HEPAR SULPH. is another of the medicines which are neglected in digestive disturbances, and many cases in which we ought to give Hepar sulph. are given Nux vomica instead.
There are many similarities between these two medicines. Mentally they are very alike. They are both hyperaesthetic in every way; irritable, snappy, hasty in their movements, impatient and very chilly. In the majority of cases both Hepar sulph. and Nux vomica tend to be rather underweight, but usually Hepar sulph. patients have more colour; very often they have bright red cheeks instead of the sallow Nux appearance.
All the Hepar sulph. patients I have treated for digestive disturbances have had very unhealthy mouths; they have a tendency to caries of the teeth, unhealthy gums and very often a history of dental abscesses. Frequently the breath is offensive and there is an unpleasant-or definitely metallic-taste in the mouth.
Most Hepar sulph. patients tend to develop a horrible sensation of hunger in the middle of the morning-a very unpleasant, empty sensation. And with this they have an acute craving for highly seasoned, strong-tasting food of every kind.
One thing that always suggests Hepar sulph. is the fact that not only are the local gastric symptoms relieved by food, but the patients themselves feel a hundred per cent. better after a meal; it seems to lift them generally, quite apart form the relief of their local symptoms.
These patients usually suffer from a good deal of heartburn, with very troublesome, acid eructations.
Associated with the empty feeling in the stomach is a very distressing sensation of the whole abdominal contents hanging down; this is particularly increased by standing about or by walking. This is particularly increased by standing about or by walking. In spite of this sagging sensation, they are made uncomfortable by anything in the nature of abdominal support; external support of any kind seems to increase their distress. So, be a little careful of anything in the nature of a Curtis belt in the visceroptotic Hepar sulph. cases. These patients are very liable to recurring attacks of vomiting almost bilious attacks. The typical feature of the attack is that the patient feels horribly sick, makes violent efforts to vomit and, after severe retching, brings up a quantity of bile-stained fluid.
Associated with these bilious attacks the patient has acute, cutting pain, usually about the region of the umbilicus, accompanied by much rumbling in the abdomen and, sometimes, definite colic. With these general abdominal upsets troublesome attacks of acute diarrhoea are very liable to develop. The type of stool in Hepar sulph. cases is very offensive and fermenting. Often these people have had recurring attacks of this kind every spring and autumn for years, and while the attack lasts there is frequently profuse, sour-smelling, generalised sweat.
In addition to the craving for stimulating foods of all kinds, there is one Hepar sulph. characteristic which is sometimes a great help: with the digestive upsets there is very often a definite craving for vinegar. This is a clear Hepar sulph. pointer.
It is said that these patients have a marked craving for fat. I have not treated one who had a craving for fat during a digestive upset; but I have had quite a number of Hepar sulph. patients who had digestive upsets of this nature and who developed an acute aversion to anything greasy or fatty. So do not ignore this drug just because the patient does not have a craving for fat.