KALI CARB. has a number of indications for digestive disturbances, varying from a general slacking down of digestion to typical flatulent dyspepsia and the development of gallstones; occasionally Kali carb. patients have very suggestive symptoms which point to an oesophageal obstruction, possibly an oesophageal spasm or sometimes a definite organic stricture.
But these symptoms alone do not help to select Kali carb. as the drug; you have to add them to the general picture which it is rather difficult to summarise. I give the one that has appeared as fairly typical, although it is not exactly what you find in the materia medica.
Kali carb, patients are usually somewhat anaemic, rather pale and always definitely chilly. They are sensitive people, dislike being alone, are rather worried-often particularly worried about their diseases and not a little frightened.
Mentally, their moods tend to alternate. At times they are quite cheery, at others they seems to be unduly depressed and liable to weep. Running through their make-up there is a strain of irritability. They are very easily irritated by noise, are often unduly sensitive to voices, and easily startled – any sudden touch or noise startles them.
Another fairly constant symptom is a tendency to a troublesome chronic nasal catarrh, usually associated with some crusting about the nostrils. With the chronic catarrh, the patients tend to develop a rather swollen, somewhat tender, upper lip.
The tongue in the Kali carb. patient tends to be rather flabby and pale. One associates two types with Kali carb. In one there is a thickly coated base, very similar to the Kali bic. base. In the other there is a very sensitive, raw tip to the tongue, sometimes with definite blisters on it. These patients often complain of a slimy, flat, bitterish taste in the mouth.
There is some apparent contradiction affecting the appetite. The patients may have complete loss of appetite and an extremely uncomfortable feeling after food; if they do not take any food, they develop a very unpleasant, empty, sinking feeling in the abdomen. On the other hand, these patients may have an increased appetite and the only thing that comforts them is a little food taken often; and immediately they become hungry they are uncomfortable again.
As a rule, Kali carb. patients have a definite desire for sweet things, actual sugar or sweets, but you will occasionally find-again, an apparent contradiction-a desire for sour things. In most of these cases there is a definite aversions to meat.
In the oesophageal spasm or stricture, the main symptom is a very distressing burning pain behind the middle of the sternum, with a sensation of something hard pressing right through from the front to the back.
When the patients attempt to swallow they have a sensation of the food sticking there, and it may regurgitate into the windpipe, setting up violent spasms of coughing and choking. Associated with the boring pain in the mid-sternum, these patients often complain of a very tender spot in the spine, about the mid-dorsal region between the scapulae.
With reference to their stomach symptoms, one of the most constant Kali carb. complaints is a feeling of bloating in the abdomen. This is often accompanied by a sensation of throbbing in the epigastrium, and the whole upper abdomen is exceedingly sensitive to pressure. The sensation of bloating and distension is much worse after any food. With these disturbances, the patients often complain of sharp, stitching pains in the epigastrium, which are very much worse on movement.
Another Kali carb. indication is that the patients are liable to have attacks of acute distension during the night, particularly in the early hours of the morning, and their sleep is often seriously disturbed by them.
There is one odd description sometimes given of their abdominal distress. They feel as if the stomach, instead of being distended by wind, were full of water which was sloshing about.
As regards the liver attacks, the usual history given by Kali carb. patients is that, after some months of flatulent dyspepsia, they develop recurring slight liver upsets, with sharp stitching pains in the region of the liver, usually extending over to the left side.
Then they begin to have definite rises of temperature-an infective process is taking place. With these temperatures, they are liable to develop a troublesome cough, with acute stitching pains in the right side of the chest and, very often, patches of consolidation in the right lung.
Naturally, they become jaundiced; but, apart from actual acute attacks, you often find Kali carb. patients with yellow, scaly patches on the skin, either on the abdomen or on the back. In acute attacks they have a bileless stool; but, quite apart from the acute liver attacks, these patients often complain of a chronic, very light-coloured, painless diarrhoea.
In the majority of cases which I have seen, the Kali carb. patients, in spite of chronic indigestion, have been rather overweight than under.