(From The Medical Advance, August, 1905).
ONE of the most important things in studying a remedy is to cause it to appear before the mind so that it can be recalled, to get an image or picture of the remedy so that it can be stamped on the memory. A remedy cannot be understood till studied and used. An old physician will be able to recall to memory past patients in whom he can see pictures of the drug he is studying. After some experience, when a patient walks into your office you will be able to classify him by his face and appearance and think of his face as that of a Sulphur patient, etc.
If he has red spots on a pale face, is stoop-shouldered, a little past middle age, you will wonder whether that patient does not need Sulphur, as he narrates his symptoms you will find them to be those of Sulphur. Or if you are drinking wine with a few friends and you notice one gets a flush of his face mounting up to his forehead after the first glass, you would wonder if he did not need Carbo vegetabilis.
Nitric acid has a sickly face, yellow, sallow, lean doughy and sore eyes, and fissures in the corners of the eyes and mouth. It looks as if there were a copious flow of saliva, and this actually takes place during his sleep and causes a red streak where if flows.
The saliva is acid, excoriating, producing red spots. The tears and other fluids from the eyes are excoriating and are attended with smarting and burning. Sickly, anxious face, emaciation of the body, a cachectic aspect; bloated eyes and face; such things causes us to look at the hands and fingers to see if they are not bloated also. His is the countenance of deep seated troubles.
There is a fissure down the whole length of the tongue, not sore or raw, but as if partially divided. The gums settle away from the teeth and the teeth become loose. The gums bleed on pressure. Sore mouth; canker patches in mouth; aphthous condition; yellow splotches on the mucous membrane. The throat is tumid and purple and there is an exudate not unlike the exudate of diphtheria, and around this the tissue are purple coloured, tender to touch and bleed easily.
He is sad and broken hearted. He says the world is against him and that he has no friends left. There is a struggle going on between a desire to die and a fear of death. He feels estranged among his friends. He is disgusted with life; is sad, anxious, sleepless, and has frightful dreams. Everything disappoints him and he is irritable.
He is worse in a cold climate and from cold raw winds and also from hot weather, and feels better in medium weather and a moderate climate. He must dress very warmly, for cold weather freezes him; the cold brings on his neuralgic pains, headache, backache and pains in the extremities. He wants warm applications and applied heat in many localities, but he is worse from hot weather.
Every cold snap aggravates his catarrh. The nose feels full of splinters; sticking and jagging pains along the sides of the nose, septum and far up in the nose. Crusts form in the nose and he cant help picking at the nose to get rid of them, and then the nose bleeds. He blows bloody water from the nose. The watery discharge floats out the crusts and continues to flow.
Every cold causes catarrh and stops up the nose. Sneezing, burning, smarting and sticking in the nose. Sensation of sticks in the posterior nares and throat. Ulceration everywhere in the throat and every little ulcer has a stick in it, with tearing and burning. Deep ulcers in the throat, which bleed, and a stick is felt in every ulcer on swallowing and touch.
The sensation of sticks in parts, is general. It is present in gonorrhoea with bloody, watery discharge and sore spots along the urethra, which are small ulcers, and in these the same sticking splinter like pains are felt. In the throat there is the sensation described as a fish bone like Hepar. In the female there is a bloody, water, brownish leucorrhoea, causing brown stains on the linen, with ulceration of the cervix, which bleeds when touched. All ulcers tend to bleed, and when touched they have a sticking pain as if from a splinter.
Little boils have the same splinter-like pains, and eruptions have sticking, pricking sensations. Ulcers on the lower extremities, over the tibia and ankles; thin, bloody, watery discharge with burning, sticking pains at night; pricking as from sticks in the ulcer.
There is much urinary trouble in this remedy. The urine is albuminous, bloody, offensive, and smells as strong as that of a horse.
The Nitric acid patient is exhausted, weak, and tires easily and has palpitation on exertion. He must be in bed most of the time. He is lean, hungry, tired and weak and has been losing flesh for some time. Again it is useful when there is an accumulation of fat; the patient is soft and flabby like Calcarea, which is closely related to Nitric acid, complementary to it and alternates with it. He has no endurance; his heart palpitates on the slightest exertion but he is ameliorated from passive gliding motion.
He cannot exert himself, but will ride on a smooth country road ten to twelve miles perfectly well. His complaints, palpitation, nervous symptoms, anxiety and sufferings pass away entirely when riding in a carriage or street car if the weather is not too cold or too warm. He is both aggravated and ameliorated from riding in a carriage. In a carriage that jars over a rough street and makes much noise he is aggravated, but in a gliding carriage on a smooth road he is ameliorated. He is ameliorated from riding in a street car because of the smooth track.
He is sensitive to noise in his pains and headaches; the noise of a carriage is very painful. Lippe said every time he noticed tan bark covering a street he suspected a Nitric acid patient within. He drives everybody into quietude; so sensitive is he that the doors must be closed with gentleness and he can bear no one to walk across the floor. Coffea and Nux are just as sensitive, and I think of these as well as Nitric acid when I see tan bark in front of a house.
Great prostration. Acrid discharges. Tendency to ulceration. Very serious head troubles. With the headache the scalp is so sensitive that the hair cannot be combed. Cannot wear a hat, sensitive to weight of the hat. School girls come home from school carrying the hat in hand, because of the headache got in school, like Calcarea phos. School girls with: “Head very sensitive even to pressure of hat; worse in the evening and on part laid on; sensitive as if confused, either all over or in certain spots; whole right side of the skull painful.”.
Scald head in children; tendency to ulcerations; fluids offensive; bleed easily. The discharge takes the hair off and causes excoriation and redness where it touches. Then there are enlarged glands in this broken-down constitution, enlarged glands in the groins, buboes, syphilitic bubo, enlarged axillary and salivary glands. The parotid is enormously swollen, hard and painful, and has the sensation of sticks in it, and there is a tendency to suppuration. Sub-maxillary glands and glands of neck affected.
It is no wonder Nitric acid is of use in syphilis, for it has all the blood changes, the aspect of the face, the ulceration, falling hair, throat symptoms, bone affections and exostoses. It antidotes Mercury and is closely related to Hepar. It is anti- syphilitic and anti-sycotic. It has fig warts about the genitals and anus, which bleed easily, are soft and pulpy. Seed warts about the hands.
As a warty medicine it is closely related to Calcarea. Warts anywhere that are pulpy and bleed easily. It is very closely related to Calcarea in many ways. I have seen patients act this way. A psoric patient, big, fat, flabby, easily tired out, with Calcarea symptoms, will be relieved by Calcarea for months, building him up; but all at once he takes a turn and a bronchitis comes on, difficult breathing, ulceration of the throat, soft, flabby, feeble muscles, waxy countenance, and suddenly about the anus and genitals a crop of warts breaks out. I at once ask: “Had you ever gonorrhoea?” “O, yes,” he says, “when I was a boy, I sinned.”
He needs Nitric acid. It will build him up. Here two miasms have been working in the system at one time; one has been suppressed and the other is uppermost. Nitric acid will benefit him for a time, and again he may need Calcarea. Nitric acid and Calcarea antidote each other, but it is a mistake to say that they do not follow each other well. Sulphur and Mercury alternate with each other in this way. Sulphur for a year or two and Mercury to meet the syphilitic condition that crops up when these two miasms are in the system at the same time and alternate.
Whooping cough. The cough is violent causing gagging; bloody expectoration; the face becomes red and blue when she coughs, pale when not coughing; rawness of lips, bleeding of the nose and gums, cracks in the corners of the mouth. It corresponds to a violent case, and after it is over Calcarea will likely be needed to meet the psoric condition.
Eruptions on face; ulcers spread; itching and ulceration among the whiskers; whiskers fall out. Disturbances from shaving. In girls and boys acne and ulcerating, pustular eruptions on face. Nitric acid stands high in this condition. Unhealthy skin everywhere, small wounds and bruises suppurate, and there is lack of healing. Waxy face; yellow, sallow skin, and sickly cachectic state such as those have who are going in consumption or cancer. It has the puffy, waxy, transparent face of albuminuria. It has cured diabetes.
This drug will keep the oculist away many times. Our oculists are a poor set, as a rule; they rarely attempt to apply the remedies to a condition of the eyes. Ulceration of the eyes, of the cornea, inflammation with ulcerous patches. White patches as a result of bad healing.
There is never any excuse for making a local application to the eyes. You do not need atropine to dilate the pupil in iritis. The iritis is a symptom, and being the last to come will be the first to go under the proper remedy. There will be no adhesions; that is, there will be no results of the inflammation. It is an acute condition and must be treated as such.
Whenever you say that atropine is necessary, it is an acknowledgment that you do not know your Materia Medica. I remember a case where an oculist was called in to satisfy the family. He pretended to be a homoeopath, but he said to the physician attending to the case: “This is a case of syphilitic iritis. You must use atropine or you will be responsible,” and there was talk of paying all around.
The physician would not use the atropine. He came to me, and on a study of the symptoms he saw that Staphisagria was the remedy and Staphisagria removed the symptoms at once. All sorts of ulceration of the eyelids, of the corner of the eyes, and of the surface of the eyes with sticking, jagging pains. “Ophthalmia neonatorum; scrofulous, gonorrhoeal, syphilitic.” The worst forms are easily cured if the symptoms agree.
Fistulous pipes anywhere that will not heal; fistula in ano; abscesses that have formed do not heal and flow from fistulous openings. Diseased bone with fistulous openings. It so improves the integrity of the bone that the opening is no longer necessary. A patient, by operation, had a part of the femur removed, but the fistula would not heal, although it was known that there was no bone there. The patient had not had any remedy. Nitric acid cured him. The tissues will not heal, there is no repair going on.
Full of rheumatic pains and aches. The pains cease suddenly and other complaints come on. Pains again come on suddenly and extend all over the body, from change of weather, taking cold, a cold bath, or getting wet. Pale and sickly people with gouty attacks; in old Calcarea subjects. Pains with swellings, swollen joints, sticky, tearing, tingling pains in joints at night, especially in old syphilitic and sycotic rheumatism. Ulceration at the root of the nails, felons, inflammations at the root of the nails; ulcers.
The Nitric acid patient is fetid, offensive, full of odours; the discharges smell strong, the urine smells like that of a horse; there is offensive leucorrhoea, offensive nasal discharge, offensive breath; fetid footsweat, sour at times, but more often of a strong pungent odour. Coloured people who take Nitric acid, if their other symptoms agree, lose their offensive odour.
“Great weakness, trembling; shocks on going on to sleep, depressed in spirits.” Haemorrhages bright, profuse; bleeding of all mucous membrane. Post scarlatinal complaints; dropsies.
I have given you the generals. When the little symptoms you find in the text are present without the generals Nitric acid will not cure. These common symptoms may be found in any remedy.