Phosphoricum acidum

Lecture L — Phosphoric and Sulphuric acids

{Debility— Aphthae— Typhoid.

Haemorrhages.

Diarrhoea.

Phosphoric Acid.

Rhus tox.

China, Arsenicum, Veratrum.

Phosphoric acid. { Nux vomica.

Ferrum >Camphor.

Baptisia.

To-day we have to study Phosphoric acid. This is a combination of oxygen with phosphorus. Phosphoric acid produces weakness or debility. Sometimes it causes a transient excitement, but the main characteristic of the drug is this debility, which is characterized by indifference or apathy, by torpidity of both mind and body, by complete sensorial depression. The patient is disinclined to answer your questions. His answers are short, consisting generally of "Yes" or " No," and are made in a way that show that it is annoying to him to speak. The delirium is quiet, not violent, but accompanied with this characteristic depression of the sensorium and muttering, unintelligible speech. He lies in a stupor, or in a stupid sleep, unconscious of all that is going on about him ; but when aroused he is fully conscious. That is characteristic of Phosphoric acid. You see it is depressing to the sensorium and to the body in general, and yet these changes are in a certain sense superficial. It does not seem to dip deep down into the tissues, so to speak, and affect those serious changes in them that call for some such drug as Lachesis. You will find the quality above-mentioned pervading every Phosphoric acid symptom I shall mention.

So, you would not expect to give the drug in advanced stages when the stupor is complete.

Now the symptoms which indicate Phosphoric acid in typhoid fever are these : pointed nose ; dark blue rings around the eyes. The patient may suffer from nose-bleed, but which, however, gives no relief to the symptoms in the early stages of typhoid fever. This is the very opposite of Rhus tox., which is otherwise similar to Phosphoric acid. Rhus has epistaxis in the beginning of typhoid fever, but the symptoms are relieved, by the haemorrhage. The Phosphoric acid patient bores his finger into the nose. Now do not suppose because the patient is picking at the nose that he has worms and that you must give Cina. He may have itching of the nose. The symptom may also come from abdominal irritation not due to worms. With Cina, it occurs from worms ; with Phosphoric acid, from the irritation of Peyer's patches, consequently you will find the abdominal symptoms plentiful. For instance, the abdomen is apt to be distended and bloated. There is a great deal of gurgling and rumbling in the abdomen. There is often diarrhoea with stools that are watery, sometimes involuntary, and contain undigested food. For instance, the milk which you have given your patient passes more or less undigested, and there is copious escape of flatus with the stool. The tongue is dry, and may have a dark-red streak down its centre ; but it is apt to be pale and clammy, and sometimes covered over with slimy mucus. Sometimes the patient bites the tongue involuntarily while asleep; this is a spasmodic motion; while the jaws come together the tongue protrudes. The urine you will find to be highly albuminous ; it has a milky appearance, decomposes very rapidly and you will find it also loaded with earthy phosphates. These are the main symptoms which would suggest the selection of Phosphoric acid in typhoid fever.

The nearest remedies here are Rhus and Phosphorus. Phosphoric acid often follows Rhus after the latter has relieved the restlessness but not the diarrhoea, and the patient goes into this quiet sort of stupor. Phosphorus has more dryness of the tongue, more sensorial excitement ; all the senses are irritated ; the patient cannot bear an3 T noises or odors. If diarrhoea is present, the stools are blood-streaked and look like '

' fresh-water.

In this sensorial apathy you should also remember the Sweet spirits of nitre. The patient lies in bed, perfectly indifferent to every one. He answers questions readily enough, but is apathetic. That is the condition in which Hahnemann gave Sweet spirits of nitre. I have found it to succeed when Phosphoric acid failed.

Arnica is also to be placed by the side of Phosphoric acid. Like the acid, it has apathy or indifference. The patient does not seem to realize that he is as sick as he is. But the Arnica condition is more advanced state. The depression and stupor are more profound. He goes to sleep when answering your questions, showing you how overpowering is the stupor. Then, too, you have the petechise or ecchymoses common to this remedy, and, still later, involuntary stool and urine.

Opium is, more than Phosphoric acid, a remedy for stupor when that stupor is progressive. It is only in the beginning of the Opium state that the patient can be aroused from sleep. The stupor goes on until no amount of shaking can bring the patient to consciousness. Breathing grows more and more labored and stertorous; the face, instead of being pale, sunken and hippocratic, as in the acid, is deeper red, almost a brownish-red. The browner the red, the more is Opium indicated.

Another important series constitutes the emotional symptoms of Phosphoric acid. It is one of the best remedieswe have for the bad effects of grief and depressing emotions, particularly for the chronic effects of disappointed love. It is here particularly indicated after Ignatia. Ignatia suits the acute symptoms and Phosphoric acid the chronic. Phosphoric acid is also indicated for homesickness. The patient is sad; he often has hectic fever and flushing of the face, especially in the afternoon, evening or toward night. He has sweat towards evening, and complains of crushing weight on the vertex. That last symptom is verjr characteristic of Phosphoric acid. Now, we may carry these indications further than this. We all know how the emotions affect the body, how bad news affects the digestion, how mother's milk is made poisonous by some powerful emotion. We may find in Phosphoric acid a remedy for uterine and ovarian diseases which arise remotely from emotional causes. Thus you may use it in prolapsus uteri which seems to have been precipitated by depressing emotions. If you have other symptoms to aid you in its selection, then all the more promptly will you find both local and constitutional symptoms removed by its administration.

In homesickness you should also think of Capsicum.

Natrum mur. may be placed alongside of Phosphoric acid for the chronic effects of grief with the " vertex headache," sadness, weeping, emaciation, etc.

Next, I would like to say a few words about the diarrhoea caused by Phosphoric acid. It is particularly indicated in diarrhoea which is preceded by rumbling in the bowels. The stools are frequent and persistent. Particularly is it indicated in young persons who grow rapidly. But the diarrhoea, despite its frequency, does not proportionately weaken the patient. The mother will tell you that her child has had diarrhoea for six weeks, with a great deal of rumbling of flatus, and yet it does not seem to be much weakened thereby. The stool may contain undigested food, and it may follow a meal.

The distinction between Phosphoric acid and Cinchona lies in the fact that the Cinchona diarrhoea exhausts the patient excessively. Then another symptom of Phosphoric acid is, that the patient, though quite weak, is rested by a very short sleep. I presume that this action of the acid is owing to the stimulating effect of the Phosphorus it contains.

Phosphoric acid is suited more to the remote effects of the loss of animal fluids rather than to the acute symptoms. Thus we find it indicated for the long-lasting effects of seminal emissions, whether occurring during sleep or when awake, with every effort at stool or urination or from excessive venery, especially onanism. The whole system seems to be weakened. The patient is dizzy, feels as if he would fall. There is another peculiar form of dizziness. On lying down he feels as if the feet were going higher up than the head. The scrotum and testicles hang down flabby and relaxed. The penis has no power of erection, or erections are deficient. Semen escapes too soon during coitus. The patient complains of formication over the scrotum. The back and legs are weak, so that he totters when he walks. He has little or no absolute pain, except perhaps a burning in the spine, which is worse at night.

Phosphoric acid is very similar to Cinchona, in fact it is superior to it in the chronic effects of loss of seminal fluid. Cinchona is useful for the acute effects. For instance, a man has emissions for three or four consecutive nights, and is thus much weakened; then Cinchona will relieve him promptly.

When you give Phosphoric acid for this relaxed condition of the genitals, give it low.

In headache, Phosphoric acid occasionally comes into play, especially when the trouble occurs in school-girls; the headache comes on when they study and continues as long as the mental effort is maintained. .34 Phosphoric acid, furthermore, is to be thought of as a remedy for the debility arising from excessive study.

Phosphoric acid also affects the mucous surfaces. We have to remember it particularly in chest affections. The cough arises from tickling in the chest, in the region of the ensiform cartilage. It is worse in the evening after the patient lies down. In the morning we find expectoration, which is yellowish or muco-purulent, and usually tasting salty. We may think of it, although less frequently than of Phosphorus, in cases of tuberculosis, when there is great weakness of the chest, so that the patient can hardly talk. This weakness seems to be a cause of dyspnoea. Every draught of air gives him fresh cold. He wraps his chest up warmly; he cannot bear a draught of air to touch his chest. When these symptoms are present, the acid is superior to Phosphorus.

Next, the action of Phosphoric acid on the bones. You may give it in scrofulous affections of children; for example, in hip diseases and in curvature of the spine from caries of the vertebra, when this symptom is present: if the child is old enough he will complain of a feeling as if the bones were being scraped with a knife. This is from inflammation of the periosteum. This symptom is worse at night and may occur after the abuse of mecury.

Phosphoric acid, like all the mineral acids, affects the kidneys. It produces first what we may call polyuria or copious urination. The symptom, as it was produced in the prover, was this: the urine flowed so rapidly and so frequently that it came out as though the urethra were twice its natural size. You may see in Phosphoric acid a possible remedy for diabetes mellitus. The symptoms which led you to it are, first of all, this frequent and profuse urination, requiring the patient to rise often at night. The urine is often milky in appearance. Sometimes it deposits jelly-like masses, particularly in catarrh of the bladder.

I would also like to call your attention to Lactic acid. As a remedy in diabetes I have used it with great benefit. There are pronounced anaemia, nausea after eating, canker sores in the mouth, salivation and polysuria.

Phosphoric acid has been recommended for growing pains. Guaiacum is also said to be useful for these.