Baryta Carbonica

Barium and Strontium are very closely related to each other chemi- cally. Of the elements themselves we have no provings. The carbo- nates of these have, however, been proved, as have also the Muriate and the Sulphate of Baryta. Baryta is somewhat of a poison, although there are not many cases of poisoning by it on record, because it is rarely used in domestic practice.

Baryta carb. has Antimonium tartaricum as its complement, particu- larly in the complaints of old people.

Animals poisoned with Baryta ca?'b. exhibit some irritation of the abdominal organs, resembling great inflammation there, with increased peristaltic action of the bowels. The heart, too, is affected by it, the animal apparently dying from paralysis of the cardiac in systole. Its action is here very much like that of Digitalis. So much for the toxic action of Baryta.

In all its symptomatology, we find Baryta adapted to ailments occur- ring at the extremities of life, age and childhood; to old age, when there are mental symptoms and bodily weakness, and to children, when there is in addition, scrofula. The child to whom we may give Baryta effectively is almost an imbecile. He, very unnaturally, shows no de- sire to play; he sits in a corner doing nothing. He cannot remember well, and is slow in learning to talk, to read, and to understand.

This slowness in learning to talk does not come from defect in the apparatus of speech — of the tongue, for instance — but it is the result of mental weakness. The child is rather emaciated, with the exception of the abdomen, which is large. The face, also, is bloated. He may have a voracious appetite, but food is not appropriated by the system, because of the diseased condition of the mesenteric glands.

A case of chronic hydrocephalus in a child improved after the exhibition of Baryta selected by these symptoms. Adults — especially old people — have a

650 A CLINICAL MATERIA MEDICA.

rather peculiar aversion to strangers, and shun the approach of any unfamiliar face. They seem to have a fear of the presence of others. They imagine that they are being laughed at. They are easily angered and suffer from cowardice. You all have seen similar symp- toms to these in persons of a half-imbecile state of mind from disease, whether in old age or in early life.

A peculiar mental symptom of Ba?yta which I give you on the authority of Dr. Talcott, of Middletown, N. Y., is this: the patient thinks his legs are cut off and that he is walking on his knees.

You may use Baryta carb. for old people when they suffer from paralysis, particularly paralysis following apoplexy. Very frequently in old people, the brain shrinks and, as the skull does not yield, there would be a vacuum formed, were it not that an effusion of serum takes place. This is followed by a more or less severe paralysis. You will find, in such cases, that the patient is childish and has loss of memory, trembling of the limbs and well-marked paralysis of the tougue.

Baryta carb. is one of the few remedies that cause positive paralysis of the tongue. You will see these paretic symptoms also in children of this half-imbecile character of which I have spoken. The mouth is kept partly open and the saliva runs out freely. The child has a silly, vacant look, showing at once that it is non compos mentis.

Baryta is one of the remedies for the apoplexy of drunkards. ( Vide lecture on Opium.)

Baryta also seems to induce paralysis by causing degeneration of the coats of the bloodvessels, even to the production of aneurisms.

Causticum acts similarly to Baryta in paralysis, but the paralysis of this remedy has more contractures or spasms.

Secale acts on the bloodvessels; but its symptoms are apt to be associ- ated with burning and numbness; gangrene.

Colchicum and Arsenic have loss of sensibility of the tongue.

Both the Muriate and the Carbonate of Baryta may be used in multiple sclerosis of the brain and spinal cord. This is not an un- common disease in infants and children in whom it may give rise to the idiotic symptoms mentioned above. These same symptoms indicate it in disseminated sclerosis occurring in old people.

For the trembling associated with this disease, Hyoscyamus should be thought of.

When associated with the symptoms just enumerated, you may use

BARYTA CARBONICA. 65 1

Baryta for non-development of the brain in early childhood. The Chloride of Baryta has been used by old-school physicians for this sclerosis, and with more or less success.

The remedy which most resembles Baryta here is Causticum.

The use of Baryta in catarrhs demands attention. It is one of the best remedies we have for the tendency to tonsillitis, particularly in scrofulous children with dry scurf on the head. Baryta mur. and Baryta carb. cause induration of connective ti.-sue. They control pro- liferation of connective tissue, hence their use in tonsillitis, enlarged tonsils, indurated glands, etc., general symptoms agreeing.

" Every little exposure to damp or cold weather awakens anew the inflamma- tion of the tonsils. This is not a simple sore throat, a swelling up of the mucous lining of the fauces with trouble in swallowing, but it is an actual inflammation of the tonsils with formation of pus. In these cases, you will find enlargement of the glands in the neck, under the jaw and behind the ear. Baryta is one of our remedies to prevent the return of this condition.

It changes the constitutional tendencies of the patient. It is thus more the remedy for the effects of the trouble than for the acute symptoms. The local symptoms for the throat are principally these: the right side of the throat is worse than the left, just as you find under Belladonna; the throat feels worse from empty swallowing. In the treatment of tonsillitis, I frequently use the same prescription that I employ in diphtheria, namely, a gargle of alcohol and water.

This seems to remove the accumulation of phlegm from the throat.

In tonsillar affections, you may compare the following remedies with Baryta:

Calcarea ostrearum, in fat, leuco-phlegmatic children.

Calcarea pAos., in chronic cases; bones diseased.

Ignatia, large tonsils, with small, flat ulcers on them; pain between the acts of swallowing.

Hepar, large tonsils, hearing poor, sensation as of fish-bone in throat.

Lycopodiu?n, large tonsils, studded with small indurated ulcers.

Calcarea tod. is similar to Baryta in some cases with enlarged glands, particularly when there are enlarged tonsils which are filled with little crypts or pockets.

Conium is suited to enlarged tonsils without any tendency to suppu- ration.

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Baryta may also be used in children who, in addition to this tonsil- litis, have post-nasal catarrh. Scabs form in the posterior nares and at the base of the uvula. The upper lip and nose are swollen just as you find in Calcarea, but the mental symptoms are different.

Baryta is also called for, for a chronic cough occurring in strumous or scrofulous children with swollen glands and enlarged tonsils. Every little exposure to cold or damp causes headache, backache and diar- rhoea. Here Baryta is similar to Dulcamara. The ears may be in- volved in the catarrhal process; crackling in the ears on swallowing, reverberations in the ear on blowing the nose, sneezing, etc. The late Dr. McClatchey used Baryta in catarrh of the middle ear after scarla- tina.

Baryta is sometimes indicated in scrofulous ophthalmia, the pains are relieved by looking downward. The general symptoms are like those of Calcarea ostrearum.

We find Baryta also indicated in old people who have what is known as suffocative catarrh, with orthopnoea. I think you can understand this when you remember the influence of Baryta on the voluntary and involuntary muscular fibres. It paralyzes them. In old people, the chest is very much weakened.

They get a catarrh, which is not very severe, but appears suddenly in the night, with difficulty of breathing and blueness of the face, etc. Baryta carb. is one of the remedies that come in after the failure of Antimonium tartaricum. The patient com- plains of a sensation as of smoke or pitch in the lungs. Baryta should not be given in catarrhal asthma or asthma with emphysema; but when the disease is of the purely nervous variety, in the aged, when aggravation occurs in wet, warm air.

You will see that its aggrava- tions are much like those of Aurum.

Amblyopia, in the aged, sometimes calls for Baryta; the patient cannot look long at any object; sparks before the eyes when in the dark.

It is also indicated in the headaches of the aged, with aggravation after waking, after meals and near a warm stove; the patient has a stupefied feeling.

We also find Baryta carb. of use for the fatty tumors which occasion- ally appear here and there over the body. It is very easy to remove these with the knife. But it is much better to cure them by medicine, if you can do so.

In tabes mesenterica, Baryta is indicated, when in addition to the

STRONTIANA CARBONICA. 653

foregoing symptoms, the following are present: food, when swallowed, seems to pass over sore spots in the oesophagus. There is always pain in the stomach after the child eats. The stool is sometimes un- digested. With this, you find the abdomen hard and swollen, and an offensive sweat on the feet, just as you find in Silicea.

Now, there are remedies which may be compared with Baryta in this form of disease. Iodine is similar to Baryta in that it is suitable in torpid cases. The complexions of the patient in the two remedies are different. The Iodine patient has a dark complexion, dark hair and eyes and sallow skin.

There is, too, extreme hunger. If you observe the child carefully, you will find it anxious and fretful, until he eats, which relieves him for the time being; and yet he grows thin despite the quantity of food consumed. Then, there is a mental symp- tom which is almost always present when you find Iodine indicated in tabes mesenterica, and that is intolerable crossness, which is even worse than that belonging to Antimoninm cmdum.

Calcarea bhosphorica is indicated in children who are weak-minded, who cannot walk, although they are old enough to do so, who are anxious and restless in their manner and who suffer from defective osseous growth. The bones are thin and brittle.

Like Baryta, the Silicea patient suffers from damp weather. He also has offensive sweat and general emaciation with the exception of the abdomen. The difference between the two remedies lies princi- pally in the mental symptoms. The Silicea child is obstinate and self- willed, and, too, his head is disproportionately large.

Lactic acid has copious sweating of the feet, but is not offensive.

For the offensive foot sweat, compare Silicea, Thuja, Nitric acid, Kali card., Graphites and Car bo veg.

STRONTIANA CARBONICA.

Strontiana carbonica has a few symptoms that are of importance. It has more effect on the circulation than has its relative, Baryta. We have, as a characteristic, flushes in the face and violent pulsation of the arteries. It may be useful in case of threatening apoplexy with violent congestion of the head, and hot and red face every time the patient walks.

Mere exertion increases the circulation upwards to- wards the head. Some erethism is shown in the chest in some patients. There is a smothering feeling about the heart; they cannot rest; there

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is a feeling as of a load on the chest. These are the congestive symp- toms of the heart, lungs and head which suggest Strontiana card., and they may occur at the time of the climaxis when flushes of heat are so common. The peculiarity which will distinguish these symptoms from those of any other remedy is, that the head symptoms are re- lieved by wrapping the head up warmly, just as you find under Silicea and under Mag?iesia mur. These patients cannot bear the least draught of air, therefore, despite this congestive tendency, they wrap the head up warmly, though it may cause perspiration.

It certainly does resemble Silicea, in that both remedies have congestion of the head relieved by wrapping the head up warmly. The Silicea conges- tion seems to come up the spine and go into the head. That is not characteristic of Strontiana carb.

Another effect that we find caused by Strontiana carb., and one, too, for which it is not often used, is diarrhoea, which is worse at night, and which has this peculiar urgent character: the patient is scarcely off the vessel before he has to return. It is better towards morning at three or four o'clock.

Strontiana carb. has a marked action on the bones. It has a particular affinity for the femur, causing swelling and caries of that bone; usually in scrofulous children. This trouble is often associated with the diar- rhoea just described.

Strontiana carb. causes an eruption which very much resembles that of sycosis. Hence, it has been given for a sycotic eruption on the face or other parts of the body, and which is moist, and itches and burns.

Another peculiarity of the drug, and the last one I care to mention, is its effects in chronic sprains, particularly of the ankle-joint, when both Arnica and Ruta have failed. The long interference with the circulation has produced some oedema about the joint.