Hepar has many close relations with Mercurius. The distinction between them is, in fact, rather negative than positive. Almost all the symptoms of Hepar are found under Mercurius, but not all those of Mercurius under Hepar.
Hepar, like Mercurius, develops its effects in the vegetative processes. Yet, whereas Mercurius increases to excess the whole secretive activity, and thereby produces emaciation (i.e., by excessive secretion, salivation, diarrhoea, diaphoresis), the same character belongs to Hepar in a much less degree. Hence Hepar produces no putrid collapse, makes no penetrating impression upon, and alteration of, the vital processes; hence, too, it exerts no visible reflex action upon the nervous life, as Mercurius. While the resolutive, alterative action of Mercurius extends even to the formation of new secreting organs (abscess, secreting pus), Hepar possesses no such power. In the action of Hepar, appears, in a slighter degree, the tendency to abnormal secretion, and the resulting symptoms have, for the most part, quite a different pathological foundation from that of analogous symptoms of Mercurius.
The effects of Hepar appear most distinctly in the lymphatic system, the activity of which it excites in a high degree; and hence it either, on the one hand, increases the absorptive activity of the lymphatic system, or else, on the other, causes a too abundant collection of lymph in the glands, and, in consequence, obstruction, inflammation, and suppuration of the glands. We find, therefore, among the symptoms of Hepar, a great number indicating this character, and we find the greatest number of symptoms in those parts of the body in which the lymphatic vessels are most abundant, neck, shoulder, bend of the elbow, dorsum of the foot, etc.
On the increased respiration, on the other hand, depend a number of other symptoms in other organs, especially in those in which the lymphatic vascular system is highly developed.
Although I have so strongly insisted on this, as the sphere of action of Hepar, I would not be understood to deny to it any farther action. The excitation of organic activity can never be circumscriber to a few determinate functions.
If the resorptive activity of the lymphatic be increased, so will be also that of the venous system. The excretions will be altered in quantity and in quality.
The action of Hepar is upon the periphery directly. Hence we find congestion of the skin and mucous membranes; and, in consequence, redness, heat, swelling in a word, an inflammatory condition shown by prickings, elevations of the skin, rhagades; a slight degree of suppuration manifesting itself in rhagades, pustules, nodes, tubercles, ulcers, also flashes of heat, and dull redness of parts rich in blood lips, cheeks, conjunctiva, etc.
Partly in this way, and partly also by the fact of engorgement and obstruction of the lymphatic glands, we may explain the symptoms which appear in the skin.
Mucous Membranes. These are similarly excited. Their secretion is not greatly increased. Often, indeed, it is diminished; and it is always thickened. The watery portion being immediately absorbed again, the secretion becomes viscous, even membranous.
1. In the Intestinal Tract, Hepar must produce diminution of action; hence anorexia, nausea, vomiting, acid eructations, alienated taste, development of gas, etc., and, above all, enfeebled peristaltic action, and this, again, causes pain (meteorismus) and difficult evacuation even of soft faeces.
Add to these considerations, the irritation of the mucous membrane consequent on the great number of lymphatic vessels in it, and we may explain the several sensations and pains in the alimentary tract, especially the frequent tenesmus and aggravation after every stool. The stools are green yellowish-brown, often mixed with blood.
2. In the Respiratory Organs we find a similar condition, various sensations indicating thickening of the secretions; hence, difficult respiration, laborious, dry cough. This condition, together with the puffy tumefaction of the mucous membrane, which usually accompanies such a condition, will explain to us the symptoms which we find especially in the larynx.
3. In the Urinary Mucous Membrane appears the same state of chemicals. Urine is scanty and dark, with abundant salts so that, when evacuated, it is already turbid, or else it soon becomes so.
4. The Salivary Glands are excited to a more abundant secretion.
The action of Hepar on the Sanguine Vascular System may be easily determined; for if it excites one portion of this system, the remaining portions must of necessity be also excited, though in a less degree. Hence, febrile symptoms are not wanting. They are still more clearly pronounced when a somewhat violent inflammatory excitement has manifested itself, producing its reflex action on the organism. The general vascular excitement, however, can never assume the character of pure, intense synocha.
The relations of Hepar to the Sexual System are unimportant. The menses appear too early, and are too copious.
Sensations. As every revulsion of the vegetative processes provides various sensations, so does that produced by Hepar. It is to be remarked, that pains, (1 1The German distinguish between Pain (Schmerz) and Sensation (Gefuhl). Pain is partial, as to extent, and determinate, as to seat, e.g., sticking in the shoulder. Sensation is general, as to extent, and indefinite, as to seat, e.g., oppression, lassitude, itching.) strictly speaking, are seldom excited by it. The more frequent sensations are itching, pricking, rending, and feeling as if beaten. (In inflamed parts, however, burning, sticking, and tearing pains are experienced.) Such sensations will be especially felt in parts where lymphatic vessels course in greatest numbers, the axilla, bend of the elbow, etc.; thus we have heat, redness, and pain from the fingers to the shoulders; needle stickings, itching in the fingers, swelling in the fingers, and the same condition in the thigh, ham, dorsum of the foot and the toes.
Characteristic Symptoms. 1. Pains. Various. Especially pressing and general sensations.
2. Aggravation of Condition. At night, and by exposure to cold.
3. Thickening of the secretions, swelling, inflammation and suppuration of the glands.
Indications for Administration. Hepar may be indicated.
1. In diseases of acute, sub-acute, and chronic form.
2. In diseases occurring in lymphatico-phlegmatic individuals, with white delicate skin, blond hair, disposition to glandular swellings.
3. In all cases of glandular affection, as well for the collective chronic process as for the individual acute exacerbations; all scrofulous and tuberculous affections; enlargement, inflammation, and suppuration of all lymphatic glands, especially those of the neck; a similar condition of the cellular tissue. Hence it is indicated in mesenteric diseases of children; in infrequently recurring angina; in inflammation of the salivary, cervical, and inguinal glands; panaris; inflammation of the eyelids; discharge of prostatic fluid.
4. All kinds of inflammation which pass into suppuration; purulent exudations (pleurities); abscess (for maturation, Mercurius is preferable); hip-joint disease (caries).
5. Inflammation terminating in solid, membranous exudations; acute catarrh; laryngeal croup (after use of Aconite); lymphangitis, as well external as uterine; phlegmasia alba dolens; hooping-cough, after the stage of inflammation (?).
6. Abscesses and analogous formations.
7. The Mercurial Cachexy. Calvities after Mercury; salivary fistula.
8. Cutaneous Affections. Crusta lactea; Tinea; Erysipelas (after Belladonna) in scrofulous individuals. Generally in scrofulous skin-diseases.