Lithium Carbonicum

Lithium carb. has not a very extensive range of action nor does it greatly depress the vital forces. In its provings, debility is noticed only in connection with or as a sort of sequel of the joint affection. It is particularly useful in affections of the joints. It is efficacious in rheumatism, and, above all, in some forms of gout. Of the various organs attacked by Lithium carb., the most important in the order of their importance are the heart, stomach, kidneys and bladder. The

LITHIUM CARBONICUM. 655

mucous membranes are also affected by the drug. At first they are unduly dry, and this dryness is followed later by thick mucous secre- tion. The skin does not escape. There appears an erythema, with itching of the skin, which occurs particularly about the joints, and is very annoying. It is particularly noticed along with rheumatism. Further than this, Lithium carb. may produce roughness of the skin and an eruption about the face resembling barbers' itch.

Studying now the symptoms of the drug with this general action before us, we find confusion of the head; headache on the vertex and in the temple, worse on awakening; the eyes pain as if sore, and it is difficult to keep the eyelids open. This vertex headache and soreness of the eyes follows suppression of the menses. The patient has pain from the left temple into the orbit of that side; relieved while eating and worse afterwards.

A very characteristic symptom of the retina, or rather of vision, is, the right half of objects vanishes.

In keeping with its effect on mucous membranes, we find the drug causing conjunctival asthenopia, just as does Alumina. The conjunc- tiva of both lids and eyeball is painfully dry and the eyes feel sore when the patient reads.

The nose is affected, too, in the Lithium proving, being swollen and red. Sometimes there is dryness of the nose when in the house, and mucus dropping from it when in the open air; or mucus seems to hang in strings from the posterior nares. Another symptom of Lithium is sensitiveness of the mucous membrane when the inspired air is unduly cold.

Lithium cures a cough which seems to come from a certain spot in the throat.

There is a form of gastralgia which Lithium will cure. It is accom- panied by the pain in the left temple and orbit, which is better by eat- ing.

Lithium has some effect on the bowels. Drinking chocolate or cocoa will cause diarrhoea.

Lithium irritates the neck of the bladder. This, you know, is often a symptom of rheumatic patients. The urine is turbid and flocculent. The pains extend down either ureter and into the spermatic cords or testicles, and are followed by red urine with mucous deposit.

In the female, you had Lithium carb. indicated when the menses are late and scanty. The provers found that all the symptoms accompany- ing the irregularity in menstruation were on the left side.

656 A CLINICAL MATERIA MEDICA.

Now, we will consider the rheumatic symptoms of Lithium carb ■. , including under this head those of the heart also. I have succeeded, in several instances, in relieving chronic rheumatic patients by this remedy. The symptoms which indicate the drug are these: rheu- matic soreness about the heart; valvular deposits will be found in many instances; mental agitation causes fluttering of the heart like Natrum mur. , Sepia and Calc. ostr. ; very marked is the pain in the heart when the patient bends forward; the cardiac muscle is evidently irritated, for we find shoeks or jerks about the heart; the cardiac pains are re- lieved when the patient urinates.

Now, the symptoms of the body, joints and limbs: tenderness, with swelling and occasional redness of the last joints of the fingers; clumsi- ness in walking from unwieldiness of the muscles; intense itching on the sides of the feet and hands without any apparent cause. The pains in the joints are usually worse in the knee-, ankle- and finger-joints. The whole body feels stiff and sore as if beaten. Pains go down the limbs.

The whole body increases in weight and becomes puffy. I may say that this puffiness is not due to a healthy fat, but is a flabby condi- tion which belongs to all the alkalies.

Gettysburg spring water, which contains carbonate of lithia, is very efficacious in scrofulous children when there are ulcers involving the joints, as in Pott's disease and hip-joint disease, when there are offen- sive pus and diarrhoea.

This character of the catarrh of Lithium carb. in which the inspired air feels cold is also found under Kali bichr. , sLsculus, Cistus, Hydrastis and Corallium rubrum.

Kali bichr omicum, Baryta carb., Sepia and Teucrium have catarrh, with expectoration of solid chunks from the posterior nares.

In valvular deposits in the heart you may compare Lithium carb. with Ledum, Kalmia and Be?izoic acid, the latter remedy being selected by the offensive character of the urine.

Zincum, Conium and Aurum have sudden jerks or shocks about the heart.

In rheumatism and gout you may compare Kalmia and Calcarea ostrearum, which resemble Lithium in the rheumatism of the finger- joints.

When there are nodular swellings in the joints, compare Calcarea ostrearum, Natrum muriaticum, Benzoicacid, Lycopodium and Ammonium phos.

LECTURE LXIV.

THE AMMONIUM PREPARATIONS.