Kali carbonicum

WEAKENING, intellection; muscles, heart, back, limbs, etc. Gives out, leans on something or lies down; with backache, profuse secretions, sweat, etc. Soft, thin blooded and cold. Old, fleshy, dropsical or paralytic. SHARP STITCHINGS, stabbings or catches in joints, muscles, chest, head, epigastrium, back, etc. Throbbing, numb or cold single parts, abdomen, fingers, etc. Acrid discharges. Sub-acute conditions. Parts lain on are painful and go to sleep. .................... Peevish. Easily startled; < touch; on dropping to sleep. Anxious aversion to solitude. Headaches, into eyes; wake from sleep. Eyes weak. Vision, spotted; like drops before. Puffs over, inner angle of eyes or baggy upper lids. Stitches out of ears. Head colds; go to chest. Nose stuffed, > open air; swelled; yellow-green or crusty discharge. Puffy face. Slimy mouth. Gray tongue. Itching gums. Hawks up tough mucus in A.M. DIFFICULT SWALLOWING. Salty regurgitation. Vomits sour mucus. Sensitive, distended stomach and abdomen. Fulness; from but little, even after drinks; as if full of water. Anxious at epigastrium. Throbbing back of stomach; at navel. Gastric pains going to back, chest, limbs, etc. Flatulence. Hard tympanites. Stool difficult; of large, hard lumps, then burning or torn feeling. Piles inflamed, bleeding; descend when urinating or coughing, > riding horseback; stick like fine needles, > cool bathing. Burning in l. kidney. Nocturnal enuresis of adults. Urine foamy, with thick, tough, red sediment. Delayed first menses. Amenorrhœa. Colic, then irritating menses; > washing. Inefficient labor pains. Catarrhal aphonia. Respiration short, < least motion or walking; asthmatic, alternating with diarrhœa; with vertigo. Incessant, hard retching or choking, futile cough; then vomiting. Pertussis. Lungs seem to stick to ribs. Pleurisy. Stabbing chest pains. Heart seems to hang by a thread; pains toward l. scapula. Palpitation; then weakness; in valvular disease. Arrhythmia. Cardiac degeneration. Fine stitches in mammæ. Everything affects the small of the back or pains start there. Back and legs give out; feel heavy. Lumbago. Arms weak; numb pinching in left. Painful tips of fingers and toes. Œdema of left foot. Sensitive soles; skin. Dry hair and skin. General itching or hives; during menses. Talks in sleep. Pulse small, soft, variable, intermittent or dicrotic. Chilly; with hot hands; and sleepiness; in open air. Internal burning. Sweat scanty, foul on feet.

Cold: AIR. Water. Drafts. Changes after Overheating. Changes after exertion. Time: 2-3 A.M. Winter. Before menses. Lying: On painful or left side. Loss of fluids. After labor.

Warmth. Sitting with elbows on knees. Open air.

Muscles; ligaments: HEART. Uterus. LUMBAR. SEROUS and mucous membranes: CHEST (R. lower). Joints. Eyes. Blood. Left side.

Complementary: Carb-v. Nit-ac. Pho. Related: Calc-Hypo. Lyc. Pho.

Kali carbonicum

Potassium Carbonate.

For diseases of old people, dropsy and paralysis; with dark hair, lax fibre, inclined to obesity (Am. c.. Graph.).

After loss of fluids or vitality, particularly in the an?emic (Cinch., Phos. ac., Phos., Psor.).

Pains stitching, darting, worse during rest and lying on affected side (stitching, darting, better during rest and lying on painful side, Bry.).

Cannot bear to be touched ; starts when touched ever so lightly, especially on the feet.

desires to be alone, Ign., Nux).

Bag-like swellings between the upper eyelids and eyebrows.

Weak eyes; after coition, pollution, abortion, measles.

Stomach ; distended, sensitive ; feels as if it would burst ; excessive flatulency, everything she eats or drinks appears to be converted into gas (lod.).

Nosebleed when washing the face in the morning (Am. c., Arn.).

Toothache only zvhen eating; throbbing; < when touched by anything warm or cold.

Backache, sweating, weakness ; after abortion, labor.

metrorrhagia; when eating; while walking feels as if she must give up and lie down.

Cough : dry, paroxysmal, loosens viscid mucus or pus which must be swallowed; spasmodic with gagging or vomiting of ingesta; hard, white or smoky masses fly from throat when coughing (Bad., Chel.).

Feels badly, week before menstruation: backache, before and during menses.

Labor pains insufficient ; violent backache ; wants the back pressed (Caust.).

Asthma, relieved when sitting up or bending forward or by rocking; worse from 2 to 4 a. m.

Persons suffering from ulceration of the lungs can scarcely get well without this anti-psoric. — Hahnemann.

Difficult swallowing; sticking pain in pharynx as of a fish-bone (Hep., Nit. ac.) ; food easily gets into the windpipe; pain in back when swallowing.

Constipation : stool large, difficult, with stitching, colic pains an hour or two before.

Heart: tendency to fatty degeneration (Phos.) ; as if suspended by a thread (Lach.).

Very much inclined to take cold.

Compare: Bry., Lyc., Nat. m.. Nit. ac., Stan.

Follows well: after. Kali s., Phos., Stan, in loose, rattling cough.

Will bring on the menses, when Nat. m., though apparently indicated, fails. — Hahnemann.

Lecture LXXIII — Kali carb.

Phos. , Carbo veg., Arsen.

Ant. tart.

Hypophosphite of lime, Psorinum.

Caust., Senna.

Natr. m.

V I^Lachesis.

Kali carb. < Carbo veg.

To-day I will study with you Carbonate of potash, known in our nomenclature as Kali carb. This is complemental to Carbo veg. and similar to it in many forms of disease, particularly in lung inflammations. Sometimes when one fails' the other completes the cure; hence the origin of the complemental relation. We have quite a number of analogues to Kali carb., some of which have been placed on the board. We will have occasion to refer to some of these as we go on. There is also somewhat of a complemental relation between Kali carb. and Phosphorus.

Kali carb. exerts an influence over the manufacture of the blood, quantitatively as well as qualitatively. This is shown in the anaemia which the remedy causes. And is illustrated by the following symptoms: frequent chilliness; every time the patient goes out of doors, he becomes chilly if the air is in the least cool, not having the normal resistance to temperature; quite consistent with this anaemia, there is throbbing in the bloodvessels all through the body. This is not plethora, but only an appearance of plethora. It is associated with local congestions which are really anaemic in origin; the blood being normal volumetrically, but is not as rich in red corpuscles as it should be. The congestion to the head is associated with humming in the ears. The patient surfers from vertigo when he turns his head rapidly, or from riding in a carriage, or from anything that diminishes, the supply of blood to the brain. He suffers from weakness of sight, especially following excessive sexual indulgence.

Again, we find Kali carb., by reason of this anaemia, indicated after severe or protracted diseases. It thus becomes useful for the weakness following labor or abortion when we have the following symptoms: there is a very troublesome backache, a weak, lame feeling in the small of the back, which makes walking very difficult to the patient; the patient suffers from cough and frequent sweating at night. You find persistent discharge of blood from the uterus. The urine is loaded with urates. This latter symptom, this excess of urates, shows great waste of tissue, and is evidence of the exhaustion which Kali carb. causes and cures.

You will recall that I mentioned Kali carb. as a drug which causes great exhaustion in the muscular system, and it is frequently in this kind of exhaustion that the urates are excessive in the urine. Kali carb. acts not only on the voluntary muscles, but on the heart also. The heart becomes weakened when it is indicated, and you thus have a pulse which is irregular or intermittent, or, being rapid, is very weak. Now, this character of the pulse in Kali carb. will qualify every disease in which you may use the drug. It is a characteristic of the drug which lies at the very root of its symptoms; therefore, you will seldom find Kali carb, indicated when there is a full round pulse. This condition of the urine, in which it is loaded with urates as evidence of exhaustion from disease, is also found under other remedies. Perhaps the best remedy in the materia medica for this symptom, other things being equal, is Causticum. Remember that this assertion is to be qualified. A symptom of this character has not the same value as a symptom of the mind would have. It is characteristic in its place, and yet, if symptoms more characteristic of the case indicate another drug, then you should not think of using Causticum. Suppose you have a patient whose other symptoms are those of Kali carb. , for example, a woman after confinement with backache, sweat, and other symptoms of importance, then you may give Kali carb. with confidence. But if you have a patient with no prominent symptoms, and with this excessive deposit of urates in the urine, Causticum will help you out.

Still another remedy for this symptom is Senna, which is one of the best remedies in the materia medica for simple exhaustion with excessive nitrogenous waste.

The particular combination of symptoms that we have under Kali carb., the sweat, the backache and the weakness, are found in no other remedy. It acts as well with the high as the low potencies. You may also remember the Hypophosphite of Lime, which comes near to the Kali carb. in the excessive sweating, weakness and pallor of the skin.

You may also remember, as akin to Kali carb., Psorinum, which, as you have already learned, is eminently useful in convalescence from disease when there is great weakness, profuse sweat and, in addition, a mental state of abject hopelessness. The patient despairs of perfect recovery.

Next, let us look at the action of Kali carb. on the nervous system. Viewed mentally, the patient is excessively peevish and nervous, and is very easily startled. You often find this in women. They are startled by imaginary hallucinations; they imagine that some one is in the room or some figure comes before the mind and tantalizes them. Especially is this anxiety manifested on any noise, as the mere shutting of a door or window, particularly if the noise be unexpected. They are not only startled as many healthy persons would be under similar circumstances, but they are so frightened, that they are driven into a fit of trembling. You will sometimes find the intellect seriously impaired when Kali carb. is indicated. The patient does not seem to care for anything. This indifference is associated with great bodily exhaustion. When questioned, the patient, usually a female, does not seem to know exactly what to say or what she wants. The condition borders somewhat on that of Phosphoric acid, but still the apathy of the two remedies is not exactly the same. Kali carb. has not a sensorial apathy, but it has exhaustion too great to frame the answers to your questions. You will frequently find these symptoms of the mind calling for Kali carb. in puerperal mania and in puerperal fever. Again, we find that spasms may occur as a symptom of the nervous system under Kali carb. The patient does not lose consciousness during the convulsions, hence the remedy is not indicated in true epilepsy; but it may be indicated in puerperal eclampsia, the spasms seeming to pass off with eructations of wind.

The spine suffers severely in the Kali carb. patient. In addition to the backache, already mentioned as the result of anaemia or of abortion, we have spinal irritation, which, by the way, is just as vague a symptom as is any other of a general character, as headache. You must always know what causes this spinal irritation. Does it come from loss of fluids, from brain troubles, from emotional causes, or what ? In the Kali carb. patient you will find it frequently occurring with the uterine symptoms. Thus, you will have pressure in the small of the back as though there were a heavy weight pushing down there. There are also bearing down in the uterine region during the menses, burning along the spine, especially along the right side of the spine. This is not a real congestion. It is merely a subjective sensation caused by irritation of the posterior spinal nerves. The backache is worse while the patient is walking. She feels so exhausted that she must drop into a chair or support herself in some way. Sometimes you find, in the morning, a pulsation in the small of the back, quite akin to the pulsations occurring in other parts of the body. Here the drug is quite analogous to Sepia and the well-known Cimicifuga. This pulsating and drawing backache is particularly relieved when the patient lies down. This suggests a comparison between Kali carb. and Natrum mur. You will recognize at once the resemblance in the spinal symptoms, the spinal irritation, the backache and the relief from lying down. Natrum ??itir. has, particularly, relief by lying flat on the back with firm pressure. Further than this, you will find these two drugs playing into each other's hands in the treatment of amenorrhcea. Hahnemann says that Kali carb. will bring on the menstrual flow when Natrum mur., though indicated, fails. I once cured a singular backache with Kali carb. A very nervous patient came under my treatment for dyspepsia. She said to me: '

' There is something very strange about my case. Every time I eat a meal I suffer for half an hour or more with most intense pain in the back." This was certainly an odd symptom. I did not know where in the materia medica to find it. I hunted, and found under Kali carb. this symptom: pain in the spine while eating. I gave her Kali carb., which cured her completely.

On the mucous membranes, Kali carb. acts, causing quite a series of catarrhal symptoms. We may give it in coryza with hoarseness or loss of voice. The patient catches cold at every little exposure to the fresh air. This is a very strong symptom of Kali carb. The Kali carb. patient has a tendency to obesity, and is rather weak in muscular development. With the catarrhal symptoms of this remedy there often occurs a sensation in the throat as though there were a lump there which must be swallowed. The neck is stiff and the uvula elongated. There are stinging pains in the throat when swallowing just as marked as under Apis.

Sometimes we have a more chronic form of catarrh in the nose ; the nasal passages are obstructed, and the patient can only breathe with the mouth open. This obstruction is relieved in the open air, but returns so soon as the patient enters a warm room. There is either a discharge of foetid green mucus or, in the morning, the nose is swollen and red, and there is a bloody discharge. There is a sticking sensation in the pharynx, as from a fish-bone lodged there, whenever the patient becomes cold. This is a good symptom for Kali card. You will find it in Allen' s Encyclopedia in large type.

Now, in addition to these symptoms, there is almost always accumulation of mucus in the pharynx. The patient "hawks and hems" in the morning. This hawking is found under every alkali, but this one peculiarity, sensation as of a fish-bone in the throat as soon as he " catches cold," with the hawking, is found under no other remedy. Hepar, Nitric acid, Alumen, Carbo veg., and Argentum nitricum all have this sensation as of a splinter or fish-bone in the throat. In coughs, we sometimes find Kali card, of use. The cough is of a paroxysmal character, and is accompanied by gagging and by vomiting of sour phlegm and of food. This suggests the use of Kali carb. in whooping cough, in which disease it has been very successful. Boenninghausen has given us a characteristic symptom for Kali carb., namely, a little sac filled with water between the upper lids and eyebrows. You will often meet with that symptom. I would warn you not to confound it with a similar condition which is in no particular pathological at all, and that is a certain looseness of the tissues in this locality occurring in persons advanced in years.

Now for the action of Kali carb. on the lungs. We find it indicated in bronchitis, pneumonia and phthisis pulmonalis. I will give you the symptoms calling for it in these separate states as we go on. The most characteristic symptom of all, and one which runs through the symptomatology of the drug, is stitching pains which are prominently located in the walls of the chest. They are made worse by any motion, but unlike Bryonia } they come at all times independently of this aggravation. They occur characteristically in the lower third of the right lung, going through the chest to the back. They may occur all over the chest, but that above mentioned is their most frequent site. Then, too, they are erratic and wander all over the body. Here it reminds you of Kali bichromicum, Pulsatilla and Sulphur.

Kali carb. is indicated in infantile pneumonia or capillary bronchitis when the following symptoms are present: intense dyspnoea; although there is a great deal of mucus in the chest, it is raised with difficulty. The child is so oppressed that it can neither sleep nor drink. Breathing is wheezing and whistling in character, and the child has a choking cough. You should here compare Kali carb. carefully with Antimonium tartaricum and thus determine which suits the case best. One cannot be the remedy when the other is indicated.

In phthisis, Kali carb. is indicated when the constitution favors it. The patient has a bloated alkaline look to the face. There are also present these well-defined stitching pains through the chest and over the body, with the puffiness of the upper eyelids. Cough is difficult. The patient cannot get up the sputum. He raises it partly, when it slips backwards into the pharynx. Now, if you examine this expectoration, you will find that it is often bloody, and that there are little globules of pus scattered through it. There is an aggravation of all the symptoms from three to five o'clock in the morning. This hour of aggravation belongs to all the potash salts. There is also a very stubborn sensation, namely, chilliness at noon.

Kali carb. is indicated in cardiac inflammations, in endo- and pericarditis when these sharp stitching pains are characteristic. Do not give it too soon in the case. It is not an early remedy in cardiac disease. It is indicated rather late when there is a deposit on the cardiac valves. In such a case as this Spigelia is apt to precede the exhibition of Kali carb. The latter follows when the sharp pains persist and there is the characteristic 3 A. m. aggravation.

We find these same stitching pains under Kali carb. in lumbago, a very stubborn form of rheumatism. The same symptom applies in cases of impending miscarriage and during labor; sharp stitching pains in the lumbar region shooting down from the buttocks into the thighs. The same kind of pain suggests this remedy in nephritis from cold, or from a blow over the region of the kidneys.

Lastly, in connection with the stitching pains, I want to refer you to its application in puerperal fever of the metritic form, that is, when metritis is a prominent condition. There are sharp, stabbing, cutting pains in the abdomen, the abdomen is bloated and distended, and the urine is dark and scanty, the pulse is rapid but feeble, and you have present the state of mind described in the early part of the lecture. One more symptom and we are done with the drug, and that is its use in dyspepsia. You will find it called for in indigestion, particularly in old persons, in those who have lost a great deal of vital fluids, when there is an empty, weak feeling in the stomach before eating and bloatedness after eating, especially after soup or coffee. There are sour eructations, heart-burn, and uneasy, nervous feeling when hungry.

You see then that Kali carb. is a remedy indicated in a great variety of diseases. It is a drug much neglected in practice, for the same reason that many other remedies are—because the hurried and careless physician falls into routinism.

Despondent. Alternating moods. Very irritable. Full of fear and imaginations. Anxiety felt in stomach. Sensation as if bed were sinking. Never

wants to be left alone. Never quiet or contented. Obstinate and hypersensitive to pain, noise, touch.

Carbonate of Potassium The weakness characteristic of all Potassium Salts is seen especially in this, with soft pulse, coldness, general depression, and very characteristic stitches, which may be felt in any part of the body, or in connection with any affection. All Kali pains are sharp and cutting; nearly all better by motion. Never use any Salts of Potash where there is fever (T. F. Allen). Sensitive to every atmospheric change, and intolerance of cold weather. One of the best remedies following labor. Miscarriage, for consequent debilitated states. Early morning aggravation is very characteristic. Fleshy aged people, with dropsical and paretic tendencies. Sweat, backache, and weakness. Throbbing pains. Tendency to dropsy. Tubercular diathesis. Pains from within out, and of stinging character. "Giving-out" sensation. Fatty degenerations. Stinging pains in muscles and internal parts. Twitching of muscles. Pain in small spot on left side Hypothyroidism. Coxitis.

Worse, after coition; in cold weather; from soup and coffee; in morning about three o'clock; lying on left and painful side. Better, in warm weather, though moist; during day, while moving about.

Vertigo on turning. Headache from riding in cold wind. Headache comes on with yawning. Stitches in temples; aching in occiput, one-sided, with nausea, on riding in carriage. Loose feeling in head. Great dryness of hair; falls out (Fluor ac).

Stitches in eyes. Spots, gauze, and black points before eyes. Lids stick together in morning. Swelling over upper lid, like little bags. Swelling of glabella between brows. Asthenopia. Weak sight from excessive sexual indulgence. On shutting eyes, painful sensation of light penetrating the brain.

Stitches in ears. Itching, cracking, ringing and roaring.

Nose stuffs up in warm room. Thick, fluent, yellow discharge. Post-nasal dropping (Spigel). Sore, scurfy nostrils; bloody nasal mucus. Crusty nasal openings. Nosebleed on washing face in morning. Ulcerated nostrils.

Gums separate from teeth; pus oozes out. Pyorrhea. Aphthæ. Tongue white. Much saliva constantly in mouth. Bad, slimy taste.

Dry, parched, rough. Sticking pain, as from a fish-bone. Swallowing difficult; food goes down œsophagus slowly. Mucous accumulation in the morning.

Flatulence. Desire for sweets. Feeling of lump in pit of stomach. Gagging. Dyspepsia of old people; burning acidity, bloating. Gastric disorders from ice-water. Sour eructations. Nausea; better lying down. Constant feeling as if stomach were full of water. Sour vomiting; throbbing and cutting in stomach. Disgust for food. Anxiety felt in stomach. Epigastrium sensitive externally. Easy choking when eating. Epigastric pain to back.

Stitches in region of liver. Old chronic liver troubles, with soreness. Jaundice and dropsy. Distention and coldness of abdomen. Pain from left hypochondrium through abdomen; must turn on right side before he can rise.

Large, difficult stools, with stitching pain an hour before. Hæmorrhoids, large, swollen, painful. Itching, ulcerated pimples around anus. Large discharge of blood with natural stool. Pain in hæmorrhoids when coughing. Burning in rectum and anus. Easy prolapsus (Graph; Pod). Itching (Ignat).

Obliged to rise several times at night to urinate. Pressure on bladder long before urine comes. Involuntary urination when coughing, sneezing, etc.

Complaints from coition. Deficient sexual instinct. Excessive emissions, followed by weakness.

Menses early, profuse (Calc c) or too late, pale and scanty, with soreness about genitals; pains from back pass down through gluteal muscles, with cutting in abdomen. Pain through left labium, extending through abdomen

to chest. Delayed menses in young girls, with chest symptoms or ascites. Difficult, first menses. Complaints after parturition. Uterine hæmorrhage; constant oozing after copious flow, with violent backache, relieved by sitting and pressure.

Cutting pain in chest; worse lying on right side. Hoarseness and loss of voice. Dry, hard cough about 3 am, with stitching pains and dryness of pharynx. Bronchitis, whole chest is very sensitive. Expectoration scanty and tenacious, but increasing in morning and after eating; aggravated right lower chest and lying on painful side. Hydrothorax. Leaning forward relieves chest symptoms. Expectoration must be swallowed; cheesy taste; copious, offensive, lump. Coldness of chest. Wheezing. Cough with relaxed uvula. Tendency to tuberculosis; constant cold taking; better in warm climate.

Sensation as if heart were suspended. Palpitation and burning in heart region. Weak, rapid pulse; intermits, due to digestive disturbance. Threatened heart failure.

Great exhaustion. Stitches in region of kidneys and right scapula. Small of back feels weak. Stiffness and paralytic feeling in back. Burning in spine (Guaco). Severe backache during pregnancy, and after miscarriage. Hip-disease. Pain in nates and thighs and hip-joint. Lumbago with sudden sharp pains extending up and down back and to thighs.

Backs and legs give out. Uneasiness heaviness, and tearing in limbs and jerking. Tearing pain in limbs with swelling. Limbs sensitive to pressure. White swelling of knee. Tearing in arms from shoulder to wrist. Lacerating in wrist-joint. Paralysis of old people, and dropsical affections. Limbs go to sleep easily. Tips of toes and fingers painful. Soles very sensitive. Itching of great toe, with pain. Pain from hip to knee. Pain in knees.

Burning as from a mustard plaster.

Drowsy after eating. Wakes about two o'clock and cannot sleep again.

Complementary: Carbo; (Lowness of vitality may suggest a preliminary course of Carbo to nurse up recuperation to the point that Kali carb would come in helpfully). Follows Nux often in stomach and bladder troubles. Compare: Kali salicylicum (vomiting, especially of pregnancy; arteriosclerosis, with chronic rheumatism); kali silicum (gouty nodosities); Kali aceticum (diabetes, diarrhœa, dropsy, alkaline urine, very much increased in quantity); Kali citricum (Bright's disease-1 gr to wine-glass of water); Kali ferrocyanatum- Prussian blue––(physical and mental prostration following infection. Inability to sustained routine work. Neuralgic affections depending on impoverished blood

and exhausted nerve centers, especially spinal. Fatty and functional heart troubles. Pulse weak, small, irregular. Uterine symptoms, like Sepia, bearing- down sensation and gastric sinking; profuse, pus-like leucorrhœa and passive hæmorrhage; use 6x); Kali oxalicum (lumbago, convulsions); Kali picro-nitricum and kali pricricum (jaundice, violent eructations); kali tartaricum (paraplegia); Kali telluricum (garlicky odor of breath, salivation, swollen tongue). Also compare: Calc; Ammon phos; Phos; Lycop; Bry; Natrum; Stann; Sepia. Antidotes: Camph; Coffea.

Thirtieth and higher. Sixth trit. Do not repeat too often. Use cautiously in old gouty cases, advanced Bright's and tuberculosis.

Kalium Carbonicum

The Kali carb. patient is a hard patient to study, and the remedy itself is a hard one to study. It is not used as often as it should be, and the reason is that it is a very complex and confusing remedy. It has a great many opposite symptoms, changing symptoms, and thus it is related to patients that withhold their symptoms and have many vague symptoms.

Mind: The patient is whimsical, irascible, irritable to the very highest degree, quarrels with his family and with his bread and butter. He never wants to be alone, is full of fear and imaginations when alone, "fear of the future, fear of death, fear of ghosts."

If compelled to remain alone in the house he is wakeful, sleepless, or his sleep is full of horrible dreams. He is never at peace, is full of imaginations and fear.

"What if the house should burn up!"

"What if I should do this or that!" and "What if this and the other thing should happen! "

He is oversensitive to everything, sensitive to every atmospheric change; he can never get the room at just exactly the right temperature; he is sensitive to every draft of air and to the circulation of air in the room. He cannot have the windows open, even in a distant part of the house. He will get up at night in bed and look around to see where that draft of air comes from. His complaints are worse in wet weather, and in cold weather.

Pains: He is sensitive to the cold and is always shivering. His nerves feel the cold; they are all painful when it is cold. The neuralgias shoot here and there when it is cold, and if the part affected be kept warm, the pain goes to some other place. All his pains change place and go into the cold part; if he covers up one part, the pain goes to the part uncovered.

This remedy is full of sticking, burning, tearing pains, and these fly around from place to place. Of course Kali carb. has pains that remain in one place, but usually the pains fly, around in every direction, Pains cutting like knives. Pains like hot needles, sticking, stinging and burning. These pains are felt in internal parts and dry passages. Burning in the anus and rectum, described as if a hot poker were forced into that passage; burning as with fire. The hemorrhoids burn like coals of fire. The burning of Kali carb. is like that of Arsenicum.

Again from studying the text it will be seen that it is a common feature of this medicine to have its symptoms come on at 2, 3 or 5 o'clock in the morning. In Kali carb. the cough will come or have its greatest < at three or four or five o'clock in the morning.

The febrile state will occur from 3-5 in the morning. The patient, who is subject to asthmatic dyspnoea, will have an attack at 3 o'clock in the morning, waking him out of sleep. He will wake up with various symptoms and remain awake until 5 o'clock in the morning, and after that to a great extent they are relieved. Of course, there are plenty of sufferings at any time in the twenty-four hours, but this is the worst time. He wakes up at 3 o'clock in the morning with fear, fear of death, fear of the future, worries about everything and is kept awake for 2-3 hours and then goes to sleep and sleeps soundly.

His body is cold and requires much clothing to keep it warm, but in spite of the fact that he is cold he sweats copiously; copious, cold sweat upon the body. Sweats upon the slightest exertion, sweats where the pain is, sweat over the forehead; cold sweat on the forehead with headache.

Neuralgia of the scalp and the eyes and the cheek bones in association with the nervous shooting pains. Violent pains here and there in the head, as if the head would be crushed. Cutting and stabbing, in the head. Violent congestive headaches as if the head were full. Head hot on one side and cold on the other; forehead covered with cold sweat.

Head: It has catarrhal congestive headache. Whenever he goes out in the cold air, the nose opens up and the mucous membranes become dry and burn; when he returns into a warm room the nose commences to discharge, and the nose stuffs up so that he cannot breathe through it, and then he feels most comfortable; so that it has stuffing up of the nose in a warm room, and opening up of the nose in the open air. When the nose is open so that he can breathe through it, that is the time the head is most painful; it is painful to the cold air and the cold air makes it burn.

The cold air feels hot. All these patients suffer from a chronic catarrh and when they ride in the wind the catarrhal discharge ceases and then will come on a headache, and thus he has headache from riding in the cold wind.

Whenever the discharge ceases from taking cold in a draft on comes headache, and as the discharge becomes free again the headache is relieved. Neuralgic pains in eyes and scalp and through the cheek bones from a cessation of chronic catarrhal discharge, and when the discharge starts up again, these pain cease. With the chronic catarrh of the nose there is a thick, fluent, yellow discharge; dryness of the nose, alternating with stuffing up. The one who suffers from a chronic catarrh will also have the discharge in the morning, which will fill up the nose with yellow mucus. In the morning he blows out and hawks up dry, hard crusts that fill up the nasal passage, clear over into the pharynx and down into the throat.

These crusts become dry as if they were partly formed upon the mucous membrane and when they are blown out there is bleeding. The bleeding starts from where the crusts are lifted up. He is subject to sore throat, is always taking cold, and it settles in the throat. He is also subject to enlarged tonsils and with these has enlargement and chronic hardness of the parotid glands-one or both. Great knots below the ear, behind the jaw.

These grow and become hard, and at times, painful; shooting, darting pains when he is moving about in the open air. When air strikes these enlarged glands they are sore and painful, and he is ameliorated by going into a warm place.

The acute colds extend into the chest, but Kali carb. has been found most suitable in the chronic catarrh of the chest, chronic bronchitis.

Chest: The chest is very often affected in just the same way as the nose.

There is the dryness and dry barking, hacking cough in cold air, but a copious expectoration of mucus when it becomes warm, and that is the time he is most comfortable, for the expectoration seems to relieve him. He suffers mostly from a dry, hacking cough with morning expectoration. The cough begins with a dry, hacking, increases gradually and sometimes very rapidly to a violent. Spasmodic cough with gagging or vomiting, and when coughing it feels as if his head would fly to pieces.

Face: The face becomes puffed, the eyes seem to protrude and then there is seen that which is commonly present in Kali carb., a peculiar sort of a swelling between the eyelids and eyebrows that fills up when coughing.

Your attention is called to that peculiar feature, for although there may be bloating nowhere else upon the face that little bagging will appear above the lid and below the eye brow. It fills up sometimes to the extent of a little water bag. Such a swelling has been produced by Kali carb., and sometimes that symptom alone guides to the examination of the remedy for the purpose of ascertaining if Kali carb. does not fit all the rest of the case.

Boenninghausen speaks of an epidemic of whooping cough in which the majority of cases called for Kali carb., and this striking feature was present. No remedy should ever be given on one symptom. If you are led to a remedy by a peculiar symptom, study the remedy and the disease thoroughly to ascertain if the two are similar enough to each other to expect a cure. Any deviation from that rule is ruinous and will lead to the practice of giving medicines on single symptoms.

Dry, hacking incessant, gagging cough with whooping, blowing of blood from the nose, vomiting of everything in the stomach, and expectoration of blood-streaked mucus, is a whooping cough that will be commonly cured by Kali carb., but especially if there is present that peculiar and striking feature of a bag-like swelling below the eyebrow and above the lids, puffiness of the eyes.

There are some cases of pneumonia that need Kali carb, in the stage of hepatization (like Sulph.). Again, when pneumonia has passed away think of Kali carb. if every time the patient takes a little cold it settles in the chest with these symptoms that I have described.

There is sensitiveness of the body to weather changes, to cold air and to wet, a continuous dry, hacking cough, with gagging, the aggravation from three to five the morning, and the patient, has flying neuralgic pains. These symptoms gradually increase and the patient dates them back to his pneumonia. He says:

"Doctor, I have never been quite well since I had pneumonia."

The catarrhal state has settled in his chest and there is a chronic tendency to take cold. These cases are threatening to go into phthisis and will hardly be likely to recover without Kali carb. In this tendency for catarrhal states to locate in the chest, Kali carb. should be thought of as well as Phosphor., Lycopod. and Sulphur.

Dropsies: Another general state that belongs to this remedy is a tendency to dropsies. It has dropsies all over the body. The feet bloat and the fingers puff; the back of the hands pit upon pressure, the face looks puffy and waxy. The heart is weak. I can look back upon quite a number of cases of fatty degeneration of the heart in which I could have prevented all the trouble with Kali carb. if I had known the case better in the beginning.

These cases are insidious, and the indications calling for Kali carb. must be seen early or the patient will advance into an incurable condition. That peculiar state of weakness and feeble circulation that finally ends in dropsy and many other complications has its likeness in Kali carb. There is an insidiousness about Kali carb. in the approach of all of its complaints.

He has a sort of nondescript appearance, he is withered, has much dyspnoea upon going up hill or even walking on the level. Examination of the lungs shows them to be in very fair condition, but finally complications come on, there is a break down and organic changes and you look back over these cases and say, if I had only seen in the beginning of this case what I see now it seems as if the patient ought to have been cured.

We learn the beginnings of remedies as we learn the beginnings of sickness. It is a prudent thing for a homoeopathic physician to glance back over a case that he has failed on, or someone else has failed on, to study its beginnings and see what the manifestations were. This kind of study to the homoeopathic physician is as delightful as post mortems are to the old school.

Teeth: The teeth present a peculiar state. The gums take on a scorbutic or scrofulous character. The gums separate from the teeth and the teeth decay and become discolored and loose, so that they have to be extracted early in life. He suffers from pain in the teeth whenever he takes cold from riding in the wind and raw weather. The pains come on even when the teeth are not yellow or decayed: stitching, tearing, rending pains in the teeth. Offensive smell from the teeth; pus oozing out from around the teeth. The mouth is full of little ulcers, little aphthous patches. The mucous membrane is pale and ulcerates daily. The tongue is white with offensive taste; coated gray, with sick headaches.

While many of the symptoms of Kali carb, are aggravated after eating, some symptoms are relieved after eating. There is throbbing in the pit of the stomach when the stomach is empty. There is also throbbing all over the body, pulsation to the fingers and toes; there is no part that does not pulsate, and he is kept awake by this pulsation. Pulsation even when there is often no feeling of palpitation in the region of the heart. It has also violent palpitation of the heart.

Stomach: Kali carb. fits many old dyspeptics. After eating be feels as if he would burst, so bloated is he. Great flatulence; belches wind upwards and passes flatus downwards; offensive flatus. The belching up is also attended with fluid eructations, sour fluids that set the teeth on edge; they excoriate, or cause smarting in the pharynx or mouth. Pain in the stomach after eating; burning in the stomach after eating. Gone feeling in the stomach, that is not even relieved by eating. A peculiar condition in Kali carb. is a state of anxiety felt in the stomach, as though it were a fear. One of the first patients I ever had expressed it in a better way than it is expressed in the books; she said, "Doctor, somehow or other I don't have a fear like other people do, because I have it in my stomach."

She said when she was frightened, it always struck to her stomach.

"If a door slams, I feel it right here" (epigastric region).

Well, that is striking, that is peculiar. It was not long before I developed another feature of Kali carb.

By a little awkwardness on my part my knee happened to hit the patient's foot as it projected a little over the edge of the bed, and the patient said, "Oh"

Sure enough that was Kali carb. again, for you will find in Kali carb. a patient that is afraid and everything goes to the stomach and when touched upon the skin there is an anxiety or fear or apprehension felt in the region of the stomach.

You might imagine that it is connected with the solar plexus, but the symptom is the all in all to the physician.

Feet: A Kali carb. patient is so sensitive in the soles of the feet that the mere touch of the sheet brings a sensation of thrill throughout the body. Hard pressure is all right, it does not disturb, but something that comes unawares excites. The Kali carb. patient is over sensitive to all the surrounding things, over sensitive to touch; shivering from the simplest and lightest touch, even when hard pressure is agreeable. Violently ticklish in the soles of the feet. I have often examined the feet when a patient would shiver and draw up the feet and scream out, "Don't tickle my feet."

I had probably touched it so lightly that I did not know that I had touched it at all.

In Lach. also gentle touch is painful, while hard pressure is agreeable but here it is not so much the ticklishness. In Lach. the abdomen is so sensitive that the touch of the sheet is painful. I have seen Lach. patients using a hoop to keep a light sheet from touching the abdomen. You may know then that you are in the realm of Lachesis, and that it is like those persons who are unable to bear the slightest touch upon the neck and suffer from uneasiness on wearing a collar. All that, however, is different from this state of ticklishness. I have seen patients who are really so sensitive in the skin that I would not dare touch it, unless they knew just where I was going to touch.

"Now I am going to feel your pulse, hold still." If I were to touch the hand, or reach out to feel the pulse without warning there would be a thrill. Such a state is in keeping with Kali carb. These things often have to be dug out by observation in studying the nature of provings, and associating things. These things that run into the oversensitiveness of patients are of great value clinically. The capabilities of our Materia Medica are something wonderful, but they could be developed much more rapidly if a number of homoeopathic physicians would make application of the Materia Medica with accuracy and intelligence, observing what they see and relating it literally.

At the present day there is only a very small number of homoeopathic physicians that can come together in a body and say things that are worth listening to, a shamefully small number when we consider the length of time Hahnemann's books have been before the world.

Liver: There are many old chronic liver subjects who talk about nothing else but the liver. Every time they go to the doctor's office they talk about the liver, and about a condition of fullness in the region of the liver and pain through the right shoulder blade and up through the right side of the chest, with a good deal of oppression and distension; vomiting of bile and a good deal of stomach disorder, fullness after eating; attacks of diarrhoea, alternating with constipation lasting for many days with great straining at stool.

Periodical bilious attacks, when a constipated state is present; cannot lie down at night; difficult breathing at night or at 3 o'clock in the morning, especially when it is in a patient oversensitive to cold, damp weather, one who wants to sit by the fire all the time.

These liver subjects are often thoroughly cured by Kali carb. Sometimes they have been resorting to all sorts of liver tappings, taking such medicines as purge or cause vomiting, drugs that really aggravate the trouble. Kali carb. goes to the bottom of these cases, and roots out the evil.

Abdomen: In the abdomen we have many Kali carb. symptoms.

Persons subjected to repeated attacks of colic, cutting pains, with distension, with pain after eating, constipation or diarrhoea. Colic, with cutting, tearing pains, doubling him up, coming on every little while. Tremendous flatulence. When the attack of colic is on it might remind you of Colocynth or of some other of the acute remedies that cure colic in two or three minutes, but you will find that these acute remedies that relieve colic so speedily when given the second or third time do not produce so marked an effect. You will find it necessary to hunt for an antipsoric, a remedy that will control the whole case. In the study of the colic alone during its attack you only get a one-sided view of the case, and after the colic is over (say he has been cured by Colocynth) you now study the patient and go over the case, and behold all the symptoms are covered by Kali carb. After giving that remedy you may expect that the patient will not have another attack.

Such is the nature of Kali carb. It is deep-acting, long-acting, goes deep into the life. It cures conditions due to psora, or to the suppression of eruptions in childhood, or to the closing up of old ulcers and fistulous openings with a history of troubles ever since. All these wandering pains and the chilliness are again relieved by eruptions, by the outbreak of discharges, by haemorrhages, by ulcers that eat in deep and flow freely and fistulous openings.

"Cutting in abdomen, as if torn to pieces." "Violent cutting, must sit bent over pressing with both hands, or lean far back for relief; cannot sit upright."

"Cutting and drawing like false labor pains." There is great coldness with the pains, with the cutting in the abdomen; he wants heat, hot drinks, hot water bags. A chronic coldness is felt in the abdomen, cold externally and internally. It would sometimes be cruel to give a dose of Kali carb. when the colic is on, because if the remedy fitted the case constitutionally, if all the symptoms of the case were those of Kali carb., you would be likely to get an aggravation that would be unnecessary.

There are plenty of short acting remedies that would relieve the pain speedily, and at the close of the attack the constitutional remedy could then be given. If the patient can bear the pain to the end, it is better to wait until it passes off without any medicine.

That sometimes is cruel, and then the short acting medicines should be given. All recurrent troubles, those that come periodically, or after eating certain articles, or from exposure, or with a periodicity that belongs to time - all these states are chronic; they are not acute troubles. They are simply a small portion of a chronic miasm, a side view and all such cases must have a constitutional remedy sooner or later. You can, it is true, relieve violent pain at the first visit, but then you must look deeper and prevent your patient having more trouble.

Otherwise, if you should give Bell. or Colocynth or any medicine that simply fits the colic, the trouble will come back again; you have not cured your patient; you have only palliated. But, on the other hand, you take such a colic as is described here and Kali carb. fits just these symptoms alone and does not fit the whole constitution of the patient.

Then it is that a constitutional and long-acting remedy like Kali carb. acts in fullness. It does not take the usual long time to act and is not attended with an aggravation.

"Abdominal muscles painful to touch; swelling of glands."

In the abdomen, also following troubles in the bowels, or following peritonitis, we have effusion into the peritoneal sac, which is usually associated with dropsy of the extremities, but not always. In liver dropsies especially is that remedy useful.

Rectum: It has a great many complaints of the rectum and anus and of the stool.

It has most persistent and enormous hemorrhoidal tumors that burn, that are extremely sensitive to touch, that bleed copiously, that are extremely painful, making it impossible for him to sleep. He is compelled to lie upon the back and hold the nates apart, because the pressure is very painful to the external piles. The piles cannot be put back; there is great distension and swelling inside. Haemorrhoids that come out after stool and bleed copiously and are very painful; they must be pushed back, and long after going to bed they burn like fire. There is great aggravation from stool, which is hard and knotty and requires great straining to expel. Fistulae of the anus. Burning temporarily relieved by sitting in cold water.

It has chronic diarrhoea and also diarrhea alternating with constipation. Many times where there are numerous particulars, we have to rely upon the generals that are characteristic of the remedy. The text gives much less of diarrhea than has been developed by clinical uses. "Diarrhoea painless, with rumbling in the abdomen and burning at stool, only by day; chronic cases with puffiness under the eyebrows."

It gives few symptoms, but it is a large and extensive remedy in diarrheas that are chronic. In old, broken down subjects, in weakly, pallid subjects, with poor digestion, with great flatulence, with much distension, with disordered liver.

Kidneys, Bladder: Then the kidney, bladder and urethra come in for their share of trouble, which is of a catarrhal nature.

Discharges from the bladder, purulent discharges of a thick, tenacious, copious mucus deposited in the urine. In keeping with this there is much burning; burning in the urethra, during and after micturition.

"Urine flows slowly with soreness and burning." Kali carb. runs very close to Natr. mur. in many of its old, long-standing bladder troubles, In old cases of gleet and long-standing cases of urinary troubles that follow gonorrhea these two medicines are useful, both suitable in the scanty, white, gleety discharge that remains. In both the urination is painful.

In Nat. mur. the burning is after urination. Where there is scanty, gleety discharge and the burning is very marked and only after urination, and the patient is extremely nervous and fidgety, Natrum mur. will cure.

If the burning is during and after urination and you have the broken down constitution we have described then the remedy may be Kali carb. Some of these old cases are entirely painless, having no pain either during or after micturition. Then you get an entirely different class of remedies. The old chronic discharges following a gonorrhoea are as troublesome for the young doctor as anything that will ever fall into his hands. The remedies are numerous, the symptoms are scanty, and many times the patient has not been long under the doctor's care, therefore he does not know the patient's constitutional state well and the patient can only tell him of the discharge.

"Nothing but the discharge, doctor."

You cannot get his mind on his symptoms; he has forgotten that he wakes at 3 o'clock in the morning and cannot get to sleep until 5 o'clock, he has forgotten all the nervous manifestations. With the patient you have had under control, whose constitutional state you get before this condition comes, you ought not to have much difficulty.

One of the evidences that the Kali carb. patient is of a weakly constitution and is on the road to a break-down is that all of his symptoms are aroused and brought into action after coition, after sexual excitement. Now you will take notice in practice and remember it, that coition is a natural thing with man, when it is carried on in order, and when that which is natural is followed by prostration, and this has been so for a long time, there is a break in the constitution, there is something radically wrong.

Genitals: All the symptoms are likely to be worse after coition in Kali carb. He has weak vision, weakness of the senses, tremulousness, and is generally nervous; he is sleepless, and weak, and he shivers and trembles for a day or two after coition.

Similar symptoms are observed in the woman. In spite of the fact that the patient is weak, the sexual desire is excessive. It is not orderly. There is a sexual erethism, which is not under the command of the will, and in the male he is subject to copious and frequent pollutions, nightly dreams, sexual prostration. Young men who have abused themselves, or who have indulged excessively in sexual pleasure, go into marriage with weakened genitals, incapacitated; and then there comes a disgust, and it is not strange that there are so many divorces in the world. When the patient is young, some of this trouble can be overcome by living an orderly life and correct Homeopathy.

In Kali carb. there are many complaints affecting the male genital organs; uneasiness and sensitiveness of the testicles. One is in a state of swelling and hardness. Itching and smarting and annoying sensations in the scrotum and sensations that constantly remind the patient that he has genital organs. Constant irritation calling his attention to the genitals, brought on from abuse, from vice, from excesses.

Phosphorus is a medicine that is abused in this sphere. Many physicians look upon it as one of the great remedies for the weakness of the genital organs.

In Phos. the genital indications are extreme excitement, too active erections, a disorderly strength of the genital organs. Beware of giving it in impotency or in weakness, as this is often associated with very feeble constitutions, and Phos. not only fails to cure, but seems to add to the weakness. It is a weakness that you will learn is a vital weakness. Phos. will set patients to running down more rapidly who are suffering from a vital weakness, who are always tired, simply weak, always prostrated and want to go to bed.

The female has a great friend in Kali carb. It is full of her complaints and has many symptoms likely to be found in a sick woman. It is useful in cases of uterine hemorrhages that have been incessant in pale, waxy, hemorrhagic women; incessant haemorrhage following an abortion. She has been curetted and has had all sorts of treatment, but still that oozing keeps right on. At the menstrual period the flow is very copious and clotted, and then after prolonged menstruation of ten days or so, during which she has had a copious flow, she settles back into a state of oozing and flowing until next month and then it rouses, up into another ten days of copious menstruation. Kali carb. has cured a number of cases of fibroid tumor long before it was time for the critical period to cure.

You must remember that there is natural tendency for a fibroid to cease to grow at the climacteric period, and afterwards to shrivel and that this takes place without any treatment, but the appropriate remedies will cause that haemorrhage to cease, will cause that tumor to cease to grow and after a few days there will be a grand shrinkage, in its size.

Pregnancy: Kali carb. is often a remedy for vomiting in pregnancy, but find out when it is the remedy for vomiting of pregnancy we ha to go to the whole constitutional state.

Vomiting of pregnancy is not cured, although it may be temporarily relieved, by Ipeca, as this is a medicine that corresponds merely to the nausea its. In a large number of instances gagging and nausea are only a second or third grade symptom in the remedy that will cure. The condition really depends upon the constitutional state, and the remedy th is to cure must be a constitutional remedy. Sulphur, Sepia and Kali carb. are among the remedies commonly indicated.

Sometimes Arsen is needed. Of course, if a pregnant woman has simply disordered her stomach and has vomited bile a few times the remedy might be Ipeca. When a pregnant woman has no constitutional symptom at all, and upon examining the case you find nothing but the nausea, overwhelming deathly nausea, with continuous vomiting day an night, a single dose of Symphoricarpus rac. will help.

That is prescribing upon very limited information, and should only be done in circumscribed or onesided cases. It is not a long acting remedy, it is not a constitutional remedy and acts very much like Ipecac.

At times you will go into the confinement room when the woman has pains in the back below the waist line. The pains in the uterus are very weak, they are not sufficiently expulsive to make progress in the labor, the kind of pain that makes the woman utter the cry, "My back, my back!"

The pains extend down the buttocks and legs. Pain in the back as if the back would break. Under good prescribing these pains are changed into contractions, which prove sufficient to expel the contents of the uterus.

When you hear such things you will look back over the history of the case. You will look back for weeks as th woman has been drawing near the end of gestation and see that the vague things, the chilliness and other features in her constitutional state for which you have been trying to find a remedy now culminate at the time of her confinement into a class of pain. Had you seen that six weeks before and given her Kali carb. you would have prevented the severe labor.

It is a severe labor, a prolonged labor; the uterus appears to be weak, and the pains are feeble they are all in the back, and do not go to the centre of operation as they should. Now, this same kind of a pain may deceive you in taking another form. The pains begin in the back, and appear to go to the uterus and then run up the back, which would turn you aside entirely from the Kali carb. pain into a pain that would indicate Gelsemium.

Sometimes these pains are so severe that they actually seem to prevent rather than encourage the contractions of the uterus; when the contractions of the uterus cease, and the woman screams out and wants her hips rubbed, and screams out with pain in each side of the abdomen rather than in the centre, pains in the region where the broad ligaments ought to be, Actea racemosa will make the pains regular. Puls. is the medicine for absence of marked contraction, in cases inclined to do nothing; in a case that is inactive when the os is sufficiently dilated and the parts relaxed, and the prediction is an easy and simple labor, but the patient does not do anything. It is a state of mildness or inactivity. Puls. will very often cause in five minutes a very strong contraction of the uterus, sometimes almost, in a painless way.

"The back aches so badly while she is walking that she feels as if she could lie down on the street," etc..

The pain seems to take the force and vigor all out of the patient. After delivery there is a tendency to prolong the flooding, rousing up at every menstrual period, as described.

Heart: Weakness of the heart, cardiac dyspnea; the breath is short and the patient cannot walk or must move very slowly.

It is the coming on of a fatty heart.

With the suffocation and dyspnoea the breathing is so short that the patient cannot stop to take a drink or eat; the breathing is rapid, not deep, but weak. Dyspnea with violent, irregular palpitation of the heart, throbbing that shakes the whole frame, pulsation that can be felt to the ends of the fingers and toes.

Violent pulsations; patient cannot lie on the left side; accompanied by stitching pain through the chest, and cough. In old asthmatic patients with weak pulse, with the same pulsations and palpitation and cannot lie down.

The only position it seems that be can find any comfort in is leaning forward, with his elbows resting upon a chair. The attack is violent and continuous, especially worse from 3 to 5 A.M., and worse from lying in bed. He is aroused at 3 o'clock in the morning with these asthmatic attacks. Asthmatic dyspnea, when the state is that of humid asthma or filling up of the chest with mucus, course rattling in the chest, loud rattling breathing.

In patients who always have rattling in the chest, rattling cough, stuffy breathing; with every rainy spell or misty spell, or in cold, foggy weather, the condition becomes that of a humid asthma; asthmatic breathing, with much weakness in the chest, worse from 3 to 5 in the morning. The patient is pale, sickly and anemic, and complains of stitching pains in the chest.

The cough: of this medicine is one of the most violent coughs of all the medicines in the Materia Medica. The whole frame is racked. The cough is incessant, attended with gagging and vomiting, comes on at 3 o'clock in the morning, a dry, hacking, hard, racking cough.

"Suffocative cough and choking cough at 5 A.M. Great dryness in the throat between 2 and 3 A.M."

Think of Kali carb. when, after troubles like measles, a catarrhal state is left behind, due to lack of reaction, the psoric sequelae. The cough following measles is very often a Kali carb. cough. Kali carb. Sulphur, Carbo veg. and Drosera are perhaps more frequently indicated than other medicines in such coughs as follow measles of pneumonia.

The expectoration is copious, very offensive, tenacious, lumpy, blood-streaked or like pus, thick yellow or yellowish-green. Very often it has a pungent, cheesy taste, strong taste, as of old cheese. Catarrh of the chest. Dry cough day and night, with vomiting of food and some phlegm, worse after eating and drinking and in the evening.

Pains: Nothing is more striking in Kali carb. than the wandering stitching, pains through the chest, and the coldness of the chest.

The great dyspnoea, the transient stitches, the pleural stitches are important features of this remedy. A great number of the cases in which Kali carb. is suitable are those where the trouble has spread from catarrhal origin and from the lower portion of the lungs upwards. It is not so commonly indicated in those cases where the dullness has begun at the apex of either or both lungs.

It will very often ward off future sickness where the family history is tuberculous. Do not be afraid to give the antipsoric remedies when there is a history of tuberculosis in the family, but be careful when the patient is so far advanced with tuberculosis that there are cavities in the lung, or latent tubercles, or encysted caseous tubercles. Your antipsorics might rouse him into a dangerous condition. Do not suppose, however, that it is dangerous to give Sulphur because one's father and mother have died of phthisis. Sulphur might be just the remedy to prevent the child from following the father and mother. Kali carb. is often suitable, and will act as ail acute remedy in the advanced stages of phthisis in cases in which it was not indicated primarily as a constitutional remedy. In such instances it will act as a palliative in phthisis, whereas if it were indicated primarily as a constitutional remedy it would do damage in the last weeks.

The fortunate thing is that a great many homeopaths are not able to find the homoeopathic remedy. If the patient has yet lung space enough to be cured, Kali carb. will do wonders where the symptoms agree.

Gout: I want to warn you in one respect concerning Kali carb. It is a very dangerous medicine in gout. When you get an old gouty subject who has big toe joints and finger joints, and they are sore and inflamed every now and then, you might think that Kali carb. covers the case very suitably; he is disturbed in just such weather, he is pallid and sickly, his complaints come on at 2 to 3 o'clock in the morning, he has the shooting pains.

But these gouty patients are often incurable, and, if so, to undertake to cure them, would be a dreadful calamity, because the aggravations would last so long. If you give Kali carb. to one of these incurable patients in very high potency it will make your patient worse, and the aggravation will be serious and prolonged, but the 30 th may be of great service. Kali iod., when it is indicated in the gouty state, acts as a soothing and palliative remedy.

But Kali carb. seems to be a dreadful medicine to handle, it is a sharp and a two-edged sword. Do not undertake to give medicine with a view to curing these old cases of gout when the nodosities are numerous. Do not give that constitutional medicine that should have been administered to these patients twenty years ago, because there is not reaction enough in the life of the patient to turn him into order, and he will be destroyed. It seems paradoxical to say it, but to cure him is to kill him.

The vital action that is necessary to restore him to health would practically tear his framework to pieces. You need not believe these things, you are not obliged to. But think about them, and some day after practicing awhile and making numerous mistakes in attempting to cure incurables you will admit the awful power of homeopathic medicines.

They are simply dreadful. In old gouty cases, in old cases of Bright's disease, in advanced cases of phthisis where there are many tubercles, beware of Kali carb. given too high.

While studying the text book, look over the sensations. They are very numerous. Of course, those most striking are the stitching, and tearing pains, shooting, sticking and wandering pains.