Phosphorus was considered by the older writers of our school as the nearest specific for pulmonary tuberculosis, it has been styled the “King of phthisical remedies.” Yet it is not wise to ask too much of Phosphorus. The choice of this remedy must be most carefully made, and it is also the universal testimony that its dose should not be too often repeated. Baehr says that no other remedy causes haemoptysis so easily as Phosphorus. Study the remedy for every case; in fact, it seems to be an accepted dictum that Arsenicum, Sulphur and Phosphorus should never be used in tuberculosis unless most carefully indicated. Phosphorus corresponds especially to phthisis in the rapidly growing young, who are brilliant in mind, but who have a hereditary tendency to lung troubles, who are chicken thoraxed, tall and phthisical, and to those who take cold easily owing to a general relaxation of the system. The chief symptomssubdue the hectic fever of the disease.
Ammonium muriaticum [Am-m]
Has a coldness between the shoulder blades, and this symptoms may call attention to it in phthisis.
Also has a diarrhoea, which may still further indicate it in the later stages of tuberculosis; it shown by the intolerance of the rectum to the presence of the faces; as soon as anything enters the rectum is expelled. Increased sexual desire in phthisis is also a good Phosphorus symptom.
Calcarea may be distinguished from Phosphorus as follows :
Scrofulous and fat. Slender and overgrown, narrow chested. Swelling of upper lip. Worse in open air. Better in open air. Not over-sensitive to pain. Over- sensitive to pain.
The treatment of tuberculosis by neucleins is an indirect way of giving Phosphorus, as all neucleins contain a large. amount of phosphorus.
Calcarea carbonica. [Calc]
In the treatment of tuberculosis it is of paramount importance to administer the proper constitutional or basic remedy; it is a constitutional disease and requires a constitutional remedy rather than one directed to the isolated symptoms. Calcarea suits pale, sallow, non-resistant patients of a leuco-phlegmatic temperament, and those whose constitutions have been broken down by frequent and profuse menstruation, or by frequent miscarriages. Patient takes cold easily, and it corresponds especially to the third stage of the disease, when large cavities are forming. Its special seat of action seems to be the middle third of the right lung; loud rales are heard all over the chest, more over the middle of the right lung. The cough is loose and rattling, or short and dry in the evening; there is much soreness of the chest and great fatigue and shortness of breath on going upstairs or on making any ascent whatever. The chest feels as if beaten, and there is persistent painless hoarseness. The expectoration is of purulent yellowish green and bloody matter. There is great repugnance to animal food; a diarrhoea which is worse in the evening, in which meat will pass undigested; there is a great emaciation, sweat, suppression of the menses in females, and these symptoms would indicate the remedy in incipient phthisis in young girls of an anaemic type. It possesses the following symptoms of the tuberculous dyscrasia which, on constitutional grounds, lead to its selection:
2. Throat symptoms, irritation and rawness.
3. Eruptive skin conditions, freckles, spots itching, pimples.
4. Sweat from least exertion profuse and exhaustive.
5. Predisposition to take cold easily. Most of its symptoms are worse from cold (do not and send Calcarea patients to cold climates).
6. Mental state of hope.
7. Eye and ear symptoms.
8. Falling of hair.
9. Fullness across the chest with spitting of blood.
Calcarea phosphorica will suit better when the emaciation is more rapid, and more marked, where there is greenish purulent expectoration, headache and languor; in short, some meningeal complications.
Calcarea iodata. [Calc-i]
This remedy is preferable, when glandular complications are present, in young subjects who grow rapidly with tickling, teasing cough, rapid pulse, high fever, and rapid hepatization; it corresponds more exactly to the miliary form of tuberculosis.
Hirschel claims that this remedy stands next to Calcarea in dry, fatiguing, tickling coughs. It has many symptoms of the tuberculous cachexia.
Tuberculinum or Bacillinum. [Tub]
These remedies have been used by homoeopaths for some fifty years and many favorable results have been observed. Dr. Burnett, of London a very careful observer, has reported many cases cured and benefited by Bacillinum; the indications, however are not clear. Dr. R. F. Rabe thinks the indications are somewhat similar to those of Pulsatilla. A feature seems to be the desire of the patient to be in the open air. Others have been specially successful with the different preparations.
Nitric acid, being a powerful anti-tubercular remedy before cavities are formed, is most useful in phthisis; it has sudden rush of blood to the chest, hectic fever, soreness of the chest, frequent haemorrhages profuse and of bright red blood, dyspnoea, hoarseness which is much worse in the morning, diarrhoea which is also worse in the morning and sharp stitching through the right chest to the scapula. There is a weak heart and much palpitation. The sweat is worse at night and towards in the mourning, particularly exhausts the patient, thus showing the acid debility so characteristic of the drug. The skin is cold towards morning, there is a tickling cough which annoys the patient all night; sometimes the cough is dry and sometimes loose and rattling; the rales are loud; the expectoration is offensive, dirty green, bloody and decidedly purulent. Nitric acid gives a greater predominance of throat symptoms than almost any another remedy. As all Nitric acid symptoms are aggravated by warmth, do not send such patients to warm climates.
Lycopodium and Pulsatilla have smooth and yellowish green expectoration.
The Nitric acid patient is thin, with dark hair and eyes, and may be easily distinguished from Calcarea as follows:
Calcarea Nitric acid.
Patients fat, light, hair, blue, eyes. Patient thin, dark, hair and eyes.
Diarrhoea worse mornings. Diarrhoea worse evenings.
Cough generally loose. Cough generally dry.
Worse in cold weather. Worse in warm weather.
Better in warm air. Worse in warm air.
In suppurative stage of tuberculosis, Silicea is one of our principal remedies; it is especially indicated by a low grade of vitality where the patient finds it impossible to keep warm. It is an excellent constitutional remedy and corresponds well to the slow phthisis mucosa of old people. The cough at first is dry, racking, but afterwards loosens; there is copious rattling in the chest and expectoration of offensive muco-pus. The purulent character of the expectoration indicating abscess formation in the lungs is characteristic, and it is more profuse after exertion. There are large cavities in the lungs, profuse night sweats and hectic or suppurative fever. There is no better remedy in the treatment of exhausting night sweats. Some seventy cases were treated with satisfactory results by the later Dr. E. R. Snader.
Is a remedy which has a horribly offensive expectoration, and it is useful in the last stages of phthisis, but the expectoration of Silicea is more purulent.
Iodine sits only after the expectoration has become purulent, and it is especially useful if tuberculosis is the result of scrofulosis. If diarrhoea be present, Iodine does not generally act favorably.
Is a remedy for what is termed “stone cutter’s consumptions,” where there are profuse night sweats and a pale, waxy skin. Offensive perspiration is also an indication for Silicea. Convulsive cough, like that of Drosera, but the tickling is lower in the larynx and suprasternal fossa, while that of Drosera is in the upper part of the larynx and throat Jousset recommends the 30th dilution.
Stannum metallicum. [Stann]
Although the mentally low-spirited and depressed condition of stannum does not correspond with the mental condition usually found in phthisis, yet it is often times a most useful remedy. It corresponds especially to catarrhal cases which are engrafted upon a scrofulous habit. There is marked hectic fever, chills at 10 A.M. flushed and hot in the evening aggravation on every exertion and profuse sweat at night, worse about 4 or 5 in the morning. Weakness is a grand characteristic, and must be present; the patient is so weak that he cannot talk more than two or three minutes at a time. Hoarseness is common. The cough is paroxysmal, and seems to be most frequently caused by mucus in the chest. The expectoration is profuse and of yellowish or yellowish-green, sweetish mucus. An abundant secretion of mucus and an empty feeling in the chest are keynotes for Stannum. A blood-streaked expectoration is a contra-indication.
Lycopodium has a grayish and salty expectoration.