COMPARATIVE MATERIA MEDICA.
Read by title before I.H.A., Bureau of Materia Medica, June 17, 1938.
The object of this paper is to fix in our minds the great value of this remedy in its application to disease, and to fasten upon our memories similar remedies.
Argentum nitricum is an ancient remedy in the “Old Schools”. The sticks of lunar caustic were called “lapis infernalis”, which Hering speaks of as a prophetic name indicating the horrible abuse of it in our age. It is an irritant poisoning, causing violent inflammation and ulceration of the throat, stomach and mucous membranes generally. It is destructive to red blood corpuscles, causing general malnutrition; produces violent tetanic convulsions, followed by paralysis. Pains in all mucous membranes are sharp and splinter-like, and the discharge mucopurulent.
The Argentum nit. patient is irrational; has all sorts of imaginations, illusions, and hallucinations, all of which are < at night; extremely anxious, which put him in a hurry; he goes for a walk, and walks faster and faster; walks until he is fatigued. He fears he is going to have a fit or have a sickness. There is an inflowing of strange thoughts that in crossing a certain bridge or high place he might kill himself, or perhaps might jump off; or the actual impulse comes to jump off a high bridge into the water.
Pulsatilla also had fear of high places, as has Nux vomica, although the temperaments are entirely different, the Pulsatilla being slow and phlegmatic, while the Nux vomica is irritable and impatient rather than hurried.
The fear of death of Argentum nit. is also present in other remedies, notably Aconite and Arsenicum, although here again the differentiation is quite pronounced. Arsenicum does not hurry; it is weak and exhausted; and its aggravation comes shortly after midnight. Fear of death is connected with this remedy, which is quite different from the fear of death as described in Argentum nit. There is no suicidal tendency to Argentum nit., only a fear that he might do himself harm, which differentiates it from Aurum met.
Aconite has fear of death, but is accompanied by high fever in acute diseases with restlessness, anxiety and thirst. Argentum nit., also like Aconite, predicts the time of his death. When going anywhere it is attended with anxiety, fear and diarrhoea. This is similar to Gelsemium. Gelsemium has general weakness but it is mostly in the spine and back of the head. Gelsemium does not have the sign which is present in Argentum nit.
Fear when alone is present in Arsenicum, Clematis and Valeriana. Depression of spirits and general aggravation after eating. Nux vomica is irritable and depressed soon after eating. Natrum carb. is distressed two or three hours after eating, with relief by eating. China distresses soon after eating, relieved by loosening of clothing. Sepia also is worse after eating, distress being mostly in the pelvis with its characteristic bearing down.
Argentum nit. has cured epilepsy, the attacks being < at night with great restlessness or tremulousness before or after the attack, and it is especially useful for attacks brought on by fright, or associated with menstruation.
Artemisia v. has epileptic seizure with irregular or deficient menstruation. Bufo attacks < at menstrual periods. Causticum mostly at puberty.
Calcarea carb. has epilepsy following fear, in the characteristic fat, waxy individual with profuse menstruation and sweaty head. Hyos. has epilepsy with stupor, alternated with periods of great mental activity, while Ignatia has the hysterical type, now laughing, now crying, and is seldom a true epileptic seizure.
Argentum nit. anticipates all sorts of dreadful things; will not consult a physician for fear he may be told he has a serious ailment. Like Gelsemium it has diarrhoea as a result of stage fright or mental emotion. Irresolute and memory poor.
Argentum nit. is of great advantage in hemicrania. Deep-seated, periodic, with boring pain, > from tight bandages, and may be brought on by any depressing emotions. Cactus, periodic hemicrania the right side and vertex. Cannabis ind., a sensation as if the head were opening and shutting. Glonoinum, hemicrania with a sensation as if the skull would burst. Sanguinaria, right-sided, coming and going with the sun. Sepia, mostly left- sided. Argentum nit. has a sensation as if the head were too large, with relief from binding the head tightly. The pain is described as pressing or boring.
The sharp stitching pains of Argentum nit. call to mind Hepar; yet the discharge is different than Hepar with extreme sensitiveness to touch.
Nitric acid also has sharp stitching pains in the throat, but the mucus is tough and stringy and bites the tongue on chewing; much salivation. Argentum nit. also differs from Nitric acid in that it has rawness. Ignatia has sensation of fishbone in throat, better by swallowing anything solid. The gastric distress comes soon after eating with sensation of a lump or load in stomach, with ineffectual efforts to eructate.
Enormous distention of the abdomen. Pulsatilla also has a sensation of lump in stomach, although it is located mostly at the end of oesophagus as though food had lodged there. Nux vomica as from a stone in the morning, or immediately after eating. Kali carb., bloating with feeling of lump in pit of stomach and sour eructations. Abies niger, feeling of hard-boiled egg in pit of stomach. Both Argentum nit. and Nux vomica have ineffectual urge to eructate. Argentum nit. has a decided craving for sweets, which aggravate. Pulsatilla has disordered stomach from sweets, while Zinc has aversion to sweets, with a sweetish taste in the mouth.
Allen speaks of Argentum nit. as unrivalled for the gastritis of drunkards. Here it may be differentiated from Nux vomica by the difference in temperament. Cadmium sulph. has persistent vomiting of drunkards with burning in the stomach, cannot retain even water. Fluoric ac., bilious vomiting of drunkards with diarrhoea, and resembles Nux vomica in that it has a craving for seasoned foods. Selenium, headache of debauchees, better from additional alcohol.
The stool of Argentum nit. is usually of a diarrhoeic nature, green looking, like chopped spinach; sometimes containing undigested food; offensive; passed with noise and flatulence and forcible spluttering. Worse from sweets, drinking water, mental excitement, worry or shock. Aconite also has green stools, as has Mercurius viv., Nitric acid, and Sepia, but none have the characteristic “chopped spinach” stool. Aconite has diarrhoea from fright, as has Gelsemium, Pulsatilla and Ignatia.
Argentum nit. is of value in both acute and chronic diarrhoea, and here resembles Kali carb., Natrum mur., Phosphoric acid and Sulphur.
Argentum nit. has been much used in ophthalmia neonatorum. Also it is of value in specific urethritis, which is frequently the cause of ophthalmia.
Willard I. Pierce stated many years ago that even then the old school advised against the use of injections of nitrate of silver early in gonorrhoeal infections, due to its irritable nature. The inner canthi are red and swollen; abundant, purulent discharge. Here it resemblance Hepar sulph., Graphites, Mercurius cor. Pulsatilla and Staphysagria.
It might be mentioned that Natrum mur. in potency internally is a valuable remedy in cases that have been abused by the local application of silver nitrate.
In gonorrhoea Argentum nit. is of valuable when there is profuse purulent discharge, with cutting and characteristic splinter-like pains, with occasional blood in the urine. Here it resembles Cannabis sat., the latter not having the characteristic stitching pains. Cantharis has bloody urine but lacks the stitching pains. Apis, stinging pains with strangury. Clematis, great burning on beginning to urinate, especially referred to the glans. Copaiva, great dysuria entire length of urethra; great effort to pass urine. Cubeba, cutting in urethra, with smarting, but little purulent discharge.
Dont forget Argentum nit. in postdiphtheritic paralysis, and here must be studied Causticum, Conium, Natrum mur., and Phosphorus and Naja.
In paralysis of the lungs following diphtheria it resembles Gelsemium, Lachesis and Opium.
Argentum nit. has been of value in angina pectoris where there is precordial pain, free of suffocation, and the sensation of a band around the chest. Here it resembles Cactus, but is differentiated by the fact that Cactus has a sensation as if the heart itself had been squeezed rather than the chest wall. Lachesis has an intolerance to the clothing or any weight on the chest rather than the band sensation. Its pain does not radiate to the left arm as in Spigelia and Cactus. Lilium tig. also has a sensation as if the heart were grasped.
While this paper in far from complete, I hope in a measure it will assist in clarifying related remedies, Argentum nit. being one of the most valuable remedies of our materia medica.
SEATTLE, WASH.
Seattle.
Chairman, Bureau of Surgery