INDICATIONS for Aurum occur in the typical malignant stomach. There are one or two very definite indications which point to such a case. Aurum is indicated for the patient who has realised that he is up against a malignancy, or at least a very serious illness, and he is very hopeless about the outcome of it.The patient is singularly obstinate and does not always carry out instructions; he gets an idea into his head, either that it is no good his doing anything, or that something of which he has heard or read is going to cure him, and it is very difficult to persuade him otherwise.
As far as the appearance of the patient goes, many of these Aurum patients have, or have had, a definite cardiac lesion of some kind and are quite liable to have a good deal of colour, very often the sort of mitral flush associated with the cardiac lesion. Add to that the symptom that all these Aurum patients have a definite desire for air; they want plenty of fresh air circulating about them.
They get flushed and hot and when they are feeling particularly depressed, heavy and miserable, are very often helped for the time being by bathing, or by sponging the face and neck, in cold water.
The next thing is that most of these Aurum patients have a good appetite, very often an inordinate appetite, but it is not so much gastric symptoms which are relieved by eating or aggravated by hunger as the patient’s general feeling. He feels very much better in himself after a meal, and he is very much worse if he is hungry-more depressed, more miserable, more disheartened.
In addition, these patients get a definite hunger pain which is relieved very often by eating, but they are much more likely to get a feeling of intense fullness, pressure, and weight in the upper part of the abdomen. Very often that feeling of fullness is more marked, or more complained of, in the left part of the upper abdomen than the right, although the majority of these cases have definite hepatic enlargement.
This may be the general enlargement due to cardiac back- pressure, the ordinary smooth, hard, congested liver, or it may be an irregular enlargement due to secondaries in the liver.
One peculiar symptom comes in here. The patient is rather hot-blooded, and yet with this feeling of drag and heaviness in the abdomen he very often complaints that when it is bad he suffers from intensely cold legs and feet, very often they are icy cold, which is in contrast to the general hot-blooded state. And, not infrequently in these carcinomata where Aurum is indicated, there is quite early development of ascites.
As regards their appetite, they usually develop a definite craving for alcohol, coffee, very often for milk, and have a marked aversion to meat. And very often there is a history of alternating attacks of diarrhoea and constipation.