KALI BICHROM
Objective.- Margins of the lid very red. Dark rings about the eyes. Inflammation of the eyes with yellow discharge and agglutination in the morning. Inflammation of the eyes. Redness of the conjunctiva, with lachrymation. Conjunctiva both of bulb and lids injected. Appearance of small white pustules in the conjunctiva. Pustules on left cornea, with surrounding indolent inflammation.
Subjective.- Itching and burning in both eyes, lachrymation and photophobia. Heat and pressure in the eyes. Violent shooting pain from the root of the nose along the left orbital arch to the external angle of the eye exactly, with dimness of sight like a scale on the eye. Heavy pain above the eyes aggravated on motion and from cold. Much smarting of the eyes aggravated in the evening and in the open air. Especially useful in affections due to a rheumatic diathesis.
Clinical.- The local application of a saturated aqueous solution of bichromate of potash to large acute granulations of the lids has often caused their disappearance. It is, however also serviceable as an internal remedy in trachoma and pannus.
Kali bichr is of great value and especially indicated in mild cases of croupous conjunctivitis (a condition midway between purulent and genuine croupous inflammation), in which the false membrane is loosely adherent, easily detached and has a tendency to roll up and separate into shreds, which come away in the discharges, giving them a stringy appearance. The discharges are profuse, and the conjunctiva very much inflamed even chemosis. The lids are swollen and the cornea may be hazy.
It is of special importance, however, in chronic indolent forms of inflammation of the eye, particularly of ulcers and pustules on the conjunctiva or cornea, in which no active inflammatory process is present and therefore characterized by no photophobia or no redness or very little, not as much as might be expected from the nature of the disease; the pains and lachrymation are also usually absent. Corneal ulcers which have a tendency to bore in without spreading laterally indicate Kali bichr. The eye may be quite sensitive to touch and the secretions are of a stringy character.
Opacities of the cornea have been cleared under this remedy; sometimes used internally alone and again both externally and internally.
For true descemetitis, characterized by fine punctate opacities in the membrane of Descemet, especially over the pupil, with only moderate irritation of the eye, there is no remedy so frequently called for as Kali bichr. If a serous inflammation of the iris accompanies the changes in the membrane of Descemet, Gelsemium should be suggested to our minds.
KALI CARBONICUM.
Objective.-Inflammation of the lids of the right eye, with pain in the eyes and inability to read by the light. Swelling between the eyebrows and lids like a sac. Redness of the white of the eye, with many vessels in it. Lachrymation.
Subjective.-Pressure above the eyes. Sharp tearing in the right orbit and in the eye at night. Soreness of the external canthus with burning pain. Burning, biting and pressure in the eyes. The eyes are painful on reading. Stitches in the middle of the eye. Smarting pain in the eye. Weakness of vision. Photophobia. Bright sparks, blue or green spots before the eyes.
Clinical.-OEdema of the lids, especially if accompanied by sticking pains and heart indications, often subsides under the use of Kali carb.
It may be occasionally of service in small round ulcers of the cornea with no photophobia.
The verified symptoms indicate its usefulness in asthenopic troubles.
KALI IODATUM.
OEdematous swelling of eyelids. Inflammation of the conjunctiva with purulent secretion; chemosis. Eyes red and burn. Lachrymation.
Vision dim and foggy; she sees objects only indistinctly. Pain over the left side of the head and in the eye, aggravated on dark, stormy days.
Clinical.-The iodide of potassium is of the greatest importance in the treatment of many syphilitic affections of the eye. It serves to antidote the syphilitic poison, and there should be no hesitation in employing it in material doses.
Periostitis of the orbit will often require this remedy, especially if of syphilitic origin, though cases in which there has been no trace of syphilis have been benefited. There will be more or less swelling extending to the temple, with oedema of the lids. The pain may be intense or absent entirely.
Tumors of the orbit have disappeared under the use of material doses of Kali iod., as in the following: “A colored woman, with a history of syphilis, had several tumors on the entire upper border of the left orbit. The growths were very hard and encroached considerably upon the upper lid, especially at the inner corner; were painless and presented no signs of inflammation or softening. Entirely disappeared under the iodide of potassium in material doses.”-A. WANSTALL.
It is sometimes useful in stricture of the lachrymal duct.
Its action in pustules of the conjunctiva and cornea is very similar to bichromate of potash, and it has been used with benefit in similar cases.
In syphilitic iritis, Kali iodatum is of great value. It is especially indicated if the inflammation is very severe and unyielding to the influences of atropine. The inflammatory process in the iris is so high that the pupil tends to contract, notwithstanding the frequent instillation of the strongest solution of atropine. The iris is much swollen and the aqueous more or less cloudy. The ciliary injection is very marked and of a bright angry appearance. The pain may be severe, but is worse at night. The photophobia and lachrymation are variable.
Kali iodatum is very prominent remedy in the treatment of acute or chronic irido-choroiditis and disseminate choroiditis, especially if of syphilitic origin. In one typical case of syphilitic choroiditis, recently under treatment, in which the chief symptom was an excessive and variable amount of haziness of the vitreous, the vision improved from R. V., counts fingers (held to outer side of the field) at two feet and L.V. 10/200, to normal, under the daily use of fifteen grains of the iodide of potassium. Its special indications are not known, though its effects are often marvellous, even when the disease is non- syphilitic in origin.
In paralysis of any of the muscles dependent upon syphilitic periostitis the iodide of potassium is the remedy most frequently called for. The following case of paralysis of the left nervus abducens will show its action: A man, 40 years of age, ten days previous to his appearance for treatment awoke in the morning with dizziness, and afterward had three similar attacks. He had a very severe cold. For two days had noticed a blurring of vision and diplopia which had been steadily increasing and was only noticed on looking to the left. Examination showed only slight action of the left external rectus. Rx. Causticum30. Two days later the paralysis of the muscle had become complete. It was found that he had syphilis. Rx. Kali iod., eight grains a day. In two days decided improvement was observed, and in two weeks the muscle had regained its normal power.
KALI MURIATICUM.
Discharge of white mucus from the eyes, or yellow-greenish matter. Superficial flat ulcer of the eye arising from a vesicle. Blisters on the cornea. Feeling of sand in the eye. Onyx and hypopyon.
Clinical.-The recommendation by Schussler of Kali mur. for the stage of exudation in inflammations suggested its employment in parenchymatous keratitis, especially since we know that the Kali’s are adapted to indolent forms of inflammation, which this form of keratitis usually assumes. The following cases will give its sphere of action in parenchymatous keratitis. Mr. L.. aet. 35. For three months there had been an infiltration into the right cornea, which commenced at the outer side and extended over the whole cornea. He could only count fingers. There was occasional pain, moderate photophobia and redness. The pupil dilated slowly and incompletely, though regularly under atropine and contracted quickly. Aurum mur, Cinnabar and other remedies, with atropine externally, had been used with no benefit, except some relief of pain. Under Kali mur., 6th dec., the inflammation was soon arrested and the cornea gradually cleared. In three months R. V. 20/50. The improvement has continued.
In asthenic ulcers of the cornea with but little redness, photophobia, lachrymation or pain. The ulcer generally begins at the periphery and extends toward the centre, its base is a dirty white or yellow, often very vascular and with considerable infiltration of cornea around the ulcer and with a moderate amount of mucous discharge. In some cases the infiltration becomes more purulent in character and extends between the layers of the cornea (onyx) or into the anterior chamber (hypopyon), but even then the inflammation retains its asthenic type.
The benefit which has been derived from the muriate of potassium in case of chorio-retinitis indicates that it may be a valuable remedy in intra-ocular troubles.
Professor of Ophthalmology in the College of the New York Ophthalmic Hospital; Surgeon to the New York Ophthalmic Hospital. Visiting Oculist to the Laura Franklin Free Hospital for Children; Ex-President American Homoeopathic Ophthalmological, Otological and Laryngological Society. First Vice-President American Institute of Homoeopathy : President Homoeopathic Medical Society of the State of New York ; Editor Homoeopathic Eye. Ear and Throat Journal : Associate Editor. Department of Ophthalmology, North American Journal of Homoeopathy, etc.