Camphor: Incessant bleeding from the nose with the body as cold as a stone.
Carbolic-acid: Another polychrest to deal with the fetid smell. It has great prostration, thread-like weak pulse and a low type of fever as in typhoid. It is a painless drug.
Crotalus-h: Malignant diphtheria, gangrene forms in the fauces, incessant and uncontrollable bleeding from the nose and the mouth; gasping for breath. It is also useful when vomiting or diarrhoea sets in.
Diphtherinum: This nosode should be used in high potencies as an intercurrent remedy to modify the condition and to enhances the action of the indicated remedy. For prophylactic purpose it can be given to other children during an epidermic outbreak of diphtheria Dr. H.C. Allen writes “The author has used it as a prophylactic and has never known a second case of diphtheria to occur in a family after it had been administered.
The profession is asked to put it to the test and publish the failures to the world.” It should be noted here that whether it is used for a curative or a preventive purpose a nosode should not be repeated often.
Kali bi. Inflammation of the fauces with pseudo-membranes of dirty yellow colour with a tendency to spread downwards, reverse of Brom, to trachea or to the larynx; croupy cough with tenacious expectoration; stringy discharge from the nose; swelling of parotid, cervical and submaxillary glands. This polychrest is more suitable for heavy and flabby children.
Lac-caninum: will be indicated when the symptoms change the sides frequently. Ichorous discharge from the nose. Pearly white diphtheric deposits of shining glazy appearance.
Lachesis: Aggravation of all the troubles during or after sleep, and the false membrane spreading from left to right will determine its selection. Even the slightest touch or covering over the throat is unbearable, they provoke suffocation. Its patient feels it more painful to swallow liquid than solid foods (Bell., Bry., Ign.). Aggravation from warm drinks.
Lycopodium: has also aggravation after sleep but other symptoms are reverse of Lach. The membrane affects the right tonsil first and thence extends to the left (l. to r. Lach.); cold drinks aggravate the throat pain (hot drinks Lach.). All its troubles are worse between 4 and 8 p.m.
Mercurius: Tonsils inflamed; uvula swollen and elongated; tongue large, flabby, indented and thickly coated; increased ptyalism; frequent and profuse perspiration without relief; constant desire to swallow although swallowing is painful; these are the common indications of the Mercury Family.
Mercurius-cyanide is one of the best remedies for the malignant type of diphtheria. It has suffocation, great prostration, and incessant bleeding and foetid smell from both the throat and the nose.
Merc-iod-ruber or Bin-iodide of Mercury: will be more useful in left sided affections with swelling of other neighboring glands. Dark-red appearance of fauces and stiffness of the neck are its accompanying factors.
Merc-iod-flavus or Proto-iodide of Mercury: Thick coating over the tongue, yellow at base, while the margins and the tip may be red. It is more suitable when the membrane spreads from the right to the left side or is worse on the right side.
Muriatic-acids: When the condition assumes typhoid like features with great prostration, sordes on teeth, crusts on lips and foetor from the mouth this medicine will be of great help to arouse reaction. It has also oedematous swelling of the tonsils and the uvula, and bleeding from the nose of a fetid smelling venous blood.
Naja is of invaluable importance in the treatment of the laryngeal diphtheria when the false membrane causes a dry, irritating cough, and suffocation with or without cardiac disturbance.
Nitric-acids: The leading features of this great antisyphilitic drug are foetid aphthous sore inside the mouth with profuse drooling, high fever and intermittent pulse.
Phytolacca: This is one of the most frequently indicated medicines in the treatment of diphtheria and is of invaluable importance. An aching pain all over the body, more particularly in the back and the limbs (in early stage Bry.) will lead to its choice. It has diphtheric deposit around the tonsils, swelling of the tonsils and uvula; swallowing painful, particularly anything warm (Lach.). In some extreme cases the child cannot drink anything at all, not even water. It acts better in right sided affections.
Rhus-tox: will be indicated in very severe cases when the swollen tonsils have a dark red appearance and the child slavers bloody saliva during sleep. Erysipelatous swelling of cervical glands. This is a restless medicine.
In Biochemistry Kali-mur 3x, 6x is the principal remedy for diphtheria. It should be given in alteration with Ferrum-phos 6x as long as the fever predominates or with Kali-phos 6x when prostration or bad smell supervenes.
For malignant cases think of Merc-cy., first and then Carb-ac or Lach.
When prostration is marked from the very beginning of the attack consider Apis, Ars., Diphth., Merc-cy., and Phyto.
For the croupy cough give Brom. or Kali-bi., and also consider Merc-cy and Spong.
For the laryngeal type think of Brom., Kali-bi., and Merc-cy.
When the false membrane spreads into the nose consider Kali-bi. and Nit-ac. first and then Arum-t., Lyco., Merc-cy. and Phyto.
For bleeding from the nose give Merc-cy. first and if it fails try Camph., Crot-h., Lach., or Nit-ac. Ferrum-phos and Carbo-veg have bleeding of bright red blood.
When liquids come out through the nose: Arum-t., Lach., Lyco. In the next group Carb-ac., Lac-can., Merc-cy. and Phyto.
When the membrane spreads from right to left: Lyco., Merc-Proto- iod., Phyto and when from left to right: consider Lach. first and Sabad. or Merc-bin-iod next. From the extending upwards Bromine. From the fauces spreading downwards: Kali-bi. Lac-caninum will be indicated when the membrane changes the sides repeatedly and frequently.
Remember:.
If the child complains of an aching pain all over the body the Phytolacca will relieve the pain and remove the diphtheric deposits. Perhaps Baptisia is the only other alternative in such cases but its choice depends more on the foul smell from the mouth.
If on the first day of examination the diphtheric deposits are noticed only on the left tonsil or worse on the left in case both the tonsils are involved then Lachesis will. no doubt, be the first choice. After the application of Lach. the membrane on the left side may disappear, yet those on the right side may not show any signs of improvement. In such a case Lycopodium will have to be resorted to.
But after Lyco. if the deposits on the right side disappear only to reappear on the left side then it will be sheer waste of time to give Lachesis or any other left sided medicine again; give Lac-caninum to take over the charge of both the sides.
