painless or colicky and an action is often induced by drinking.
Other agents cause emaciation, of which iodoform and calcarea phos. are noteworthy instances. Both these may require consideration before making a choice. Cravings for savouries and salt, and love of heat would turn the scale in favour of the phosphate.
The mention of heat to a reference to one of the chief general modalities of nitrate of silver, namely, aggravation of the patient`s general condition in a warm and close room and corresponding amelioration in the open air. This modality extends to many of the local symptoms also-such as headache and ocular symptoms. It is very important clinically.
The headaches calling for arg. nit are often unilateral, either left-sided or not distinctively one side more than the other, though they may be usually the same side in any one patient. The sensation of fulness, bursting, swelling of being enlarged or expanded, may be experienced by the patient-the description probably being an interpretation of hyperaemia or congestion. The left side of the forehead is a favourite spot, the pain is brought on or aggravated by sharp physical exertion,. such as tennis, running or dancing, and by mental strain or effort; it is ameliorated by pressure or firm bandaging.
Vertigo may be an accompaniment of the headache, with buzzing in the ears; also giddiness on looking down from a height or even on looking up to a height, or on walking over water on a bridge or plank.
Mind.-When at a height and crossing water an impulse may seize the patient to throw himself down or to jump into the water, and this is with difficulty restrained.
The arg. nit patients finds it difficult to force himself to do things because he fears he will fail (comp. silica in more chronic cases); he is nervous in facing a trifling ordeal, such as meeting strangers or at the idea of having to be punctual, e.g., in keeping an appointment, catching a train, &c.
This nervous tension may induce diarrhoea; or in children fear of punishment on being found out in a fault may cause incontinence of urine, or an urgent desire to pass water. This, if discovered, would be suggestive of argent. nit. which, in this feature, recalls anacardium. In the adult this is matched by a patient breaking out in a sweat on facing some unexpected responsibility.
The fear of failure causes a constant feeling of being in a hurry, and compels the patient to walk fast or hurry in his work. He gets so much into his day that time seems very long. The feeling of being in a hurry is met also by ac. sulph. and lilium tig., but in the latter drug it is more likely to be associated with disease of the female pelvic organs.
More pronounced mental symptoms are irrational actions, illusions, hallucinations, loss of memory, fear of death, with prediction of the date (aconite), degenerating into melancholia. Such cases must be compared with the aurum pathogenesy, and with that of metallic silver. Obsessional states, especially fears; dementia praecox; impulsive suicidal tendency, and some cases of general paralysis with tremor may require the consideration of the nitrate. The mental condition may be associated with (if not due to ) nervous excitement, trembling, palpitation, pulsation all over the body, with feeble, irregular action of the heart. Palpitation brought on by lying on the right side is an unusual indication for argent nit. Subjective symptoms of the nervous system are various pains in joints and soft parts of the limbs and back-“boring, crawling, pressure, stitches, tearing and weariness.” Pains and tenderness along course of nerves. Objectively there may be cramps, twitchings, drawing up of legs towards abdomen by spasm, or tenderness of tendons (or teno- synovitis), staggering from weakness, amounting to paresis.
The sacral pain and stiffness extending down the thighs are important symptoms of argent. nit. The pain necessitates moving about and the patient must straighten his back to get ease. THe pains have various modalities. Amelioration from standing or walking (back), but movement if continued is painful (scapula and shoulder, &c). Walking or motion in the open air relieves some of the chest pains, rapid walking relieves others (ankles). Distant muscular effort aggravates many muscular pains, e.g., blowing the nose, sneezing, deep breathing (chest, loins, head, &c).
In time past nitrate of silver was used in substantial doses for epilepsy, but this is now abandoned. The convulsions induced by the drug might be held to indicate it homoeopathically, and Nash states that the dilated pupils for hours or days before the attack is a characteristic indication in epilepsy. For convulsions a preceding restlessness is indicative. The convulsive movement induced by slight draughts or slight stimuli remind one of tetanic spasms. In any of these cases a number of other symptoms common to drug and disease would be required to justify the use of argent. nit. The same may be said of locomotor ataxy, where shooting pains in limbs, stiff gait, inability to stand with the eyes closed, and girdle pains have caused the drug to be used.
Respiratory diseases requiring Argentum nit. are mainly laryngeal, in which there is hoarseness with phlegm rattling in the throat till expelled in small lumps by coughing. It is useful in the chronic laryngitis of singers and is indicated when raising the voice causes coughing.
Eyes.-The ocular lesions of our drug have caused it to be prescribed with success in acute conjunctivitis with swelling of the lids, chemosis, sticking together of lids. Even in purulent ophthalmia and in keratitis it has been successful in low and high dilutions, but it is said to require to be supplemented by local use in gonorrhoeal require to be supplemented by local use in Gonorrhoeal ophthalmia. It was strikingly useful in one case where the conjunctivitis was part of a widespread infection, dermatitis being present above and below the eyes, and on the nape and on adjoining hairy scalp as recorded in provings. Argentum nit. is useful in eye strain (from over-use) and defective accommodation.
Genito-urinary Sphere.- Urethritis due to Bacillus coli should be amenable to argent. nit., and it should be considered in gonorrhoea. Other symptoms are indicated in the previous sections. Involuntary or unconscious urination may require its exhibition.
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,