THE greatest use for Phosphorus is in acute gastric ulcers. There may be indications for it in cases of jaundice-acute jaundice with congestion of the liver-and there may also be indications in acute diarrhoeas; but the commonest digestive condition in which it is required is the acute gastric ulcer.
The condition is a very acute one, with acute burning pain in the stomach. It is frequently accompanied by a very bitter or sour taste in the mouth; and there is often a complaint that the food tastes unnatural, either salty or sweetish. With the bitter taste, patients often complain of acute salivation and of the mouth generally feeling sore and hot.
In spite of the burning pains in the stomach, there is a horrible faint, hungry sensation which returns again quite soon after a meal. There is always great thirst and a constant desire for cold fluids. The cold things which are taken relieve the burning in the stomach for a time-any thing up to half an hour.
In characteristic Phosphorus vomiting, mouthfuls of material are eructated and this goes on persistently until the stomach has been emptied. This is much the most common story; but there may be a feeling of constant nausea with a sense of distension and then a sudden violent vomit of a quantity of bright blood. This is liable to be followed of recurring attacks of nausea, burning pain and a tendency to bring up quantities of coffee-ground or black vomit.
As far as the desire for food and drink is concerned, in acute conditions all that is wanted is sips of cold water or some cold juicy fluid. In the less acute stage the desire is for spicy or tasty things-salt food or generally refreshing food. There is also a liking for sour things and, often, for stimulating wines. There is a marked aversion to sweets, boiled milk puddings, and, often to meat, tea and coffee. Tea very often definitely aggravates the complaints. Such is the ordinary stomach condition. You may be dealing with an acute gastritis with a general oozing from mucous membrane, with an acute gastric ulcer or with a gastric carcinoma.
In general make-up, there is the typical Phosphorus appearance – the rather delicate, somewhat emaciated, tired and yet excitable, irritable, sensitive patient. These patients very much dislike being alone; are responsive to sympathy and much soothed by being stroked. They are very sensitive to thunder and to noise; liable to be a bit apprehensive, particularly in the dark; worse from any excitement, which is likely to produce a sensation of general pulsation, and sensitive to odours and to music. As a rule they are rather pale, but under any stress they flush up very easily. They are a little apt to become unduly depressed, just dejected and miserable.
As they become weaker, these patients rapidly develop extreme tremor of the hands and become very shaky-this is very noticeable on any excitement.
They are definitely chilly patients, sensitive to cold and to strong winds. They get a feeling of oppression, tightness, embarrassment of breathing on any attempt to walk against a wind.
With the disturbances of the lower digestive tract, you have to deal with chronic enteritis; and there are sometimes indications of Phosphorus in cases of chronic pancreatitis or in acute jaundice. In any of these condition the patient’s complaint is very similar. There is a feeling as if the whole abdomen were sensitive, painful, tender, and as if the abdominal contents were hanging down. This is accompanied by a good deal of rumbling and gurgling in the abdomen. Very often the gurgle starts in the stomach, seems to run right down through the alimentary tract and is followed by an involuntary stool.
The patients, get a good deal of flatulence and colic and are liable to very troublesome of diarrhoea. The stool is usually rather offensive, with a considerable amount of colic before the bowels act, and there is liable to be very violent tenesmus after these attacks of diarrhoea, there is a tendency to prolapse with the violent tenesmus, which is extremely painful.
In more chronic conditions, Phosphorus patients often complain of a horrible, empty, sinking sensation about 11 a.m.
As may be expected with jaundice or pancreatitis, there is liable to be a bileless stool-quite white, watery and offensive.
In attacks of diarrhoea, they frequently have acute palpitations following stool. In any of their disturbances, they complain bitterly of intense coldness of the extremities, particularly the legs and feet.