THE majority of instances indicating Natrum ars. are cases of definite gastric ulcer, the type of gastric ulcer which is going on to malignancy. As a rule there is a history of the patients being very well nourished, often they have been quite fat; and now they are rapidly losing weight. There is always a feeling on their part that they are seriously ill.
They develop an acute, anxious, nervous kind of restlessness, and very often complain of the feeling that something serious is about to happen to them. With this marked restlessness, they find it quite impossible to settle down to anything, to do any serious work or make any attempt to concentrate.
Natrum ars. patients are always chilly and very sensitive to cold, particularly damp cold. They often get an aggravation from change of weather, particularly a change to wet. In spite of their aggravation from cold, they say that mentally they feel clearer and more alert in the open air; in the stuffy room they become more muddled and find concentration more difficult.
In contrast to their general nervous restlessness, they complain of extreme lassitude, of a sensation of severe weakness, and a very marked aggravation from any exertion-either mental or physical. This sense of tiredness, exaggerated by any exertion, is slightly helped by a meal : food lessens the tired feeling. The appetite may be excessive or there may be a complete aversion to food.
All Natrum ars. patients complain of a good deal of flatulence-general flatulence-and they all suffer from particularly acute gastric pain. The pain may be a general sinking, uncomfortable feeling, a feeling of weight in the epigastrium; or more acute pains, cramping, gnawing, cutting; or just an indefinite feeling of general soreness.
The pain in the stomach usually comes on immediately after food, in spite of the fact that when the condition is not too acute, the patients themselves feel better, less tired and weary, immediately after a meal.
With their digestive upsets, Natrum ars. patients develop an acute aggravation from any cold food or drink, either of which increases their discomfort. Any fatty food tends to upset them, and they are particularly aggravated by fruit, milk and pork. Mostly they are aggravated by any alcoholic drink, wine in particular, and especially if it is sour. If they have been in the habit of smoking, they find they develop an acute aversion to their accustomed tobacco, and it seems to increase the gastric discomfort.
They develop a definite desire for sweet things and, occasionally, for bread. They also develop an acute thirst. Very often they have a longing for cold things. But any cold drink or food is apt to produce a sensation of nausea, whereas any hot drink or food tends to increase the pains, particularly the sore, raw feeling.
They have frequent attacks of eructation, with which they bring up a quantity of sourish watery material, and they suffer from almost constant heartburn. As the condition becomes more acute, they get attacks of vomiting; and they may vomit anything- sour mucus, very bitter mucus, bile or blood.
With the tendency to malignancy, there is usually some degree of enlargement of the liver, which is commonly very tender; and the patients are liable to alternating attacks of diarrhoea and constipation.
Natrum ars. patients are more liable to get ulceration on the posterior wall of the stomach; and frequently a severe aching pain going right through to the back, midway between the scapulae. With digestive complaints, they commonly suffer from a degree of urinary frequency, accompanied by difficulty in passing the urine.
These patients often complain bitterly of intensely cold hands and feet. Also of a very troublesome, cold sensation in the back, and they have great difficulty in relieving it. This latter symptom is a useful distinguishing point from Natrum phos., which does not have this sensation of coldness in the back.
Most Natrum ars. patients that I have seen have suffered from indefinite rheumatic pains. All have had a degree of skin irritation. In some, the itching has been very troublesome, and in none has it been entirely absent.
Patients requiring one of the sodium salts are liable to suffer from eye strain. The peculiarity of the Natrum ars. eye strain is that, where these patients are complaining of pains in or about the eyes, the pains are relieved by warm applications.
I have seen several of these cases where there has been a definite malignant stomach, beyond the operation stage. They have gone downhill quite comfortably on doses of Natrum ars. given in low potency. It relieves the greater part of their pain, and I have seen it entirely relieve their vomiting. But they do go downhill in spite of it: it may be that, if one got in earlier, one would be able to cure them, but of that I have no proof.