You will think a moment and see that filling up the pleural cavity does not cause very much outward distension, because the ribs prevent it. They form a wall, and hence the growth or distension is towards the lungs, and downward towards the diaphragm. By this means we get increasing dyspnoea, with cough. This medicine, like Apis, must sit up; cannot lie down.
You will find it is a common-feature in hydrothorax for the patient to be compelled to sit up. because lying down increases the pressure upon the lungs and narrows the breathing space; and hence, he must sit up in order to let this heavy water-bag, the pleural sac, hang down, against the diaphragm, and that produces pressure in the abdomen and distension of the bowels.
“Thirst on waking. Thirsty all day. Great thirst but water disagrees.”
He likes cold water, but it so disagrees with his stomach, causing pain in the stomach, or causing him to vomit before it even gets warm, or causing distension, or causing uneasiness, so that he dreads to take cold drinks. He is more comforted by hot drinks. Warm drinks warm him up, make him more comfortable, cold drinks aggravate. Yet his thirst is for cold.
Then come distension and vomiting. You will find patients so distended in all their cellular tissues with a general anasarca that it seems that no more water can be taken from the stomach into the blood. He is full.
The blood vessels are distended, his stomach is distended and he must vomit; and with this distension of his whole body he drinks and vomits. It is with difficulty he can eat; cannot keep it down; it will not digest. From this comes a part of these symptoms.
“Sense of pressure in the epigastrium, in the chest,” so that it is almost impossible for him to get breath enough to move.
Very little food makes him feel distended. He wakes up and wants something in his stomach. There is a gnawing hunger, but every little thing, even a mouthful, makes him feel distended. His stomach is already full of water and he vomits up great quantities of water, of bile, and of undigested substances that he has swallowed.
The stomach finally, in dropsical conditions, becomes very irritable. It seems as if nothing passes through him, He finally becomes paralyzed in the bowels. The kidneys are not acting, and scarcely any urine passes. The tongue becomes inflamed. The mucous membranes are all inflamed, and probably the stomach is. Abdomen very much distended; dropsy of the abdomen.
The another phase comes on. It seems that one by one each organ ceases to perform its functions.
The ovaries and uterus fail to perform their functions, and amenorrhoea comes on with dropsical conditions. Many times this seems to be the beginning of such troubles; a failure of these organs to perform their functions, and then dropsy sets in.
A woman passes along to a low state of weakness and nervous excitement, no menstrual flow, tenderness of the abdomen, distension of the abdomen, and then distension of the limbs.
Apocynum has been a curative remedy in diarrheic conditions alternating with dropsy. Sometimes a diarrhea will set in and all the other troubles go away. The diarrhea is copious, yellow, watery and involuntary. 1 once knew large doses to be given in a case of dropsy, and it established its own peculiar diarrhea and while that diarrhea lasted the enlarged spleen and the dropsical condition of the body all went away apparently, to the doctor, in a natural manner.
It was brought to my observation, and I said, “Wait.” Finally he was brought to stop, the poisoning by Apocynum, and heart failure followed at once. A similar effect is to be seen from the allopathic use of Digitalis.
The time comes when the doctor will be compelled to stop Digitalis, and the patient dies of heart failure; Digitalis is never charged with the death, and the doctor never seems to learn that Digitalis will kill.
Everywhere the functions are impaired, in the skin, the kidneys, bowels, uterus, and all tends toward the formation of dropsy.
Urinary troubles are exceedingly troublesome. Scanty urine accompanies many complaints among the early symptoms. Retention of urine; painful micturition; urging to pass urine constantly.
The bladder is sometimes only partially full, but he cannot pass urine.
“Retention with great urging.”
“Paralysis of the extremities. Urging to urinate.”
Numbness, tingling in the extremities, and finally entire loss of power. Some patients remain this way for a while, and finally dropsy will set in. It has alternating conditions, as I have mentioned; dropsies, alternating with copious discharges.
The dropsy may be relieved with copious watery discharges from the bowels or by copious spasmodic action of the kidneys, the urine being so profuse that he can hardly realize where so much water comes from. All at once it ceases.
The urine becomes scanty, and then the tissues fill with serum, and the dropsical condition progresses. These conditions cease after a while, and the heart fails.
“Urine diminishes to one-third its usual amount, without pain or uneasiness about the kidneys or bladder. Urine suppressed. No urine at all in brain affections.”
It was a routine medicine once, given to all children for wetting the bed, and as it cured many it must have that symptom, but that is a clinical symptom. It is not surprising, seeing its action is so marked upon the bladder, that it has cured involuntary passage of urine.
“Dropsy of the genital organs.”
I have mentioned the suppression of the menstrual flow, the amenorrhoea, but it has also a marked hemorrhagic tendency. It will establish haemorrhage anywhere, but especially from the uterus. Copious haemorrhage. The menstrual flow may become copious, too frequent, last too long; but it will also establish a uterine haemorrhage at another time. It will cause the patient to bleed so copiously that she becomes anaemic from uterine haemorrhage; and then will follow dropsy.
The old practitioners were in the habit of giving China in most instances where dropsy followed a haemorrhage. It was so generally useful, and so commonly relieved, that they seldom used any other remedy.
But Apocynum is also a remedy for dropsy following haemorrhage. Many times it will fit the symptoms clearly in dropsy following haemorrhage.
“Prolonged menorrhagia, or haemorrhage from the uterus for six weeks. Blood expelled in large clots, sometimes in a fluid state.”
Moderate flow for a day or two; suddenly sets in with such violence that she cannot be out of bed. Compels her to lie quietly.
“Shreds, or pieces of membrane with the fluid blood. Menorrhagia continuing, or paroxysmal,” that is, a continuous flow until the patient is exhausted.
That is like Phosphorus and Ipecac. and Secale. In most instances, a uterine haemorrhage will cease after about so much blood has been lost. In medicines where the flow is so liquid as it is in this medicine that tendency to cease does not come until a state of profound exhaustion has come on.
Then the dyspnoea, as has been described, will not permit the patient to lie down. This is commonly from hydrothorax. It has also a hypostatic congestion of the lungs in patients that have been sitting up a long time, so that it fills up from below, gradually creeping up so that a large portion of the breathing space is destroyed.
“Great oppression about the epigastrium. Difficult breathing. Gasping for breath. Wheezing and coughing.”
It has all the rattling that is found in Tartar emetic and Tartar emetic has a similar filling up of the chest, cannot lie down.
Pulse small and irregular; almost pulseless. Disposed to faint whenever she attempts to raise her head from the pillow. Small weak pulse. Dropsy of the pericardium. Palpitation very troublesome.
In 1881, Kent accepted a position as professor of anatomy at the Homeopathic College of Missouri, an institution with which he remained affiliated until 1888. In 1890, Kent moved to Pennsylvania to take a position as Dean of Professors at the Post-Graduate Homeopathic Medical School of Philadelphia. In 1897 Kent published his magnum opus, Repertory of the Homœopathic Materia Medica. Kent moved to Chicago in 1903, where he taught at Hahnemann Medical College.