Indicated later, when the patient becomes drowsy and lies in a profound stupor [more profound than Baptisia]. There is a well- marked excoriating, watery discharge from the nose making the upper lip sore.
It in the form of Brandy and water, tends not only to destroy the diphtheritic growth, but also aids in counteracting the terrible prostration.
I frequently employ a gargle of Alcohol and water. This seems to remove the accumulation of phlegm in the throat.
Ammonium Causticum [Am-caust]
Has been used as a remedy for Diphtheria, appearing in the nasal cavities, with a burning excoriating discharge from the nose and great prostration.
Amygdala Amara [Amyg-am]
I have myself cured cases of this disease with it alone, when there were present: The dark-red color of the throat (palate,
fauces, uvula and tonsils), the sudden sharp (lancinating) pains (in the swollen tonsils) and general prostration (very great).
Antimonium Crudum [Ant-c]
I know of one case of this disease cured by it, when the symptoms were these: The child was very cross-whining and crying, simply because he was looked at, this was esp. so on awaking from sleep; and there were crusts around the nostrils and in the corners of the mouth.
It not only removed the crusts, but also cured the Diphtheria.
Apis Mellifica [Apis]
A magnificent remedy in Diphtheria. It is indicated when, from the very beginning the child is greatly prostrated; he is feverish and drowsy at 3 A. M., and his pulse is accelerated. At first, the throat has a varnished appearance, as though the tonsils and fauces were coated with a glossy, (bright) red varnish. The membrane forms on either tonsil, oftener on the right, than on the left and it is thick, like a wash-leather. The tongue is red and often swollen, later, there are blisters on its border. Sensation of fulness in the throat, necessitating swallowing, but making the act very difficult. Uvula hangs down like a sack of water, and in fact the whole throat is swollen and oedematous, with stinging pains. The rima glottidis is swollen, red and oedematous and the breathing is labored, owing to the narrowing of the entrance of larynx. In some of these cases, the breath is very foetid, while in others it is little or not so in the least. In some cases, a red rash appears over the body, greatly resembling Scarlatina-the characteristic of Apis. The external throat is swollen and oedematous. The skin is dry and hot and the fever runs very high, and inspite of the presence of fever, the child is often thirstless. The pulse ranges from 130 to 140 beats per minute. The patient is restless and very weak.
It has often been successfully employed in Paralysis following devitalizing affections, such as Diphtheria, etc. In all such cases, suppressed or pre-existing exanthemata constitute a leading indication for the bee-poison, and the reappearance of the skin symptoms calls for its discontinuance as long as the improvement lasts. Sulphur is a great aid here.
In Diphtheria, it is to be compared with Arsenicum, Kali Permanganicum and Nat. Arsenicum which are similar.
In Diphtheria it comes into use as a most valuable drug and is called for in severer cases. It cures when: The throat is swollen very much, both internally and externally [Apis], with intense burning [Arsenicum Iodium, Caps., Mercurius C.] The membrane looks dark and gangrenous and is very foetic [Apis., Caps., Hyd. Ac., Kali bichromicum, Kali Per., Mercurius Cyan., Nat. Arsenicum]. OEdematous uvula. A thin excoriating discharge from the nose and the breath is foetid. The fever is adynamic, with a great deal of somnolence, which is
broken by starts, crying out and jerking of the limbs. The pulse is rapid and weak. The bowels are constipated or else there is an offensive, watery diarrhoea. The urine is scanty. The patient is restless, esp. after midnight and is greatly prostrated; he may be thirsty, drinking often and little at a time.
Arsenicum Iodatum [Ars-i]
It is indicated, if in addition to the usual Arsenicum symptoms, there is marked enlargement of the lymphatic glands.
Arum Triphyllum [Arum-t]
It is very similar to Nitric Acid in Diphtheria of the nose. It has like the later excoriating discharge from the nose, making the lips sore; the corners of the mouth crack, so that the child cannot open his mouth. The saliva also is acrid. The patient is restless, tosses about, bores head into the pillow or picks or bores his fingers into the nose or nervously picks at one spot till it bleeds.
Baptisia Tinctoria [Bapt]
It has proved itself one of our best remedies in Diphtheria, when it has assumed a typhoid type, and the child is very much prostrated and lies in a half-stupid state, as if intoxicated. The face is dark-red and has a besotted look. The mouth is excessively putrid and the discharges from mouth and nose are horribly offensive. The membrane is dark-red and exhibits a gangrenous tendency. Sometimes early in the disease the patient can only swallow liquids, but rejects solid food at once.
It may occasionally be the remedy in the very early stage, when the violence of the attack calls it or if there is congestion of the head, before the membrane has formed. Constriction of the throat, (<) from swallowing liquids.
Note of Warning : When you want to give this remedy in Diphtheria, be certain that it is the remedy or you will lose valuable time. When it is administered in Diphtheria, it must be indicated on other symptoms than those belonging to the membrane.
It has been used very successfully in Diphtheria, when the following throat symptoms and dysuria were present : Severe burning and raw feeling in the throat; great constriction any attempt to swallow water. The debility also is very marked.
Its related remedies are : Arsenicum, Arum T., Belladonna, Caps., Diffen., Mercurius Cor.
It is indicated in Diphtheria when there are : Burning blisters in the roof of the mouth, and an odor from the mouth like that of carrion; the throat feels constricted, as if spasmodically closed. The patient is worse when not swallowing and in extreme cases greatly prostrated. The most similar remedy here is Cantharis.
Carbolic Acid [Carb-ac]
Indicated in Diphtheria when the putridity is well-marked [Kali Permang.] and is associated with burning pains in the mouth to the stomach or little or no pain, dusky red face, pale about the mouth and nose and rapid sinking of the vital forces.
Carbo Vegetabilis [Carb-v]
It is indicated in epistaxis or nose-bleed during the course of Diphtheria [Camph., Mercurius Cyan.]. The blood is dark and rather fluid and flows persistently for hours, perhaps for days. The face of the patient is pale and sunken, and almost hippocratic.
A prominent remedy is Post-diphtheritic Paralysis.
Post-diphtheritic Paralysis-the sensation is but little involved.
It is indicated, when the epistaxis is persistent. The blood oozes from the mouth, not merely coming from the posterior nares, but also escaping from the mucous membranes of the buccal cavity.
A prominent remedy in Post-diphtheritic Paralysis.
Feeling as of a lump in the throat, which is not felt during, but between the acts of deglutition. The lump may feel sore while swallowing, but it is felt markedly between the acts of deglutition.
Kali Bichromicum [Kali-bi]
It is indicated in Diphtheria when : The membrane is quite thick, and is decidedly yellow-looking, like wash-leather. The tongue is coated yellow or red, dry and glossy. Pain in the throat extending to the neck or shoulder. Swollen cervical glands. Well- defined slough in the throat. The discharges, whether coming from the nose or throat or both, are decidedly stringy and ropy. Weariness, sleepiness and prostration, and at times esp. if there is gastro-enteric inflammation, there are cold sweat, lowered temperature and pale sunken face.
Kali Permanganicum [Kali-perm]
It is useful when the membrane, as also the breath are horribly offensive- this extreme foetor is its chief characteristic. The throat is painful, and is swollen and oedematous, both inside and outside. The muscles of the neck are also painful. There is a thin discharge from the nose.
Lac Caninum [Lac-c]
It is very similar to Lachesis, but is readily distinguished from that remedy by its peculiar habit of alternating sides. Starting on one side, frequently the left, the soreness and swelling, and even the membrane, suddenly shift to the right, only to return, in a few hours, to the starting point. The membrane is grayish- yellow and curdy, and if ulcers form, they shine like silver- glow.
An invaluable remedy is Diphtheria from which much can be hoped. It is called for when the membrane forms on the left tonsil, with an inclination to spread thence to the right, and there is an early development of that gangrenous state which obtains in Diphtheria, with the attendant foetid breath and the increased danger of systemic infection. Symptoms for which you will be called upon to prescribe it are : Constant feeling as of a lump in the left side of the throat, which descends with each act of deglutition, but returns again or a sense of constriction, as if the throat were suddenly closing up; when the case is developed, there is rawness and burning in throat and pains in the left side, extending to larynx, jaws and ears; sometimes on waking from sleep, there is a feeling, as if, there were needless in the throat, which creates suffocation; externally the throat is very sensitive to the slightest touch. The fauces are of a dark purplish color. The discharge from the nose is thin, sanious and excoriating. Swelling of the glands of the neck, also of the cellular tissue the swelling may be so great that neck becomes even with the chin and sternum. Swelling of the lymphatic glands, with a dark, purplish hue, which threatens suppuration. Great prostration. The child is drowsy, even though feverish; its pulse is feeble and extremities are cool. Aggravation after sleep.
When the diphtheritic deposits extend down into the larynx, it is indicated when the patient arouses from sleep smothering and has a diphtheritic, croupy cough.
It is to be distinguished from drugs which act in the similar manner, by the fact that the symptoms are (<) from empty deglutition, and are often (>) by eating or swallowing solid food.
Sometimes after giving Lachesis the membrane goes to the right side, then Lycopodium comes in as the substitute.
Generally when it is the remedy the nose is affected by the disease. In it the diphtheritic deposit is most copious on the right side, with a tendency to spread towards the left [Lachesis- opposite] or the right side is mostly affected, so much so that even when during the course of the disease under Lachesis, when the membrane goes to the right side, it comes in as a substitute. Often the symptoms are (<) from 4 to 8 P.M.
The indicating symptoms are : A constant desire to swallow, amounting almost to spasms of the throat, with violent stinging pains, (<) from swallowing drinks, esp. cold drinks; the cervical glands are swollen. The tonsils are very much swollen, as is also the tongue, so that he is obliged to open the mouth and protrude the tongue in order to get breath. The nose is so stuffed up that the child cannot breathe through his nose at night; an excoriating nasal discharge from the nose, making the nose and upper lip sore [Arum T.], usually associated with a dull, throbbing headache at the root of the nose or over the eyes; the patient bores and picks at the nose [Arum T.] The child suddenly awakes from sleep, crying out as if frightened; he is cross and angry.
In more advanced cases: The child is unconscious and remains in a deep sleep. His lower jaw drops, the urine is scanty, or even suppressed, and what does pass, stains the bedding or clothing red and deposits a red sand. The breathing is rapid, rattling, with waving of alae nasi and snoring. Every symptom points to impending Paralysis of the brain.
Mercurius Biniodatus [ ]
It is of use when the left tonsil is inflamed and there is yellow-gray membrane forming there; the glands of the neck are swollen and also some involvement of the cellular tissue around the throat; slimy or sticky mucus may accumulate in throat and mouth. The symptoms are worse from empty swallowing, so that a simple attempt to swallow saliva excites more pain than does the swallowing of food.
Mercurius Corrosious [Merc-c]
Its symptoms are very violent. It is indicated, when : The uvula is swollen, elongated and very dark-red. Intense burning in the throat [Arsenicum, Arsenicum Iodium, Caps.] which is rendered intolerable by an external pressure. Violent constriction of the throat and any attempt to swallow solid or liquid, causes violent spasms of the throat, with the immediate ejection of the solid or liquid.
Mercurius Cyanatus [Merc-cy]
We have in this drug one of the very best remedies in Diphtheria, esp. when it is of a true adynamic or malignant type, and the patient is very much prostrated from the beginning. The symptoms indicating it are : The membrane covering the velum palati and tonsils, is at first white, becomes dark, threatening even to grow gangrenous later, when the glands of the neck swell. The tongue is coated brown, in severe cases dark, even black. Persistent nose-bleed [Carb. Veg.]. The breath is foetid. Loss of appetite. Extreme weakness. Pulse quick, may be as high as 130 or 140 beats per minute and has no volume at all.
It may also be used in Diphtheria of the larynx. Here it has saved life, but it will not do so always. Indicating symptoms are: Thick and ropy expectoration and a harsh, barking croupy cough, with dyspnoea.
Mercurius Iodide [Merc-i]
It is to be thought of when : The membranous deposit is more or less profuse, involving the tonsils and posterior nares. Swelling of the glands of the neck. The tongue is coated dirty yellow and excessive accumulation of mucus in the throat, causing great deal of hawking.
Mercurius Protoiodide [ ]
It is to be thought of more, when the deposit forms on the right side of the throat, with swelling of the glands of the neck and with accumulation of tenacious mucus in the throat. The tongue almost always presents thick, yellow, dirty coating on the base and posterior part, the tip and sides being red.
Muriatic Acid [Mur-ac]
Under this remedy there is the most intense prostration. The patient seems to have scarcely life enough to move. Its symptoms are : A thin, excoriating discharge from the nose, making the upper lip sore. The mucous membrane of the mouth becomes intensely red and even denuded of its epithelium. By and by, yellowish-gray deposit forms in the mouth, particularly in the fauces and on the tonsils, uvula and posterior wall of the pharynx. The breath becomes very foetid and the uvula oedematous, which sometimes hangs down as thick as thumb and lies on the tongue, causing the child to gag and choke. The appetite is lost. Later, the mouth may be studded with deep ulcers, which tend to perforate parts on which they are situated. The pulse becomes intermittent [Acid nitricum], accompanied by involuntary stools and urine. The patient is worse about 10 or 11 o’clock in the morning.
It is indicated when the larynx is invaded. The patient grasps at the throat, with a sensation of choking. The fauces are dark-red. There is foetid breath and short, hoarse cough, with raw feeling in the larynx and upper part of the trachea. It is also to be administered when there is impending Paralysis of the heart and the patient is blue; he awakes from sleep gasping. The pulse is intermittent and thready.
Natrum Arsenicosum [Nat-ar]
It is the remedy when despite the dark purplish hue of the throat and the marked swelling and great prostration, there is not much pain. The uvula is oedematous and is marked by excessive foetor.
Nitric Acid [Nitr-ac]
It is one of the chief remedies in Nasal Diphtheria, when the discharge from the nose is watery and very offensive, excoriating every part which it touches-no remedy has it so marked, not even Arum. There are also : Frequent epistaxis. A well-developed white deposit within the nose. The pulse intermits every 3rd or 5th beat-very characteristic. If the membrane descends into the throat, foetid odor comes from the throat and there is a feeling, as though there is a splinter there-a general characteristic.
In Diphtheria, it is also preferable to any of the other remedies when there is nasal discharge as described above and the disease advances and affects the stomach; when with great prostration and false membrane in the throat and nose, there are distress and uneasiness referred to the stomach, with total rejection of all food. The throat is extremely sore and covered with membrane, either dark and offensive or else yellowish white. The mouth is studded with ulcers, principally on the inside of the cheeks, on the lips, and on the borders of the tongue, accompanied by salivation- the saliva usually being watery and very acrid. The intermittent pulse as stated above is very characteristic.
Nux Vomica [Nux-v]
Indicated when the patient is better after an uninterrupted sleep; marked relief from a nap; when the sleep is disturbed he is always worse. Early in the evening he is drowsy.
It is indicated when the prostration is very sudden in its onset, and the nervous system is exhausted.
It is useful, when in the beginning of the disease, there are creepy chills and back-ache; the patient is weak, feels faint when he sits up in the bed. The throat looks dark-red, almost purple and is worse on the right side. There is great burning in the throat, with agg. from the hot drinks and there is inability to drink the same.
Ranunculus Sceleratus [Ran-s]
It is sometimes indicated by the presence of mapped tongue, which is also found in Arsenicum, Nat. Mur., Rhus Tox., and Tarax., but none of them has the same amount of burning and rawness that it has. The acridity of this drug differentiates if from all others.
Rhus Tox [Rhus-t]
It is indicated in rather severer cases, esp. when the disease takes on a typhoid form [Baptisia], and when no other remedy is indicated. The membrane is dark in color and bloody saliva runs out of the mouth, during sleep. The tongue exhibits a triangular redness at the tip. Inflammation of the glands about the neck, of a dark erysipelatous hue. It is also useful when Cellulitis accompanies the disease, with formation of pus.
Sulphuric Acid [Sulph-ac]
It is useful when the tonsils are bright-red and quite swollen-so swollen, in fact, that the liquids escape through the nose. The patient can hardly breathe or talk or make any noise, on account of the abundance of membrane. The child is deathly pale- so pale that it looks like a corpse. It is inclined to drowsiness or somnolence.
Besides the above remedies, the following remedies also may be needed infrequently :
Bromine, Camphor, Chlorine, Cyanide of Potassium, Hydrocyanic Acid, Iodine and Phosphoric Acid.