THE Natrum carb. digestive disturbance is that of a typical flatulent dyspeptic. Natrum carb. patients are always complaining of flatulence, heartburn, eructations; and they are acutely conscious of a very spoiled stomach. Usually there is history of having taken one of the antacid preparations, and of taking it in quite large doses.
It is difficult to place the Natrum carb. patient, but I will describe the kind of picture I associate with it.
These patients are usually rather pale, sometimes definitely sallow, with a tendency to yellowish blotches on the skin. They tend to be rather underweight and of poor physique. They very often stand badly with rather stooped shoulders, and give the impression of having sagging abdomen. They are always tired-out people; very often with a history of having had a long spell of overwork, and they are exhausted nervously and physically. They complain of inability to work or to concentrate, of a sensation of confusion and a general feeling of brain fag. Most Natrum carb. patients are depressed, and occasionally the depression goes on to a definite religious melancholia.
There is always some degree of depression with a dislike of any mental effort. This shows itself in a dislike of meeting strangers or having to talk to people; very often it develop into a dislike of their family, dislike of company in general, and a marked aversion to certain people.
They explain this dislike of certain people in various ways : sometimes they say it is just that they cannot get on with certain people, at other times that certain people exhaust them and leave them dead tired; or simply they are sensitive to the atmosphere of people.
Natrum carb. people are always nervous, and they have a general trepidation which is very much aggravated by any sudden noise. If they are startled by a sudden noise they are liable to have definite trembling attacks; they will often get these attacks from excitement of any kind. In addition to being sensitive to noise, most of their senses tend to be over acute; they are over sensitive to light, their sense of taste is over acute. Their sense of smell, too, is always disturbed-sometimes it is over acute but, more commonly, it is entirely absent.
They are always chilly patients, very sensitive to cold, particularly to cold draughts, and yet they are aggravated by extreme heat and are very sensitive to exposure to the sun-they nearly always suffer from sun headaches. They are extremely sensitive to any atmospheric electrical storms.
As regards actual digestive disturbances, they mostly suffer from an acute acid dyspepsia. Their flatulence is greatly aggravated by any starchy food, by vegetables and fatty food. One outstanding point about them is that they have a complete intolerance of milk. It increases the flatulence and is very likely to bring on an attack of diarrhoea.
With the gastric upsets, they always develop an acute thirst, which is liable to be particularly marked after meals.
In spite of the tendency to flatulence after food, they are generally rather more comfortable after eating; but this lasts only for a short time and, a little later, a nasty sinking sensation leads to abdominal pain, general heartburn, flatulence, a feeling of acute distension, probably some colic and later still, a headache may develop.
Natrum carb. patients frequently get a period of extreme hunger late in the evening about 11 p.m., and again in the early morning about 5 a.m. Between 10 a.m. and 11 a.m. they may feel an empty, sinking sensation, but it is not real hunger-the actual hungry periods are more likely to be in the evening, or in the early morning, when the hunger may wake them.
Natrum carb. is very useful in many of the digestive disorders of pregnancy when these are associated with hunger during the night.
Most Natrum carb. patients are constipated but in acute digestive upsets they occasionally get an attack of violent diarrhoea, which is usually greyish and watery, very sudden in its onset and difficult to control. The Natrum carb. patients who tend to have these recurring attacks of diarrhoea may also have a certain amount of enlargement of the liver, and be slightly jaundiced.
All Natrum carb. patients tend to suffer from recurring attacks of catarrh in various situations : it may be a recurring leucorrhoea, a recurring nasal discharge, or an old otitis. The constant characteristic about these catarrhs is that, no matter where they are situated, they are always accompanied by very thick yellow discharges.
All the Natrum carb. patients I have seen have and diffuse rheumatic pains; complaining of creaking sensations in the cervical region, pains in their backs, weakness of the ankles and sensitiveness of the soles of the feet.
They all tend to have very dry skins, and they frequently complain of painful, dry cracks on the fingers, particularly the finger-tips, and of the same sort of thing on the toes.
Many of these patients, in spite of their general emaciation or loss of weight, get oedema about the ankles in the evenings, when they are tired.
They are all susceptible to herpetic attacks. They get eruptions round about the hair, they may get herpetic patches on the lips, and are liable-particularly the older patients-to suffer from attacks of thrush. Thrush in old women not infrequently requires Natrum carb. For children with milk upsets and milk diarrhoea accompanied by thrush, Natrum carb. is one of the biggest standbys.
The drug that is most commonly confused with Natrum carb. is Sepia, and many of the patients who appear to need Sepia really require Natrum carb.