THE most common condition requiring Natrum sulph. is that which used to be called a sluggish liver. The patients have a very slow digestion, and can digest only the simplest of food. They suffer a lot from nausea, particularly after any farinaceous food, and are liable to attacks of bilious vomiting, usually associated with a good deal of abdominal colic.
The mouth feels horribly slimy, and there is always a dirty tongue-a dirty, greyish, slimy tongue-and a very bitter taste in the mouth. There is a very definite aversion to bread and meat, and usually a marked thirst for cold drinks.
This typical condition, occurring in patient who is very sensitive to heat, very much worse in warm weather, liable to attacks of this type coming on in the spring, aggravated by damp, and who is definitely better in the open air, better when moving about, worse when at rest, and who has the peculiar mentality of Natrum sulph. will respond to this drug every time.
The characteristic state of these patients is one of depression. They feel heavy, they do not want to be disturbed, they do not want to be spoken to, and they cannot be bothered to speak. There is a general feeling of dislike of everything, and this may go on to an acute loathing of life, almost a melancholic state. But in spite of the tendency to turn their faces to the wall and give up the struggle, there is a streak of anxiety about themselves running through their outlook.
Their depression is very marked, and it is aggravated by music. It is usually very marked in the morning on waking, and tends to improve after breakfast, i.e. after some food; and it is definitely relieved after stool.
In spite of their general sluggishness, Natrum sulph. patients are always over-sensitive to pain. And they have a peculiarly extreme sensitiveness to light. In acute conditions, they want their room darkened and to be left in peace; it is astonishing how often you find a Natrum sulph. patients lying with his back to the room.
With liver upsets, they very quickly acquire a slightly jaundiced tinge. It may be an extreme jaundice, and, in acute attacks, they are prone to develop vesicles, particularly on the lower lip.
The attack may be a simple catarrhal jaundice, with enlarged, tender liver-very sensitive to pressure; or it may be a definitely enlarged gall-bladder with gall-stones and gall-stone colic. But, no matter which it is, there is the same description of the discomfort they feel below the right costal margin-that is to say, they get pain and tenderness on lying on the right side, owing to the pressure on the liver. They also get a dragging sensation if they lie on the left side, due to the drag of the congested liver.
Such is the most likely type attack which the Natrum sulph. patients are liable to suffer. Usually with these bilious attacks, they suffer from very severe occipital headache, often with the sensation that the head is being dragged back on to the pillow.
Another condition to which Natrum sulph. patients are prone is a fairly acute attack of appendicitis, with extreme pains in the cecal region. Apparently, it is a retro-cecal appendix, because they always complain of extreme pain going right round to the back, rather than of pain over McBurney’s Point. It is the type of appendix which is associated with a degree of jaundice.
Some of the most striking results from Natrum sulph. have been in cases of appendix abscesses, where there has been a retro-cecal appendix and a tendency for the inflammation to track up and conditions suggesting a sub-phrenic.
I have never seen a definite sub-phrenic abscess cleared up with Natrum sulph., but I have seen several cases in which there was a definite tracking inflammation going up under the liver, with a nasty swinging temperature. Cases which had been operated on and were obviously going downhill, and in which there was a tendency to involvement of the chest, particularly the left lower lobe; and they have cleared up in the most astonishing way on Natrum sulph.
In the ordinary acute appendix, in addition to the locality of the pain and the general make-up of the patient, one constant is a very troublesome urging to stool, which merely results in the passage of a quantity of flatus. The other characteristic with these appendix cases is a vary troublesome, gushing diarrhoea, accompanied by acute cramping pain in the abdomen. This is liable to be very marked first thing in the morning, immediately the patient gets out of bed.
Concurrently with the attack-be it liver, gall-bladder or appendix-the patients are very liable to get a supportive condition about the root of the nails. I have verified this several times. A patient with a chronic liver who, with a slight increase of digestive disturbance always develops suppurating places round his nails, will very often need Natrum sulph.