The chief field for acidum picrinicum is the severe nervous exhaustion, so severe that it permits one to think of a transition to organic alterations of the central nervous system. Mental work, reading and writing decidedly exhaust, thinking can no longer be concentrated. It can proceed to a complete loss of energy and mental power. Headaches “up to bursting” begin in the occiput and extend foreward to the eyes; they are relieved y tightly binding the head and are worse from movement, from any effort, from dazzling light, from summer heat, in warm rooms, better in the fresh air and on lying down.
But the pains also extend over the neek to the back along the vertebral column and here the syndrome is characteristic and one which played a great role in older medicine as “spinal irritation” a burning and sensation of heat along the vertebra with extreme paralytic-like weakness in the back and in the legs, numbness and sensations of tenseness in various places, particularly in the legs and feet. It is hard to keep the feet warm. Also in partial hyperirritability syndromes as writer’s cramp, picric acid has been employed with good result. After exhausting diseases and mental over-exertion, but particularly in sexual hyperexcitability and states of weakness this picture of a severe neurasthenia is a good indication for acidum picrinicum. Vertigo and ear noises recall those of salicylic and benzoic acid.
The spinal cord for the sexual functions are especially involved; sexual weakness with seminal emissions, spermatorrhoea, states of irritation and priapism from organic spinal cord diseases and finally impotence; in women, pruritis vulvae before the menses. A clinical connection exists to prostatic hypertrophy and for this purpose ferrum picrinicum is usually employed. Dribbling urination and nocturnal urgency are the symptoms. Perhaps the action is to be placed in a series with that on the kideney and urinary passage in general, because in addition to nephritis, strangury is also observed in poisoning. In subacute nephritis with many renal elements and scanty, dark urine one may use picric acid when the exhaustion is particulary outstanding.
In organic nervous diseases as facial paralysis and paralysis agitans, zincum picrinicum is preferred, in prostatic hypertrophy ferrum picrinicum.
SUMMARY ——- Indications: ———— Severe nervous states of exhaustion with “spinal irritation” and states of sexual hyperexcitability;transition to organic disturbances. Nephritis; prostatic hypertrophy.
Modalities: ———- Worse from mental effort, from sun’s heat, better in cold air. Headache better from firmly binding the head.
DOSE
The usual dose is the D 6.
ACIDUM HYDROCYANICUM
Hydrocyanic acid, HCN, is known as a poison of rapid action. And still it occurs physiologically fairly often in the plants of different families, usually Rosacea, and particulary in the form of so-called cyanogenous glycosides, for example as amygdalin. In cherries, plums, peaches, apricots, in phaseolus lunata and linum usitatissimum, the content has not obtained medicinal significance, in bitter almonds only a little, but in prunus laurocerasus, crataegus oxyacantha, sambucus nigra, the hydrocyanic acid probably participates in the medicinal effect. The cyanogen containing glucosides in plant metabolism are sugar reserves; through ferments as emulsin which appears in the same plants, the sugar is liberated (for example from amygdalin, hydrocyanic acid, oil of bitter almonds and sugar develops).More- over these glucosides are probably steps in the formation of amino acids in the plants. (The CN2 stands very near to oxalic acid; it is its nitrile and develops from ammonium oxalate by heating with dehydrating agents.) In animals, hydrocyanic acid appears in the glands of certain centipedes. So far as it develops in the metabolism of man, it is detoxified through compounds with sulphur as the thiocyanates (CNS).
POISONING
The almost lightning-like course of poisoning with HCN or KCN (from which HCN is easily liberated by CO2) shows the extraordinary capacity for penetration in the organism to the vital centers, the respiratory center becoming paralyzed. But the symptoms also diminish just as rapidly as they occur, when the excretionof HCN occurs sufficiently rapidly, and here chiefly through the respiratory passages. In slower poisoning with smaller doses the respiratory and vasomotor center is first stimulated, respiration deepened, cardiac activity slowed, the blood pressure rises, then follows sudden falling of the blood pressure, and respiration ceases; the cardiac action remains unaltered for a relatively long time. In addition the action proceeds on the cell respiration, the respiratiory ferments unable to exert their catalytic activity, the oxygen of the blood cannot be taken by the cells, and the blood remains arterial. According to O. Warburg the iron-containing respiration ferment is poisoned; it is changed into a complex iron compound which is unsuitable for surface catalysis.
The first signs of inhalation of hydrocyanic acid are irritative manifestations in the throat and larynx, burning in the tongue, redness of the mucous membranes, then restlessness and anxiety, headache, nausea and a desire to vomit. Slowing of the pulse and respiration with oppression and constriction of the cardiac region and in the throat, dyspnoea and convulsive breathing (short inspiration and long exhalation) pass over into tonic clonic spasms which can increase up to tetanus and loss of consciousness. Then suddenly the asphyxial stage sets in with falling of blood pressure and ends in respiratory paralysis. After recovery from the poisoning at times there is a persistent weakness in the muscles and the heart.
The alkali cyanides act because of the hydrocyanic acid set free in the stomach, although more gradually according to the amount of HCN liberated. Moreover local corrosive actions occur from the strongly alkaline salts.
HALOGEN SIMILARITY
Chemically the CN compound behaves entirely like a halogen. The first affinity for the mucous membranes of the upper respiratory passages is entirely similar to that of iodine. Formerly the hydrocyanic acid-containing preparations as aqua amygdalarum amararum were used for the relief of cough, although now they are regarded chiefly as correctives. Heavy metal compounds as cyanide of mercury, Hg (CN)2, are used in homoeopathy much like the corresponding iodine compounds. Hydrocyanic acid itself however through its rapid capacity for the character of carbon compounds so that its considerations at this place seems logical. Outside of numerous descriptions of poisoning, intentional provings of hydrocyanic acid are found:
1. Jorg: Materialien zu einer kunft. Heilmitell., Leip-zig, Bd. 1, S. 82, u. 118, 1825.
2. Hartlaub u. Trinks: Reine A.M.L., Bd. 1, S. 127. 3. Preyer: Die Blausaure, Bonn. 1870.
DRUG PICTURE
According to its severe and sudden method of action acidum hydrocyanicum is a remedy for attacks. Convulsive states of a general type, as epileptic, tetanic, and uremic are said to experience transient improvement of the attack from the remedy. But since the epilepsy which has a lightning-like seizure is described as the type suitable for the drug and acidum hydrocyanicum comes into consideration only for the attack and nothing known of a lasting effect on the disease, this use must be rare. The spasm should involve particularly the neck, facial and the jaw muscles.
Acidum hydrocyanicum is more successful in partial spasms which precede paralysis or are associated with it. As with other remedies with spasma such as cuprum, the symptom “drinks roll audibly through the esophagus” refers to spasm of the esophagus. In spasm of the diaphragm acidum hydrocyanicum in the D 6 has proven useful. The initial symptom of scratching in the throat and the larynx provoking dry spasmodic tickling cough has been relieved by acidum hydrocyanicum, in the tuberculous form as well as others. Sensation of constriction in the throat or in the chest and spasm in the respiratory passages, laryngismus and spasmodic cough, with the most severe dyspnoea and cyanosis, precordial anxiety and ice cold skin are the signs of impending respiratory and vasomotor paralysis in which acidum hydrocyanicum is one of the most important remedies for the moment. The remedy is also recommended in cholera when vomiting and diarrhoea cease and col- lapse appears. Sudden weakness belongs to the picture in general. The mental state is anxious as long as confusion or loss of consciousness does not prevail. The headaches are severe and numbing.If, immediately after an apoplexy, the vital centers of the medulla are threatened, one should think of acidum hydrocyanicum. Involuntary stools and urine often appear in the HCN poisoning.
A sensation of warmth, nausea and vomiting which relieves is reported of the stomach; moreover (without point of departure from the provings)a feeling of emptiness in the epigastrium and pain in the empty stomach. The occasional use of HCN containing remedies in nausea and vomiting, gastric pain is traced back to the local anesthetizing action of HCN. Still even in this field the vagal spasm underlies the special influence of acidum hydrocyanicum.
Leeser, a Consultant Physician at the Stuttgart Homeopathic Hospital and a member of the German Central Society of Homeopathic Physicians, fled Germany in 1933 after being expelled by the German Medical Association. In England Otto Leeser joined the staff of the Royal London Homeopathic Hospital. He returned to Germany in the 1950s to run the Robert Bosch Homeopathic Hospital in Stuttgart, but died shortly after.
Otto Leeser wrote Textbook of Homeopathic Materia Medica, Leesers Lehrbuch der Homöopathie, Actionsand Medicinal use of Snake Venoms, Solanaceae, The Contribution of Homeopathy to the Development of Medicine, Homeopathy and chemotherapy, and many articles submitted to The British Homeopathic Journal,