That there is something in the distillate, which is different from distilled water, one is convinced best through the soda-like odor and the mildly astringent taste. Furthermore, with Merck’s universal indicator, it shows that the distillate actually has an alkaline reaction. The fresh preparation has a pH of 8.0- 8.5 which decreases gradually after twenty-four hours to a pH of about 7.5. Likewise the fresh preparation reacts weakly alkaline to litmus. With Nessler’s reagent it gives a light yellow color, which colorimetrically determined corresponds to about the fifth decimal potency of ammonia. Even earlier it was suggested that the ammonia arises from the lime and indeed from the inclusions of animal tissues. In the burning, ammonia would become free, be taken into solution by the water, and be distilled over.
Also if chemically pure, apparently nitrogen-free, original materials is employed (calcarea ustae marmore pro analysi and potassium bisulfuricum crystallisatum [KHSO4], pro analysi, [Merck] ), the result remains the same. Up to now it has not occurred that a causticum is distilled which does not give an ammonia reaction. That the control distillates from the same water do not furnish an alkaline reaction nor ammonia need not be stressed.
In what form the ammonia exists in the distillate is still unknown. At any rate the preparation must be added to the ammonium compounds. Its persistent action which characterizes it beyond simple ammonium hydroxide and other ammonium compounds must be ascribed to still unknown properties which indeed it owes to its method of preparation.
The proving symptoms from the first edition of Chronic Diseases (see above) have been added by Hahnemann in the second edition of 1837, to the symptom of the impure preparation tinctura acris sine kali.
One can consider causticum as a chronic acting ammonium preparation. But it also stands close to the potassium picture although this element has not been proven in it.
The trend toward the locomotor apparatus appears the predominant in causticum. In the second place stands the influence on the respiratory passages. The type deviates from ammon. carb. and kali carb. in so far that the chronic, insidious maladies, in causticum, condition a yellowish, wan facies, and furthermore through the improvement in unsettled, damp weather, aggravation in clear weather and also from dry cold. Etiologically, indolent affections are reported Causticum has a depressed melancholic frame of mind but also much terror and irritability: children will not go to sleep alone, cry out on the least occasion. For the locomotor apparatus, the drawing, tearing, as well as burning pains are characteristic; and for the mucous membranes, burning pains. The time of aggravation, like ammonium and potassium, is toward 3-4 A.M.
Chief indications are: subacute and chronic muscle tendon-joint- and peripheral-nerve affections of a rheumatic type, aggravated by dry cold and cold winds, through drafts, through movement, better from the warmth of the bed. There exist great nocturnal restlessness, twitching in the extremities. The rheumatic inflammations easily pass over into secondary alterations; there are an arthritis deformans, tendon shortening, muscle contractions (Dupuytren), peripheral paralysis with increasing weakness and uncertainty in the muscles.
In its great neuromuscular weakness with trembling and twitching, causticum stands close to kali carb., moreover, the paralytic weakness of causticum goes over much sooner to actual paralysis.
A chief field of application is the weakness of the sphincter vesicae: involuntary discharge of urine on coughing, sneezing, walking, often unnoted, or enuresis in the first sleep. But urinary retention also occurs and the postoperative type forms a suitable field of employment. Facial, ocular paralysis, ptosis, paralysis of the tongue with indistinct speech, vocal-cord paralysis (recurrent nerve paralysis after diphtheria, from hard goiter, etc.) Failure of the lower rectum and of the sphincter ani, the stool can be passed only when standing, but also partial paralysis anywhere else in the locomotor apparatus, either of rheumatic cause, from cold wind, or after infectious diseases, will be favorably influenced by causticum. Furthermore, sciatica with numbness comes under causticum. Other neuralgias have burning pains, for example, after herpes zoster.
On the respiratory organs the huskiness and aphonia stand in the middle point. Here the mucous membrane and the peripheral nerve actions come together so that chilling as well as overexertion from singing and talking are reported as causes. Characteristic is the morning aggravation.
The catarrhal manifestations involve particularly the larynx and the trachea and are characterized by a feeling of soreness and burning (in the larynx, under the sternum, in the chest.) The cough is dry, hard, the sputum is scanty and raised with difficulty and must be swallowed. The cough is relieved by drinking cold water. The improvement from the warmth of bed does not refer to the cough, but on the contrary the aggravation at 3-4 in the morning was especially evident in the provings. Outside of the involuntary discharge of urine, a pain in the left hip is noted with the coughing. An echoing of the voice in the ears may result from the catarrhal processes in the throat.
The gastro-intestinal symptoms are without significance except the already mentioned weakness of the sphincter ani. The burning pain prevails everywhere, also in the hemorrhoids, whose condition is said to be worse from thinking about them. In the mouth the burning vesicles and ulcers are worthy of note.
The menses do not have a definite type, but the blood flows only during the day and ceases at night.
On the skin, warts, old scars and the results of burning should react, likewise itching and burning intertriginous eczema.
As an extraordinary symptom reported the feeling as if a hollow space existed between the forehead and the brain, which perhaps can be connected with the feeling of looseness of ammon. carb. In the Hahnemannian symptom register besides diverse trembling and twitching in the muscles, also epileptiform attacks are described. The therapeutic use for this purpose is rare. The dependence upon the weather should guide the choice.
The indications for cataract are very uncertain.
1. Locomotor apparatus; rheumatic affections; peripheral nerve paralysis (sphincter vesicae!).
2. Respiratory passages (larynx and trachea).
Aggravation from dry cold, in cold weather; better damp weather; rheumatic affection better from warmth of bed; cough worse nights, particularly 3-4 A.M.; huskiness worse mornings; burning pain chiefly predominates.
DOSE : Usually the sixth and higher potencies.