Introduction
HAHNEMANN points out that this medicine is more beneficial to individuals with a rigid fibre (brunette), than to those with a lax fibre (blonde). And, indeed, it is one of the drugs that, suggested by the appearance of the patient-brown eyed-makes one at once consider Nitric acid as a possible remedy: of course, symptoms must agree, but they so often do.
In out-patient work, where one has to “get along”, the symptom- complex, desire for fat, desire for salt, chilliness, indifference, puts you on to Acid nitricum in Materia Medica; to find, more often than not, that the rest of the symptoms fit the patient, and that you have got the curative remedy. In the desire for fat and salt, Sulphur only, in the Repertory, competes with Nitric acid, but in lower type. The Repertory gives us very few fat-cravers, Acid nitricum being the one in black type: they are usefully memorized, viz. (Arsenicum), (Hepar) NIT. AC., Nux and Sulph. But, among these, Arsenicum, Hepar and Nux have not the salt craving: while the mentality of Nitric a., as it seems to us, is more that of Sepia: but Sepia loathes fat, and does not crave salt. Here is the little Nit.a. symptom-complex which helps one to the drug, in rapid work: one cannot miss it!-
Nit.a., besides its craving for fat and salt, in its full development, is-
Chilly. Depressed. Indifferent. Intolerant of sympathy. Sensitive to noise-pain-touch-jar. Irritable: suspicious: obstinate: restless. Fears death. Worse: wind; thunder, wet.
Has profuse sweat of hands and feet.
Some years ago, after one of our post-graduate lectures, a doctor from “the other end of nowhere” asked help of the lecturer in regard to a child-patient of his, with inveterate constipation. She was found to have the Nitric acid cravings for salt and fat, and the lecturer proceeded to read out to the astonished doctor, from Allen’s Keynotes, the Nitric acid symptoms. “But-do you know the child?” Of course he did not: but he knew Nitric acid; and these symptoms suggesting the drug, the rest fell into line. That is how one gets through an over-crowded out-patient afternoon; a little symptom-complex suggests a drug, and you look it up, and are happy to find that you are “there”.
Hahnemann tells us that Nitric acid is more useful for persons who suffer from diarrhoea (Pulsatilla); but Clarke says that it is one of the remedies that has been most useful to him for constipation. Clarke was always insistent about this:- that while positive symptoms are all-important, negative symptoms are less so. For instance, the fact that a person cannot kneel without faintness, or giddiness, or whatever it may be, suggests Sepia- the only drug that appears in the Repertory as “worse kneeling”. But the fact that she can kneel without suffering in such ways does not contra-indicate Sepia. You will find that symptom is very few Sepia cases: though I think you will find it under no other remedy. (By the way, this “worse kneeling” means the patient: not his inflamed and swollen knees. That would be a common symptom in arthritis and not helpful in the choice of the remedy.)
Another almost unmistakable feature of the Nitric acid sufferings, is the character of its pains:- not only sticking, but SPLINTER-LIKE. Wherever the pains occur, in bone, in mouth, in nose, in anus, the sensation is “a SPLINTER”: especially when the sore part is touched or pressed. Clarke, in his Dictionary of Materia Medica, has a brilliant little article on Nitric acid, introducing its provings. Here he points out, in regard to the sticking pain as from splinters-“This is a grand keynote of Nitric acid, and will serve to indicate it wherever it is found. It requires a touch or movement to elicit it. When it occurs in the throat it requires the act of swallowing to set it up; in the anus, the passage of the stool; in ulcers, the touch of a dressing. It may occur in any part of the body: in in-growing toenails. (Magnetis Polus Australis.)
Then, the localities affected by Nitric acid, to torture or to cure, are very striking and definite. It selects orifices: situations where mucous membranes are merging into skin- endothelium into epithelium. The eyes, the nose, and (especially) the mouth, with lips, tongue, gums, tonsils, extending down the throat. Then, passing by the digestive tract without much malice, it vents its spleen on the rectum and anus, the urethra and the genitalia, with, always ulceration, fissures, stitching, splinter-pains, bleedings and offensiveness. As Guernsey says, “This remedy so closely resembles Mercury in many points, that it is often very difficult to distinguish between the two.” And therefore, since we prescribe on symptoms, and since the antidote to any drug or to any disease is always the drug of most-like symptoms, Nitric acid is found to be the most useful remedy to counter poisonings and sicknesses from abuse of Mercury. And again, since the symptoms of Mercury and syphilis are almost indistinguishable, Nit. a comes in also, as will be seen, for the treatment of that disease.
Nit.a. again, is like Mercurius in offensiveness. It has offensive mouth and saliva: offensive sweat in axillae and feet: offensive moisture about anus: offensive, strong-smelling urine (urine that smells like that of the horse is characteristic): with (a peculiar symptom) “it feels cold as it passes”. Here the only other remedy is Agar, in lowest type.
Another painful symptom heads straight for Nit.a.:- not only painful stool, but pain for hours after stool. The anus suffers frightfully with Nit.a. There are not only haemorrhoids-painful haemorrhoids, but fissures, which gape and bleed and are exquisitely painful. To have to examine the rectum of a Nit.a patient is a terror to doctor as well as to the victim. One remembers, years ago, being asked to go across Great Ormond Street to see a lady who was in agony with pain in anus, and who had applied to the Hospital to send one of its homoeopathic doctors. The remedy was Nit.a., which she got, with speedy relief, and on enquiry next day one heard that she was all right.
And here we will quote NASH. He says:-
“No remedy has a more decided action upon the anus, and one very characteristic symptom is, ‘great pain after the passage of stool, even soft stool’. He walks the floor in agony of pain for an hour or two after a stool (Ratanhia). In dysentery this symptom distinguishes this remedy from Nux vomica which is relieved after stool and Mercurius which has tenesmus all the time, or before, during and after stool.
Nitric acid helps in all Hahnemann’s “Chronic Diseases”,- syphilis, gonorrhoea (sycosis) and that other one which he terms “psora”, as well as in Mercury poisonings and overdosings. In syphilis one has seen its magnificent work in acute and chronic cases. One was very interested in a patient who recently reappeared after some twenty years’ absence from hospital. She had originally come for leucoplakia, which had been cured by Nitric acid in homoeopathic dosage. She is now eighty, healthy- looking and robust: doctors sitting by guessed her age as sixty!- and, tell it not in Gath! her “Wassermann” is still positive! One recalls Hahnemann’s contention that syphilis, untreated by the methods of the schools, is not such a deadly disease: and this woman, young looking and vigorous, complaining only of something trivial (one has failed at the moment to remember her name of discover her notes) has had no treatment all these years! well, for the sake of our worried Old School brethren, we will put it at this, “The exception proves the rule.”
Clarke says that Nit.a is also an antidote to overdosing with Potassium iodide: and he says that Burnett cured brilliantly a case of action mycosis, with Nitric acid, which, since it had been going the round of the schools, would doubtless have been much dosed with that drug.
For sycosis (? gonorrhoea) Hahnemann suggests that two remedies will be found useful-Thuja and Nitric acid: given according to symptoms, and each allowed to complete its work before-the symptoms changing-the other is made to follow. In this way only Hahnemann alternates. See HOMOEOPATHY, Vol. IV, pp. 202,203, in regard to Rhus and Bryonia in war typhus.
Another use, to which Clarke alludes, for Nitric acid, is in lung troubles-pneumonia and phthisis. Inhaled, among all the acids it is the only one that produces a very rapid and fatal inflammation of the lungs-Clarke gives a case:- and in the provings quite a number of its symptoms suggest phthisis. Hence, wherever the key symptoms are those of Nit.a., that drug should be considered in pneumonia and phthisis. One remembers a case, years ago, in dispensary days, where Nit.a. did surprisingly good work for a consumptive patient. But, somehow, it is not one of the drugs one readily remembers for lungs, acute or chronic: though Kent has it in italics for “inflammation of lungs”.
I do not know why, but one gets a sort of affection for Nitric acid. It is so dramatic and has such definite and intense characteristics and actions. One hopes that this little picture may help others to a closer acquaintance with “a very strong personality” among our drugs.
