This chemical combination, Trinitrophenol, was discovered by the chemist Hausmann in the year 1788. It is a bright yellow crystal, or scale, and is an explosive, and dye. It may be obtained by the action of concentrated nitric acid on indigo, aniline, silk, wool, or leather. There are other ways in which it can be prepared, but they lead into the realm of organic chemistry, and are relatively complicated and unimportant.
In its pure state it burns quietly and is difficult to explode but, its salts are very active explosives. Picric acid and gun cotton produce “melinite.” The British “lyddite,” and the Japanese “shimase,” are thought to be identical with “melinite”.
Only four provings are listed in the Guiding Symptoms – three are undated – one made by Couch is dated 1874.
First volume of Herings Guiding Symptoms were copy righted in 1879, and at that time blood-pressure readings were unknown, or certainly only in their infancy. No record of blood-pressure is therefore available.
As this drug is related to Glonoine, we would expect it to be one in which the vasomotor system would play an important role, in that it would possibly be frequently indicated in cases of arterial hypertension.
However, reasoning from the standpoint that it is a phenol compound, we would expect extreme weakness, lassitude, and exhaustion, both mental and physical. The provings have brought out the fact that, in truth, the phenol symptoms predominate – and we find it useful for people who are worn out – tired out by work both mental and physical.
The patient is exhausted from mental exertion, from any effort to use his mind. Physically he is tired – tired out on waking in the morning – tired from walking – the legs feel heavy – with this tired feeling there is a lame sensation over the whole body – too tired to talk, think or walk. He is better from moving about and in the open air. Generally he becomes worse in the evening. They are too tired to enjoy company, want to be alone, to be quiet, are indifferent and low spirited.
In the head we have a great amount of pain. Some of the symptoms suggest supraorbital and occipital neuralgia with shooting pains, pains relieved by pressure and bandaging the head. Other and more fixed type of pain is in the nape and occiput, worse toward evening. This headache is quite violent, is worse form mental exertion, and the patient is generally tired. This pain is intense and throbbing and bursting.
In the eyes the pupils are dilated, vision is blurred and shortened – conjunctivitis. There is tinnitus accompanied by vertigo and headache, and deafness. There is quite marked action upon the throat. It feels raw and scraped, swallowing is difficult, especially empty swallowing.
In the stomach we have greatly increased appetite in the evening with loss of appetite for breakfast and lunch; nausea with the headache accompanied by eructation, bitter taste water-brash; great thirst for cold water. It effects the kidneys causing a sub-acute nephritis with the presence of mucus, granular casts, albumen, and increased specific gravity.
The sexual sphere is much irritated causing pruritis in the female and violent erections in the male. There are many lame and dragging pains in the back. In the extremities, numerous lame rheumatic pains with muscular weakness and loss of power; sensations of heaviness in the arms and legs; worse left side if anything.
From a study of the foregoing symptoms it would appear that had blood-pressure readings been available when the provings were made, we would have had an entirely different conception of this remedys field of action. It is hardly conceivable that the bursting throbbing headaches referred to are accompanied by a very marked rise in blood -pressure, nor that when such kidney involvement is present was the blood-pressure low.
It is likely that this remedy is much more frequently indicated in our practice, and that it is closely related to Glonoin, but possibly more deeply acting. Some patients will show indications for the phenol half of the compound, while in others the nitrate symptom will predominate.