The Kali carb. patient is a hard patient to study, and the remedy itself is a hard one to study.
It is not used as often as it should be, and the reason is that it is a very complex and confusing remedy. It has a great many opposite symptoms, changing symptoms, and thus it is related to patients that withhold their symptoms and have many vague symptoms.
Mind: The patient is whimsical, irascible, irritable to the very highest degree, quarrels with his family and with his bread and butter. He never wants to be alone, is full of fear and imaginations when alone, “fear of the future, fear of death, fear of ghosts.”
If compelled to remain alone in the house he is wakeful, sleepless, or his sleep is full of horrible dreams. He is never at peace, is full of imaginations and fear.
“What if the house should burn up!”
“What if I should do this or that!” and
“What if this and the other thing should happen! ”
He is oversensitive to everything, sensitive to every atmospheric change; he can never get the room at just exactly the right temperature; he is sensitive to every draft of air and to the circulation of air in the room. He cannot have the windows open, even in a distant part of the house. He will get up at night in bed and look around to see where that draft of air comes from. His complaints are worse in wet weather, and in cold weather.
Pains: He is sensitive to the cold and is always shivering. His nerves feel the cold; they are all painful when it is cold. The neuralgias shoot here and there when it is cold, and if the part affected be kept warm, the pain goes to some other place. All his pains change place and go into the cold part; if he covers up one part, the pain goes to the part uncovered.
This remedy is full of sticking, burning, tearing pains, and these fly around from place to place. Of course Kali carb. has pains that remain in one place, but usually the pains fly, around in every direction, Pains cutting like knives. Pains like hot needles, sticking, stinging and burning.
These pains are felt in internal parts and dry passages. Burning in the anus and rectum, described as if a hot poker were forced into that passage; burning as with fire. The hemorrhoids burn like coals of fire. The burning of Kali carb. is like that of Arsenicum.
Again from studying the text it will be seen that it is a common feature of this medicine to have its symptoms come on at 2, 3 or 5 o’clock in the morning. In Kali carb. the cough will come or have its greatest < at three or four or five o’clock in the morning.
The febrile state will occur from 3-5 in the morning. The patient, who is subject to asthmatic dyspnoea, will have an attack at 3 o’clock in the morning, waking him out of sleep. He will wake up with various symptoms and remain awake until 5 o’clock in the morning, and after that to a great extent they are relieved.
Of course, there are plenty of sufferings at any time in the twenty-four hours, but this is the worst time. He wakes up at 3 o’clock in the morning with fear, fear of death, fear of the future, worries about everything and is kept awake for 2-3 hours and then goes to sleep and sleeps soundly.
His body is cold and requires much clothing to keep it warm, but in spite of the fact that he is cold he sweats copiously; copious, cold sweat upon the body. Sweats upon the slightest exertion, sweats where the pain is, sweat over the forehead; cold sweat on the forehead with headache.
Neuralgia of the scalp and the eyes and the cheek bones in association with the nervous shooting pains. Violent pains here and there in the head, as if the head would be crushed. Cutting and stabbing, in the head. Violent congestive headaches as if the head were full. Head hot on one side and cold on the other; forehead covered with cold sweat.
Head: It has catarrhal congestive headache.
Whenever he goes out in the cold air, the nose opens up and the mucous membranes become dry and burn; when he returns into a warm room the nose commences to discharge, and the nose stuffs up so that he cannot breathe through it, and then he feels most comfortable; so that it has stuffing up of the nose in a warm room, and opening up of the nose in the open air. When the nose is open so that he can breathe through it, that is the time the head is most painful; it is painful to the cold air and the cold air makes it burn.
The cold air feels hot. All these patients suffer from a chronic catarrh and when they ride in the wind the catarrhal discharge ceases and then will come on a headache, and thus he has headache from riding in the cold wind.
Whenever the discharge ceases from taking cold in a draft on comes headache, and as the discharge becomes free again the headache is relieved. Neuralgic pains in eyes and scalp and through the cheek bones from a cessation of chronic catarrhal discharge, and when the discharge starts up again, these pain cease.
With the chronic catarrh of the nose there is a thick, fluent, yellow discharge; dryness of the nose, alternating with stuffing up. The one who suffers from a chronic catarrh will also have the discharge in the morning, which will fill up the nose with yellow mucus. In the morning he blows out and hawks up dry, hard crusts that fill up the nasal passage, clear over into the pharynx and down into the throat.
These crusts become dry as if they were partly formed upon the mucous membrane and when they are blown out there is bleeding. The bleeding starts from where the crusts are lifted up. He is subject to sore throat, is always taking cold, and it settles in the throat. He is also subject to enlarged tonsils and with these has enlargement and chronic hardness of the parotid glands-one or both. Great knots below the ear, behind the jaw.
These grow and become hard, and at times, painful; shooting, darting pains when he is moving about in the open air. When air strikes these enlarged glands they are sore and painful, and he is ameliorated by going into a warm place.
The acute colds extend into the chest, but Kali carb. has been found most suitable in the chronic catarrh of the chest, chronic bronchitis.
Chest: The chest is very often affected in just the same way as the nose.
There is the dryness and dry barking, hacking cough in cold air, but a copious expectoration of mucus when it becomes warm, and that is the time he is most comfortable, for the expectoration seems to relieve him. He suffers mostly from a dry, hacking cough with morning expectoration. The cough begins with a dry, hacking, increases gradually and sometimes very rapidly to a violent. Spasmodic cough with gagging or vomiting, and when coughing it feels as if his head would fly to pieces.
Face: The face becomes puffed, the eyes seem to protrude and then there is seen that which is commonly present in Kali carb., a peculiar sort of a swelling between the eyelids and eyebrows that fills up when coughing.
Your attention is called to that peculiar feature, for although there may be bloating nowhere else upon the face that little bagging will appear above the lid and below the eye brow. It fills up sometimes to the extent of a little water bag.
Such a swelling has been produced by Kali carb., and sometimes that symptom alone guides to the examination of the remedy for the purpose of ascertaining if Kali carb. does not fit all the rest of the case.
Boenninghausen speaks of an epidemic of whooping cough in which the majority of cases called for Kali carb., and this striking feature was present. No remedy should ever be given on one symptom. If you are led to a remedy by a peculiar symptom, study the remedy and the disease thoroughly to ascertain if the two are similar enough to each other to expect a cure. Any deviation from that rule is ruinous and will lead to the practice of giving medicines on single symptoms.
Dry, hacking incessant, gagging cough with whooping, blowing of blood from the nose, vomiting of everything in the stomach, and expectoration of blood-streaked mucus, is a whooping cough that will be commonly cured by Kali carb., but especially if there is present that peculiar and striking feature of a bag-like swelling below the eyebrow and above the lids, puffiness of the eyes.
There are some cases of pneumonia that need Kali carb, in the stage of hepatization (like Sulph.). Again, when pneumonia has passed away think of Kali carb. if every time the patient takes a little cold it settles in the chest with these symptoms that I have described.
There is sensitiveness of the body to weather changes, to cold air and to wet, a continuous dry, hacking cough, with gagging, the aggravation from three to five the morning, and the patient, has flying neuralgic pains. These symptoms gradually increase and the patient dates them back to his pneumonia. He says:
“Doctor, I have never been quite well since I had pneumonia.”
The catarrhal state has settled in his chest and there is a chronic tendency to take cold. These cases are threatening to go into phthisis and will hardly be likely to recover without Kali carb. In this tendency for catarrhal states to locate in the chest, Kali carb. should be thought of as well as Phosphor., Lycopod. and Sulphur.
Dropsies: Another general state that belongs to this remedy is a tendency to dropsies.
It has dropsies all over the body. The feet bloat and the fingers puff; the back of the hands pit upon pressure, the face looks puffy and waxy. The heart is weak. I can look back upon quite a number of cases of fatty degeneration of the heart in which I could have prevented all the trouble with Kali carb. if I had known the case better in the beginning.
These cases are insidious, and the indications calling for Kali carb. must be seen early or the patient will advance into an incurable condition. That peculiar state of weakness and feeble circulation that finally ends in dropsy and many other complications has its likeness in Kali carb.
There is an insidiousness about Kali carb. in the approach of all of its complaints.
He has a sort of nondescript appearance, he is withered, has much dyspnoea upon going up hill or even walking on the level. Examination of the lungs shows them to be in very fair condition, but finally complications come on, there is a break down and organic changes and you look back over these cases and say, if I had only seen in the beginning of this case what I see now it seems as if the patient ought to have been cured.
We learn the beginnings of remedies as we learn the beginnings of sickness. It is a prudent thing for a homoeopathic physician to glance back over a case that he has failed on, or someone else has failed on, to study its beginnings and see what the manifestations were. This kind of study to the homoeopathic physician is as delightful as post mortems are to the old school.
Teeth: The teeth present a peculiar state. The gums take on a scorbutic or scrofulous character. The gums separate from the teeth and the teeth decay and become discolored and loose, so that they have to be extracted early in life.
He suffers from pain in the teeth whenever he takes cold from riding in the wind and raw weather. The pains come on even when the teeth are not yellow or decayed: stitching, tearing, rending pains in the teeth. Offensive smell from the teeth; pus oozing out from around the teeth. The mouth is full of little ulcers, little aphthous patches. The mucous membrane is pale and ulcerates daily. The tongue is white with offensive taste; coated gray, with sick headaches.
While many of the symptoms of Kali carb, are aggravated after eating, some symptoms are relieved after eating. There is throbbing in the pit of the stomach when the stomach is empty. There is also throbbing all over the body, pulsation to the fingers and toes; there is no part that does not pulsate, and he is kept awake by this pulsation. Pulsation even when there is often no feeling of palpitation in the region of the heart. It has also violent palpitation of the heart.
Stomach: Kali carb. fits many old dyspeptics.
After eating be feels as if he would burst, so bloated is he. Great flatulence; belches wind upwards and passes flatus downwards; offensive flatus. The belching up is also attended with fluid eructations, sour fluids that set the teeth on edge; they excoriate, or cause smarting in the pharynx or mouth. Pain in the stomach after eating; burning in the stomach after eating.
Gone feeling in the stomach, that is not even relieved by eating. A peculiar condition in Kali carb. is a state of anxiety felt in the stomach, as though it were a fear. One of the first patients I ever had expressed it in a better way than it is expressed in the books; she said,
“Doctor, somehow or other I don’t have a fear like other people do, because I have it in my stomach.”
She said when she was frightened, it always struck to her stomach.
“If a door slams, I feel it right here” (epigastric region).
Well, that is striking, that is peculiar. It was not long before I developed another feature of Kali carb.
By a little awkwardness on my part my knee happened to hit the patient’s foot as it projected a little over the edge of the bed, and the patient said, “Oh”
Sure enough that was Kali carb. again, for you will find in Kali carb. a patient that is afraid and everything goes to the stomach and when touched upon the skin there is an anxiety or fear or apprehension felt in the region of the stomach.
You might imagine that it is connected with the solar plexus, but the symptom is the all in all to the physician.
Feet: A Kali carb. patient is so sensitive in the soles of the feet that the mere touch of the sheet brings a sensation of thrill throughout the body. Hard pressure is all right, it does not disturb, but something that comes unawares excites.
The Kali carb. patient is over sensitive to all the surrounding things, over sensitive to touch; shivering from the simplest and lightest touch, even when hard pressure is agreeable. Violently ticklish in the soles of the feet. I have often examined the feet when a patient would shiver and draw up the feet and scream out,
“Don’t tickle my feet.”
I had probably touched it so lightly that I did not know that I had touched it at all.
In Lachesis also gentle touch is painful, while hard pressure is agreeable but here it is not so much the ticklishness. In Lachesis the abdomen is so sensitive that the touch of the sheet is painful. I have seen Lachesis patients using a hoop to keep a light sheet from touching the abdomen. You may know then that you are in the realm of Lachesis, and that it is like those persons who are unable to bear the slightest touch upon the neck and suffer from uneasiness on wearing a collar.
All that, however, is different from this state of ticklishness. I have seen patients who are really so sensitive in the skin that I would not dare touch it, unless they knew just where I was going to touch.
“Now I am going to feel your pulse, hold still.”
If I were to touch the hand, or reach out to feel the pulse without warning there would be a thrill.
Such a state is in keeping with Kali carb. These things often have to be dug out by observation in studying the nature of provings, and associating things. These things that run into the oversensitiveness of patients are of great value clinically. The capabilities of our Materia Medica are something wonderful, but they could be developed much more rapidly if a number of homoeopathic physicians would make application of the Materia Medica with accuracy and intelligence, observing what they see and relating it literally.
At the present day there is only a very small number of homoeopathic physicians that can come together in a body and say things that are worth listening to, a shamefully small number when we consider the length of time Hahnemann’s books have been before the world.
Liver: There are many old chronic liver subjects who talk about nothing else but the liver.
Every time they go to the doctor’s office they talk about the liver, and about a condition of fullness in the region of the liver and pain through the right shoulder blade and up through the right side of the chest, with a good deal of oppression and distension; vomiting of bile and a good deal of stomach disorder, fullness after eating; attacks of diarrhoea, alternating with constipation lasting for many days with great straining at stool.
Periodical bilious attacks, when a constipated state is present; cannot lie down at night; difficult breathing at night or at 3 o’clock in the morning, especially when it is in a patient over-sensitive to cold, damp weather, one who wants to sit by the fire all the time.
These liver subjects are often thoroughly cured by Kali carb. Sometimes they have been resorting to all sorts of liver tappings, taking such medicines as purge or cause vomiting, drugs that really aggravate the trouble. Kali carb. goes to the bottom of these cases, and roots out the evil.
Abdomen: In the abdomen we have many Kali carb. symptoms.
Persons subjected to repeated attacks of colic, cutting pains, with distension, with pain after eating, constipation or diarrhoea. Colic, with cutting, tearing pains, doubling him up, coming on every little while. Tremendous flatulence. When the attack of colic is on it might remind you of Colocynth or of some other of the acute remedies that cure colic in two or three minutes, but you will find that these acute remedies that relieve colic so speedily when given the second or third time do not produce so marked an effect.
You will find it necessary to hunt for an antipsoric, a remedy that will control the whole case. In the study of the colic alone during its attack you only get a one-sided view of the case, and after the colic is over (say he has been cured by Colocynth) you now study the patient and go over the case, and behold all the symptoms are covered by Kali carb. After giving that remedy you may expect that the patient will not have another attack.
Such is the nature of Kali carb. It is deep-acting, long-acting, goes deep into the life. It cures conditions due to psora, or to the suppression of eruptions in childhood, or to the closing up of old ulcers and fistulous openings with a history of troubles ever since. All these wandering pains and the chilliness are again relieved by eruptions, by the outbreak of discharges, by haemorrhages, by ulcers that eat in deep and flow freely and fistulous openings.
“Cutting in abdomen, as if torn to pieces.”
“Violent cutting, must sit bent over pressing with both hands, or lean far back for relief; cannot sit upright.”
“Cutting and drawing like false labor pains.”
There is great coldness with the pains, with the cutting in the abdomen; he wants heat, hot drinks, hot water bags. A chronic coldness is felt in the abdomen, cold externally and internally.
It would sometimes be cruel to give a dose of Kali carb. when the colic is on, because if the remedy fitted the case constitutionally, if all the symptoms of the case were those of Kali carb., you would be likely to get an aggravation that would be unnecessary.
There are plenty of short acting remedies that would relieve the pain speedily, and at the close of the attack the constitutional remedy could then be given. If the patient can bear the pain to the end, it is better to wait until it passes off without any medicine.
That sometimes is cruel, and then the short acting medicines should be given. All recurrent troubles, those that come periodically, or after eating certain articles, or from exposure, or with a periodicity that belongs to time – all these states are chronic; they are not acute troubles.
They are simply a small portion of a chronic miasm, a side view and all such cases must have a constitutional remedy sooner or later. You can, it is true, relieve violent pain at the first visit, but then you must look deeper and prevent your patient having more trouble.
Otherwise, if you should give Belladonna or Colocynth or any medicine that simply fits the colic, the trouble will come back again; you have not cured your patient; you have only palliated. But, on the other hand, you take such a colic as is described here and Kali carb. fits just these symptoms alone and does not fit the whole constitution of the patient.