Kali bichromicum

Slow, deep processes; little fever, but great weakness. Sickly, chilly and cachectic. Fair, fat and sluggish. Bitings, like bugs. ADHESIVE SECRETIONS; STICKY taste, expectoration, leucorrhœa, foot-sweat, etc. STRINGY, TOUGH, lumpy or thick discharges. Fibrous exudates going downward. Yellow, eyes, vision, tongue, etc. Slow reaction. Heaviness. Crusts in nose, on skin, etc. Pains in small spots; jump about and finally attack stomach. Sharp stitches. Ascending; gastric pains, chills, heats, etc. Furred membranes. Old catarrhs. Ulcers; with dark dots, deep, perforating, round; look punched out; septal; peptic; with overhanging edges or thick crusts. Like a solid block on forehead. As of a hair on tongue, in nostril, etc. Internal itching; vagina, lungs, etc. Cracking joints. .................... Indifferent. Indolent. Pains outward along (r) brow. Bristling hair. Blindness, then pain over one eye, < cold, > pressing on root of nose. Migraine. Vision seems crossed, > looking with one eye. Eye-lids red, itching, swelled, granular. Nose pains at bridge or root; pressure or stuffed at root; retains foul secretions. Abscess. Ozœna. Nasal discharges, acrid; profuse; green clinkers. Nasal diphtheria. Snuffles. Radiating toothache; with swelled glands. Tongue, glistens; cracked, smooth or heavy, lemon yellow cast; pains when protruded. Sticky mouth. Sweet, metallic taste. Hawks thick mucus; must wipe it away. Œdema of uvula. Fissured pharynx. Throat; dry; burning in; something sticks in; with pains into neck and shoulders. Craves beer. Regurgitates liquids. Vomits bright yellow water. Sore spot in stomach, or food lies like a load. Constriction from liver to shoulder. Gelatinous stools or gushes of brown, frothy water, then burning and tenesmus, < after rising. Heavy kidneys. A drop remains after urinating. Constriction at root of penis. Acrid leucorrhœa. Milk is stringy. Hoarseness. Laryngitis. Tickling cough, after eating; with eructations; > heat; then vertigo. Under sternum; rawness; pains through to back. As of a bar across chest. Asthma. Deep cough with stringy expectoration. Heart weak; feels cold. Paralytic weakness of hands. Sciatica, < flexing leg. Sore heels. Pains along border of foot. Stubborn suppuration. Pustules with black apices. Skin, > in cold air. Hot flushes, then sticky sweat, then chill. Cold sweat on hands and feet. Chill with sweat.

COLD: Damp. Open air. Spring. Undressing. MORNING; after sleep. 2-3 A.M. Protruding tongue (Cist.). Hot weather. Alcohol. Beer. Suppressed catarrh.

Heat. Motion.

MUCOUS MEMBRANES: Air passages. NOSE. Pharynx. Stomach. Duodenum. Fibrous tissue. Ligaments. JOINTS. Skin. Circulation. Kidneys. Root of nose, tongue, or penis, etc.

Complementary: Ars. Pho. Psor. Related: Kali-c. Merc. Phyt. Pul.

Kali bichromicum

Potassium Bichromate. K2Cr20^.

Fat, light-haired persons who suffer from catarrhal, syphilitic or psoric affections.

Fat, chubby, short-necked children disposed to croup and croupy affections.

Affections of the mucous niembranes — eyes, nose, mouth, throat, bronchi, gastro-intestinal and genitourinary tracts — discharge of a tough, stringy mucus which adheres to the parts and can be drawn into long strings (compare, Flyd., Fys.).

Complaints occurring in hot weather.

Fiability to take cold in open air.

Rheumatism alternating with gastric symptoms, one appearing in the fall and the other in the spring; rheumatism and dysentery alternate (Abrot.).

Pains : in small spots, can be covered with point of finger (Ign.) ; shift rapidly from one part to another (Kali s., Lac c., Puls.) ; appear and disappear suddenly (Bell., Ign., Mag. p.).

Neuralgia every day at same hour (Chin. s.).

Gastric complaints : bad effects of beer ; loss of appetite; weight in pit of stomach; flatulence; < soon after eating; vomiting of ropy mucus and blood; round ulcer of stomach (Gym.).

Nose : pressive pain in root of nose {in forehead and root of nose, Stict.) ; discharge of plugs, ‘‘ clinkers ; ’’ tough, ropy, green fluid mucus; in clear masses, and has violent pain from occiput to forehead if discharge ceases.

Ulceration of septum, with bloody discharge or large flakes of hard mucus (Alum., Sep., Teuc.).

Diphtheria : pseudo-membranous deposit, firm, pearly, fibrinous, prone to extend downwards to larynx and trachea (Lac c. — reverse of, Brom.).

(Edematous, bladder-like appearance of uvida; much swelling, but little redness (Rhus).

Cough : violent, rattling, with gagging from viscid mucus in the throat; < when undressing (Hep.).

Croup: hoarse, metallic, with expectoration of tough mucus or fibro-elastic casts in morning on awakening; with dyspnoea, > by lying down (worse when lying down, Aral., Lach. ).

Deep-eating ulcers in fauces; often syphilitic.

Headache : blurred vision or blindness precedes the attack (Gels., Lac d.); must lie down; aversion to

KAI^I light and noise; sight returns as headache increases (Iris, Nat., Lac d.).

Prolapsus uteri, seemingly in hot weather.

Sexual desire absent in fleshy people.

affections.

After: Canth. or Carb. ac. has removed the scrapings, in dysentery.

After: lod. in croup, when hoarse cough, with tough membrane, general weakness and coldness are present; Cal. in acute or chronic nasal catarrh.

Ant. t. follows well in catarrhal affections and skin diseases.

Aggravations. — Heat of summer; hot weather.

Amelioration.. — Skin symptoms are better in cold weather (reverse of. Alum, and Pet.).

Lecture LXXI — Kali bichromicum

Today I shall lecture on Kali bichromicum, or the Bichromate of Potash. You would expect in a drug having the combination of this one, to obtain not only the results of potash, which forms the base of the salt, but also the modifying influence of the chromic acid. You will find, therefore, that while there are evident general resemblances to the other Kalis, there are decided differences arising from the acid combined with it. Chromic acid, as you probably well know, is a highly irritating acid. It is a powerful escharotic, destroying animal tissue very rapidly, and penetrating quickly into the part, and so producing a deep ulcer or sore.

Kali bichromicum is a drug which acts generally, although not exclusively, on fat persons, and fat, chubby children more than on adults. We find that it possesses great virtues in inflammation of mucous surfaces, with tendency to plastic exudation and pseudo-membrane. It attacks mucous membranes, causing at first inflammation of these, violent in character and associated with a great deal of redness and swelling, and at first a production of an excessive amount of mucus, from over-action of the muciparous glands. This excessive mucous secretion is very rapidly turned into a fibrinous exudate ; hence there is a tendency to the formation of false membranes. This character of the exudation on mucous surfaces gives us the well-known characteristic of the Bichromate of Potash, discharges are ropy and stringy. This S3miptom is true of the coryza, it is true of the discharges in pharyngitis and laryngitis, and it is true of the vomited matters in gastric catarrh. It also applies to the leucorrhcea and also to the gleety discharge from urethra, which may sometimes call for Kali bichromicum. Illustrations, then, of this general characteristic of the drug are not wanting in any part of the body. We find this same quality of the mucous discharges even in scrofulous children, for whose diseases Kali bichromicum is often an excellent drug. For instance, it is indicated in inflammation of the middle ear, particularly when it affects the membrana tympani. There is ulceration not only of the membrana tympani, but also of the mucous surface of the middle ear. The distinction between Kali bichivmicum and other remedies in these cases is that the discharge is tenacious, stringy and purulent. With this there will be earache, with pains of a sharp stitching character which shoot up into the head and down into the neck. You will find the glands of the neck swollen and also the parotid gland on the affected side. This becomes large and indurated, and pains shoot from the ear down and into the swollen parotid.

In these stringy discharges compare Alumen, Senega, Kali carb., Asafcetida, Coccus cacti, etc.

In diseases of the mucous membrane of the throat we find this same character to the exudation. Thus, in diphtheria, we find Bichromate of Potash indicated under two or three contingencies. It may be a remedy when diphtheria assumes the croupous form. The membrane is quite thick, and is dicidedly yellow-looking, like wash-leather. The tongue is coated yellow or is 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. This has been, in nry mind, a sufficient distinction between Kali bichromicum and the Iodides of Mercury. When I am giving Iodide ofMercury in diphtheria, as soon as I find that the expectoration becomes stringy I change to Kali bichromicum because it suits that condition, and also because it may prevent the extension of the disease to the larynx. Although, in general, Kali bichromicum is suited to rather sthenic types of inflammation, yet we have indications enough to prove that it may be suited to the adynamic cases also. So far as our knowledge of this drug goes it does not produce many neurotic symptoms or blood changes, but what few are recorded belong to weariness, sleepiness and prostration, etc. , and at times, especially if there is gastro-enteric inflammation, there is cold sweat, lowered temperature, pale sunken face, showing that the drug may suit actual collapse and cases of asthenic type. The Iodide of Mercury is to be thought of in diphtheria when the membranous deposit is more or less profuse, involving the tonsils and posterior nares. The glands in the neck are swollen. The tongue is coated dirty yellow. There is excessive production of mucous in the throat, causing a great deal of "hawking."

Carbolic acid and Kalipermanganicum are kindred remedies in diphtheria. Both have putridity well marked, the former associated with burning pains in the mouth to the stomach, or little or no pain, dusk} T red face, pale about the mouth and nose, rapid sinking of vital forces; the latter with painful throat, soreness of the muscles of the neck. We find Kali bichromicum indicated in forms of inflammation of the throat other than diphtheritic. Thus, it is called for in follicular pharyngitis. The follicles of the throat become hypertrophied and look like little tubercles on the pharyngeal walls. These discharge a white cheesy-like mass, which, when crushed between the fingers, gives forth a foetid, disagreeable odor. These are attended by a feeling of roughness and dryness in the throat, and at times by an accumulation of tenacious mucus. You will find this disease a stubborn one to treat. In addition to Kali bichromicum, it will be well enough to remember Hepar, Kali chloricum (especially when there is a great deal of foetor of the breath) and /Esculus hippocastanum , or the horsechestnut. sEsculus resembles Kali bichromicum very closely, but lacks the tenacious stringy mucus. There is dry, rough, burning feeling in the throat and pharynx and yet no swelling. The face is sallow and digestion is slow. There is tendency to portal congestion, as shown by deep throbbing in the hypochondrium, and constipation and haemorrhoids.

In other cases you will have Nux vomica indicated by well-known symptoms, which I need not here repeat.

Still other cases call for Secale cornutum, which has hawking up of these little follicular exudates; Sulphur, Hepar, Ignatia, Mercurius jod.

t also Chimaphila maculata, which produces swollen tonsils, and tensive pain in the throat on swallowing.

We have Kali bichromicum indicated in yet another form of throat disease which is neither scrofulous nor croupous nor diphtheritic, but syphilitic. Ulcers form on the fauces and tend to perforate. The surrounding mucous surface is of a coppery-red color.

It is also indicated in nasal catarrh. It produces, at first, dryness of the nasal mucous membrane, with tickling in the nose and sneezing, these being especially marked in the open air. The secretion from the nose is ropy and stringy, and often collects in the posterior nares. It may or may not be offensive.

In catarrh of the post-nares compare Spigelia, Hydrastis, Natrum sulphuricum. The latter hawks up saltish mucus every morning. At other times, as in ozsena, there are discharges from the nostrils or posterior nares consisting of plugs, or clinkers, as they are sometimes called. Lumps of hard green mucus are hawked from the posterior nares, particularly in the morning. At other times (often in syphilitic cases) you will find ulcers which carry out the perforating character of Chromic acid, and tend to perforate the parts on which they are located.

Kali bichromicum is indicated in true membranous croup. It suits best, although not exclusively, light-haired, fair-complexioned children who are rather fat and chubby. The cough has a decidedly metallic sound. It has more than the mere bark of catarrhal croup. The fauces you will generally find quite red; the tonsils, perhaps, are somewhat red and a little swollen. The cough seems to descend; that is, the rattling goes down lower and lower until it apparently reaches the upper part of the epigastrium, or rather the lower third of the sternum, the irritation of the cough seeming to start from there. In this position, as well as in the throat, there seems to be a smothering, oppressive sensation; breathing becomes very labored. The child has smothering spells, arousing it from sleep, choking. The whole chest heaves with the efforts at respiration. The membrane forms quite thickly in the larynx, narrowing its lumen. The expectoration is tough and stringy, and, perhaps, mucous, and contains pieces looking like boiled macaroni. The patient is worse in the morning from three to five o'clock. Sometimes there is a tendency in these cases of croup to extend downwards and involve the trachea, and even the bronchi, giving rise to what has been termed croupous bronchitis. This is not a very common disease, but it is an exceedingly dangerous one. I remember treating a patient who, after taking Kali bichromicu?n, expectorated pieces looking like vermicelli and having numerous little branches, probably casts of the ramifications of the bronchial tubes. One of the remedies following Kali bichromicum well in the throat and croupous diseases is Lachesis. It suits particularly when the spasmodic cough becomes so violent as to cause choking spells, and when the patient drops off to sleep, he awakens as if smothering. Kali bichromicum has modified the inflammation, but has not succeeded in preventing spasm of the throat. Then Lachesis comes in and relieves the remaining symptoms. Should the croupous symptoms increase, you ma3- return to Kali bichromicum.

There is also a resemblance between Mercurius cyanatus and Kali bichromicum in diphtheritic croup.

Kaolin is very useful for membranous croup when it extends downwards, and when one of the characteristic symptoms is intense soreness along the trachea and upper part of the chest.

The mucous membrane of the stomach, too, falls under the influence of Kali bichromicum . The drug is so irritating that it causes gastritis. Thus it produces gastric symptoms varying in severity all the way from those of simple indigestion to those of malignant disease of the stomach. In the milder forms of dyspepsia we find it indicated when there is headache, the pain usually being supra-orbital. This may be periodical in its return, but is particularly excited by gastric irritation. Although it is neuralgic in its character, it is reflex from gastric irritation. Another form of headache which is associated with these gastric symptoms is one of a peculiar kind. The patient is affected with blindness more or less marked, objects become obscured and less distinct, the headache then begins. It is violent, and is attended by aversion to light and to noise, and the sight returns as the headache grows worse. I have met with that symptom in my practice four or five times. I have found the same symptoms precisely given under Gelsemium, but I have never used that drug under these circumstances, so I have not confirmed it. There are quite a number of remedies having blinding headache, but Kali bichromicum is the best of them. We have Causticum sometimes indicated for blindness with the headache, but not diminishing as the headache increases. We also find it under Natrum mur., Iris versicolor, Psorinum and Silicea. In the latter remedy the blindness comes after the headache; in Psorinum before, the sight returning before the pain begins.

With this headache of Kali bich?

romicum the face is apt to be blotched and bloated, and covered with pimples or acne. It is also sallow and yellowish, as if the patient were bilious. The whites of the eyes are yellow and a little puffed. The tongue is thick and broad and scalloped on its edges, as though it had taken the imprint of the teeth.

The stomach seems to swell up immediately after a full meal, just like Lycopodium. The bowels are constipated, or else there is early morning diarrhoea, as you find under Sulphur, Rzimex, Bryonia and Natrum sulph. The stools are watery, and are followed by tenesmus, which distinguishes this drug from Sulphur, Rumex, Bryonia and Natrum sulphuricum, all of which have morning diarrhoea. These are some of the gastric symptoms which will yield to Kali bichromicum. They are particularly apt to occur after excessive beer drinking. Kali bichromicum is one of the best remedies for the chronic effects of excessive indulgence in beer and ale.

Gnaphalium is one of the little used remedies that has diarrhoea worse in the morning. The stools are watery and offensive, with nausea and vomiting. It is sometimes useful in the beginning of cholera infantum. Urine dark, scanty. Irritability of temper, continuing even after the diarrhoea ceases.

We also find Kali bichromicum producing gastritis, herein very much resembling Arsenicum. The vomited matter is sour, and is mixed with clear mucus. You see how Kali bichromicum everywhere excites an over-production of mucus. The vomit may be bitter from admixture of bile. It is renewed by every attempt at eating or drinking, and is associated with a great deal of distress and burning rawness about the stomach. With this kind of vomit you may give Kali bichromicum in the vomiting of drunkards and in the round, perforating ulcer of the stomach.

In dysentery, Kali bichromicum is sometimes indicated. The disease occurs periodically in the spring or in the early part of the summer. The stools are brownish and watery, and mixed with blood and attended with great tenesmus. The distinctive symptom is the appearance of the tongue, which is dry, smooth, red and cracked. In its action on the skin, Kali bichromicum causes, first of all, a rash which very much resembles that of measles. Kali bichromicum is particularly indicated in measles after Pulsatilla. The latter remedy is suited for the milder symptoms, the former for the more severe. The inflammation of the eyes grows worse with the formation of vesicles or pustules on or about the cornea. The meibomian glands or other structures of the lids ulcerate, so that the lids agglutinate, and there is more or less purulent discharge from the eyes. The ears, too, become involved, and there is a discharge from the ears of quite offensive pus. There are also violent, stitching pains which extend from the ear to the roof of the mouth and to the parotid gland on the affected side. The external auditory meatus is greatly swollen. Kali bichromicum is one of the best remedies we have, when measles is associated with these ear symptoms and swelling of the glands, with sharp pains shooting from the ears into the glands. There is also diarrhoea which resembles that of Pulsatilla, but differs from the latter in the presence of slight tenesmus. The rash is the same as we find in nearly every case of measles. In a general way, we may say that it resembles Pulsatilla, only it is much worse. It has the simple catarrh of Pulsatilla, watery or more commonly yellowish green secretions, made worse and even advancing to ulceration.

We next find Kali bichromicum , like all the potash salts, producing papules. These papules are hard and tend to enlarge and develop into pustules. If the crude drug itself be applied to a slight abrasion in the skin its caustic action is severe enough to eat down to the bone. In extreme cases these pustules may even develop into deeply eating ulcers. Lupus, with severe burning pains, has been relieved and in some cases cured by this remedy.

We have also developed by Kali bichromicum symptoms resembling those of sycosis. This places the drug alongside of Thuja, Pulsatilla, and Sarsaparilla. We find scabs on the fingers, often about the nails, and also on the corona of the glans penis. There is a gleety discharge from the urethra, which is very often stringy, thus keeping up the general action of Kali bichromicum on mucous membranes. Ulcers looking like chancres, and tending to eat deeply rather than spread superficially, form about the glans penis and prepuce. In addition to these symptoms you must have the inflammation of the nose and throat of the character already described, w Tith perforating ulcers affecting even the bones.

Kali bichromicum is also called for in inflammations of the eyes; this inflammation being rather indolent in character. There is lack of reactive power, so that ulcers form which progress slowly and show but little tendency to heal of their own accord. The same is true of the conjunctivitis, which may be of scrofulous or of sycotic origin. The lids are swollen and agglutinated, especially in the morning, with thick yellow matter, and, to keep up the indolent character of the remedy, you find very little photophobia. Sometimes we find chemosis with these cases. It is very similar to Graphites and Calcarea ostr., in the indolent ophthalmia. Graphites has more cracking of the tarsi and photophobia especially in artificial light. Calcarea and Kali bichrom. meet in fat children, leukoma, etc., only Calcarea has the photophobia, the sweaty head and large abdomen.

You will find that iritis, whether syphilitic or not, may call for Kali bichromicmn . It is indicated, not in the beginning but late, when there has been exudation posteriorly between the iris and crystalline lens, causing adhesions of these structures to each other. These exudations, if not too great, will be absorbed under the action of Kali bichromicum. Characteristic of this iritis is indolence. There is little or no photophobia and not a very decided redness attending the inflammation. This is a general hint which will guide you to Kali bichromicum, and will save you the memorizing of less characteristic symptoms. Do not, therefore, forget the indolence of the ulceration, the absence or deficiency of inflammatory redness and the disproportionate absence of photophobia.

We next come to the action of Kali bichromicum on the chest. It is indicated in bronchitis, particularly if the glands are involved. Posteriorly, on either side of the spinal column, you find dullness on percussion. The cough is of a hard, barking character, almost as in croup. It seems to start from the epigastrium. The expectoration is generally of a stringy character. Sometimes it consists of bluish lumps, and is attended with a great deal of difficulty of breathing, arising mechanically from thickening of the lining membrane of the bronchial tubes. The cough is almost always made worse after eating, and is better when warmly wrapped up in bed. There is a great deal of feeling of tightness in the epigastrium.

You must also remember Kali bichromicum as a remedy indicated in asthma dependent upon bronchiectasia. The bronchial tubes are filled up with this tough tenacious exudation. But we find Kali bichromicum indicated in another form of asthma, which is worse from three to four o'clock in the morning, and is especially liable to return in the winter weather or in summer time, when chilly. The patient is compelled to sit up in bed in order to breathe. Relief comes when the patient raises stringy mucus. This kind of asthma calls for Kali bichromicum, whether the patient be stout or thin. If you have this after midnight aggravation and relief from sitting up and bending forward, and from the expectoration of stringy mucus, you have a certain remedy in Kali bichromicum. Here is it a perfect complement to Arsenicum , which has nearly the same symptoms, but lacks the tenacious sputum. The low potencies have been most successful in the treatment of asthma. The high potencies have not failed, but in all of the literature that I have been able to see, the low potencies have seemed to be the most successful. Whether this is true or not, I do not know. I only give you the facts as I find them, that you may judge for yourselves.

Aralia racemosa is another remedy for asthma when the patient must sit up for relief. It seems as if he would suffocate if he did not. Dry, wheezing or loud musical whistling respiration. But the expectoration, at first scanty, later increases, is warm and of a saltish taste.

Lastly, I have to speak of the use of Kali bichromiaim in rheumatism, particularly in rheumatism which occurs in spring or summer weather, when there are cool days or nights. The smaller joints seem to suffer. Thus we have pains about the fingers and wrists more than in any other part of the body. Pains wander about, suddenly jumping from one part of the body to another and relieved by moving the affected part. Gastric and rheumatic symptoms alternate. I have had several instances in which I have been able to confirm this characteristic of the drug. It is somewhat like Artemisia abrotanum, in which remedy diarrhoea and piles alternate with rheumatism.

Bichromate of Potash The special affinities of this drug are the mucous membrane of stomach, bowels, and air-passages; bones and fibrous tissues. Kidneys, heart, and liver are also affected. Incipient parenchrymatous; nephritis. Nephritis with gastric disturbances. Cirrhosis of liver. Anæmia and absence of fever are characteristic. General weakness bordering on paralysis. It is especially indicated for fleshy, fat, light complexioned persons subject to catarrhs or with syphilitic or scrofulous history. Symptoms are worse in the morning; pains migrate quickly, rheumatic and gastric symptoms alternate. More adapted to subacute rather than the violent acute stage. Mucous membranes everywhere are affected. Catarrh of pharynx, larynx, bronchi and nose, and a tough, stringy, viscid secretion is produced, which condition is a very strong guiding symptom for this drug. Perforation of the septum. Chronic atonic catarrh. Polypus. Dilatation of stomach and heart.

Better, from heat. Worse, beer, morning, hot weather, undressing.

Vertigo with nausea when rising from seat. Headache over eyebrows, preceded by blurred vision. Aching and fullness in glabella. Semilateral headache in small spots, and from suppressed catarrh. Frontal pain; usually over one eye. Bones and scalp feel sore.

Florid complexion. Blotchy, red appearance. Acne (Juglans; Kal ars). Bones sensitive, especially beneath orbits.

Supra-orbital neuralgia, right side. Eyelids burn, swollen, œdematous. Discharge ropy and yellow. Ulcers on cornea; no pain or photophobia. Descemetitis, with only moderate irritation of eye. Croupous conjunctivitis; granular lids, with pannus. Iritis, with punctuate deposits on inner surface of cornea. Slight pain, with severe ulceration or inflammation (Conium opposite).

Swollen, with tearing pains. Thick, yellow, stringy, fetid discharge. Sharp stitches in left ear.

Snuffles of children, especially fat, chubby babies. Pressure and pain at root of nose, and sticking pain in nose. Septum ulcerated; round ulcer. Fetid smell. Discharge thick, ropy, greenish-yellow. Tough, elastic plugs from nose; leave a raw surface. Inflammation extends to frontal sinuses, with distress and fullness at root of nose. Dropping from posterior nares (Hydr). Loss of smell. Much hawking. Inability to breathe through nose. Dryness. Coryza, with obstruction of nose. Violent sneezing. Profuse, watery nasal discharge. Chronic inflammation of frontal sinus with stopped-up sensation.

Dry; viscid saliva. Tongue mapped, red, shining, smooth, and dry, with

dysentery; broad, flat, indented, thickly coated. Feeling of a hair on tongue.

Fauces red and inflamed. Dry and rough. Parotid glands swollen. Uvula relaxed, œdematous, bladder-like. Pseudo-membranous deposit on tonsils and soft palate. Burning extending to stomach. Aphthæ. Diphtheria, with profound prostration and soft pulse. Discharge from mouth and throat, tough and stringy.

Nausea and vomiting after beer. Load immediately after eating. Feels as if digestion had stopped. Dilatation of stomach. Gastritis. Round ulcer of stomach. Stitches in region of liver and spleen and through to spine. Dislikes water. Cannot digest meat. Desire for beer and acids. Gastric symptoms are relieved after eating, and the rheumatic symptoms reappear. Vomiting of bright yellow water.

Cutting pain in abdomen, soon after eating. Chronic intestinal ulceration. Soreness in right hypochondrium, fatty infiltration of liver and increase in soft fibrous tissue. Painful retraction, soreness and burning.

Jelly-like, gelatinous; worse, mornings. Dysentery; tenesmus, stools brown, frothy. Sensation of a plug in anus. Periodic constipation, with pain across the loins, and brown urine.

Burning in urethra. After urinating a drop seems to remain which cannot be expelled. Ropy mucus in urine. Urethra becomes clogged up. Congestion of kidneys; nephritis, with scanty, albuminous urine and casts. Pyelitis; urine mixed with epithelial cells, mucus, pus, or blood. Hæmatochyluria.

Itching and pain of penis, with pustules. Ulcers, with paroxysmal stitches; aggravated at night. Constriction at root of penis, at night on awakening. Syphilitic ulcers, with cheesy, tenacious exudation. Erections (Picric ac).

Yellow, tenacious leucorrhœa. Pruritus of vulva, with great burning and excitement. Prolapsus uteri; worse in hot weather.

Voice hoarse; worse, evening. Metallic, hacking cough. Profuse, yellow expectoration, very glutinous and sticky, coming out in long, stringy, and very tenacious mass. Tickling in larynx. Catarrhal laryngitis cough has a brassy sound. True membranous croup, extending to larynx and nares. Cough, with pain in sternum, extending to shoulders; worse when undressing. Pain at bifurcation of trachea on coughing; from mid-sternum to back.

Dilatation, especially from coexisting kidney lesion. Cold feeling around heart (Kali nit).

Cutting through loins; cannot walk; extends to groins. Pain in coccyx and sacrum extending up and down.

Pains fly rapidly from one place to another (Kali sulph; Puls). Wandering pains, along the bones; worse cold. Left-sided sciatica; better, motion.

Bones feel sore and bruised. Very weak. Tearing pains in tibia; syphilitic rheumatism (Mez). Pain, swelling and stiffness and crackling of all joints. Soreness of heels when walking. Tendo Achilles swollen and painful. Pains in small spots (Oxalic ac).

Acne. Papular eruptions. Ulcer with punched-out edges, with tendency to penetrate and tenacious exudation. Pustular eruption, resembling smallpox, with burning pains. Itching with vesicular eruption.

Compare: Tart emet; Brom; Hepar; Ind; Calc; Ant cr. In the production of false membranes compare: Brom; Ammon caust; Sulph ac; Ipecac. Antidotes: Ars; Lach.

Third trituration, also thirtieth attenuation and higher. The lower preparations of this salt should not be kept too long.

Kalium Bichromicum

This remedy is recognized by most physicians by the copious ropy mucous discharges from all mucous membranes, but it is also a most important remedy in rheumatic affections of the joints with swelling, heat and redness, whenever these conditions wander around from joint to joint.

The bones all over the body feel bruised, and caries is reckoned among its symptoms. A marked feature of this remedy is the alternation between catarrhal symptoms and rheumatic pains. Exudations from mucous membranes, somewhat like croup, are found in the larynx, trachea and in the rectum. it is not surprising, therefore, that it has proved a very effective remedy in diphtheria. It emaciates, like the rest of the Kali salts. We have running through it the cachectic conditions, or malignant diseases with ulceration; and especially is it indicated when the ulceration period is present.

Ulceration: is a striking feature of this remedy. Its ulcers are deep; are said to be as if punched out and are very red. Gouty conditions are as common in this remedy as in the other Kalis. It is especially like Causticum with its cracking in the joints. Syphilitic conditions have been cured in the most advanced stages. It has the sharp stitching pains like Kali carb., it has one feature quite its own very severe pain in small spots that could be covered by the end of the thumb.

Pains: It has wandering pains from place to place, and wandering rheumatism in from joint to joint. There are pains in all parts. Pains are sometimes very violent; sometimes shooting; sometimes stitching stinging; again aching. Burning is a very marked symptom of the remedy. The pains appear rapidly and disappear suddenly.

Cold and warm: The patient is sensitive to cold. There is a lack of vital heat. In fact, he wants to be wrapped up and covered warmly, and many of his complaints are much better when he is perfectly warm in bed. All the pains and his cough are relieved from the warmth of the bed, and yet there are other complaints, like rheumatic conditions, that come on in hot weather.

The cough is better in warm weather and worse in winter. Catarrhal conditions of the larynx and trachea are worse in winter, especially in the cold, damp weather, like Calc. phos. when the snow melts. Sensitive to cold winds. Causticum, it ill be remembered, is sensitive to cold, dry winds.

The Kalis generally are sensitive to cold, dry weather, but Kali bichromicum throat troubles are continuous in the winter and during cold, damp weather, and are worse in cold, damp winds. It is a most useful remedy in septic and zymotic fevers.

Many of its symptoms are aggravated about 2 or 3 A.M., like Kali carb. Most of the symptom are worse in the morning yet some come on in the night. A marked feature of Kali. bichromicum is a feeling of great weakness and weariness. When the pain has passed off, if in the limbs, the limbs are felt very weary. Great prostration and cold sweat.

It has neuralgia every day at the same hour, showing its periodicity. Like the rest of the Kalis it has cured epilepsy. Ropy saliva and mucous discharges from the mouth during the convulsion has led to its use in epilepsy. The symptoms generally, especially the pains, are worse from motion, except the sciatic and some of the pains in the lower limbs, which are better from motion. The patient pulsates all over the body. There are very few mental symptoms owing to the fact that the remedy has been proved only in crude form. It needs to be proved in potencies to bring out the mental symptoms.

Head: It has violent headaches and its headaches are mostly associated with catarrhal conditions. A Kali bichromicum patient always suffers more or less from catarrh of the nose, and if he is exposed to cold weather the catarrhal condition will turn to dryness; then will come on violent headache; also headaches during coryza. Headaches during coryza when the discharge of the coryza slacks up a little. Headaches often begin with dim vision. Pains are violent. Headaches are better from warmth, especially warm drink; better from pressure; worse from stooping; worse from motion and walking; worse at night and still much worse in the morning. Pain is pulsating, shooting and burning. Headaches come on with vertigo. Headaches are often one-sided. It has been a very useful remedy in syphilitic head pains.

Pains over the eyes and in the forehead. It is very useful when the headaches are with retching and vomiting; when the pain is confined to a very small spot that could be covered with the thumb and is violent; when the headaches come periodically and with dizziness. Headaches are somewhat ameliorated in open air if it is not too cold. It has cured eczema of the scalp with thick, heavy crusts from which ooze a yellow, thick, gluey substance.

Eyes: Daylight brings on photophobia, There are sparks before the eyes; dim vision before the headache, as mentioned above. Rheumatic conditions affecting the eyes, hence it is said rheumatic affections of the eyes. Granular lids. Ulceration of the cornea. The ulcer is deep with pulsation in it. The eyes are much inflamed and red. The lids are red and swollen. Eyes and lids are injected.

Croupous inflammation of the eyes. Burning and itching in the eyes. Inflammation of the mucous membrane of the eyes with copious flow of thick mucus. Margins of the lids are red and swollen. It has cured polypus on the conjunctiva, swelling of the lids and stringy mucus.

Ears: There are yellow, viscid discharges from the ears, with stitching pains and pulsating in the ears. Chronic suppuration of the middle, ear with perforated tympanum; eczematous eruptions on the ears, itching of the whole external ear.

Nasal passages: The symptoms of the nasal passages are very numerous. The most prominent are the catarrhal symptoms. It has catarrhal symptoms both acute and chronic, with copious, thick, viscid, yellow or white mucus. Foetid odor from the nose.

Troubled much with a sensation of dryness in the nose. Loss of smell, and the nose is obstructed nights with thick yellow mucus, too viscid to be blown out. Accompanying this catarrhal condition there is a hard pain at the root of the nose. Ulcers form all over the nasal mucous membrane. There are ulcers, crusts, mucous plugs; must blow the nose constantly without success, but finally blows out large green crusts or scabs from high up in the nose. Sometimes they are drawn into the posterior nares. There is burning and pulsating in the nasal cavities. When the nasal cavity is in this state of ulceration and catarrh there is shooting pain from the root of the nose to the external angle of the eye through the whole forenoon. Extreme soreness inside of the nose.

Expired air feels hot and causes a sensation of burning. He has snuffles and increased catarrhal conditions in damp weather. There are also burning. excoriating, watery discharges from the nose, as in acute catarrhal conditions. Coryza is fluent, excoriating, with loss of smell. With the chronic condition there comes perforation of the septum and pressing pains of the frontal sinus. A very strange condition then is observed. Scabs form upon the nasal septum; when these are removed there comes photophobia, then dimness of vision, followed by hard frontal headache. The septum is sometimes destroyed by ulceration. Much thick blood is blown out of the nose. Now, it has cured these conditions when they were syphilitic. It has cured nasal polypus. It has cured lupus of the nose.

Face: The bones of the face are often very sore, with shooting pains in the malar bones. Pain in the malar bones on coughing. With the catarrhal conditions there is much suffering from the malar bones, like Merc. It has cured lupus exedens. It has cured ulceration of the lip. Swollen parotid is quite a common feature in its proving. It has cured impetigo.

The tongue: is smooth, shiny, sometimes cracked. This is especially observed in low forms of fever, like typhoid. The tongue is often coated, thick and yellow at. the base. Papillae raise on the dorsum of the tongue, making it look like strawberry tongue. Again the tongue is coated a thick brown. The provers seemed to be much annoyed by a sensation of a hair on the base of the tongue. It has produced and cured ulceration of the tongue; even when syphilitic, it is a useful remedy. Ulcers deep as if punched out; with stinging pains.

There is great dryness of the mouth; ropy saliva and mucus ulcers anywhere in the mouth; aphthous patches; ulcers of the roof of the mouth; even when these are syphilitic it is a most useful remedy; deep punched out ulcers.

The throat: symptoms are very numerous. I will only mention a few of the most characteristic ones. Inflammation of the throat in general, involving all the tissues in it, extending up into the nose, and down into the larynx, even with a high degree of ulceration with copious, ropy mucus.

It has cured diphtheria exudation in the throat when it is confined to the throat, and also when it has extended to the larynx. A marked feature of the Kali bichromicum throat is its oedematous uvula: This symptom, is also found in Apis, Kali i., Lach., Mur. ac., Nit ac., Phos., Sulph. ac., and Tab.

Deep ulcers in the throat and ulcers on the tonsils. Ulceration so extensive that it has destroyed the whole soft palate. Inflammation of the tonsils when they are swollen and very red, when the neck is swollen; inflammation of the tonsils with suppuration. In this sore throat there is quite commonly a shooting pain extending to the ears.

Throat: There are also enlarged veins in the throat. Like the sensation of the tongue as if a hair in various places in the fauces and nose. Dry, burning sensation in the throat is very common. Quite a characteristic symptom of Kali bichromicum is the intense pain in the root of the tongue, when putting the tongue out. It has much exudation in the throat that is not diphtheria, but resembles it.

The stomach: symptoms are also very numerous. There is aversion to meat and strange to say, he craves beer, which makes him sick, brings on diarrhoea. Food lies like a load in the stomach; digestion seems suspended; there is a pressure as of a load after eating and much foods eructations. Nausea comes on very suddenly, sometimes while eating, soon after eating; vomits all food and it is sour as if it had turned sour very rapidly; so that there is vomiting of sour, undigested food, bile, bitter mucus, blood, yellow mucus and ropy mucus. It is a very useful remedy in nausea and vomiting of drunkards and beer drinkers. When a beer drinker has arrived at a point where he can no longer tolerate his beer but it makes him sick, Kali bichromicum is a useful remedy. In the stomach there is also soreness and coldness. It is a very useful remedy in ulceration of the stomach; and when such ulcer is cancerous it relieves the pain, stops the vomiting, makes the patient comfortable for a long time.

In other words, it palliates him. There are some pains in the stomach that are ameliorated by eating; nausea sometimes is ameliorated, but such is the exception. He has a faintness in the stomach which drives him to eat often. Chronic catarrh of the, stomach is a strong feature and perhaps is a condition that is generally present with Kali bichromicum patients.

Liver: There is pain in the liver, hard contracting pain extending to the shoulder, resembling Crot. h. Pain in the liver from motion. Dull, aching pain in the liver. It is a useful remedy in liver conditions associated with gall stones. It corrects the action of the liver so that healthy bile is formed and the gall stones are dissolved. Stitching pain in the liver, and also in the spleen, on motion.

The abdomen is very tympanitic, with tenderness. There are stitching, cutting pains. Sinking in the abdomen with nausea after eating, then comes vomiting, then comes diarrhoea. This is the order in which these symptoms generally appear. It is a very useful remedy in gastrointestinal cases. Ulcers of the intestines in typhoid conditions.

This remedy has also a morning diarrhoea like Sulphur. It has diarrhoea in phthisis. It has diarrhoea in typhoid fever. Watery Stools. Stools are brown and watery, or may be blackish watery. There is often much tenesmus at stool. Chronic diarrhoea in the morning. Diarrhoea after beer like Aloe, China, Gamb., Lyc., Mur. ac., and Sulph.

Frequently there are clay colored stools. Again there are bloody stools, as in dysentery. It has both diarrhoea and dysentery after rheumatism has disappeared. It seems rheumatic conditions are inclined to alternate with diarrheic conditions. In hot weather it has diarrhoea and dysentery; in winter it has chest troubles and catarrh of the air passages.

There is pain in the abdomen before the stool much pain during the stool, cramping and tenesmus. After stool it has tenesmus like Merc. It has constipation with hard, knotty stool, followed by severe burning in the parts. Burning in the anus after stool. Prolapsus of the rectum. After dry hard stool there is burning in the rectum. Patient suffers from a sensation of a large plug in the rectum and there is great soreness in the anus. He suffers much from hemorrhoids which protrude after stool and are very painful.

Urines: Pain in the back with bloody urine. Shooting pains in the region of the kidneys, also aching in the region of the kidneys with urging to urinate in the day time. There is suppressed urine with aching in the kidneys. Ropy mucus in the urine. Pain in the coccyx before urination, relieved afterwards. Burning in the fossa navicularis during urination.

In the male the sexual desire is generally absent. There is a strong constricting or contracting pain in the end of the penis and much itching of the pubes. Deep punched, out chancres, very hard. Stitching in the prostate gland when walking. Ropy, viscid, mucous discharge from the urethra. As there is much relaxation in the remedy during hot weather, it especially affects the woman. She suffers from prolapsus in the summer time, during hot weather.

It is a very useful remedy in the woman for subinvolution. In the menstrual flow there are often membranes that cause her to suffer. The menstrual flow is too soon, excoriates the parts, causes the labia to swell and itch. Like the catarrhal conditions of other mucous membranes, there is leucorrhoea that is yellow and ropy.

It has been a most useful remedy in the vomiting of pregnancy when the other symptoms agree and also where the milk becomes stringy. There are numerous symptoms connected with the larynx and as is usual copious, thick, ropy mucus. Chronic hoarseness, rough voice, dry cough, swollen feeling in the larynx and sensation as if there was a rag in the larynx. Catarrh of the larynx, croup, cough when breathing, membranous croup, diphtheria, burning, smarting and rawness of the larynx, rattling in the trachea.

Now these symptoms come in the cold, damp weather, in the winter. They are associated with much coughing and uneasiness. Sometimes these symptoms are entirely relieved and he is comfortable in a warm bed at night; and he is worse always in cold weather; they come on when the cold weather comes in the fall and last all winter.

Chest: He has much wheezing when breathing; tightness at the bifurcation of the trachea. Quite a characteristic pain in the chest is the pain from the sternum to the back, associated with catarrhal conditions and with cough. Cough is caused from tickling in the larynx and at the bifurcation; dry, frequent, hard cough; great soreness in the chest when coughing and breathing deep.

Cough with pain in the sternum through to the back. Cough with stitching pain in the chest. Loud, hard cough. When he wakes up in the morning he begins this hard coughing. He is often ameliorated by lying down and is ameliorated by the warm bed; is worse undressing, from exposure to the air, worse after eating, aggravated by taking a deep breath, ameliorated by getting warm in bed.

The irritation and the cough is increased very much exposure to cold air. The cough is also a choking cough at times; sometimes a hoarse cough. It is sometimes much like whooping cough, spasmodic and constrictive.

The expectoration connected with the chest cough is ropy, yellow, or yellowish green, sometimes bloody; sometimes expectorates quantities of clotted blood. There is much rattling in the chest, catarrhal conditions in the winter, last all winter, with rattling catarrhal conditions in old people, rattling in the chest.

It is a most useful remedy in phthisis and hemorrhages from the lungs and cavities in the lungs. There is a cold sensation in the chest which is generally felt in the region of the heart. There is a pressure in the chest after eating also near the heart or supposed to be about the heart and there is palpitation.

It has cured and been a very useful remedy in hypertrophy of the heart with palpitation. In all parts of the body there is chilliness, in the back, especially in the back of the neck. Stabbing pains in the neck and in the dorsal region. Sharp pains in the region of the kidneys. Dull ache in the back. Many of the symptoms in the back are of a rheumatic character and wander from place to place. The rheumatic pains are worse stooping, and, like other pains, worse from motion.

Pains: An exception to this is in the sacrum where there is an aching pain at night when lying and is better in the day time on motion. There is pain in the sacrum on straightening up from sitting. Pain in the coccyx from rising after sitting; pain in the coccyx on first sitting down and in the act of sitting down.

The limbs are stiff in the morning on rising and the pains wander about, especially in the joints. Rheumatic pains that wander about. Pains in the limbs are worse from cold and worse from motion. They are better from heat and better in rest. Periodical pains, coming at regular times. The bones feel sore to the touch or on deep pressure.

There is cracking in the joints. Rheumatic pains are very common in the shoulders; lameness; there is burning in the forearms; rheumatic pains in the elbows; weak feeling in the hands and fingers with much clumsiness; spasmodic contraction of the fingers. Bones. in the hands and fingers feel bruised and very tender to hard pressure. Rheumatic pains of the fingers are very common to this remedy. In the lower limbs we have marked rheumatic pains through to hips and knees, worse walking and on motion.

Then comes the exception: pains in the sciatic nerves very, severe, worse in hot weather; these are better in motion, better in the warmth of the bed, worse from changes in the weather and better on flexing the leg. Drawing pains in the tibia are very common. It has cured ulcers on the legs, deep as if punched out.

Burning on the ankles, soreness of the heels. It has cured ulcers on the heels.

The sleep is most restless. Starting in sleep and turning and tossing. Its chest symptoms are worse on walking.

Upon the skin we have pustules, boils, eczema, blisters, herpes, shingles, ulcers on the skin, tubercles, suppurating tubercles and eruptions that are syphilitic in character.