Selenium metallicum

Easily debilitated; by heat of sun; a little mental or physical exertion makes him sleepy. Senility. Emaciation; of single parts, face, hands, etc. Cramp, then stiffness. Bitings. .................... Loquacity. Sadness. Frets when awake and dreams of it as he falls asleep. Nervous headaches. Scalp feels gathered together. Falling hair, < eyebrows; don't want hair touched. Ache over l. eye; < tea. Coryza, ending in diarrhœa. Thirstless. Craves stimulants, tea, etc. Sharp stitches in or rash over liver. Abdominal pulsation; hinders sleep. Very large stools. Coarse sand in urine. Lascivious, but impotent. Urine and semen dribble. Easy loss of semen; at stool, etc. Watery semen. Chronic gleet. VOICE HOARSE, as soon as he sings; affected by every cold; rattles. Nodes in vocal cords. Hawks up clear mucus. Sudden sciatic pains (l), leave soreness behind. Oily skin; itches in folds or about ankles. Skin remains moist after scratching. Burning spots. Acne. Imagines drafts of air. Sweat, profuse, yellow; leaves a salty deposit, stiffens the linen or makes the hair stiff and wiry; < genitals.

Debilitating causes: Hot days. Sexual excesses. Loss of sleep. Singing. Drafts. After sleep. Tea. Lemonade.

After sunset. Inhaling cool air.

Nerves: GENITO-URINARY ORGANS. Supra-orbital (L). LARYNX. Liver.

Related: Nat-m. Sul.

Selenium

Selenium. The Element.

Adapted to light complexion; blondes; great emaciation of face, hands, legs and feet, of single parts.

Very forgetful in business, but during sleep dreams of what he had forgotten.

Headache: of drunkards; after debauchery; after lemonade, tea, wine; every afternoon.

Hair falls off, on head, eyebrows, whiskers, genitals.

Coryza ending in diarrhoea.

Hungry: at night (Cina, Psor.) ; longing for spirituous liquors, an almost irresistible maniacal desire.

Constipation : stool large, hard, impacted so that it requires mechanical aid (Aloe, Cal., Sanic., Sep., Sil.) ; after serious illness, especially enteric fevers.

Urine : red, dark, scanty ; coarse, red, sandy, sediment; involuntary dribbling while walking.

Impotence, with desire; lewd thoughts, but physically impotent (sudden impotence, Chlor.).

Erections slow, insufficient, too rapid emission with long-continued thrill; weak, ill-humored after coitus, often involuntary dribbling of semen and prostatic fluid which oozes while sitting, at stool, during sleep; gleet (Calad.).

Priapism, glans drawn up (Berb. — drawn down, Canth. ) .

Aphonia: after long use of voice; husky when beginning to sing; obliged to clear the throat frequently of a transparent starchy mucus (Arg. m., Stan.) ; tubercular laryngitis.

Weak, easily exhausted ; from either mental or physical labor ; after typhoid, typhus, debauchery.

Irresistible desire to lie down and sleep; strength suddenly leaves him; especially in hot weather.

Very great aversion to a draft of air either warm, cold, or damp.

After typhoid great weakness of spine, fears paralysis.

Emaciation of affected parts respiratory symptoms ; Arg. m. and Stan, in laryngitis of singers or speakers ; Alum, hard stool, inactive rectum.

t'ollows well: after, Calad., Nat., Staph., Phos. ac., in sexual weakness.

Itch checked by Mercurials or Sulphur often requires Selenium.

Aggravation. — Draught of air; in the sun; from lemonade, tea or wine.

Amelioration.^ — Taking cold water or cold air into the mouth.

Lecture XLIV — Mineral Kingdom — Selenium

I propose now to begin the study of the drugs obtained from the mineral kingdom. I have placed on the board {see next page) for your study the elements, arranged in order according to some of their relations, just as we find them in chemistry. I wish to explain here the general idea of the relation of drugs, and especially of those belonging to the mineral kingdom. If you consult chemistry you will find that the elements hold to each other an electrical relation. They hold to each other a relation of polarity as positive electric and negative electric. Certain of these elements are emphatically negative, and others are just as positively positive. Some of the elements, as gold, silver, etc., hold a middle relation, being rather neutral. These I have placed at the neutral point of the magnet. The advantage of this method of study will be seen as we proceed. The negative electrics are known to be conductors of light, the positive conductors of heat. The extreme effects in this respect are noticed at either pole, diminishing as we approach the curve of the magnet. Another fact which is well worth knowing is this general statement: the electronegatives act on the bowels in the morning, and the chest in the afternoon: that is, they act upward on the body during the day. Exactly the opposite holds true with the electro-positive. These act on the chest in the morning, and on the bowels in the latter part of the day. Most of you are acquainted with the morning diarrhoea of Sulphur, which hurries the patient out of bed. You know how the asthma of that remedy increases in the afternoon. Taking the remedies at the other extreme, we have the Kali salts as examples; you know that they have aggravation of their chest symptoms in the forenoon, and of their bowel symptoms in the afternoon. This is, of course, a very general statement, but it may be of great use to you in enabling you to differentiate between drugs. Let me illustrate. You have a case of scrofula and you are obliged to decide between Sulphur and some salt of lime. You will be astonished to see how similar are many of the symptoms of these two drugs. The very fact of the diarrhoea Elect?'o- Electro+.

Oxygen.

Ozone.

Nitric ac.

Amyl nitr.

Sulphur.

Selenium.

Sulph. ac.

Carboneum sulph.

Fluoric ac.

Iodine.

Spongia.

Bromine.

Chlorine.

Muriatic ac.

Cyanogen.

Carbo veg.

Carbo an.

Graphites.

Petroleum.

Cosmoline.

Silicea.

Phosphorus.

Phosphoric ac.

Arsenicum alb.

Arsenicum iod.

Tellurium.

Antimon. crud.

Antimon. tart.

Aurum.

Argenturn.

Mercury.

Thallium.

Cuprum.

Antozone.

Hydrogen.

Ammonium.

Kalium.

Natrum.

Lithium.

Calcarea.

Baryta carb.

Strontia carb.

Zincum.

Magnesium.

Cadmium.

Alumina.

Plumbum.

Stannum.

Ferrum.

Manganum.

Niccolum.

Kobaltum.

coming in the morning or afternoon, insignificant as it may appear under other circumstances, serves as a differentiation between these two drugs. Now in making this statement I do not mean that because Sulphur produces a morning diarrhoea, that it must always be the remedy when that symptom is presented; but I do mean that when you are compelled to decide between two remedies having opposite directions in action, this relation becomes of great importance. As you approach the remedies or chemicals at the neutral point of the magnet, you find these effects less marked, until, finally, they are unnoticeable.

There is another fact which we may learn from this arrangement of drugs. You notice that here we have oxygen and sulphur. They are chemical elements, which are placed near together in chemistry, and are similar not only as chemicals but also as medicines. Next on the list we have nitrogen, which is used in medicine in the form of Nitric acid. Below this we have a list of remedies which constitute a group in chemistry known as the halogens; they consist of Fluorine, Fluojic add, Iodine, Bromine, and Spongia. The latter drug is placed here not as a chemical substance, but as a drug which owes its medicinal properties to the iodine and bromine which it contains. It is of practical value to remember these drugs in this connection, because they are not only chemically similar, but they are also similar as medicines. Moreover, this grouping of remedies enables you to keep in mind a group of remedies from which you may choose one to suit your case. I have introduced cyanogen here because it holds important chemical and medicinal relations to the halogens. Below we have the carbon group, Carbo veg., Carbo animalis, Anthrakokali , the diamond, and Graphites. I have also placed in this group Petroleum and Cosmoline or petroleum jelly, two oily substances, rich in carbon, and having many resemblances to the pure carbons.

In a future lecture I shall give you the characteristics which belong to all the carbons, so that you can say here is a patient who needs some preparation of carbon, which shall it be? This you determine in the same way as you selected one of the halogens. Next we have a group composed of Phosphorus and its acid and Arsenicum. Below, we have Tellurium, Antimonium crudum and Antimoniu7n tariaricum, which is similar enough to the sulphide to be placed along side of it. This group of drugs possesses many similarities. Phosphorus and Arsenic are continually placed in contrast in the physician's mind, and it is often difficult for him to decide which he shall give. The Antimony preparations are similar in form and isomorphous with Sulphur and Selenium. There is another fact which we may borrow from chemistry, and that is that substances of similar crystalline structure have similar medicinal effects. These substances often replace each other in chemistry. I give you these facts so that you may have a rational conception of drugs, not as mere individuals, but as consistent with nature and with themselves. Here below we have the noble metals, gold and silver. Then we may go up on this side tracing the drugs through the same relation we did on the other. Every one knows how closely related, chemically and medicinally, are Barium and Strontium. This relation is very much like that of similarity in origin. They are not apt to follow one another well. Here are Sulphur and Sulphiiric acid; suppose you are going to decide between them and suppose it to be a perplexing case. You say '

' I will give Sulphur, and if he is not better to-morrow I will give Sulphuric acid.''' That is bad practice. It would be much better to say that I will give Sulphur to-day and Calcarea to-morrow. Why ? They are similar drugs, but entirely foreign in their family relations and origin. Why do I dwell on these two relations ? Because I want you to distinguish between that which is the same and that which is similar. Ignatia and Nux vomica are too much as though they were the same thing. Ignatia and Zinc are concordant remedies which are similar but which are not identical. You note that I have placed hydrogen above all the potash salts. You notice that here is placed antozone. Ozone is negative oxygen, and antozone is positive oxygen. Ozone exists in the sea-air and how many times do you send your patients to the sea-shore for relief. We may derive a hygienic fact from this statement; if I have a patient who is something of a Sulphur patient, I would think that sea-air would do him good because sea-air is rich in ozone, and ozone in a general way suits his condition. On the other hand, if he belongs more to the " salt" class of drugs I would not send him to the sea-shore. I would send him where antozone exists, as in fogs. We will now proceed to study the drugs derived from the mineral kingdom. The remainder of the hour I will devote to the consideration of Selenium. To-morrow we will study the king of remedies, Sulphur.

Selenium.

f Arum tri. < Cinch.

Selenium. \ Caust., Carbo v., Phos., Spong. ^J^'

! Sulphur. <F g* s Selenium is isomorphous with Sulphur and resembles it both chemically and medicinally. We find it producing very little effect on the blood and lymphatic vessels, but it acts on the nervous system. We often find it the remedy in nervous diseases. It seems to produce a weakness or general debility involving all parts of the body. This debility is expressed by easy fatigue from any exertion or labor. If the patient sits up a little too late at night, or exerts his mind a little too much, he is exhausted the whole of the next day and is thereby unfitted for either mental or physical work. Particularly is he weakened from hot weather. It is evident that the hot weather weakens him. This is further shown by the fact that he becomes stronger as the sun sinks and the temperature with it. He is sluggish on account of this debility. He wants to sleep from sheer exhaustion, and yet he is always worse after sleep. He cannot bear any nervous exhaustion, consequently he is made worse by seminal emissions, whether voluntary or involuntary. As a result of the seminal loss, the next day he is irritable, suffers from mental confusion, headache, almost paralytic weakness of the spine, involuntary escape of prostatic fluid, dribbling of semen during sleep, and after stool and urination. Now you will notice at once the resemblance of the drug to Sulphur. Both have bad effects of mental exhaustion and loss of sleep, and both have involuntary emissions and prostatorrhoea. The distinction lies in the fact that Selenium has more of the relaxation. Here you find two substances suitable in similar conditions, and yet the shade of difference is sufficient to enable you to know which one is the more useful for your case. Both have impotence. With Sulphur there is more coldness and shrivelling of the genital organs. With Selenium there is more of this total giving up or relaxation, so that semen dribbles away involuntarily.

We may be called upon to use Selenium for the sequelae of typhoid fever. When the patient begins to walk about, there is such great debility of the spine that he fears that he will be paralyzed. Again, you see the great similarity between Sulphur and Selenium. Sulphur is invaluable in the exhaustion consequent upon protracted diseases. This again we have in Selenium. In Selenium, such characteristic Sulphur symptoms as flushes of heat on the least motion are lacking. Sulphur has more of that gone weak feeling in the forenoon, which is not marked under Selenium.

We find Selenium also indicated in headache of nervous origin. The pain is of a stinging character, and is usually situated over the left eye, and it is worse from the heat of the sun. Notice again how hot weather influences the Selenium patient. The headaches return quite periodically every afternoon, and are increased by any strong odor, as the odor of tube-roses, musk, etc. This headache is evidently nervous because it is associated with profound melancholy and profuse flow of clear limpid urine. You often find this last symptom in hysterical patients. Other remedies, however, have it in more marked degree, as, for instance, Gelsemium, Ignatia, Lac defloratum, Moschus, etc.

Again, another indication of the nervous origin of this headache is seen in the fact that the patient is worse from drinking tea and from certain acids, notably lemonade. Even tamarind-water aggravates. Here again we have resemblances to the Sulphur, in the periodical return of the headache. With Sulphur, however, it does not return every afternoon, but every week; nor has this remedy the aggravation from tea, although it has from coffee.

You will find both remedies indicated in the headache of drunkards and of those who have been guilty of debauchery. The Sulphur headache is worse from all forms of alcoholic drinks. The Selenium headache is sometimes improved by brandy, as are also the gastric symptoms. You will find that the patient has a longing for brandy. Now this is not the drunkard's craving. It is the result of a peculiar weakness in the stomach, a feeling as if the patient wanted something to stimulate him, and brandy is desired, as it has a temporary palliating effect. The same symptom you find under Staphisagria and Hepar sulphur, both of which have that great relaxation and dragging or want of tone in the walls of the stomach and consequent insufficiency in the secretion of gastric juice.

Seleniwn comes to us well-recommended, in a peculiar form of constipation, though it failed me in the one case in which I used it. The constipation for which it is indicated is one purely due to atony of the intestinal tract. Peristaltic action is almost nil, so that faeces become impacted. The faeces are hard and dry from absorption of their moisture, and require removal by artificial means, yet Selenium is said to tone up the rectum and prevent the recurrence of this symptom. The same symptom is found under Alumina, Opium, Plumbum and Bryonia, but these are probably not indicated so often during convalescence. Another peculiarity of Selenium which qualifies its symptoms is the character of the sleep. The patient sleeps in cat-naps. He awakens often in the night, or is easily aroused by any slight disturbance. He awakens at precisely the same hour every morning before his usual rising time, when all his prevailing complaints are worse. Here again it resembles Sulphur. These "cat-naps" are characteristic of Sulphur. The true Sulphur sleeplessness is this : The patient is aroused from sleep and is then wide awake. He has not this periodical hour of awakening each morning, which calls for Selenium.

Another resemblance between the two drugs you will find in affections of the skin. Selenium is useful in skin diseases, particularly when there is itching in the folds of the skin as between the fingers, and about the joints, particularly the ankle joint. The itching may also occur in small spots and is associated with tingling, here again showing involvement of the nervous system. The hair falls off, not that of the head, the eyebrows and whiskers, but of other parts of the body. You will find on the scalp an eczematous eruption which oozes a serous fluid after scratching. Here, again, it bears a striking resemblance to Sulphur, but is distinguished from that remedy if the patient is old enough to describe his case, by this tingling in spots. We sometimes find, although not often, that Sele?iiu?n, like Sulphur, is indicated in chronic affections of the liver. Especially is it called for in enlargement of the liver with loss of appetite, particularly in the morning; there is white coating on the tongue, thus separating it at once from Sulphur. Then, too, with loss of appetite, Sulphur has increase of thirst, which is lacking in Selenium. There are sharp stitching pains in the hepatic region, worse on any motion and worse on pressure and sensitiveness of the liver. Now if there is a peculiar fine rash over the hepatic region, Selenium is the only remedy you can think of to suit your case.

Selenium has a very marked action on the larynx and lungs. Several animals were poisoned with Selenium. It produced inflammation of the lining membrane of the larynx and congestion of the lungs with exudation into the pulmonary substance. Post-mortem examination showed the mucous membrane to be congested, with dark purplish spots here and there through it. Oozing of blood and frothy serum followed the incision of the knife. I have used Selenium successfully in the hoarseness of singers, particularly when the hoarseness appears as soon as they begin to sing. It may also be used when hoarseness appears after long use of the voice. There is frequent necessity to clear the throat by reason of the accumulation of clear starchy mucus. These symptoms point suspiciously towards incipient tubercular laryngitis. Here Selenium is grouped with Arum triphyllum, Spongia, Causticum, Carbo veg. and Phosphorus.

Arum triphyllum has entirely different effects, but it bears a strong symptomatic resemblance to the throat symptoms of Selenium. It is also useful for the hoarseness of singers and orators, but especially indicated when the voice suddenly gives out during use. For example, the patient is talking in a sort of monotone when the voice suddenly breaks and goes up to a higher key.

The antidotes to Selenium are Pulsatilla and Ignatia. China and wine are inimical to it. The debility caused by Selenium, so says Hahnemann, is very much increased by the use of Cinchona. Now the emaciation caused by Selenium is very similar to that of Cinchona. We have debility and emaciation from loss of animal fluids, a condition also found under Cinchona; yet the two drugs are inimical.

Lascivious thoughts, with impotency. Mental labor fatigues. Extreme sadness. Abject despair, uncompromising melancholy.

Selenium is a constant constituent of bones and teeth. Marked effects on the genito-urinary organs, and often indicated in elderly men, especially for prostatitis and sexual atony. Great debility; worse, heat. Easy exhaustion, mental and physical, in old age. Debility after exhausting diseases.

Worse, after sleep, in hot weather, from Cinchona, draught of air, coition.

Hair falls out. Pain over left eye; worse walking in sun, strong odors and tea. Scalp feels tense. Headache from tea drinking.

Incipient tubercular laryngitis. Hawking and raising transparent lumps of mucus every morning. Hoarseness. Cough in morning, with expectoration of bloody mucus. Hoarseness of singers. Much clear, starchy mucus (Stann).

Desire for brandy and other strong drink. Sweetish taste. Hiccough and eructations after smoking. After eating, pulsation all over, especially abdomen.

Chronic liver affections; liver painful, enlarged, with fine rash over liver region. Stool constipated, hard and accumulated in rectum.

Sensation in the tip of urethra as if a biting drop were forcing its way out. Involuntary dribbling.

Dribbling of semen during sleep. Dribbling of prostatic fluid. Irritability after coitus. Loss of sexual power, with lascivious fancies. Increases desire, decreases ability. Semen thin, odorless. Sexual neurasthenia. On attempting coition, penis relaxes. Hydrocele.

Paralytic pains in small of back in the morning. Tearing pain in hands, at night.

Dry, scaly eruption in palms, with itching, Itching about the ankles and folds of skin, between fingers. Hair falls out from brows, beard, and genitals.

Itching about finger-joints and between fingers; in palms. Vesicular eruption between fingers (Rhus; Anac). Seborrhœa oleosa; comedones with an oily surface of the skin; alopecia. Acne.

Sleep prevented by pulsation in all vessels, worse abdomen. Sleepless until midnight, awakens early and always same hour.

Incompatible: China; Wine. Compare: Agnus; Calad; Sulphur; Tellur; Phosph acid. Antidotes: Ign; Puls.

Sixth to thirtieth potency. Colloidal Selenium injection for inoperable cancer. Pain, sleeplessness, ulceration and discharge are markedly diminished.

Selenium

Marked mental and physical weakness following prolonged fevers, after sexual excesses, from secret vice, from exposure to the heat of the sun in summer.

Generalities: Great fatigue from which he seems unable to recuperate from rest.

Slight exertion brings great fatigue and weakness and especially in hot weather. Sudden weakness in hot weather. Great weakness in the back, almost paralytic after typhoid fever or other temporary diseases. Extremely sensitive to a draft of air, cool, warm or damp. Marked general emaciation, also special emaciation of face, thighs and hands.

The diseased limb withers. The hair falls out all over the body, head, eyebrows, whiskers and genitals. All his nervous symptoms are aggravated after coition. Pulsation in all the limbs and in the abdomen after eating.

Mind: Extreme sadness.

Some complaints are worse from wine, tea and lemonade. It is of great value in drunkards. Irresistible desire for alcoholic stimulants. Symptoms worse after sleep, especially on a hot day. Irritable after emissions. He is indifferent to his surroundings and his mind is dull and in confusion.

He is very forgetful during his waking hours, but in sleep he dreams what he has forgotten. Makes mistakes in syllables and. mispronounces words. Stammering speech. Often fails to understand what he hears or reads. He has become unfit for his business. He is excitable and talkative in the evening. Mental exertion is exhaustive and he dreads company. His mind dwells on lascivious thoughts, yet he is sometimes impotent. All the mental symptoms are worse after coition. Vertigo on rising from bed or seat, on moving about, with nausea, vomiting and faintness, worse after breakfast and dinner.

Head: Headaches from strong odors, after wine, tea, lemonade and alcoholic stimulants, violent stinging over left eye when walking in the heat of the sun. Increased flow of urine in headaches. Headaches in old drunkards.

The hair falls out from the whole head, leaving the scalp smooth and hairless; also the hair falls from the eyebrows and face, giving a strange appearance. In syphilitics it often checks the falling of the hair. It has cured eczema, tingling and itching of the scalp. The scalp feels as though tightly drawn over the bones of the skull.

Face: Itching vesicles on the edges of the eyelids and spasmodic twitching of left eyeball. The ear is stopped and ear wax becomes hard, from which he has hardness of hearing. Dark clotted blood from nose. Nose full of thick, yellow, jelly-like mucus. Itching of nose and he bores into his nose with the fingers. Chronic obstruction of nose. Coryza followed by watery diarrhea.

The face is sickly, looking greasy and shiny. Great emaciation of the face. Twitching of the muscles of the face.

Toothache from drinking tea.

Aversion to food much salted. White tongue and he does not relish his breakfast.

Irresistible longing for strong drink. After eating pulsation all over the body, especially in the abdomen. Symptoms are worse from sugar, salt food, tea and lemonade. Soreness in liver from pressure and inspiration, with rash over the right hypochondrium. Searching pain in right hypochondrium, worse on deep breathing. The liver is enlarged. Stitching pains in liver from motion and pressure. Constipation with inactivity of the rectum. Most difficult stool, even impaction. Stool large, hard and very dry, requires mechanical aid. Softy pasty stool. Watery diarrhoea.

Involuntary urination while walking, after urination and after stool. Twinge of pain outward along the urethra with a sensation as though drops were pouring out. Sensation as if biting drop was forcing itself out.

The urine is dark, scanty, red in evening. Sediment coarse, red and sandy. It has caused inflammation of the prostate gland. III chronic gonorrhea it is a very useful remedy.

Men: Extreme weakness of the male genitalia. Though the desire is strong there are no erections, or the act of coition is unsatisfactory and incomplete. Frequent emissions and constant flow of prostatic fluid. Erections in the morning without sexual desire, but on attempting coition the penis becomes relaxed. Itching and formication of genitalia.

Women: Menses copious and dark. Pulsating in the abdomen during pregnancy, worse after eating.

Voice: The weakness and failure of the voice is in keeping with the general weakness.

Hoarseness on beginning to use the voice. Hoarseness from weakness after over-use of the voice for a long time. Much clear, starchy mucus scraped from the larynx. Must frequently clear the larynx. It is a very useful remedy in tubercular laryngitis, glands of neck large and hard.

Cough: Dry, hacking cough in the morning, weak feeling in the chest.

Expectoration of lumps of bloody mucus. Difficult breathing from any exertion and from mucus in the chest and air passages. Pain in right side of chest under lowest ribs extending to kidneys which are tender to pressure.

Back: Weak back and spine as if he would be paralyzed after typhoid fever, and other lingering diseases. Stiffening neck on turning head; lameness in back in the morning.

It has cured syphilitic psoriasis of the palms. Itching palms. Hands withered. Tearing pains in hands at night.

Emaciation of the legs. Great weakness of lower limbs. Itching of the ankle in the evening, blisters on the toes. Flat ulcers on the legs and about the ankles. Cramps in calves and soles. He is sleepless until midnight. Sleeps in short naps. Awakens early and always at same hour. Symptoms worse after sleep.

Chill alternates with heat. Burning heat in spots. Sweat, profuse on chest, armpits and genitals staining yellow. Sweat from least exertion. Moist itching spots here and there on the skin and tingling after eruptions have been treated locally. Flat ulcers. Itching about finger joints and between fingers.

It is said to be incompatible with China. It is much like Sulphur in general action, and Phos. acid in its action upon the nervous system and genitals.

The chest symptoms and expectoration are like Argentum met., Stannum. Its constipation is much like Alumen and Alumina. It should be carefully compared with these remedies.