Probably no fact is more fully established in medicine, in any school, than the beneficial action of Aconite action of **Aconite in pulmonary congestions. It is the remedy of remedies in the first stage of pneumonia, because it corresponds more closely to the symptoms usually found in that stage. It should not, however, be used in this or any disease in the first or any stage unless the symptoms call for it.
The symptoms are these: High fever preceded by a distinct chill; the pulse is full, hard and tense; a history of exposure may also be taken into consideration; dry, cold winds. The skin is hot and dry, without moisture upon it; ***there is a hard, dry, teasing and painful cough; there may be some expectoration present, if so it is watery, serous and frothy, may be blood tinged, but not thick. Thick expectoration indicates that exudation is commencing, and then **Aconite is no longer the remedy. There is pain also with **Aconite, which is poorly borne. With these symptoms there is great restlessness, tossing about, anxiety and perhaps fear;of death. It will strengthen confidence in remedies to see **Aconite act in these cases. **Veratrum viride in some is similar to **Aconite in some particulars, but it is easily distinguished; there is a full rapid pulse and a great deal of arterial excitement; the eyes are glistening and there is a red streak down through the centre of the tongue. It is, perhaps more often indicated at the commencement of a pneumonia than is **Aconite.
A great indication for Aconite in pulmonary congestions is **suddenness;of onset, and especially so if it occurs in young and plethoric persons who are full of life and vigor; for it is per-eminently in such patients that congestions, when appearing at all, appear suddenly. **Gelsemium lacks the suddenness;of **Aconite. Here apathy is marked, and the two drugs need never be confounded.
Ferrum phosphoricum. [Ferr-p]
This, like **Aconite, is a remedy for the first stage before exudation takes place, and,, like **Aconite, if there be any expectoration it is thin, watery and blood streaked. It is a useful remedy for violent congestions of the lungs, whether appearing at the onset of the diseases or during its course, which would show that the inflammatory action was extending; it thus corresponds to what are termed secondary pneumonias, especially in the aged and debilitated. There is high fever, oppressed and hurried breathing, and bloody expectoration, very little thirst; there are extensive rales, and perhaps less of that extreme restlessness and anxiety that characterizes **Aconite. This remedy, with **kali muriaticum, forms the Schuesslerian treatment of this disease.
This remedy is one both for the first and second stage of pneumonia, especially for the croupous form. It has high fever and restlessness like Aconite, and there is a tendency to rapid extension of the hepatization. There is a decided cough and great difficulty in breathing, as if the chest would not expand; the sputum is blood streaked. **Iodine may also be a remedy in the later stages when resolution does not progress, the lung breaking down with hectic and suppurative symptoms.
Dr. Kafka, our celebrated German confrere, prescribed drop doses of **Iodine in the 1st, 2nd or 3rd dilution every hour or so as soon as physical signs of pneumonia showed themselves, and claimed that it would arrest the process of hepatization within twenty-four hours. He considered that **Aconite was entirely unnecessary in the treatment of pneumonia. It is also favorably spoken of by Prof. T. F. Allen.
Veratrum viride. [Verat-v]
In violent congestions about the chest preceding pneumonia **Veratrum viride may be the remedy, and thus it is seem that its use is more in the beginning of the disease, and especially where there is great arterial excitement, dyspnoea, chest oppression and stomach symptoms of nausea and vomiting; the engorgement is profound, and here it greatly resembles **Sanguinaria; but it differs from that drug, in that it is of;little use after hepatization has taken place. There is high fever, violent action of the heart, the pulse is full, hard and rapid, and the tongue has a red streak down the center; this latter symptom is a characteristic keynote of the drug. The air cells at the bottom of the lobes are filling up with frothy mucus. the pulse will indicate, it being full and hard. Hard, quick and small indicates **Aconite. Strike out anxiety and alarm and insert an ugly delirium with a deeply flushed, bloated face and headache and you have **veratrum viride. One must beware not to encourage cardiac depression with this remedy.