CAUSTICUM is one of the most useful drugs we have for a type of patient that is very difficult to handle. For the rather broken down, chronic dyspeptic. Broken down in health, rather shaky, very depressed, very hopeless and very miserable. They give you a history of chronic indigestion, and what makes you think of Causticum is that, whenever the wind changes into a cold, dry quarter they are certain to get attack of indigestion.
Another indication for Causticum is that these patients are very liable to develop a stiff neck, stiff back, stiff arm or a stiff muscle somewhere, from exposure to the same kind of cold, dry wind.
They suffer a great deal of abdominal discomfort. They describe their complaints in variety of ways-a burning sensation in the stomach, a feeling that it is constantly out of order, a constantly soured stomach, a feeling as if everything fermented when it was swallowed-just the hundred and one expressions that you get from the chronic dyspeptic.
The symptom that indicates Causticum is that in spite of this spoiled stomach, they are painfully hungry all the time, though they cannot bear the thought of eating. If they want anything at all, they want something with a definite taste about it; pungent food of some kind, smoked meats, acid beer. They have a definite aversion to sweet foods, pastries, cakes, delicacies of most kinds.
Another interesting thing which always points to Causticum is that after a meal they are very liable to develop acute thirst with a desire for cold drinks-and yet, if they take very cold drinks after a meal, they get acute abdominal pain.
In their gastric attacks, Causticum, patients get a certain amount of eructation or, more frequently, a feeling of sour fluid coming up into the throat. They may actually vomit, in which case they vomit is very sour and seems to scald the throat. After any starchy food they are liable to become flatulent, distended and very uncomfortable. And they usually suffer from pretty obstinate constipation.
As far as their actual lesion is concerned, I think chronic gastritis is the most common, but there are also indications for Causticum in cases of definite gastric ulcer.