CLINICAL EXPERIENCES WITH NATRUM MURIATICUM. Case histories found in our publications, together with my own experiences, have convinced me that no remedy deserves a thorough clinical study more than Natrum mur. In fact, even our best provings need supplementing by clinical observations, as it is these observations that enable us to eliminate the furtive element of arbitrariness from our prescribing.

Case histories found in our publications, together with my own experiences, have convinced me that no remedy deserves a thorough clinical study more than Natrum mur. In fact, even our best provings need supplementing by clinical observations, as it is these observations that enable us to eliminate the furtive element of arbitrariness from our prescribing. This applies to Natrum mur. in an especially high degree and is the reason for this study.

The consideration that not all people can assimilate all the sodium chloride contained in their food was my starting point. That part which is not assimilated is eliminated either by kidneys and other organs of excretion or it is retained and accumulated in the extracellular spaces and blood plasma. Whether eliminated or retained, in both cases the cells of the organs and tissues suffer from deprivation of salt. Dehydration of the tissues and hyperchloraemia result. When, on the other hand, the elimination is inadequate, over-hydration and hyperchloraemia are that result.

In the presence of too many chlorides, water is attracted and turgor of the tissues maintained or increased; in their absence water is lost with depletion, dehydration and emaciation following. Consequently we have two types of cases. One type with insufficient salt in the cells as well as in the blood plasma and in the extracellular spaces this is the dry and emaciated type with good renal function. The other type has also too little salt in its cells but the renal function, as far as salt is concerned, is poor so that salt, and with it water, is retained in the blood and in the extracellular spaces. This type is heavy, fat, semi-dropsical, puffy and chubby.

In the first type the loss of water may affect the body all over uniformly. The skin then becomes dry, thin, withered, flabby, scaly, brittle, the subcutaneous fat disappears, the mucous membranes become dry, the blood pressure falls, nervous sensitiveness develops, etc.

In the second type the lagging excretion of salt is followed by overhydration which also may affect the body uniformly. This then gradually leads to salt and water retention obesity in which the skin is tense, flesh solid, face puffy and without wrinkles, abdomen distended, etc.

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Either of these processes may also affect parts of the body only, while other parts remain normal. The two processes may also exist simultaneously in one and the same person, one of them attacking one part of the anatomy, the other another part, e.g. the neck may be scrawny and wrinkled while the legs may be heavy and oedematous. An endless number of variations of these two forms of pathology is found in our clinical cases. The distribution of salt and water is evidently not governed by the osmotic tension alone, but by many other factors.

Observation shows that individuals whose salt assimilation is below normal become salt provers. Salt is a chronic insidious toxin to them. The fact that surgeons once in while succeed in saving a life by infusing physiology salt solution does not refute this. Surgical measures of this kind restore the fluid balance in the body in a mechanical way but do not improve the chronically weakened salt metabolism. This latter can be accomplished only by the dynamic action of a homoeopathic remedy. Only because of the low toxicity of the sodium chloride are these surgical infusions possible, otherwise their harm would greatly exceed their immediate benefit.

It is known that large doses of crude salt are injurious, but it is less known that sea water in hypodermic injection gives therapeutic results if not sterilized. There is, however, no such wholesome effect if the sea water is boiled. We owe this discovery to Quinton, a French practitioner, but Hippocrates knew it also. This is parallel to the practice of Hahnemann, using only raw plant juices for his tinctures. Hahnemann found that decoctions of plants are inactive. Heat devitalizes them.

Plant life vitalizes the chemicals contained in plants. Only through this vitalization of the chemicals is their assimilation in the animal body made possible. Chemicals straight out of the ground are not assimilated, are therefore toxic. According to Quinton sea salt is not a part of the inorganic crust of the earth but a product of plants. He calls sea water an organic milieu and salt a physiologic tonic when not boiled. It may therefore be that it is not so much salt that is responsible for the proving of salt, but the cooking and refining of salt because this destroys the property of its being assimilated.

Here, most probably, lies the reason why all over the western world potentized Natrum mur. is so often indicated in chronic cases. Anything else, of course, that weakens the metabolism in general, may diminish the assimilation of the drug and start its proving. Once started, the proving usually continues throughout life and passes on to the descendants. In a dozen families under my treatment every member of three generations is an involuntary salt prover and responds to its potencies or to some related remedy.

Provings which extend over several generations of the same family must necessarily produce a greater variety of deeply seated chronic symptoms than the short voluntary provings made by Hahnemann and his followers. Long clinical observations show that especially the number of the mental symptoms developed in these long-range provings defies all imagination, while the functional physical symptoms progress in many cases into structural, degenerative, pathological changes.

It must be plain to everybody that one hundred years of a proving will necessarily produce more symptoms that only one year. Only to some extent can those voluntary homoeopathic provings which were made with high potencies compensate for the element of time. By clinical study of these long-range provings we can greatly enrich our knowledge of Natrum mur.

Natrum mur. has received a very thorough proving by Hahnemann and many of his early disciples. Its description, as bequeathed to us in Hahnemanns Chronic Diseases, in the Encyclopedia of T.F. Allen and Herings Guiding Symptoms, are masterpieces of our literature. These three works should be read and re-read many times by every prescriber. For every days perusal, however, the Guiding Symptoms are best because they are in a way more complete as they contain a number of clinical symptoms. Such as are often found only in the involuntary provings and which are not mentioned in the other two works.

Good prescribing is impossible without knowing every symptom of this remedy as given in the Guiding Symptoms. Everything there is concise, nothing superfluous; many symptoms are only faintly touched. If you study text books and pocket books alone and rely on the repertories, you will miss the remedy half of the time. In these short books too many important symptoms are deleted, which is natural since abbreviations cannot be made otherwise. Such books often leave the prescriber in darkness.

To avoid faulty suggestions, the first study of this remedy should be made with the original provings. To pounce on repertories and abbreviated books right at the start, leads into a hit and miss art, from which it may be hard to extricate oneself later. In the long run the long study is the shortest. It eliminates uncertainty and makes prescribing a pleasure.

This is by far the richest remedy of the Materia Medica. It has so many mental symptoms that it is impossible to prescribe on any of them per se. Here it does not suffice that the mental symptom characterizes the patient, the symptom itself must be further qualified. It is the way the symptom is grouped and related to other symptoms which makes its use possible and the prescribing safe.

The term “imbalance” characterizes most of its symptoms. Imbalance is the red thread that runs through its symptomatology. There is excess and unstable equilibrium in every function. Everywhere there is oscillation or fluctuation between two opposite extremes, like a pendulum constantly swinging or swinging too far away from its central position. Other natrums, in fact most remedies, have excesses and imbalances, but nine of them has this regularity of fluctuation and alternation of excessive manifestations that Natrum mur. has.

Here are some of these symptoms I see to often: the patient has two natures, one the reverse of the other. The fastest to alternate are his emotions. He may be very sad but you can make him laugh in a second. He may even have a causeless spell of laughter in the midst of the darkest depression, or may laugh involuntarily in the middle of a quarrel. When in company away from his home he is a perfect devil. One day he loves to go places, another day he enjoys to be alone at home not saying a word to anybody all day.

The Austrian Empress Elizabeth loved gay amusements but people have found her sitting on a bench in the part weeping. When asked why she wept she answered that she hated to see herself getting old. Natrum mur. would have cured her. The patient is either sympathetic or cruel. He cries when his wife has a pain but would slap her for a mere trifle. He is very much afraid to die but a slight annoyance makes him want to die. A woman falls in love and is very affectionate, but if the man is more affectionate then she, her love turns into hatred.

Hitler took a fancy to a member of his party or army general and, if they were often seen together, it was soon rumored that this mans life was in danger. He needed a dose of Natrum mur. very high. The patient may be very generous but does not pay his bills. The government official who squanders the taxpayers money with a fascinating simile needs this remedy. A lady loads her girl friend with kindness but very soon attacks her with kitchen knives. Tremendous ambition may alternate with a terrific inferiority complex, hurry and industry with indolence and procrastination. He wants to please but at other times offends people with his brusqueness.

Sometimes the mere idea of an emotion arouses the contrasting emotion. He cannot cry at a funeral, he even laughs when everybody else is sad, and his eyes are dry. On the other hand he may be sad and quarrelsome at a party when everybody else is cheerful and smiling. There may be exceptions to this kind of behavior. Sometimes the pendulum does not swing to the opposite side but swings still further in the same direction. At a party where everybody laughs, a boy wants to laugh most.

At a funeral where everybody weeps, he wants to weep most; in a quarrel where one person shouts, he shouts more. If someone tells a joke, he adds to it and wants to tell a still bigger joke. Among humble people he wants to be the humblest; if someone is kind, he is still kinder; if a girl loves him, he loves her more and could sacrifice himself for her. The books say that consolation aggravates and makes angry. It does sometimes, but just as often it is soothing and craved by the patient exactly as in Pulsatilla. Consolation makes him feel better is therefore not a symptoms counter-indicating Natrum mur.

Some Natrum mur. cases, when starting a job, cannot stop until it is finished, e.g. if painting a house, they would not stop at nightfall but continue late into the night or paint all night. They are given to excesses in work and sport, drinking and eating, smoking and amusements. It is natural for normal people to desire things they like. But in the kleptomaniac this desire is exaggerated to such a degree that it wipes out all caution and self-control, it therefore belongs to this remedy.

In mythomania the patients imagination is so lively that its subject becomes real to him. The desire for possession may grow further and lead to robbery, juvenile delinquency and the worst kinds of crimes. Yet this same individual that has a violent temper and dangerous instincts may at other times be mild mannered, sympathetic and even charming. A boy may be as good as gold when handled with love and kindness, but throws himself on the floor and kicks and screams when antagonized.

Fear and anxiety partake of the same excessiveness. A girl wakes up panicky and cant tell why. She is afraid of birds, worms, and other small animals. She cant relax, sucks her thumb or bites her nails. A grown up man is afraid of underground, cannot go into a mine, tunnel, cave, telephone booth or clothes closet. When left alone in a room, the door must be wide open.

To shut it would simply terrify him. When swimming he would be afraid of diving, thinking that it would smother him. Others are afraid of wide open spaces but there is no fear if a fence or wall or a tree is somewhere near on which their eyes find a support. Mostly they are afraid of the dark, some of a dark room, others would not venture going on the street at night. One of my patients was deathly afraid to look up at the stars on a clear night. An old man could handle big troubles with ease, but little matters upset him beyond measure.

There is also excessiveness in anger and hatred, but only sometimes. Point blank statements that these patients ar hateful, vindictive, dangerous, formidable, quarrelsome, are only half true. A number of them are the very opposite. They are amiable, considerate, kind, generous, great philanthropists, liberal, jovial, jesting, in short the nicest specimens of humanity. The time is past when I am afraid to give Natrum mur. to a sweet modest lady or to a decent mild-mannered man. Intellectual faculties may show similar abnormalities, that is they may be either over-developed or not developed enough.

The memory may be so phenomenal that an individual remembers telephone numbers of all his friends for ten years back, or he may be a cretin, idiot, mongoloid. Many inventive geniuses, creative artists such as painters, composers, poets, musicians are Natrum mur. cases. The atomic spy, Klaus Fuchs, is likely to be one of them. His face with its puffy form, as we saw it in pictures in magazines, confirms this diagnosis. A poetess and musician, suffering from gout, found that she could not write poetry as she could previously after her gout had improved under a dose of Natrum mur. CM. Van Gogh could have been cured with Natrum mur. His painting talents may have been a Natrum mur. symptom.

Besides he was a refined sympathetic soul, but with his friend Gauguin he quarreled so violently that he threw dishes at him. Moments of sublime artistic inspiration alternated with spells of darkest depression so that one day he cut off one of his ears. His sadness later reached such a proportion that he committed suicide. Richard Wagner was luckier, he found a good homoeopath who cured him. Voltaire would have had a greater opinion of his immortality if he had had a dose of Natrum mur.

He said that he would have gladly given his immortality for a good digestion. Cezanne would work hard for a period of time, then suddenly, for no apparent reason, he would throw away his brush and he unable to make a stroke for weeks. Examples of this kind could be multiplied if we had more time. In short, it may be said that increased creativeness, artistic and other, and increased intellectuality coexist with decreased rationality or other short-comings in the mental development.

Alteration and excess in one direction or another are found also in physical symptoms. Ignorance of this fact has caused many failures in prescribing. Everywhere in the physical sphere there is excess of function or lack of it, one form or its opposite, one disturbed condition or its opposite. They are alternating with each other or replacing each other. Oversensitiveness or loss of sensation, drowsiness or sleeplessness, restlessness or aversion to motion, thirst or thirstlessness, craving or aversion for one and the same food article, growing too fast or too slowly, body temperature too high or too low, chilliness or intolerance for heat, well one day, sick the next, are symptoms belonging to this remedy and encountered in one and the same individual at different times in alternation or singly.

Twenty years ago I took Natrum mur. for a cold infection and immediately started to prove the drug. Of the symptoms that I developed the one which particularly impressed itself on my memory was the effect of cold baths. The cold bath felt like balmy oil on my skin. The colder it was, the more soothing it felt. This experience, together with Kents assertion that Natrum mur. is warm blooded, have been false guides in my prescribing for many years. Further experience gradually taught me that, at the level of vitality we find in our Natrum mur. cases at present, very few enjoy cold bathing.

The majority bathe lukewarm and some bathe hot and would be shocked by a cold bath. This remedy, I have gradually become convinced, is not contra- indicated if the patient bathes hot. In a Natrum mur, family of three generations the oldest generation usually likes cool bathing, the middle likes it lukewarm and the youngest likes it mostly hot. The oldest has the best vitality, its symptoms are sthenic, it likes cold temperatures; the second has less vitality, prefers therefore somewhat warmer temperatures; the third suffers from asthenia and is sensitive to cold.

The partial discrepancy between this observation and the voluntary homoeopathic provings is easily explained by the fact that the voluntary provers had good vitality and reached with sthenic symptoms just as the older generations in a family. I also feel obliged to emphasize that Natrum mur. is not warm blooded though he may dislike hot air, hot baths, hot sun. His vitality is always diminished. This makes him often chilly, yet his aversion to heat is only an effect of the sensitiveness of his vascular system to temperature changes, and while he is sensitive to heat, he is just as sensitive to cold. he feels better in winter only if he is warmly dressed or heavily covered in bed.

Nor is it true that emaciation proceeds from above downward. This symptom, as well as every other general symptom, proceeds either from above downward or from below upward. This applies to emaciation, obesity, dehydration, overhydration, perspiration, dryness, atrophy, itching, venectasiae, paraesthesiae, pains, etc.

The particulars of this remedy are of great prescriptive importance as they are, though local, so often an expression of the functional deviations affecting the whole system.

They oscillate and become excessive just as the general symptoms; here are some examples: hair is dry or watery, sunken or protruding, hot or cold; ear canals puffy and narrow or atrophic and wide; ear lobes large and turgescent or thin and waxy; face to red or too pale; cheeks puffy or sunken; tip of nose red and bloated or shiny and atrophic; lips swollen or dehydrated; mouth cold or hot; tongue large and indented or small and smooth; saliva excessive or deficient; pharynx small or patulous; secretion of sebaceous and sweat glands copious or scanty; pigmentation excessive or leukoplakia; neck emaciated and withered or strong and fat with double chin and buffalo hump; shoulder girdle bony and weak or over-developed; breasts undeveloped or hypertrophic and pendulous; abdomen sunken or too prominent; buttocks small and dehydrated or too large and fat; legs heavy and unwieldy or emaciated and under-nourished with bones and tendons shining through the atrophic skin; nails short, thin, crippled, ridgy, splitting or long, thick, strong and growing fast; hands and feet large and puffy like those of Calcarea or thin and emaciated; cold or hot spots in different regions of skin; heart beats weak and soft or loud and sharp, especially the second aortic and pulmonary; etc. There are very few particulars that have no opposites; they can be found in the Guiding Symptoms.

Diminished salt metabolism with its dehydration or overhydration prepares the soil for many a chronic disease. Improve the soil and you will withdraw the very subsistence of disease. There are other contributing causes, of course, but their removal will not yield any therapeutic results as long as the soil remains the same. Remedies given for contributing causes are useless and sooner or later bring disappointment. Permanent results come only from treating the soil. Deficient salt metabolism needs potentized Natrum mur. more often than any other remedy.

To learn to recognize its symptoms quickly, we must first go back to our original provings which represent an admirable start for its study. However, as these provings were necessarily affected by limitation of time, they describe only functional changes grown in healthy individuals under the influence of the drug for a period of six to twelve months at most. They dont give us any information on the degenerative changes which require decades and generations to develop.

These degenerative changes affect the whole system more or less uniformly and pass from one generation to then other. They are the soil on which local diseases, sometimes malignant, sprout and thrive. if we first become familiar with the provings of our predecessors and use them as a starting point for further clinical studies, we gradually become sufficiently acquainted with the nature of the Natrum mur. soil to become able to prescribe afterwards for degenerative diseases even when there is a paralyzing paucity or a confusing superabundance of symptoms.

F K Bellokossy