When you have read through the provings of this remedy you should be able to see a picture of sickness just a little different from that produced by any other medicinal substance. All medicines are capable of producing one or more images of sickness, which they alone can cure in the shortest possible time, and no two can produce images that are exactly the same. However, we do have a few materia medica twins, such as Ferr. acet, and Ferr. met., Merc. sol. and Merc. viv., mang, acet. and Mang. carb., and others that our fathers thought looked so much alike that they always kept them together, and they never seemed to know which was Jack and which was Jill.
Yet there was and is a difference, a difference which, perhaps, may be best expressed by the word similia, so familiar to all of us. The two are similar, most similar, and yet they are not the same; but in a given case one is always more similar than the other, and the more similar of the two will produce curative action more quickly and more thoroughly than the other. Twins may look alike, they may even be of the same sex, as frequently happens, and all marriages should be as cohesive as possible, not merely adhesive. That is what real prescribing brings about, a marriage, a satisfying of a craving, abnormal though it may be. When the similimum is given a dynamic union is consummated.
If we can judge by the small amount of clinical material found in our journals and transactions, Kali phos. has not been largely used, and yet we have quite extensive provings of this substance in the I.H.A. Transactions for 1890-91. In the Guiding Symptoms and in Kent the symptoms are detailed in a more workable form, though they do not give as much evidence of having been clinically confirmed as do our older remedies.
The Kali phos. subject is pale, sensitive, nervous, irritable and disposed to weep. She is worse after eating and while at rest, which in a measure foreshadows the nightly aggravation, although she is also worse in the morning and in the evening. That looks something like the Puls. make-up, but no reputable Kali can live in the same atmosphere with Puls. Most of the Kalis hate cold and are made worse by it, and Kali phos. is no exception, while Puls. is a homoeopathic symbol for all that is of the open air.
There is great lassitude in this medicine, and with it great depression. She complains of feeling so tired. She is tired, weak and depressed, both mentally and physically. Great depression with sinking vitality with anaemia and emaciation or not, is one of the great characteristics of this remedy. Here and in several other features it is remarkably like Amm. carb. The two should be closely compared.
The provers of this drug became tired and nervous, so nervous that their hands trembled, so weak tired that life was a burden, and they lost much flesh; they were nervous, restless, fidgety. Does this not correspond well with those mothers who are worn out physically with nursing and caring for babies, and mentally driven to distraction with the ailing demonstrations of the sick and nervous infant; or of the worn-out man, emaciations and tired to the limit with his own particular worries. Clarion mentions the modality “worse after coition” as being quite characteristic of this remedy. Does it not fit in perfectly with the mento-physical conditions that have just been mentioned?.
Along this same line of exhaustion and failing vitality, and other prominent use for this medicine is strongly suggested, and the suggestion is borne out to some extent by its clinical use refer to its obstetrical indications. When labor has been until exhausting and progress seems to have come to an end, when it seems as if the patients powers and vitality had reached their limit, and the forceps must be used, do not forget Kali phos.; it will save both you and the patient much anxiety and will often make the use of the forceps unnecessary.
There is too great a disposition with physicians generally to regard the symptoms attendant upon labor as something normal, or at least as a condition to be merely watched without medical interference. I think this is wrong. If the woman, during labor, has symptoms connected therewith, and she usually does, she should have the indicated remedy, and that often may be Kali phos. Let us look at the symptoms again, beginning with those that would naturally come before the stage of utter exhaustion above mentioned.
Nervous, sensitive, irritable, weepy, jumpy, trembling, so fidgety she could not control herself, she wants her hands held by someone, and her mouth is so dry that the tongue cleaves to its roof. The pains are weak, and the patient is weak. She says: “I have no strength. I cannot bear down”. Do we not often see these symptoms! Are they not common and frequently met during labor! Certainly they are suggestive, and should place this remedy high in our obstetrical repertory.
Again, after miscarriage, or infection after child-birth, when in addition to the sinking vitality and other symptoms already given, we have a scanty uterine discharge of a most terrible odor, an odor that penetrates the whole house, it is well to study this remedy as well as Sulph., Pyrogen and Gunpowder. Here, then, we add another characteristic expression of this remedy, horribly smelling discharges. Therefore we might expect to find it useful in diphtheria that has gone on to the putrid or gangrenous state where the mouth odor pervades and sickens the whole room.
Putrid discharges from any outlet of the body are characteristic. We see this in the hot, putrid stool with much very offensive flatus. Offensive, undigested stool of a golden- yellow color after each meal, followed by insatiable urging to stool like Nux vom. This reveals another characteristic, golden or orange-colored excretions.
With greater use other features of this remedy will undoubtedly come into prominence, but in this paper it is thought best to bring out largely the striking and peculiar symptoms, the character lines which determine the form and strength of the picture. We have, then, the following:
Mental and physical irritability.
Aggravation from cold, from rest, after eating and after coition; also in the morning, evening, and particularly at night.
Depression, lassitude, sinking vitality.
Anaemia and emaciation.
Putrid discharges from any outlet of the body; also golden- yellow or orange colored discharges or excretions.
Let me add a few striking particulars: Pain at the base of the brain, better by belching, and better by eating. Always hungry with the headache. The relief by eating, a particular symptom, is opposed to the general aggravation after eating and relief from fasting.
Toothache alternating with headache.
Colicky pains in the hypogastrium with ineffectual urging to stool, better by bending double. (Coloc., Nux vom.).
PHILADELPHIA,.
DISCUSSION.
CHAIRMAN J. HUTCHINSON: This very interesting paper is open for discussion. I would like to say at the outset that it would please me very much if Dr. Olds, in his answer to the discussions, would differentiate a little bit-between Pulsatilla and Kali phos. Of course, we have in Pulsatilla the chilly habit as well as the longing for fresh air.
DR. P. BROWN: I have enjoyed this paper very much because it brought back very pleasant memories.
In 1890 while in Chicago I had the honor of being a member of H.C. Allens proving class and Kali phos. was one of the remedies we proved at that time. There was one striking symptom that in accord with what Dr. Macfarlan said this morning has made a lasting impression on me, having had it myself. That was a peculiar, fluttery feeling over the stomach, very, very characteristic, that was most persistent and most annoying all the while we were making the proving.
PRESIDENT C. STEVENS: What was the adjective you used for that feeling in the stomach?.
DR. P. BROWN: A fluttering, a peculiar, fluttering, waving feeling.
DR. A. PULFORD: I believe that one of the characteristic features and a distinguishing difference between Pulsatilla and Kali phos. is that one is a sluggish remedy, the Pulsatilla, and the Kali phos.is one of the most profound inertia remedies we have.
DR. A.H. GRIMMER: The paper gives us a picture of a remedy that corresponds to deep, wasting, chronic diseases especially tuberculosis and those diseases dependent upon it, even cancer itself. There is one point the doctor made that I dont think he brought out as fully as he might have. All the Kalis do not come in the same classification as Pulsatilla. There is one exception and that is the Kali sulph. The Kali sulph is sensitive to heat and is the chronic of Pulsatilla. Dr. Kent stresses that very fully.
DR. GRIGGS: I remember a case of criminal abortion that was brought into the hospital Pyrogen had been given with mediocre results. The patient was wasting, and this very foul discharge from the uterus. Kali phos. seemed to restore and regenerate the nervous system. The patient recovered very nicely after the failure of Arsenic and some other remedies. For this excessively tired feeling and occipital headache, I have often, after Picric acid failed, given Kali phos. Picric acid and Kali phos. to my mind run very close together in some of those neurasthenic conditions.
