Mercurius cyanatus. [Merc-cy]
The mercurial preparations generally have very little, if any, relation to the diphtheritic process, and their efficacy the disease is a matter of doubt. They may be indicated, however, by bilious, glandular or other symptoms. **Mercurius does not produce the sudden and intense prostration of diphtheria. Mercurius vivus and Mercurius solubilis are ***never indicated in this disease. The iodides of mercury are sometimes of use, the **Mercurius biniodide with its left side indications, inflammation, febrile excitement, headache, etc., and the **Mercurius protoiodide with the right side indications, yellow tongue, glandular swelling, etc.; but there is a preparation of mercury which is one of the best remedies in diphtheria that we have, and that is **Mercurius cyanatus. It seems to get most of its symptoms is from the hydrocyanic acid of its composition. Thus we have, as indications, great and sudden prostration and very high pulse. The weakness is extreme, collapse symptoms showing themselves even at the commencement of the disease. There is an exudation in the throat; at first it is white, but it may turn dark and threaten to become gangrenous. The tongue is brownish and blackish, with foetid breath, nose bleed, loss of appetite, profuse flow of saliva, etc. It is especially a remedy in the malignant type of diphtheria and when the disease invades the nostrils. The great prostration will serve to distinguish it from **Kali bichromicum, which has the thick, tenacious exudation, also found under **Mercurius cyanatus. Clinical experience with this remedy has proved that preparations below the 6th are less effective than the higher, and not as safe, since it produces a tendency to heart failure. The 30th potency seems to have been a favorite one. Dr. Villiers, of St. Petersburg, treated 200 cases of all sorts of severity without a single death, using the 6th to 30th potencies. Dr. Neushafer treated 85 cases with three deaths, using the 5th to 15th potencies hypodermically. Dr. Sellden, in 1879-82, reported in a district of Sweden 564 cases of diphtheria, of whom 523 died, a mortality of 92.7 percent. None treated with the cyanide of mercury. In 1883-86, 160 cases were reported, of whom 29 died. In 132 of these 160 cases the cyanide of mercury was used and only one case died. He and his colleagues have treated 1,400 cases with a mortality of 4.9 percent. A strength equal to the 2x was used.–London Lancet, April 24, 1888.
The Nosode of Diphtheria and the idea of its use did not urgent with Boerhing, nor with Roux. Long before Pasture, a German homoeopathist named Lux conceived the isopathic idea and successfully treated cases with it. Cartier, whose long experience in the diphtheria pavilion of the Children’s Hospital in Paris advocates **Mercurius cyanatus and **Diphtherinum as the successful remedies in this disease, the latter also being useful in post-diphtheritic paralyses. The higher potencies are used.
Kali bichromicum. [Kali-bi]
This remedy, which is perhaps more useful in the croupoid form of the disease, has marked symptoms. There is apt to be deep ulceration and a thick, tenacious exudation, often streaked with blood; the membrane is yellow looking and the cough is croupy and accompanied with pain in the chest. There is also swelling of the glands. The indication for **Kali bichromicum may be chiefly summarized as follows:
1. The yellow-coated or dry, red tongue.
2. The tough, tenacious exudation.
3. Pain, extending to neck and shoulders.
These, and the fact that it is most useful in the later stage of the disease, when the line of demarcation has formed and the slough has commenced to separate, make the indication for the drug certain.