IODIUM is one of the very interesting digestive drugs, and it covers a number of definite pathological conditions. There are three conditions which Iodium covers particularly well. The most important is chronic pancreatitis. The condition of second importance is a very chronic gastric carcinoma. The third is a cirrhotic liver, which may be a primary cirrhosis, a chronically inflamed liver or a liver with metastatic growths in it.
No matter what the pathological condition, there are certain constant factors which lead to the prescription of Iodium. My experience has been rather contrary to what is laid down in the textbooks of materia medica as to the Iodium make-up.
The textbooks all stress the intense irritability, the intense restlessness and the strung-up nervous state of Iodium. But in the cases in which I have seen Iodium helpful, a marked characteristic has been a general mild despondency.
The patients have always been rather mild, intensely scrupulous in all their dealings and somewhat timid. But it is that intense scrupulousness of the Iodium patient which, to my mind, is their outstanding characteristic.
As far as the irritability is concerned, in these digestive cases it is a symptom which tends to develop during the process of digestion, and is by no means a constant factor in the patient’s make-up.
Another constant in Iodium patients is their tendency to become worried and anxious if their meal is delayed and they become at all hungry. They have a very marked desire for food. They do not necessarily want a great quantity at a time-in fact, they often are not able to eat much at all-but they have a very quickly recurring need for food and, if they do not get it, become worried, anxious, restless and distressed.
So far as their desire for food is concerned, they do not seem to have very definite cravings. Some have a marked desire for meat; but, usually, it is food of any kind that the Iodium patient wants, more than any particular articles of diet. These patients always have a good deal of generalised abdominal pain, the exact nature and situation depending to some extent on the pathological lesion. But in all these cases there is a certain amount of relief immediately after taking food.
In gastric carcinoma they often complain of a burning pain, associated with marked epigastric pulsation and quite extreme epigastric tenderness. In these gastric carcinomas the patients usually have rather a pale, yellowish complexion, with somewhat striking, bluish lips. This holds good for all the Iodium lesions, no matter what they are.
Both in gastric carcinomas and in pancreatic lesions, Iodium patients are liable to get attacks of acute salivation and vomiting, which are often extremely distressing. The tongue tends to be very dry, and patients often complain that it feels scalded or burned.
In spite of the general restlessness the patients often complain of extreme faintness on movement : sitting up, getting out of bed, standing, will bring this on-particularly when they are hungry.
In their gastric conditions they mostly suffer from obstinate constipation, which is a great trial to them, and is associated with marked abdominal distension. They may also get spasms of localised distension, which are extremely painful.
With that can be linked another Iodium symptom : the distension due of diffuse, generalised enlargement of the abdominal glands in carcinoma cases. You will get the same thing with the pancreatic lesions and, if you are dealing with a secondary hepatic carcinoma, you will find the enlarged glands there, too. The characteristic feature is that these glands are definitely tender on palpation, and they feel very, very hard.
As far as the pancreatic cases are concerned, Iodium patients suffer from the typical pancreatic pain, that is to say, a pain right across the upper part of the abdomen, about an inch above the umbilicus, associated with a horrible fullness, tenderness and an intense pressing feeling. Cases with these pancreatic lesions have attacks of diarrhoea, with very unpleasant, frothy stools.
Where you are dealing with the disturbances of the liver, whether as a primary cirrhosis or as a secondary carcinomatous condition, there is liable to be jaundice, but it is fluctuant in intensity; the jaundice is constant, but it varies in degree. These cases have clay-coloured stools, very often recurring attack of exhausting diarrhoea, with somewhat frothy stools.
As regards results of treatment. In pancreatic cases, where there could be no question about the diagnosis, with definite fermentation of the stools, the patients have definitely improved after treatment. I have cases with definite masses of glands in the abdomen clearing up, and the patients’ capacity for dealing with fats going up out of all recognition.
I do not say that these patients are cured. I have treated one or two of them who died. But their pain had been removed, their abdominal distension went down, they put on weight, they lost their hopeless outlook, and they lost their recurring attacks of diarrhoea. These patients do not get well, but it is astonishing what comfort you can give them.
I treat carcinomas who have had X-rays with one of the radioactive salts as a first measure-to try to antidote the x- rays. Usually one of the radium salts, Radium bromide or Radium iodide. If there are any indications for Iodium, I prefer the Radium iodide to the Radium bromide.
Iodium is not of the very useful medicines for relieving those patients who normally go on to massive sedative treatment and have an appalling end. With the aid of Iodium it is astonishing what relief can be given to these patients, although it may not actually cure them.
In any of these cases I give the drug fairly frequently to begin with, and find it holds for longer and longer intervals; so I think there is no doubt that it definitely has a curative effect.
I have seen Iodium indicated in mammary carcinomas, but I have never had a clear indication for it in uterine carcinoma. I had a case once with a carcinoma of the tongue, and she did very well on Iodium. Eventually I lost sight of her and did not know the ultimate result. But the epithelioma of her tongue shrank to half the size, and the mass of glands in her neck almost disappeared.