A MIXTURE OF CAUSTIC LIME AND BISULPHATE OF POTASH.
Causticum occupies a peculiar position, as a remedy, in my mind. I look upon it as I do upon certain people in whom there is no brag nor bluster, no claim to superior knowledge, and when the hiding of what they do know until the occasion arises that leads you to seek their help. While they are seldom leaders, being too unobtrusive for that position, they are constantly being called upon to finish the work that others have started and were unable to complete. The better you know them, the greater is your admiration for their ability and the more you are inclined to be governed by their opinion.
Causticum does not claim to cure diphtheria or pneumonia, and is very modest about telling of what it has done in paralysis or rheumatism, so is very apt to be overlooked; and while in most cases you do not ask it help in the beginning of trouble, the better you know it the more inclined you become to refer to it and in particular to expect it to be able to complete the cure that other remedies have left but half finished.
Causticum is used exclusively by our school and was first proved by Hahnemann, who directed that it be prepared as follows: A piece of freshly-burnt lime is put for one minute is distilled water, and then placed in a dry vessel, where it crumbles to powder. Equal parts of this powder and pulverized bisulphate of potash (previously ignited and melted) are dissolved in the same amount of boiling water and stirred to a stiff paste; this paste is dissolved to dryness, the vapor being condensed by means of cold water, and this clear, distilled liquid is mixed with an equal amount of alcohol and called Causticum tincture.
The exact composition of Causticum has not been determined and it seems to me that some day a simpler preparation will be found to take its place, but until such time we must take it, that is, our pharmacists must make it for us, exactly as Hahnemann directed.
In an article by T. F. Allen we find the following: “I have been in the habit of including Causticum in the potash group, as it has been considered a weak solution of caustic potash; but recent investigations at Columbia College have shown me that this tinctura acris sine Kali of Hahnemann, and which, as he thought, contained the alkaline principle or spirit separated from the potash, is really aldehyde. Symptomatically, it has always to my mind, belonged to the potashes; from end to end its features are similar, even to the symptoms of cardiac paralysis; there is something remarkable in its origin as related to its symptoms and to the potash salts; but there is no potash in it, that seems certain” (Trans. Am. Inst. Homoeo.,’94).
The Causticum patient is anaemic (15), weak, and has no desire and scarcely the ability to make an effort, the child being slow in learning to walk (208), and young or old, is subject to affections of the urinary and respiratory tracts. Many conditions arise from getting cold or wet, or are aggravated during stormy weather (9) and in Causticum there is a general tendency to rheumatic and paralytic affections, especially paralysis of single parts and paralysis resulting from rheumatism or diphtheria. The r. side is especially apt to be affected in Causticum (163).
The girl requiring this remedy is peevish and apprehensive, with aggravation of these conditions preceding or during menstruation, and it is to be thought of in epileptiform (67), or chorea-like spasms at the time of puberty, and for chorea (31) affecting especially the r. side and r. eyeball.
In the eye we find asthenopia (72) with frequent loss of sight, as from a mist (78), and paralysis of the muscles of the eye and of the upper lid (78), with the resulting ptosis, and particularly ptosis after catching cold. There is weakness of the muscles of the eyeball, amounting even to paralysis, especially with feeling of sand in the eyes (77), also double vision (77) from paralysis of the ocular muscles; vision worse on turning the eyes to the right.
Causticum is a most useful remedy to arrest the progress of cataract (73), Hering giving, with a “constant inclination to touch and rub eye, which seems to relieve a pressure in it.” In the outer ear we have burning and tingling, as after a frostbite (64) or an excessive accumulation of wax (65), which may have an offensive odor. In the middle ear it is useful in chronic inflammation, with deafness and re-echoing of sounds or of his own voice (65), or with buzzing or roaring in the ears (65).
Causticum is of value in paralysis of one side of the face from taking cold, with hemiplegia, in facial neuralgia from change of weather to cold and stormy (79), and in rheumatism of the articulation of the jaw (162), with pain on attempting to open the mouth, in all these conditions with aggravation, perhaps, on the r. side.
The gums are swollen and bleed easily (84), there is a painful looseness of the teeth (187) and on one or more of the teeth feel too long (187). There is severe toothache, even in sound teeth, due to talking cold (187), but there is no preference given, in the symptoms to any particular side.
In the stomach it is to be thought of in acid dyspepsia (178) with sour eructations and sour vomiting and for haemorrhoids (86) that are very painful and with aggravation from standing or when walking.
There is constipation, with frequent, ineffectual efforts at stool (34) or a partial paralysis of the rectum, with difficulty in expelling the contents and the stool is passed better when standing.
In the bladder we find a condition of great interest that calls for Causticum, not only because it is so frequently met with, but also because the remedy does so much for us in effecting a cure. There is a weakness or paralysis of the muscles of the bladder (22) so that the urine is expelled very slowly after much effort (200), or it is retained; it is of value in paralysis of the bladder after labor with retention of urine (200). There is also found a weakness of the sphincter of the bladder, with too easy escape of urine and in children it passes involuntarily and unconsciously at night, especially during the first sleep (199), or during the day (198) from the least excitement or over exertion. A loss of sensation of the urethra.
In older persons micturition is so easy that they are not conscious of what is going on until they notice the results, or there is a spurting of urine on blowing the nose, sneezing, coughing (52) or walking.
Allen was the first to call our attention to the value of Causticum during labor when we find the pains growing weaker, owing to the complete exhaustion of the patient (153), and in post-partum haemorrhage (152) due to inertia of the uterus.
The menses flow only in the day-time (134), while the leucorrhoea, which is bloody and accompanied by great weakness, is noticed only at night or is worse at that time (126).
On the vocal and respiratory organs Causticum is of great value and the more we study the remedy the more indications we find for its use.
It is indicated in various paralysis resulting from diphtheria (62) and especially so for paralysis of the muscles of the pharynx and larynx. In acute laryngitis, with hoarseness or sudden aphonia after taking cold it is frequently called for, as well as in loss of voice in singers and speakers (117), especially when it occurs from exposure to cold air, after use of the voice, when the larynx is more or less heated and congested. The vocal cords will be found to be reddened and there will be noticed more or less rawness and soreness in the larynx and trachea.
In the early morning there is great dryness in the larynx and the voice is very harsh and rough, all of which sensations are relieved by eating or drinking and the use of the voice, and a valuable differentiation, as emphasized by Dr. G. G. Shelton, between Causticum and Phosphorus is that in the former the hoarseness is better from talking and in the latter worse. There is also a feeling as if there were mucus sticking to the vocal cords which causes the hoarseness and they try to get rid of it by clearing or rather, scraping the throat.
The cough of Causticum is worse from the warmth of the bed (41) and better from sips of cold water, and while several remedies are mentioned in the Handbook as having cough better from drinking (40), this is the only one where cold drinks are spoken of at all prominently. Frequently with the laryngitis or cough calling for Causticum, we have a sore or raw streak extending down the trachea, which is irritated by every cough, and the patient will show the extent of the rawness by means of one finger passing over the line of the trachea; with the rawness on coughing requiring Phosphorus, all the fingers of one hand are used to illustrate the extent, as a broader surface is to be covered. This differentiation, as first given by Dr. Shelton, should be kept in mind, as it is frequently demonstrated to us by our patients.
A common sensation under Causticum is as though the irritation to cough was caused by mucus situated just below the larynx, just too low to be reached by the cough although frequent efforts are made to raise it; a sip of cold water will now relieve the necessity to cough. We must not forget the symptom already spoken of, cough with involuntary micturition (52), nor the symptom that I have learned to place great reliance upon, cough at the end of pronounced expiration, the cigarette cough.
Many rheumatic conditions call for Causticum, with a general aggravation from taking cold and during stormy weather (9). The pains make the patient restless, but motion does not relieve.
It is useful in stiffness of the neck from taking cold (174), in lumbago, with painful stiffness in back, sacrum and “coccyx” (Dunham), worse on attempting to straighten out, and in sciatica of the r. side, with pain on motion, and in all these conditions with relief from heat (10) and aggravation from easterly storms. It is of value in many conditions of paralysis resulting from rheumatism, and in rheumatic paralysis of the r. deltoid, especially (161), with inability to raise the hand to the head or to fix the hair.
There is stiffness and cracking in the joints (125) when walking, weakness of the ankles (71), cramps in the calves (71), feet and toes, a sensation as though the hamstring muscles were too short (71), so that the leg could not be extended, or there is contraction of the tendons of the palms of the hands.
Causticum may prove useful in arthritis deformans (161), especially in persons who suffer from great weakness of the limbs, and with aggravation from easterly winds or storms.
On the skin there is more or less tendency to soreness in the folds back of the ears, between the thighs, etc., especially when associated with sour sweat.
It is of value for warts (208), small flat, or horny, that appear on the eyelids, tip of nose, hands and fingers, especially on the tips of the fingers and about the nails.
The acids, Coffea cr., and Phosphorus, are incompatible with Causticum.
I use Causticum 3d.