YESTERDAY in finishing my remarks on the Acids in general, you will remember that I divided them into two classes, the vegetable and mineral. Then I referred to the debility characteristic of acids in toto, and observed that in vegetable Acids debility is marked by a soft, feeble pulse, where as that of the mineral Acids is marked by irritability, the pulse being rather wiry.
I next drew your attention to the dietetic value of Acids and also to their general medicinal properties. I referred to their power of increasing the alkaline secretions and of diminishing the Acid. Therefore they increase the flow of saliva and lessen the secretion of the gastric juice. I referred to the use of Acid drinks during the course of fevers for the purpose of promoting the flow of saliva, and spoke of the pseudo-membranes which many of these Acids, notably Lactic and Acetic Acids, can produce.
I referred to the power of Lactic Acid to dissolve even the enamel of the teeth. Speaking of the vegetable acid, I gave you a few hints regarding the use of Citric Acid in haemorrhages. This Acid is often employed as a Homoeopathic remedy for a peculiar state of mind in which careful house-keepers suddenly become indifferent to all that formerly interested them. This symptom does not come from simple stubbornness, but is the result of a debilitated condition. You will here recall a similarity to Sepia, which has indifference, not only to household matters, but also to persons, formerly loved.
I incidentally referred to symptoms of a rheumatic character produced by Lactic Acid, namely, inflammation, redness and swelling of the joints, especially of the smaller joints, with profuse sweating; also to hawking of mucus and to swelling of the tonsils, with pain and sense of constriction which are worse from swallowing. There is a pseudo membrane in the throat.
I also referred to the grape-cure; stating that grapes were useful for the purpose of diminishing obesity, and also in Dropsy when it came from sluggishness of the circulation rather than from organic disease. At the same time I remarked that the abuse of these vegetable Acids may develop their characteristic debility; the patient will then have diarrhoea, the mouth will become sore and filled with aphthous ulcers, the saliva run from the mouth, and symptoms of Scorbutus appear.
To-day I invite your attention to two of the mineral Acids, Phosphoric and Sulphuric Acids. Phosphoric Acid causes and therefore cures, a peculiar debility, a debility which is not a simple weakness, such as occurs when one is worn out by work, but which comes from alteration of the fluids of the body (particularly of the blood) as after long-lasting weakness of digestion, malnutrition etc.
Phosphoric Acid differs materially from Phosphorus. I cannot, therefore, agree with those who assert that the latter becomes oxidized in the system, and that when we are taking what is called Phosphorus we are in reality taking Phosphoric Acid. This is asserted by Heinigke in his “Outlines of Materia Medica,” and by Hempel. While we cannot deny that Phosphorus quickly appropriates Oxygen, it is certain that its effects potentized are different from those of the Acid. No one is willing to admit that Phosphoric Acid can be replaced in Typhoid Fever by Phosphorus.
Phosphoric Acid at first causes an increase of vitality. True to its Phosphorus, it is at first slightly stimulating. This, however, is soon followed by the opposite condition, in which the sensorium seems to be very much depressed, so that we have developed a condition of complete apathy. Not only is there dulness of thought, but also want of feeling apathy. This sensorial apathy is usually accompanied by more or less drowsiness and indifference to one’s condition.
When not extreme, you will notice that the predominant mental state is one of melancholy or sadness. These symptoms have led to the use of the drug for the effects of disappointed love and for jealously, and also for the protracted effects of grief. You will recall Ignatia as a remedy for the acute effects of grief. You will recall Ignatia as a remedy for the acute effects of grief, and Opium for the immediate effects of fright. The Ignatia-woman is introspective. She sits brooding over her trouble, and suffers from nervous complaints as a result. In Phosphoric Acid mental and bodily depression result from the grief. There are frequent sighing, heat, and a crushing weight on the top of the head, perspiration in sleep, or from every little exertion or mental excitement, palpitation of the heart, etc. The body seems to emaciate steadily. The nearest ally here is Natrum Mur., which also in the protracted effects of grief has its same sort of headache.
You may use Phosphoric Acid in a peculiar kind of headache which occurs in school-children. The pain is constant and is of a dull depressing character, with blurring of vision. These symptoms always disappear during the holidays, but return again as soon as studies are resumed.
Phosphoric Acid has a marked effect upon the stomach and abdomen. You may give it with confidence in diarrhoea when the movements are watery, whitish or grayish-white, often containing undigested food and accompanied by constant rumbling and gurgling in the bowels. It seems, as if, the patient’s abdomen had become converted into a yeast-pot.
Now you will read in the books that the great key-note of this diarrhoea, in addition to this rumbling and distension of the abdomen, is that despite the long continuance of the disease there is but little prostration. I do not deny this. It is a legitimate inference from one of the symptoms which reads something like this : “The prover is astonished that his symptoms last so long, and yet he does not feel weak.” This has been crystallized into a characteristic of the drug. But you will go astray if you depend too much upon it.
Phosphoric Acid can cause a distressingly debilitating diarrhoea, and I do not hesitate a moment to prescribe it when the patient is greatly prostrated, if he has bloated abdomen and undigested stools, particularly if the latter are watery and whitish. Accompanying this diarrhoea, especially in children, you will notice the mouth becoming sore, and the tongue is pale and clammy, rather than bright red or dry. The face is pinched, there are dark rings around the eyes and other evidences of exhaustion.
Phosphoric Acid is used for the complaints of women when menstrual irregularities are associated with dull pressure in the right hypochondrium-probably from passive congestion of the liver.
Phosphoric Acid, like Phosphorus, sometimes acts on the lungs. It is very useful in some of the stages of Phthisis. There is a tickling cough, which seems to come from the pit of the stomach, accompanying with burning in the chest, passive congestion. The cough is followed by great thoracic weakness and dyspnoea. The patient is worse from every little exposure.
It is stated, I think by Buchner, that Phosphoric Acid is useful for diphtheritic Croup. I have given the remedy in Diphtheria but once, and then, although it seemed nicely indicated, it gave no relief. The apathy, the drowsiness and the cough were all so marked, that had the case been one of Typhoid I should have been astonished at the failure. It did not fail because I gave a high potency, for I used the 2x or 3x.
Phosphoric Acid is indicated in bone complaints, Periositis, Caries, etc., when the only pain is, as if, the bone was being scraped with a knife. This symptom is generally worse at night, and is accompanied with weakness.
Phosphoric Acid is of use in typhoid types of fever, when the most marked symptoms are these : “Complete sensorial apathy; the patient is utterly regardless of his dangerous condition. He has but few wants. If you ask him any question he either does not reply to it or replies in the most laconic language. Very characteristic, too, is drowsiness; he goes readily into a deep sleep, but from this condition he is usually quite easily aroused, and then is clear-headed, but soon drops off again.” Accompanying this mental state, are great debility, nose-bleed which gives relief, dry tongue or tongue covered with sticky mucus. The abdomen is bloated, with rumbling of wind, with or without the diarrhoeic stool which I mentioned to you a few moments ago.
There is another form of debility for which Phosphoric Acid is indicated; one from loss of animal fluids. Hence it is useful after protracted nursing, and after excessive venery. The debility is often accompanied by symptoms of great nervous exhaustion, shown by a tingling and formication, which no remedy is more likely to cause. It is also an excellent remedy when sexual excesses have taken all the tone out of the sexual organs, particularly in young men, who are not suffering from any constitutional taint, and whose organs hang flabby, the penis refusing to become erect on any excitement. This condition Phosphoric Acid, given low, will remove, but China will not. China will be of use for the acute effects of loss of semen.
Before passing to one of the other remedies, I want to place before you some of the analogues of Phosphoric Acid. Sweet Spirits of Nitre runs close to the Acid in this sensorial apathy of Typhoid Fever. Hahnemann was accustomed to give it when the patient lay like a log in this complete state of apathy. He has no wants and no complaints. He is simply dull and sleepy; arouse him and he looks like a man awaking from a drunken sleep. There are no marked organic changes going on in the abdomen. The whole burden of the poison seems to have been thrown upon the sensorium. Hahnemann used a few drops of the Nitre in water, given every few hours until relieved. His instruction was to give it when the drug was old enough not to redden the cork in the bottle.
The next remedy in this group is Sulphuric Acid. The hour is so nearly spent, I can but allude to it at present. This Acid is much more irritating than the Phosphoric. It is a more violent corrosive poison.
First as to the mind. The Sulphuric Acid patient is usually rather hasty, nervous and restless in his disposition. He can not do things fast enough to suit him. He lacks the stupidity of Phosphoric Acid. He suffers from neuralgic pains, which come gradually and leave suddenly. They are not like the Belladonna pains, which came suddenly, last awhile, and then leave as suddenly as they came. The face is apt to be pale. Sometimes the patient has a sensation, as if, the white of an egg was dried on the face.
This Acid is a valuable remedy in Diphtheria, especially in the naso-pharyngeal form. of course, you will expect to find the Acid debility and also fetid breath but the symptom which will lead you unerringly to this remedy is that there hang from the posterior nares strings of a sort of lemon-colored mucus. It is not the stringy, tough, fibrinous membrane of Kali bichromicum, but is a thinner, yellow mucus.
The “lemon color is borrowed from the color of the diarrhoea of this remedy, a diarrhoea in which the movements have a lemon-yellow chopped-up appearance; or there is fecal matter mixed with shreds of lemon-yellow mucus. I remember once making a rapid cure of milk-crust guided by this sort of stool. An elder brother of my patient, similarly affected, gave its parents incessant worry for eight months before a cure was effected.
The second child, which I was called to treat, started in with the same trouble, to the dismay of both father and mother. With the milk-crust on the face was a frequent, lemon- yellow, mucous diarrhoea. The child was cured by Sulphuric Acid 30 in three weeks, and remained well. Some physicians, remembering this symptom, transferred its ailments to the nasal mucous membrane, with the result of curing many cases of catarrh and Diphtheria.
You will find Sulphuric Acid useful in certain cases of dyspepsia. The patients vomit everything they eat or drink. They have a carving for brandy or some other alcoholic stimulant after taking which they can retain food. This fact has led to the use of the Acid for inebriates who cannot retain food and who are weak and trembling. Dr. Hering used to give Sulphuric Acid in the crude from, one drop in a tumblerful of water, a teaspoonful to be taken every few hours until symptoms were produced, such as diarrhoea. Aversion to liquor soon followed. If the diarrhoea becomes annoying. Pulsatilla modifies at once.
Sulphuric Acid cures a peculiar cough. We may say it involves the stomach. It ends in the belching of wind. Ambra has a similar cough.
The essential debility of Sulphuric Acid is of a peculiar kind. It is accompanied by characteristic sore-mouth with aphthae in yellowish-white dots over the buccal mucous lining. You will be astonished to see how readily that condition is cured by Sulphuric Acid, especially if there is present a subjective trembling sensation of the body.