Natrum Arsenicatum

Natrum arsenicatum, or the arseniate of soda, affects markedly the mucous membranes, producing dryness and sensitiveness to dust, smoke and even to the indrawn air, and later the secretion of tough, gluey mucus, crusts, etc. This property of the drug has led to its use in catarrhs of the respiratory passages. It is indicated in a coryza which, as you will observe, resembles somewhat that of the parent arsenic. There is a copious discharge of watery fluid from the nose, and yet the nasal passages feel stuffed up.

This is accompanied with dull, supra orbital headache, compressive pain at the root of the nose, dry- ness and smarting of the eyes, injected conjunctivae, flushed and puffy face and dryness of the throat. There is sometimes a good deal of sneezing, which is provoked by the least draft or inhalation of cold air. All these symptoms are worse in the morning and forenoon.

This continues until the mucous secretion becomes thicker. Tough, yellow or yellowish grey mucus drops down from the post-nares into the throat, or hard, bluish mucus is blown from the nose every morn- ing and its removal is followed by bleeding. At night and in the morning the nose is stuffed up so that the patient breathes with mouth open.

Looking at the throat, you will find it dark red, swollen, and cov- ered with yellow gelatinous mucus which gags the patient when he attempts to hawk it out.

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As the ' ' cold ' ' creeps downward a dr5^ cough supervenes. There is a sensation of oppression in the chest and of stuffiness as if the lungs were full of smoke. Soreness in the supra-clavicular regions and pain over the fourth and fifth costal cartilages of the right side. The oppressed feeling in the chest has this peculiarity: it is better when the patient urinates freely, and it is aggravated by dust or smoke.

You may use the remedy in bronchitis when the above S3^mptoms are present, or even in graver forms of disease. It maybe of great service in tuberculosis, with emaciation, dry heat of the skin, chilliness at night and thirst for small quantities of water frequently repeated.

Lastly, I have to speak of the use oiNatrum arsenicatuni in psoriasis. It should be classed here with Arse?iicum, Arsenicum iodatu??i and Sepia. The scales are thin and whitish and when removed leave the skin slightly reddened. The eruption is apt to appear on the chest and itches when the patient warms up from exercise.

LECTURE LXIX.

BORAX VENETA.

( Staphisagria, Mercurius. Borax. < Sepia, Pulsatilla. ( Bryonia.

> Chamomilla, Coffea.

\ Vinegar.

/ Wine.

Borax is the biborate of soda. As a medicine, it won its first laurel in the nursery, where it has long been used in the treatment of sore nipples and children's sore mouth. Like all popular remedies, it has been greatly abused. Homoeopathy has rescued it from the nursery and now offers it to the profession as a medicine of great value, telling when it may and when it may not be used.

Underlying this sore mouth, which seems to be the keynote for the use of Borax, is a system or constitution which will permit of the sore mouth, that is, an illy- nourished system. Thus the infant becomes pale or of an earthy hue, its flesh grows soft and flabby; it cries a great deal when it nurses, screams out during sleep and awakens clinging to its mother as if frightened by a dream. It is excessively nervous, so much so that the slightest noise, the mere rustling of paper, as well as a distant heavy noise, will arouse and frighten it.

This nervous excitability qualifies the pains. For instance, in the earache, you will find that each paroxysm of pain causes the child to start nervously. The ear- ache is accompanied by soreness, swelling and heat of the ear, just as you find in Belladonna. Pulsatilla and Chamomilla.

There is a mucous or muco-purulent otorrhcea. Borax is distinguished from these remedies by this starting with the pain or from slight noises, by the paleness of the face and above all by another well-proved symptom, the dread of downward motion. Thus if the little one is sound asleep in its mother's arms and she makes the attempt to lay it down in its crib, it gives a start and awakens. If she attempts to carry it down stairs, it will cling to her as if afraid of falling.

This must not be con- founded with the excitability of other medicines, as Chamomilla and

BORAX VEXETA. 709

Belladonna. It is not simply the motion that awakens the child, for the child will not awaken if it is moved without any downward motion. It must, then, be the downward motion that arouses it. The reason for this is, that the child is suffering from cerebral anaemia and this downward motion causes a feeling as though it were going to fall.

This symptom may also be utilized in adults, as, for example, in the case of invalids who have been ordered to take horseback rides, but who cannot do so, because when the horse lets them down, they feel as if they were in torture. You will also find that ladies, after some exhausting disease, cannot use a rocking-chair, because when they rock backwards, they feel as if they would tumble.

The digestion in the Borax case is impaired, as you might infer from the defective nutrition. Colic precedes the diarrhoea in the child I am describing. The stools are usually green, or they may be soft and yellow, but they always contain mucus. Here you have another illus- tration of the affinity of Borax for mucous membranes.

Aphthous in- flammation of the mouth appears as a concomitant of the diarrhoea. Aphthae form in the pouches on the inside of the cheeks, on the tongue and in the fauces. The mouth is hot, which the mother notices when the child takes hold of the nipple. The mucous membrane around these aphthae bleeds easily.

The child lets go of the nipple and cries with pain and vexation, or else refuses the breast altogether.

Similar to Borax are the following remedies: first, Bryonia; this remedy has caused and has cured infants' sore-mouth. But the char- acteristic symptom in Bryonia is this: the child refuses to nurse or makes a great fuss about it, but so soon as its mouth is moistened, it takes hold of the nipple and nurses energetically. Is not this in keep- ing with the character of Bryonia? Those of you who know anything of that drug will remember how dry the mouth is, and how devoid of secretion is the mucous tract.

Hence, when the mucous membrane of the mouth is moistened the child nurses at once.

Mercurius comes in as a substitute for Borax when, with the sore mouth, there is profuse salivation. Water dribbles from the child's mouth. The diarrhoea is accompanied by well-marked tenes- mus. These are sufficient distinctions between Mercury and Borax.

Again, you must remember a neglected remedy, and that is sEthusa cynapium, or the fool's parsley. This is to be preferred when the colic and crying are accompanied by the violent vomiting characteristic of this drug.

7IO A CUNICAI, MATERIA MEDICA.

Another remedy is Arum triphyllum. This is readily distinguished from Borax by the violence of the symptoms. The inflammation of the mouth is exceedingly violent and is accompanied by soreness and scabs around the mouth and nostrils.

Another common baby symptom in the Borax case is that the infant screams before urinating. The urine when passed is hot and has a peculiar pungent foetid odor. Now this is not to be confounded with gravel, which is not uncommon in little children, and which will call for Sarsapari/la. Lycopodium, Benzoic acid, etc.; but it is the equivalent of the inflammations of other mucous membranes, so that it compares with Aconite, Cantharis and another excellent baby medicine, Petrose- linum.

Do not forget this last named drug. It is not generally men- tioned in our materia medicas, yet it is an excellent remedy for condi- tions very similar to those calling for Borax when there is sudden violent urging to urinate. It may be indicated even in gonorrhoea when this sudden urging is present.

Passing from child to adult, we find that although the aphthous condition is still master, we still have many of the other symptoms of Borax, the same difficulty in digesting food, the same weakness, and the mucous membranes still the point of attack. We find, for instance, the conjunctiva, particularly the palpebral portion, affected by Borax, giving you soreness especially marked along the borders of the lids. The eyelashes grow inwards instead of outwards and irritate the eye- ball. You should remember it as a remedy which will sometimes help in trichiasis or " wild hairs," and here you should compare it with Graphites.

The nostrils ulcerate in the Borax case, causing a great deal of sore- ness, pain and swelling of the tip of the nose.

On the mucous membrane of the throat we find Borax having an action, being indicated, like all the soda salts, for accumulation of mucus there. But under Borax, the mucus is tough and difficult of detachment.

The leucorrhoea of Borax is clear, copious and albuminous. Like all the other secretions of Borax, this, too, has an unnatural warmth or heat to it.

The action of Borax on the lungs must not be forgotten. We find it indicated when there is cough which is accompanied by sharp stick- ing pain, worse through the upper part of the right chest. So sharp are these pains that they make the patient catch his breath. The

BORAX VENETA. 7II

expectoration has a sort of musty, mouldy odor and taste. You can often use Borax in lung troubles and even in phthisis when these symptoms are present.

Lastly, we have to mention a few symptoms of the skin. The skin is unhealthy ; every little cut or scratch suppurates readily. There is itching of the skin, particularly on the backs of the fingers, here being something akin to the dorsal eczema of Natrum carb. Little ulcers form about the joints of the fingers.

The best remedy we have for these small ulcers about the joints is Sepia.

Lastly, Borax has been used in erysipelas of the face, particularly of the cheeks. The distinctive character of the drug is a feeling as though there were cobwebs on the face.

I would advise to caution your nurses, if you can do so, not to use powdered borax every time the child has a sore mouth. It may do harm if it is not indicated. I think that I have noticed after this use of the drug that the bowels suffer and the child grows paler and dwindles rapidly, which it did not do before the meddlesomeness of the nurse.

LECTURE LXX.

SALTS OF POTASH.

Toxicologic ally, potash may be of some interest to you when, by accident, caustic potash is swallowed. Its great affinity for water makes it attack the tissues with great avidity, producing very deep escharotic effects. It has more power to penetrate the tissues than have some of the other caustics, nitrate of silver, for instance ; hence, it has been selected as the caustic for use when it is desired to reach far into the parenchyma of a part, as in the treatment of carbuncle ; when a large portion of tissue has become gangrenous and a slough must be produced, caustic potash is used.

The tissues thus acted upon have a greasy appearance, which is due to the formation of a soap made from the combination of the fats with the potash. Thus it differs materially in its action from the mineral acids, which make the tissues dry and dark, almost like a mass of tinder.

When swallowed by accident, for it is seldom used for suicidal pur- poses, the effects of caustic potash are violent. It causes such violent contraction of the stomach that what little of it gets that far is imme- diately ejected by violent vomiting. If the amount of caustic taken is sufficient, it causes a brownish film over the mucous membrane, or there may be spots here and there in the mouth and throat which are denuded of their epithelium. The inflammatory process may increase to such an extent that these spots ulcerate, and as they heal they form cicatricial tissue with the subsequent unfortunate contraction and stricture of the part.

The antidotal treatment to such accidents is both chemical and mechanical ; chemical, to relieve the effect of the drug, and mechan- ical, to relieve the trouble that remains. Vinegar, lemon-juice and large draughts of mucilaginous drinks are mostly relied upon to relieve the acute symptoms of this poisoning.

But there are many cases of slow poisoning with the potash salts, particularly when our allopathic friends use bromide of potassium so extensively. We, therefore, have the chronic effects to treat. These may require to antidote them : Hepar, which is an antidote to the metals in general ; Sulphur, and other remedies may be called for according to the symptoms present.

SAI/TS OF POTASH. 713

It has been determined by experiments on mammals, that potash, particularly the carbonate, acts paralyzingly on the muscles. This ac- counts for the general weakness which belongs to all potash prepara- tions. This paralyzing effect is very manifest in the case of the heart muscle, which becomes early affected in poisoning with potash, the animal eventually dying with the heart in diastole, that is, the heart is widely dilated at the moment it ceases to beat. With this hint, you would expect to find potash salts of use in great muscular weakness, in what has been termed paresis, such exhaustion as accompanies con- valescence from protracted diseases as typhoid fever.

We have it on the authority of Dr. Hering, that mushrooms contain a large percentage of potash, and are therefore to be recommended as an article of diet in cases of exhaustion.