These symptomatic specifications of various ulcers are a mixture of proven symptoms and clinical observation. Their clear cut descriptions are arresting an therefore quite expedient.
Arsenicum: Active ulcers of impoverished, exhausted persons or those tending to abdominal plethora. Serrated edges high, severe; greenish, thin acrid, bloody discharge; yellowish or white film over base; areola bluish, inflamed oedematous.
Indolent ulcers of exhausted people with chronic eruptions; alcoholic history. Long standing ulcers with a gray scurf and surrounded by an inflamed margin, or with shining hot swelling of the feet,. The surface of the ulcer burns and there is tearing pain in the margins, especially when becoming cold; when the edges are raised high above the surrounding skin or the areola is red and shiny, the base bluish, having a scurf resembling lard. There may be discharges of thin bloody pus with unhealthy granulations, foetid odor, or slight discharge.
Asafoetida: Nervous or phlegmatic individuals with venous sluggishness. The sore is extremely sensitive; margins deeply serrated bluish, elevated. The discharge is ichorous, and may be foetid.
Irritable ulcers with pressure and tense sensation around them; bleeding at slight touch; base bluish; areola the same, and wide; watery, corrosive discharge, or discharge of degenerated pus. The Patient is often peevish or irritable; there is a bluish tinge of the body or where inflammation is pending, or around inflamed surfaces.
Indolent ulcers after severe loss of vital fluids; or in cachectic people; or in those weakened by gastric affections caused by various excesses. The margins are elevated, deep blue, and the surrounding skin is also blue, hard and painful. There is heaviness in the extremity and the push a cadaverous odor.
Hepar: Corrosive or ulcerative pain, burning and throbbing, aggravated at night. Stitching in ulcer especially when laughing.
The surface is excessively sensitive, profusely when lightly touched. The surrounding tissues are affected and the condition tends to become chronic. The patient is usually irritable and worse at night.
Graphites: Patient corpulent, blonde, unhealthy appearing skin, often chronic eruptions. The ulcer covered with a scurf, often light yellow and powdery, like crumbling honeycomb, the surrounding skin likewise. Pain is worse at night, the entire extremity affected, when touched or moved, feels as if the bone would be dashed to pieces, even parts distant to the ulcer feel the same way. Itching and pressing in the sore, or there may be tearing or stitching pains. The scurf, if present, smells like herring pickle, or simply foetid.
Lycopodium: The mild or melancholy disposition, the pains worse at night, stitching, tearing, itching; burning and stitching in the sore. Pains are worse in warm room, and much ameliorated in the cool air. Old ulcers with fistulae and hard, red shining edges and swelling.
Mercurius Sol.: Pains of the ulcer intolerable at night in bed; extremely painful to touch; instead of granulations there is a spongy, bluish mass which is sensitive and bleeds easily. The discharge is acrid and corrosive. The elevations are very irregular at the base; there is a sensation as if corroded by insects, with unequal quick pulse, sleeplessness, dripping nightsweats, intense nervousness and irritability.
Nitric Acid: Patient sad or desponding, impatient, irritable and vehement; general coldness at night with profuse sweat. Thin, ichorous discharge mixed with blood, corroding the surrounding skin; shooting, pricking pains in and around the ulcer, with burning as from nettles; or itching and pricking in the surrounding parts, violent intolerable pains.
Phosphoric Acid: Indolent ulcers with much itching or burning pain; inveterate or flat ulcers with dirty appearing pus and indented base.
Phytolacca: After crude anti-syphilitic treatment; special locations, the throat, nose, rectum, legs, genitals, breasts. Shooting, lancinating, worse after sleeping, worse toward morning. Pus, water, foetid, ichorous. Tendency to stiffness of the denser fibrous tissues.
Sanguinaria: Old, indolent ulcers, ill conditioned sores with callous borders and ichorous discharge.
Silicea: To complete the cicatrization or to prevent chronicity, Irritable ulcers with stinging, burning pains round about, with aching and smarting in the sore. Also when there is thick, discolored pus or thin acrid sanies or large flabby vegetations. Indolent ulcers that are putrid, especially if in old psoric persons living in poverty and fifth; when there is inflammatory redness quite a distance about the sore; fistulous ulcers with dingy appearance; with shaggy, callous edges extending through to the bone; or when the surrounding parts are hard, swollen and bluish red.- W.T.HELMUTH, SR.
For ulcers, necrosis, etc., in general, where dead done has to be removed, Calcarea fluorica is useful; also Silicea.
Calendula, internally and externally, for ulcers that will not heal.
Silica for insensitive suppurative processes of all kinds; dental apical abscesses. Kali bi. ulcers near tibia with punched out look.
Lyc. for ulcer of knee below left patella. Sil. in ulcers after vaccination.
Mer. flat ulcers on the shin. Asafoetida, syphilitic ulcers with atrocious pain.
Opium, old, painless, insensitive ulcers, blue base, no attempt at healing.- G.B.STEARNS.
Whenever the symptoms return in the same image, calling for the same remedy, then it is that we have demonstrated, that for a time, if the disease be chronic, we have but to commend the range of dynamic to cure this case. This rule is almost free from exceptions if the remedy is an antipsoric. What must the physician do who has not the knowledge of dynamic medicines? He must sometimes see sick images come back without changes of symptoms, though I believe it is seldom.- KENT.