Calcarea Ostrearum

Calcarea ostrearum is a drug that may come into use in almost every form of disease, and is second in importance only to Sulphur. You will recall that it is not a perfectly pure carbonate of lime, but con- tains some phosphate of lime and some organic matter from the body of the oyster. Chemically it differs but slightly from the carbonate of lime made in the laboratory.

Calcarea ostrearum is suited to cases in which there is defective growth, hence it is a very necessary remedy in childhood and in in- fancy. It affects chiefly the vegetative system, altering materially the nutrition of the body. Under its influence secretion and absorption progress rapidly, and so it becomes a favorite remedy in cases in which the " constitution" is to be changed. The glands are readily affected by Lime; they swell, inflame and even become the seat of pathologi- cal deposits.

This is especially true of the cervical and mesenteric lymphatics. The nervous system, is not primarily affected, but be- comes eventually influenced by general nutritive failure, thus causing spasms, excitement, etc. The Calcarea ostrearum patient is fat and plump, rather of a bloated than of a solid, hard fat. It is especially suited for children who are scrofulous ; who are fleshy, yet not well developed as to bone, brain or muscle.

The face is rather pale, occasionally, however, flushing up red. Usually the color is of a watery or chalky paleness. The child is slow in its move- ments. It is not active, nervous, or quick, as we find in the case of the Sulphur child.

It is peevish and self-willed, especially towards morning. Growth is irregular, so that the head is disproportionately large to the rest of the body. This defect is one of osseous growth; thus you find the fontanelles remaining open, particularly the anterior fontanelle. The abdomen is large and has been compared to an in- verted saucer or basin.

The features are rather large, and the lips, particularly the upper, are swollen. Dentition is slow. There is craving for boiled eggs. The scalp sweats profusely, particularly during sleep.

This is not usually a warm sweat, nor is it a cold sweat; but it is cool from natural evaporation. When the child awakes, you notice the pillow damp or wet for some little space around the head. The feet are often cold and clammy. Do not, however, be deceived by this symptom, for there are some children who, by wearing too

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heavy a stocking, will have sweaty feet. This patient suffers from partial sweating of still other parts of the body. That is in itself an almost certain symptom of Calcarea ostrearum. Thus it may affect the chest or knees when all other parts of the body may be perfectly dry.

Now, from this extreme picture we may have the opposite con- dition, one of great emaciation. The skin hangs flabby and in folds. Despite this emaciation, the abdomen remains abnormally large. Such children are scrofulous, and it is genuine scrofula, for which Calcarea ostrearum is indicated.

There is another form, which is tubercular in its character, and in this form we have Phosphorus indicated. We find the same swelling of the glands, the same indolent ulceration, and the same difficulty in learning to talk and walk, but the patient has a delicate, refined skin, and the features are sharp and rather handsome. The eyelashes are long and silky, and the hair dark and glossy. This is the kind of scrofula which will, if not neutralized, ultimately end in consumption of the lungs.

As the Calcarea child grows older it is slow in teething. It may even have fever or convulsions attending the tardy eruption of the teeth. In cases in which the convulsions persist, Calcarea is far superior to Belladonna. Belladonna may help for a while, but the deeper acting remedy must follow to complete the cure.

Scrofulous inflammation of the eyes is almost always present. There are pustules on the cornea, and these threaten to destroy that membrane. The parts about the ulcer are very vascular. The child dreads artificial light in particular, although it complains bitterly of the daylight hurt- ing its eyes on awaking in the morning.

The discharges from the eyes are apt to be bland. The cornea is left more or less opaque by ulceration. Calca?-ea has often been used after the acute symptoms, to remove the corneal opacity and the chronic thickening of the eyelids. No remedy excels Calcarea in corneal opacities; but compare Apis, Saccharum officinale, Cuprum, Alumen, Kali bi., Natrum sulph., etc.

Saccharum officinale in particular is to be remembered as similar to Calcarea ostrearum. This drug has been proved on several persons, and has many confirmations. It is indicated in children who are large- limbed, fat and bloated, with a tendency to dropsy. It has produced opacity of the cornea, and it ought to cure it. The mental states which lead me to the use of Cane-sugar are these: the child is dainty and capricious; he cares nothing for substantial food, but wants little

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" nicknacks;" he is always cross and whining, and if old enough he is indolent, and does not care to occupy himself in any way. Everything seems to be too much trouble to him.

You will find that in the eye-symptoms Calcarea acts better after Sulphur than before. It is suited to advanced cases that are sluggish and refuse to react to Sulphur. Hahnemann noticed that Calcarea particularly followed Sulphur when there was tendency to dilatation of the pupils.

Another remedy which holds a relation to Calcarea ostrearum in scrofulous and tubercular ailments is Nitric acid. This must be sub- stituted for Calcarea if the ulcers on the cornea progress and threaten to perforate or destroy the cornea.

The Calcarea children are subject to eruptions on the skin, particu- larly eczema. This eczema is quite characteristic, too. It appears on the scalp, with a tendency to spread downwards and over the face. Frequently it appears in patches on the face or scalp, forming thick crusts, which are often white like chalk deposits. Another symptom which may suggest Calcarea is this: the child scratches its head on awakening from sleep. The change from sleep to activity seems to excite the itching of the existing eruption.

We find in these scrofulous children calling for Calcarea, inflamma- tion of the external ear or auditory canal, and also of the middle ear or cavity of the tympanum. First, Calcarea produces thickening of the membrana tympani, with all the symptoms of defective hearing. There are humming, roaring and buzzing in the ears, all dependent upon the abnormal pressure on the chain of bones. The otorrhoea has a sort of pappy or fatty appearance.

It is purulent, but it also has a pappy appearance, looking just like chewed-up paper. Now, on cleansing the external ear of this pus and looking at the membrana tympani, you find it perforated from previous inflammation. You will find the edge of the rupture thickened and granular, and you may even notice a tendency to the formation of polypi. The pains are of a sudden, jerking, pulsating character.

In three different cases, Calcarea 30 produced vesicles in the auricles.

Here Calcarea is, according to the best authorities, to be followed by Silicea, if the ulceration becomes very indolent and will not heal despite the exhibition of Lime. The Silicea patient has a head dispro- portionately large to the rest of the body. The sweat appears on the whole head and face rather than on the scalp alone, and the offensive

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foot-sweat causes soreness of the feet. These symptoms you will recall from our lecture on Silicea. Besides Silzcea, you should here compare Calcarea with Hepar and Mercurius.

Attending these inflammations of the eyes and ears with Calcarea we may have scrofulous enlargement of the lymphatic glands of the neck, axilla, etc. These are hard and firm, and yield very slowly to medicine.

We have also in these cases a coryza or chronic nasal catarrh. The wings of the nose are thickened and ulcerated. There is apt to be a moist scurfy eruption about the nostrils. There is an offensive odor, as of rotten eggs, gunpowder or manure from the nose. The nose is stopped-up, with thick yellow pus. The patient often has nose-bleed in the morning. Here you may compare Bellado?ma which follows Calcarea well.

Xow, if the Calcarea children are attacked with summer complaint or a genuine cholera infantum, you will find these symptoms of the digestive organs: there will be an unusual craving for eggs. Why this is I do not know; it may be because of the sulphur in the eggs. This is a very common symptom. Milk disagrees.

As soon as they take it they vomit it in sour cakes or curds. That is a strong symp- tom for Calcarea. Or the milk may pass by the bowels in white curdled lumps. There are ravenous appetite and thirst, the latter being worse toward evening.

The diarrhoea, too, is worse toward evening, thus being distinguished from Sulphur. The stools are greenish, and may contain undigested food. They are more or less watery and sour.

In these symptoms Calcarea ostrearum is similar to two or three other drugs. One is sEthusa cyyiapium, or fool's parsley. This is indicated in vomiting of children, when they vomit everything they drink, particularly milk, which is ejected in white or yellowish or greenish curds. This vomiting exhausts the child, so that it at once goes to sleep.

Still another remedy is Antimonium crudum, which has this condi- tion: after nursing, the child vomits its milk in little white curds, but refuses to nurse afterward; the Aithusa patient, on the contrary, wants to nurse again. There is also the characteristic diarrhoea of Antimonium crudu?n, which will help you to distinguish it from cases that call for Kreosote. If the latter remedy had no other symptom than the following it would still be invaluable, and could not be

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replaced: the stomach is so weak that it cannot retain or digest food, so that food is vomited either immediately or hours after eating.

Phosphorus and Arsenicum should also be compared in this vomiting.

_Mag?iesium carb., Ipecac and Sulphur should be compared in the sour vomiting.

In diarrhoea with green stools do not forget Calcarea phos.

Again, we may find Calcarea ostrearum indicated in acute hydro- cephalus in the early stages. Here, as in many other cases, it acts particularly well after Sulphur. It may even do good when symptoms of effusion are present. It is indicated mainly by the general consti- tutional symptoms present in the case.

In these cases you frequently find that it follows the previous use of Belladonna. You are called to attend one of these cases. You find the patient with hot head, flushed face, starting in sleep, and you give him Belladonna, which relieves. In a few days a relapse occurs; again you give Belladonna, and this time it fails.

This intermittency of the disease shows that it is not a Belladonna case. Then you have to select another drug, which is sometimes Sulphur and very frequently Cal- carea, the latter especially if the patient be the characteristic Calcarea child. Bellado?ina and Calcarea are complementary, particularly in affections of children, in brain troubles and in dentition.

Again, we may find Calcarea ostrearum indicated later in life, at puberty. Here it is more frequently indicated with girls than with boys. We find it called for at the time for the onset of the menses, when they are delayed. The girl is apparently plethoric, and suffers from congestions of the head and chest.

She is fat and apparently robust, but if you were to examine the blood of such a patient you would find it disproportionately full of white blood-corpuscles or leu- cocytes. She complains of palpitation of the heart, dyspnoea and headache, worse when ascending. Calcarea will bring on the men- strual flow, and will relieve all these symptoms.

Again, you may find it useful at puberty for similar symptoms when tuberculosis of the lungs threatens. The patient has this dyspnoea, palpitation and rush of blood to the chest on ascending, and even haemorrhages from the lungs. There is dry cough at night, which becomes loose in the morning. The patient has fever, which is worse in the evening, with partial sweat and soreness of the chest to touch, this soreness being worse beneath the clavicles.

Digestion is greatly disturbed. The patient cannot eat any fat food without becoming

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sick. There is chronic tendency to diarrhoea, and with it prolapsus ani. So you see Calcarea is a companion to Phosphorus •, but there is a difference between the two remedies. The difference is expressed in these few symptoms. In Calcarea, you find the patient scrofulous and fat, and his or her past history shows the well-marked symptoms of Calcarea. As children they have been slow in teething, have had slowly-closing fontanelles, and often there is yet remaining dispropor- tionate swelling of the upper lip.

On the other hand, the Phosphorus patient is slender and overgrown, for his years, and narrow-chested. He has a fine grain of tissue, rather than fat and coarse as in Calcarea.

Calcarea is indicated late in phthisis when large cavities are forming. It acts particularly upon the right lung about its middle third. There will be pain in the middle of the right side of the chest; loud mucous rales are heard all over the chest, of course worse on the right side. Expectoration is purulent, yellowish-green and bloody.

The patient has great repugnance to animal food, as meat, which passes undi- gested. Emaciation progresses, sweat increases, and the menses, if it is a female, become checked. These are the symptoms calling for Calcarea in tuberculosis.

Both Calcarea ostrearum and Calcarea phosphorica affect the middle lobes of the lungs. Sepia is here similar, but lacks the external sen- sitiveness to touch, in fact may be ameliorated thereby.

Senega is somewhat similar to Calcarea in fat persons, but may be distinguished, having soreness that is worse on moving the arms, espe- cially the left arm.

Still later in life we find Calcarea indicated for the ailments of women, particularly for irregularities in menstruation. It is especially indicated when the menstrual flow is too frequent, coming every two or three weeks, and is profuse, amounting almost to a menorrhagia. The flow is provoked by over-exertion or by emotions. The patient complains of sweating of the head and coldness of the feet.

One of the best remedies I know of for ordinary profuse menstrual flow, coming frequently and yet without any decided constitutional character by which to judge the case, is Trillium pendulum, especially if the flow exhausts the patient very much. I have never given it in any potency but the sixth. That has been sufficient in all my cases.

In suppression of the menses Calcarea has several concordant reme- dies. Belladonna is suitable when there are hyperemia, rush of blood

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to the head, subjective feeling of coldness, wakefulness, and throbbing about the temples.

Gelsemium is indicated in menstrual suppression when there is a drowsy, apathetic state.

Glonoin is an admirable remedy when there is violent throbbing about the head, and particularly if the urine is albuminous, as it may be, from congestion of the kidneys.

Aconite is indicated for suppression of menses from violent emotions, as fright.

Still other drugs called for under these last-named circumstances are Actea spicata and Lycopodium.

The leucorrhcea of Calcarea ostrearum is rather profuse, with con- siderable itching and burning, and is generally milky, purulent and yellow or thick in appearance. It is especially indicated for leucor- rhcea occurring before puberty, even in infants.

Another remedy that I have found very valuable in the leucorrhcea of little girls is Caulophyllum, when the discharge is profuse and weakens the child very much.

Sepia, Cannabis saliva, Mercurius, Phosphorus, Pulsatilla and Cubeba have also been sufficiently confirmed to be listed here.

Calcarea ostrearum is useful in diseases of the male sexual organs. It is one of that little group of remedies, Nux, Sulphur and Calcarea, first suggested by Jahr for sexual weakness arising from masturbation or other excesses in sexual indulgence. Calcarea is indicated when there is excessive sexual desire, but this sexual desire is more mental than physical — that is, there is more passion than the objective con- comitants of passion. Erections are diminished or imperfect during coitus, emission is imperfect or premature.

Calcarea is also indicated when, after abuse of this kind, a man settles down to a moral and quiet life. His sexual power is of a character just described, and its gratification is followed by vertigo, headache and weakness in the knees.

In milder cases, which have not been traced to so deep an origin as defective nutrition, you will find Dioscorea all-sufficient for the exces- sive loss of semen with weakness of the legs, particularly about the knees.

In old men, who, having spent their youth and early manhood in the practice of excessive venery, are just as excitable in their sexual passion at sixty as at eighteen or twenty, and yet they are physically

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impotent, Agnus castus is a good remedy. They suffer from constant dribbling of semen.

We may use Calcarea ostrearum from its action on the nervous sys- tem. It is indicated in nervous fevers, even in typhoid fevers, in the beginning of the disease, with these symptoms: the patient falls into a troubled sort of sleep and dreams of some perplexing subject which awakens him. He again goes to sleep and dreams of the same thing. As soon as he closes his eyes, he sees persons, objects, etc., which dis- appear as soon as he opens them.

Later, in the course of typhoid fever, about the second week, you will find Calcarea ostrearum indi- cated when, for instance, the rash will not appear, and the patient goes into a sort of stupor. The abdomen swells and becomes more tympanitic. The patient becomes very restless and anxious and dis- tressed, although he may be unconscious. He cries out, twitches and grasps at flocks.

The body may be too hot and the limbs cold and clammy. There may be diarrhoea or constipation present. He starts up from sleep and looks about him as if frightened. A drug which is complementary to Calcarea here is Lycopodium.

But diarrhoea maybe present in Calcarea. This is never the case with Lycopodium.

Another use that we may make of Calcarea ostrearum in nervous affections is one which would not appear from a superficial study of the drug, and that is its application in insomnia. The sleeplessness that calls for this remedy does not consist simply in lying awake an hour or two, but it is that long wakefulness which is the precursor to some dis- eases and the accompaniment of others. For instance, during child- bed a woman cannot sleep. In such cases you have this class of symptoms: she has visions on closing the eyes; she starts and twitches at every little noise, and is beside herself with anguish.

The tongue is dry. She borders on the state of acute mania. Calcarea ostrearum, particularly in the thirtieth potency, given every three hours during the day, almost invariably produces a desire to sleep the next night. How does Calcarea produce it?

Like opium, caffeine or chloral? No; but by bringing about a health}- sleep. Still another use of Calcarea ostrearum is in that unhappy affection, delirium tre- mens. It is indicated when there are pretty much the same symp- toms as I have mentioned for the insomnia, particularly with visions of rats and mice, and of horrible objects which terrify the patient.

He talks deliriously about fire and murder. He has a constant fear that he is going crazy.

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Calcarea ostrearum seems to be able to cure epilepsy, not so much the paroxysms themselves, as to aid in the change of constitution by which this dreadful disease may be cured. The aura which precedes the attack in some cases begins in the solar plexus and moves up- wards, and the patient is at once thrown into convulsions, a character- istic also of Nux vomica, Bufo and Silicea. In some cases it feels as if a mouse were running up the arm. In still others the aura may go from the epigastrium down into the uterus or into the limbs.

The causes for the Calcarea ostrearum epilepsy are fright, suppression of some chronic eruption, and also excesses in venery. It follows Sul- phur well in these cases. You are apt to think first of Sulphur for this sensation as of a mouse creeping up the arm; the symptom is just the same in Sulphur and Calcarea; the causes, also, are the same, viz., excessive venery or suppression of an eruption. Calcarea is particu- larly indicated if Sulphur does not cure, or if the pupils do not dilate after the use of Sulphur.

For the paroxysms, Hydrocyanic acid is a useful drug. Artemisia vulgaris is indicated in cases which have arisen from fright, and in which the attacks are duplicated.

If indigestion starts the trouble, Nux vomica is the first remedy to be thought of, especially if the aura starts in the epigastrium and spreads upwards.

Calcarea ostrearum is useful in diseases of the bones and in curva- tures of the spine, especially for curvatures in the dorsal region in children who are slow in learning to talk and walk, who are weak at the ankles, and turn their feet in or out according to the muscles that are affected. In weak ankles compare Natrum carbonicum, Silicea, Car bo animalis, Sepia.

There is a remedy which has been suggested for this weakness of the legs which I have never been able to confirm, and that is Pinus sylvestris. This is said to have cured emaciation of the lower extrem- ities, with tardiness in learning to walk, in scrofulous children.

Calcarea ostrearum is also indicated in affections of the joints; for instance, in white swelling and in hip- joint disease. It is indicated in the second stage of these diseases, when abscesses have formed.

Now, you must learn to distinguish between Calcarea and Silicea. To the superficial observer the cases are very similar, but there are some differences which you may note. In the first place, the Silicea patient has sweat about the whole head, and this sweat has a sour or

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offensive odor; the head is unduly large, the rest of the body being rather emaciated; the sweat of the feet in Silicea is apt to be offensive, and produces soreness between the toes and on the soles of the feet; the face is rather of an earthy or yellowish- waxen hue. The Silicea child is nervous and excitable rather than sluggish, as is the case with the Calcarea ostrearum patient. Silicea has the same imperfect nutri- tion from defective assimilation that Calcarea has. There seems to be, in the Silicea child, a decided weakness of the cerebro-spinal nervous system; and yet, with this weakness, there is a certain amount of irri- tability, so that it is made worse by any external impression.

Thus, if there is any tendency to epilepsy, any little emotion will tend to throw it into convulsions. There is more tendency to ulceration in Silicea than you find in Calcarea. The discharge from these ulcers is not a healthy, laudable pus, but it is rather thin and excoriating.

Calcarea ostrearum is of service in rheumatism. The symptoms indicating it are these: rheumatic affections, caused by working in water; rheumatism of the muscles of the back and shoulders after failure of Rhus. It is also indicated for gouty nodosities about the fingers. It may be useful in constitutional gout and in arthritis de- formans.

Rhus tox. seems to be the best remedy we have for lumbago, whether the pains are better from motion or not. It seems to have a special affinity for the deep muscles of the back.

Calcarea fluorica is a good remedy to follow Rhus in chronic cases; for lumbago, worse on beginning to move but improving on continued motion.

Secale cornutum is indicated for sudden " catch " or " kink " in the back.

Nux vomica is called for in rheumatism of the back, when the pa- tient is unable to turn over in bed without first sitting up.

The uses of Calcarea in eruptions have already been touched upon in former lectures. It is one of the best remedies in chronic urticaria. It produces herpes, one prominent locality being on the parts of the face covered by whiskers, here suggesting a comparison with Mezereum, which has itching in the whiskers as from vermin, scaliness; Lithium carb., cheeks under the whiskers rough as a grater, itching; and Cicuta virosa, thick honey colored scabs in the whiskers as well as about the corners of the mouth.

LECTURE LXVL

CALCAREA PHOSPHORICA AND HEPAR.