Kali Bichromicum

[bichromate of potash.]

This salt is obtained in large quantities from the native chromate of iron. We make triturations and a watery solution in the pro- portion of five to ninety-five ; if made stronger, the bichromate crystallizes again out of the solution. The second attenuation is made in the proportion of twenty to eighty ; the third, in the pro- portion of ten to ninety.

"This salt, in small doses, say a few grains, acts as a purgative; in larger doses, say fifteen grains, it acts as a poison. A work- man in a factory put some bichromate into a barrel of cider by way of a joke. The cider was rendered dark in color, but the workmen drank of it, and were all affected with severe colic and diarrhoea. Diseases of the nostrils have been produced in work- men, who, having stained their fingers with the salt, have put them into the nostrils.

In transforming neutral chromate of potassa into bichromate, by means of acid, the vapor arising carries with it an infinity of molecules of the product, which spread through the workshop. This cloud of particles is easily visible in the sunlight. The molecules inhaled, give a bitter and very disagreeable taste to the palate ; but as profuse salivation is the result, the chromate is thrown off in the saliva and has not time to inflict any permanent injury. If, however, respiration be made through the nose, the mole- cules are dissolved in the layer of secretion which lies on the mem- brane, creating a violent pricking, suffusion of tears and irresistible sneezing.

In time, the membrane begins to be thrown off, and por- tions of it are carried into the handkerchief used in blowing the nose; this process, when once started, goes on so rapidly that after a period of six or eight days the septum becomes thin, permeated with openings, and is ultimately detached altogether. Snuff-takers escape this evil.

"On the skin, in its normal state and when intact, the bichromate exerts no baleful influence: the hand may, in fact, be plunged into a hot, concentrated solution of the salt, without fear ; the hand may also be covered with the salt for an entire day without any percep- tible effect; but if the skin is torn or abraded, however triflingly, by the prick of a pin for example, a sharp pain is felt on contact of the salt, and if it be left in contact with the wound, the caustic charac- ter of the salt is brought out intensely, the cutaneous tissue is de- composed and violent inflammation is established. These symptoms are accompanied with intense pain, especially during very cold weather; the action of the salt does not cease till cauterization has penetrated to the bone." (Dr. Cloet, in the Annales d' Hygiene, 1863.)

KALI BICHROMICUM. 233

The action of Kali bichromicum upon the healthy organism is of great interest to the medical student. It affects the mucous mem- brane of the body far more deeply than almost any other agent known, unless it be mercury. The inflammation, caused by the drug, is characterized by a decided tendency to degeneration and presents the various degrees of intensity which run from a deeply injected, sensitive and highly-reddened membrane, which soon secretes a stringy, tough mucus or is covered by false membrane, to a destructive ulceration.

Nor is this remarkable effect confined to any part or parts of the organism. On the contrary, it takes in the whole alimentary track, the vocal and respiratory organs, the conjunctiva, ureters and vaginal mucous membrane; and, no matter where its action is located, it is the same active, aggressive poison, swift in its action, overwhelming in its intensity, thorough in its destructiveness. Kali bichromicum acts also upon the fibrous tissue and upon some of the larger glands ; especially upon the liver and kidneys.

Its action upon the cartilaginous tissue is well-marked and illustrated by the destruction of the septum of the nose in workmen who are exposed to contact with this salt. The periosteum also seems sensibly affected by it, and not only have we, among its pathogenetic symptoms, tearing and shooting pains, and even hard swellings near the bone, but clinical experience has demonstrated the curative power of the salt in corresponding conditions.

The remarks of Dr. Cloet, concerning the action of the bichro- mate upon the skin, must not mislead us, for the following symp- toms are reliable ; they were either noted as the effects upon work- men in factories or recorded by trustworthy provers. Papula?, ecthyma, eczema, impetigo. Solid eruption, like measles, over the whole body.

Eruption of pustules over the whole body ; the pus- tules are of the size of peas, with a small back slough in the centre, resting on an inflamed base. Itching, followed by an eruption of small pustules forming scabs, which are painful, smarting and burn- ing. After exposure to the furnace, the men are attacked with blotches on the legs discharging a yellow matter. Papular rash.

Large ulcer with dark centre and overhanging edges ; these ulcers also form on other parts of the body, are of variable size, the hardened base movable on the subjacent tissues, with a blackish spot in the centre.

CATARRHAL AFFECTIONS. —Bichromate of potash has been found of great service in the treatment of catarrhal affections

234 KALI BICHROMICUM.

generally. Among them we might mention stoppage of the nose of infants, commonly called "snuffles/' when there is a tough, stringy discharge from the nose, and some tendency to cough.

NASAL CATARRH, acute or chronic. Thin watery discharge, with great sorenesss of the nose, redness of the nose; bad, foul smell ; ulceration in the nostril, in the septum ; accumulation of green masses of offensive mucus. Pain across the bridge of the nose ; soreness and pain commencing at the root of the nose, extend- ing along the frontal sinus with dimness of vision and lachrymation ; violent frontal headache if the discharge stops ; discharge of tough, stringy mucus.

CATARRHAL OPHTHALMIA with little redness or sensitive- ness to light, but sensitiveness to touch ; secretion of stringy mucus from the eye ; ulcers and pustules on the cornea.

ANGINA, especially of a chronic form, when there is dryness and rawness in the throat; difficulty of swallowing solids, leaving behind them a sensation as if something were left in the throat ; sharp, shooting pains in the left tonsil; sharp stitches in the left ear; slimy, yellow-coated tongue with bitter taste in the mouth; chronic nasal catarrh.

DIPHTHERIA with raw, shining tongue or yellow-brown fur on the tongue ; patches of greenish-yellow, firmly-adhering exudation all over the fauces ; sharp stitches in the left ear ; swelling of the parotid glands ; great weakness. The fauces are frequently covered with ulcers, dipping deep into the tissues ; the diphtheritic mem- brane shows a tendency to extend into the nostrils, and downward into the larynx ; hoarseness ; difficulty of breathing ; cough, hard and croupy ; expectoration, at times streaked with blood.

A characteristic indication for this remedy is the increased redness of the sound places of the mucous membranes of the mouth and fauces with increased sensitiveness. (Dr. Hirsch.)

On May 21st I was called to R. S., aged eleven months, said to have suffered from a cold for several days. I found the child lying on its mother's lap, very weak and languid, with low fever and almost total inability to nurse. I was told that it had been restless during the night, and that, though it desired food, it had been unable to swallow.

The face, especially the forehead, was of a bluish tinge, and the nose looked pinched and the mouth drawn. I applied the stethoscope to the larynx and found a thick, gurgling sound, intermingled with a flapping noise, as of a piece of loose membrane. The pharynx was red and swollen, white on the tonsils, and be- tween them, was a thick, tenacious membrane, of an ashy-gray color, tough and glutinous and could be drawn out in long strings. A spoonful of a solution of kali bichrofaycum, second decimal trituration in a cupful of water was given every hour.

NexJuBiyjhe patient was better in all respects and was dismissed on May 25th. (Dr. ThoHrs Nicholl in Am. Observe?-, Nov., 1877.)

KALI KTCHROMICUM. 235

Late in the evening of May 25th, R. H., aged six years, was brought to my office, suffering from sore throat. It was already dusk, but I saw, that though a high degree of inflammation was present, no exudation had yet taken place. Nex day, at 2 P.

M., I found that exudation had taken place during the night, and that the entire pharynx was coated with a tenacious pseudo-membrane, grayish in color, and of a very of- fensive smell. On auscultating the larynx and trachea, it was found that the disease had invaded these organs, and as a result, the breathing was harsh and stridulous and the voice partially suppressed. A harsh cough afforded additional evidence of danger. The nasal mucous membrane was also affected, but in a slighter degree.

Considerable fever was present, which apparently had not been preceded by chills. Kali bichro- micum was given internally, and every two hours the patient used a gargle prepared by adding two grains of Kali bichromicum, first decimal trituration, to half a cup of water. By evening a marked improvement had set in. The pseudo-membrane in the fauces was less consistent, though it had spread a little; the nasal mucous mem- brane was less virulent; the hoarse roll in the larynx and trachea was ameliorated; the ominous cough was looser and less frequent, and the patient felt less languid and . weary.

The disease was checked and the patient was dismissed by June 4th. [Ibid.)

Kali bicliromicum has caused "a dryness and burning in the oesophagus with difficulty of swallowing, especially solids/' and has been prescribed in

STRICTUKE OF THE OESOPHAGUS, depending upon, or accompanied by, spasmodic contraction.

On Monday evening I saw Mrs. G., who had been suffering since the previous Thursday with acute pain, on swallowing the slightest morsel, especially solids. The lower two-thirds of the passage was tender, but the most acute pain was at the cardiac orifice of the stomach, seeming to stop the passage of anything, until several efforts to force it through had been made. No fever or thirst, and, with the excep- tion of being hungry, she was feeling as well as usual.

Treatment from that time until Wednesday morning was unsuccessful, the patient growing rather worse, when she received Kali bichromicum, one dose every hour. The difficulty was wholly relieved by five o'clock that evening. (Dr. O.

D. Childs in Ohio Med. and Surg. Reporter, January, 1S70.J

LARYNGITIS. — The bichromate is better adapted to chronic inflammations tban to acute forms and is found very useful in fol- licular laryngitis, with secretion of tough, stringy mucus, causing a hard, suffocating cough which is especially troublesome toward morning. Symptoms of chronic catarrb, with relaxation of uvula ; difficult breathing as from a thickening of the bronchi ; sensation of choking upon lying clown. When

APHONIA develop]}, in consequence of such an inflammation, with chronic catarrhal complications, with characteristic symptoms, and when the voice becomes husky toward evening, it may act curatively.

CEOUP. — The disease develops gradually; hoarseness of voice; dry, metallic cough ; painful deglutition ; swelling of the tonsils and larynx ; false membrane ; difficult expectoration of false, stringy membrane ; great difficulty of breathing ; asphyxia. In

CATARRHAL INFLAMMATION OF THE RESPIRA- TORY ORGANS kali bichromicum will act promptly, Avhen^the

236 KALI BICHROMICUM.

cough is excited by a tickling in the larynx or at the bifurcation or from an accumulation of mucus in the larynx. Expectoration is difficult and the mucus raised can be drawn out into long strings. The cough is worse in the morning, after eating, and in the cold. Better after getting warm in bed. Pain from the middle of the sternum to the back. Dull pain in the right side, over a circum- scribed spot, worse on inspiration.

CHRONIC BRONCHITIS with great dryness of the throat and uneasiness, soreness and pain in the larynx. Pain in the chest, from the mid-sternum to between the shoulders ; soreness, rawness and heat in the chest. Cough from tickling in the throat, followed by dizziness ; expectoration of tenacious, white mucus. Transient, flying pains all over the body ; restlessness ; disturbed, unrefreshing sleep; dyspnoea; trembling of the limbs ; loss of appetite.

PNEUMONIA, with croupy symptoms and indications as de- scribed previously.

PERTUSSIS with expectoration of tough, stringy mucus. Worse after eating, after inspiration and from cold. In

PHTHISIS, also, the bichromate may be found of occasional use. The following indications are given: "Dry, titillating, or loose, hoarse cough; especially indicated when the larger bronchi are affected ; cough aggravated on rising in the morning, or first part of the night ; sputum stringy, ropy, of a yellowish-white color ; some- times it 2'ets attached to the throat and causes a suffocative feelino-; hoarseness; stitches in the sternum, darting through to between the scapulas, also across the chest and right infra-clavicular region.

Fre- quent thirst for large quantities of water. Tongue coated yellow, especially at the base ; breath very offensive ; great restlessness at night." (Dr. B. G.

Carleton, Horn. Times, August, 1879.)

Kali bichromicum may be found useful in

DYSPEPSIA, with waterbrash and chilliness ; nausea, vomiting of undigested food, sense of coldness in the stomach.

CARDIALGIA, with uneasiness in the stomach, soreness and ten- derness in the stomach, nausea, restlessness, heat of hands and feet, dryness of the mouth, afterward perspiration of hands, feet and legs.

DYSENTERIC ATTACKS, with pain at the navel and bloody evacuations, every summer.

CONSTIPATION with dry, dark, knotty stools, followed by burning in the anus and, at times, with retraction of the anus. Debility, loss of appetite, coldness of the extremities ; flatulence.

KALT BICHROMICUM. 237

N. A., aged thirty years, consulted me in October. Her symptoms were: Want of appetite ; fulness at the chest ; a great deal of flatulence ; taste of rotten eggs, with constant nausea; great dislike of fat meat; tongue reddish and rough; head- ache ; sharp, shooting, stabbing pains extending all over the head ; pains worse in the afternoon and evening; the bowels obstinately constipated. The patient was getting very weak, since she could take but little nourishment.

She also complained of great heat of the body on walking about. Her eyes felt weak and there was a great deal of pain in the eyeballs. Great drowsiness and languor in the daytime, with sleeplessness at night. Sharp, shooting, aching pains frequently existed in the sides and back.

Kali bichromicum*, taken four times per day, soon cured the patient. (Dr. A. E.

Hawkes in the Horn. World, December, 1874.)

Kali bichromicum has caused wandering, jerking, shooting, tear- ing pains in different parts of the body, frequently in the articula- tions of the upper and lower extremities and inclined to change location suddenly. Hence it has been used in

RHEUMATISM, presenting such symptoms, accompanied by or alternating with gastric derangements.

SCIATICA running downward as far as the knee; shooting, darting pains, shifting about and coming on and subsiding quickly ; pressure aggravates the pain greatly ; worse in hot weather ; relieved by motion of the leg ; better adapted to men than to women.

RHEUMATIC PAINS ABOUT THE HEART, of a pricking nature, with coldness in the region of the heart. Dyspnoea.

In diseases of the sexual aud urinary organs you will find Kali a useful though not frequently indicated remedy. Its effects upon the mucous membrane have been pointed out and the characteristic secretion of stringy mucus, one of the most reliable symptoms of the drag, makes it of occasional use in

LEUOORRHCEA. The discharge is often yellow, at times whitish, but has ever that "ropy" character; there is weakness in the back, dull heavy ache in the hypogastrium ; profuse and too early menstruation ; catarrhal symptoms. It is particularly suitable to fleshy people of light complexion with indications of a scrofulous diathesis.

UTERINE PROLAPSE. — Similar symptoms are often found in uterine prolapse, and here also the remedy may be exhibited to advantage ; the local difficulty is unfavorably affected by hot weather.

Kali bichromicum has caused : escape of prostatic fluid at stool ; burning in the urethra while urinating ; acute drawing from the perineum into the urethra ; frequent desire to pass urine, frequent emission of watery, but strong-smelling urine. Urine rel, with pain across the back ; scanty urine with white film and milky deposit ; turbid urine with a copious, thick, mucous sediment.

238 . KALI BI0JIKOM1CUM.

These symptoms suggest its use in

INFLAMMATION OF THE PROSTATE GLAND; in

DIFFICULT AND PAINFUL URINATION, and in certain

forms of

GONORRHOEA, characterized by corresponding symptoms.

The symptoms of the bichromate would seem to justify its use in syphilitic diseases ; it has not only many skin-symptoms, but we have also the bone-pains, the inflamed, disorganized state of the mucous membrane and various other, seemingly pointed, indications. Clin- ical experience shows that this salt is adapted to the scrofulous taint rather than to the syphilitic poison, and we are inclined to think that it can be of much service only in those cases of syphilis, where the disease is largely modified by this scrofulous dyscrasia.

In the treatment of diseases of the skin Kali bichromicnm pJays an important part. You will find it of particular service in the following :

HERPES witli great itching and burning, worse in warm weather ; mostly on the arms aud legs ; pustules small.

ECTHYMA. — The eruption covers the whole body, even to the roots of the nails and resembles small-pox. The pustules have a small, brown scab on the top, which comes off after a few days, leaving a small, dry and round, cleanly-cut ulcer.

IMPETIGO or pustular eczema with dry pustules and considerable itching ; these disappear gradually, drying off, to make place for a new crop.

In prescribing for these and other forms of skin disease, it will be necessary to repeat the old plea for a thorough study of your patient, including all that may throw light upon the general health and to bring put all the symptoms, which may aid in the selection of the remedy. In kali bichromicum, then, you must remember that it is well adapted to the scrofulous diathesis and eminently suitable to fat persons of a light complexion, old or young ; the scrofulous taint may show itself in various ways ; in chronic sore eyes, in catarrhal and other irritations of the mucous membrane, in cough, sore scalp, etc. The characteristic symptoms of the remedy must be present, if you would expect any benefit from its administration. When these conditions are fully met with, you may derive the best results from its use in conditions even, whose counterpart are not found in the pathogenesis of the drug, as in the following:

LUPUS.—

KALI BR0MATUM. 339

Dr. Edward F. Blake relates a case of lupus non exedens, occurring in a woman of forty- eight years, which was first noticed in 1866 as a scab at the angle of the right nostril. On March 27, 1873, she presented herself with characteristic nasal lupus.

There was no copper tint, no circumferential induration ; the nostrils were obstructed ; occasionally they discharged yellow crusts and blood. Oh April 3d she received kali bichromicum 3d decimal trituration, which was changed to the 5th decimal on April 15th. An improvement was noticeable in a short time, and was continuous, as was the treatment, until on the 18th of December, there was neither tubercle nor depression on the nose ; in fact, the cure was complete. {Brit. your. of Horn., October, 1870.)

ULCER ON THE CORNEA with stringy discharge from the eye, and an absence of the symptoms which usually accompany in- flammation; indolent ulcer. Corneal opacity. (See case of Dr. Hawkes, Dec, 1874, Horn. World.)

ULCERS. — In ulcers on various parts of the body the bichromate is a valuable remedy. The ulcer is cut deep, as if punched. Its edges are regular.

Mental symptoms: listlessness ; languor; depression; ill-humor; disinclination for mental or bodily labor. These symptoms are of value only as a part of the totality of symptoms.

- KALI BEOMATUM. [bromide oe potassium.]

The bromide of potassium, of which Hearing swallowed thirty- seven grains in the space of nine days, developed all the symptoms of bromine, and moreover a disagreeable and exceedingly painful hoarseness.

Ten grains of this bromide, applied to the denuded surface on the arm, caused a violent, drawing-burning pain in the whole arm, with the pulse up to 85 or 90. Next day he had several papescent and afterward liquid stools ; increased secretion of urine ; racking cough with dullness and confusion in the head ; violent headache, particu- larly in the occiput; loathing, effort to vomit, with vomiting of mucus ; saltish taste in the mouth.

Heimerdinger swallowed thirty grains of the bromide of potassium dissolved in half an ounce of water, upon an empty stomach. He experienced the following symptoms, which we give in the order of their development : Ptyalism, saltish taste, feeling of warmth in the abdomen ; in a few hours, violent vertigo with confusion of the head, dilatation of the pupils, repeated eructations, slight colic, flatu- lence, slight oppression when drawing breath ; troublesome pressure

240 KALI BROMA.TUM.

at the stomach after dinner, lassitude, thirst, increased secretion of urine.

Sixty grains divided into six powders and the whole of them swallowed in the course of the day, produced the same symptoms.

Dr. Puche has administered the bromide of potassium in enor- mous doses to syphilitic patients. These doses induced a re- markable headache. Soon after setting in, it developed a sort of dullness and giddiness such as may be observed in some forms of typhus, and the sight and hearing likewise became disturbed. The memory and the thinking faculty were impaired; the giddiness was generally accompanied with drowsiness and sometimes with actual stupor ; delirium was seldom present.

As a consequence of this giddiness or intoxication we observe a remarkable degree of restlessness and fitfulness of motion, the patients being sometimes unable to keep themselves on their feet. At the same time the sensibility is so far gone that the skin can be pricked, pinched, and burned even without the patient being at all conscious of it. This insensibility, however, is one of the more remote effects of the bromide of potassium, and only sets in after the continued exhibition of enormous doses.

Many of these headache symptoms correspond with the symptoms developed by Hcering and Heimerdinger.

These symptoms do not seem to justify the use of the bromide of potassium in ordinary forms of headache. The headache, which conies within the curative range of this agent, seems to form part of a constitutional cachexia, hydrargyria, scrofulosis or perhaps tubercu- losis. In syphilitic affections the bromide of potassium has disap- pointed Puche, Ricord and other experimenters. It has been tried in secondary as well as tertiary syphilis, roseola, papulae, glandular en- largements, exostoses, nocturnal bone-pains, gummata, ulcers in the throat, without producing the least favorable change in a single case.

According to the observations of Dr. Puche, the bromide of potassium affects the sexual organs of the male very differently from what is observed from the iodide of potassium. Even in the case of the most robust individuals the sexual morning-erections ceased, and a state of impotence supervened, which lasted even for some days after the drug was discontinued. The iodide of potassium, on the contrary, produces an opposite result.

The erections are more frequent, more vigorous than in the normal state of the organism. Hence we may conclude that

KALI BROMATUM. 241

IMPOTENCE may be favorably acted upon by the bromide of potassium, more especially in the case of scrofulous individuals who have been guilty of excesses, or when constituting a symptom of mercurial cachexia! This consideration may be complicated with incontinence of urine, which is likewise one of the effects of the bromide upon the urinary system.

CHRONIC AFFECTIONS.— We may recommend the bromide of potassium in chronic affections of the air-passages, with distressing hoarseness, headache, hacking cough, oppression on the chest, saltish taste in the mouth. It may prove eminently adapted to such affec- tions when grafted upon a scrofulous or tubercular base.

The effect of this salt upon the mind is unique. The physio- logical school looks upon it as one of their best remedies in the treatment of epilepsy, prescribing it in very large doses and. contin- uing it until characteristic skin-symptoms make their appearance ; it is but justice to add that the result of this treatment is by no means satisfactory to the candid observer. Their literature abounds in articles which give us much valuable information on the effect of the drug upon the mind, producing, in many instances, strongly marked mental aberration.

Dr. Hammond prescribed for a gentleman who suffered from a severe headache, a solution of bromide of potassium, of which he was ordered to take three doses per day, each dose containing about fifteen grains of the salt. The patient, on his own responsibility, increased the strength of the solution, until he frequently took one ounce of the bromide during one day. Unsteadiness of gait de- veloped itself and he was arrested and fined for drunkenness in con- sequence of it.

Soon after, insanity declared itself. He thought that lewd women had got into his mother's house ; that his life was threatened by members of his family ; that he was pursued by the police, etc. His appearance was similar to that of a drunken man, except that his face was exceedingly pale. His pulse had fallen from eighty to sixty per minute ; his skin was cool, and his pupils con- tracted.

His manner was excited and rambling and his hands were constantly busy at some trivial occupation. His character alsu had undergone a radical change. From having been very frank and brave, he had become excessively timid and suspicious of everything. Finally he became dangerous, attempted to jump out of a window and was at last removed to a lunatic asylum, recovering in about a month.

But his headaches returned as soon as the effects of the bromide of potassium wore off.

A middle-aged lady had been suffering with epilepsy from early

VOL. II. — I".

242 KALI CARBOXICUM.

childhood, and received from Dr. Hammond thirty grains of the bromide of potassium three times each day. After she had taken it for thi'ee days, she experienced weakness of the lower extremities, and an inability to stand erect. There was also well-marked numb- ness throughout the body and very decided diminution of sensibility.

Her eyesight, hearing, taste and smell were likewise weakened and the pupils were greatly contracted. Extreme drowsiness now came on Her memory was absolutely destroyed, she could not even re- member her name. Frequently she would burst into -tears for no cause whatever. There was also constant twitching of the ringers.

The dose was then increased to forty grains, because some symptoms of an epileptic seizure showed themselves. When seen later she was incoherent, full of delusions of no fixed character, was unable to walk, thought she was deserted by her friends; imagined her child dead and refused to acknowledge it as hers, when brought to her. The remedy was continued in smaller doses and the patient was thought to have been cured of the epilepsy. In another case intense melancholy, accompanied by fits of uncontrollable weeping and positive delusions were produced.

Another patient imagined himself singled out for divine vengeance, and spent his time in weeping and loudly lamenting his fate. Thought himself accused of robbery and pursued by officers. His gait was unsteady ; his hands and fingers in constant motion.

A lady, who had taken the bromine under advice of Dr. Brown- Sequard, was taken to Long Branch. She there fancied that the boarders had insulted her, and imagined that the weekly bills of the landlord were the evidences of a conspiracy which had been entered into against her father. On the way from Long Branch to New York, while standing on the guards of the boat, she suddenly gave a loud shriek, and declared she had seen her brother fall overboard.

The discontinuance of the remedy was followed by a disappearance of insanity.

INSANITY. — Homoeopathic physicians are evidently justified in prescribing the bromate of potassium in cases of insanity, charac- terized by symptoms like those described above.

KALI CARBON IOTJM.

[carbonate oe potash.]

This salt is obtained from the bicarbonate of potash by driving off the water of crystallization by heating this last-mentioned salt, then allowing the crucible to cool, and dissolving the contents in distilled water, filtering and evaporating to dryness, stirring all the time with a rod, and keeping the crystals in a well-closed vessel.

KALI CARB0N1CUM. 243

We make a watery solution ; the second solution is likewise to be made with water, the third with dilute alcohol.

According to the few cases of poisoning which we possess of this drug, it exerts a most irritating action upon the oesophagus, upon the mucous lining of the stomach and alimentary canal generally, and upon the ovario-uterine system. In one case related by Sir Charles Bell, the inflammation of the oesophagus developed a stricture from which the patient suffered for twenty years, and finally died, completely starved, as it were.

Like kali bichromicum the carbonate of potash has a strong affinity for the mucous membrane, but the preference for the respi- ratory organs is even more marked and in the various coughs which afflict mankind, this remedy occupies a most important position. It causes a peculiar stitching pain in various parts of the body, which is strongly characteristic of the remedy and is frequently found in diseases of the thoracic viscera, the heart included. It is also a valuable remedy in derangements of the ovarian-uterine system. Like the other salts of potassium, it affects the skin and is homoe- opathic to many eruptive diseases.

An exhaustive proving of kali carbonicum can be found in the Chronic Diseases. A number of spmptoms of provings published were obtained by means of the thirtieth dilution. These are exceed- ingly unreliable and from them might be established a homceo- pathicity of the drug to every disease mentioned in our text-books ; while its true sphere of action is indeed somewhat limited.

You will find the carbonate of potash a reliable remedy in the following :

COUGH produced by tickling in the throat. It may be impos- sible for the patient to expectorate, and if so, the cough becomes very annoying and wearing, since a sensation, as if something were loose and ready to be thrown off, causes a continuance of the effort ; there may be an expectoration of tough mucus or pus, even streaked with blood. We find great debility, constant, dry cough, day and night, with expectoration of blood and pus, especially tormenting between 3 and 4 a. m.

The least provocation brings on this cough, motion, sitting up in bed or exposure to the slightest draught of cold air. There is hectic fever ; keen, stitching pains in the chest ; and an irritability of the stomach, depending in part upon the constancy of the cough and upon the continued expectoration, these fits of

244 KALI fiAEBOKICUM.

coughing frequently terminate in spells of vomiting with complete unloading of the contents of the stomach.

PHTHISIS. — Many of these symptoms are found in phthisis, a pathological condition which is foreshadowed in the pathogenesis of the drug. We may add : stitches in various parts of the body ; con- stipation; constrictive pains in the chest and throat; copious pers- piration ; puffing of the upper eyelids. Kali carbonicum is said to act most readily upon the lower portion of the right lung. In

ASTHMA, kali carbonicum may be of service if the patient is somewhat advanced in life, has a severe cough and complains of stitching pains in the chest and heart.

OAEDITIS. — Lilienthal recommends the remedy in carditis with stitching pain in the cardiac region, frequent intermission of the beat of the heart ; impending suffocation with inability to lie down ; crampy pains as if the heart were suspended by bands; systolic murmurs, the second tick loud from pulmonary stagnation ; insuffi- ciency of the mitral valves ; ebullitions, with heat from the abdomen "to the head ; pulsations all over.

ANGINA PECTORIS

Miss K., a lady of twenty- five years, was attacked with angina pectoris. The paroxysms commenced from 3 to 4 p. M., and lasted from two to four hours. There was great suffocation with inability to assume a recumbent position ; nun.bness of the extremities, with great rigidity of the wrist, ankle and knee-joints.

If the joints had been anchylosed, they could not have been more rigid, the patient requiring them rubbed for hours before this condition was overcome. Aconite, bryonia, phosphorus, arsenicum were taken for six days without any relief. Owing to her inability to re- cline the head backward, or even to raise it erect without producing suffocation, I was induced to give kali carbonicum500. The first paroxysm, after taking this remedy, was comparatively light, and much shorter than the previous ones, and the body could recline at an angle of forty-five degrees, even during the paroxysms.

This was the last attack the patient had. (Dr. C. Preston, in Am.

Jour. Horn. Mat. Med., Nov., 1875.)

H. R., a lad of eleven years, was taken with neuralgia of the heart, complicated with pneumonia of the left lung. I found the patient in a half-recumbent position, inclined to the left side, and he could lay in no other posture, owing to the aggrava- tion of the severe stitching pains in the chest by the slightest movement, and the increase of the distressing dry cough. Pulse 145 per minute and respiration about fifty.

Gave aconite for 24 hours without any relief, followed by arsenic for an equal length of time with no benefit. Bryonia followed by phosphorus were given for the next 48 hours, at the end of which time I think the patient was less comfortable than when I first saw him, being unable to recline the head, or turn the body to either side, not having slept more than ten minutrs at a time for four days, and such naps far between. At this juncture I gave kali carbonicum500. The effect was immediate.

The stitching pains were relieved, and the cough softened, and the night following the first dose, the patient was able to lay comfortably, with the body reclined at an an angle of forty-five degrees, and slept several hours. From this moment convales- cence commenced. While other remedies were given at the commencement of these cases, no permanent improvement took place until kali carbonicum was given, and after it had been given, improvement was permanent. (Dr.

Preston.)

DYSPEPSIA. — Kali carbonicum is homoeopathic to dyspepsia

KALI CARBONICUM. 245

with nausea provoked by the mere sight of food. Chilliness, dry skin-j pulse small, unequal; face pale and sunken, oedema of the upper eyelids ; yellowish-white coating of the tongue ; desire for sugar and sweets. Epigastrium hard and sensitive to the touch ; feeling of fulness after eating even a small amount of food, which soon gives way to a feeling of goneness; nausea, eructations; vom- iting of food and mucus ; constipation from inertia of the rectum ; restless sleep toward 2 or 3 a. m. with aggravation of all the symp- toms. Vertigo provoked by the least motion, and especially by riding in a carriage ; cardialgia.

Anna Custer, of delicate constitution, aged twenty years, was attacked by asthma and severe pains of the joints and was treated at the hospital. Since her dismissal from there, more than a year ago, she suffers from gastric and other troubles ; every- thing she eats produces continual pressure; tension in the stomach; small portions of coffee or weak soup fill her up, with eructations ; nausea and vomiting ; she com- plains also of frequent headache and toothache; hot flashes with abdominal pulsa- tions ; vertigo ; continual chilliness ; cold feet ; internal chilliness, with constant inclination to micturate, but the urine flows slowly and causes a burning sensation ; stool dry, retarded ; pit of stomach hard and painful to the least touch ; respiration heavy, oppressed, especially when walking ; when stooping, the pain at the pit of the stomach increases and the respiration becomes more oppressed ; the pain frequently moves over the ribs to the back : feet cold ; features pale, cedematous around the eyes ; sleep restless and dreamy ; skin dry.

The patient suffered on as long as she was able to work, but as the sufferings increased, she felt obliged to take to her bed, Dec. 2, 1869. Cured by three doses of Kali carbonicum800. (Dr. Schelling in Am.

Jour, of Horn. Mat. Med., vol. iv.)

DIARKHCEA of strumous subjects and of old persons; stool light gray; burning at the anus after stool ; hard, bloated abdomen, sensitive to pressure ; daily colic. In

LUMBAGO kali has been, recommended, when the pain shoots into the nates and aggravation of the symptoms occurs at 3 a. m.

MORBUS COXARIUS has been treated with the same remedy, as illustrated in the following cases :

M. H., twenty years old, lymphatic, has been confined to his bed for six weeks; he complains of sharp, drawing pains in the right knee and thigh ; the afflicted leg was about three fingers' breadth longer than the sound one, the nates flattened, movement of the joint painful, although pressure caused no discomfort; pulse fever- ish ; loss of appetite, tongue coated white ; aggravation at night of the pains, but little sleep. Kali carbonicum*0, ten globules in one hundred and fifty grammes of distilled water, every three hours a table-spoonful.

Rapid improvement; in less than three weeks he was cured without a repetition of the remedy being necessary. {Cincinnati Med. Advatice, November, 1878.)

M. V., aged fourteen years, sanguine-lymphatic, weakened by the loss of semen. He had felt for some time pains and heaviness in the left thigh, increased by walk- ing and particularly by forced marches. This affection was mistaken for rheumatism and treated by inunction.

On examination of the lower extremities I learned that the left leg was a finger's length longer than the right one, and the head of the femur was partly forced out of the acetabulum and threatened a spontaneous luxa- tion. Considering the severity of the case I ordered absolute rest in bed, and pre- scribed kali carbonicum as above. Cured in fourteen days. [Ibid.)

246 Kali chloricum.

Kali carbonicum has been found a valuable remedy in some diseases peculiar to women ; among them we may mention the fol- lowing :

LEUCORRHCEA with troublesome itching and burning ; excori- ations from the leucorrhoeal (yellow) discharge and from the menstrual flow ; great sensitiveness of the vagina ; stitching pains.

DYSMENORRHEA. "Pains colicky, cutting, stitching in the abdomen ; the flow is pungent, acrid and excoriating ; headache, with heaviness ; coryza ; itching of the whole body ; irritable ; anxious." (Prof. J. 0. Sanders.)

PUERPERAL EEVER.— The characteristic symptoms of the remedy are the stitching pains, which do not depend upon motion, but are as apt to occur during perfect quiet, and the extreme tym- panitis. (Dr. Guernsey.)

EXTERNAL OTITIS The late Dr. Woodyatt recommends the carbonate of potash in external otitis with violent itching and tickling in the ears. Discharge of a yellow liquid, cerumen of pus, with previous tearing in the ear.

Gurgling in the right ear and secretion of a quantity of soft wax. Redness, heat and violent itching of the outer ear. Throbbing in the right ear at night. Ulcerative pain in the right outer ear.

Boring and aching in the ears. Clawing sensation in the left outer ear. Throbbing in the right ear at night, when resting upon it.

KALI OHLOEIOUM.

[CHLOEATE OF POTASH.]

Chlorine gas in combination with a solution of caustic potash. " It occurs in white rhomboidal plates of a pearly lustre, of an acerb taste, dissolving in sixteen parts of water at 60° F. and in two and a half parts of boiling water." (H. C. Wood, Therapeutics.)

Chlorate of potash is an irritant poison, producing strong irritant effects when applied to mucous membranes and raw surfaces, and violent inflammation and even death when taken internally. When fatal consequences follow the internal administration of this salt, they are evidently due to its irritant action upon the stomach ami intestines. It is supposed that an elimination of the salt takes place through the secretions, more particularly through the urine. Within five minutes after its ingestion it has been found in the saliva; in

EALI HYDRIODICUM. 247

ten minutes it was present in the urine, where it could be found for fifteen aud even forty-eight hours. The physiological schools use the salt in the various forms of stomatitis, especially in the aphthous stomatitis of children, also in dropsical affections. Locally it is fre- quently employed as a gargle or wash in the various forms of angina and in other conditions where a stimulant to the mucous membrane is desired.

We have a few provings of this drug. It seems to act with some specific power upon the thoracic organs, causing oppression of the chest, violent beating of the heart, and a sensation as if the lungs were strung together as with a cord.

KALI HTDEIODIOUM.

[iodide of potassium, htdriodate op potash.]

This is iodine in combination with caustic potash. It is one of the mildest preparations of iodine, which has been used empirically by old-school practitioners in a variety of diseases. It is particu- larly in affections of a mercurial, syphilitic and scrofulous character that this important salt is employed by homoeopathic practitioners. Some of them make triturations of it, but it is far better to make a watery solution at the time when it is to be used, unless we decide to resort to the potentized drug.

CEREBRO-SPINAL GEOU

This agent may cause congestions to the head, especially in the frontal region. It also causes a sudden headache as if a wedge were forced in between the eyes down to the base of the brain, accom- panied by a violent pain in the eyes, violent pain and swelling of the corner of the eye; continual discharge of a clear fluid from this corner, with profuse secretion of tears. Lancinating stitches through the head, temples, vertex, forehead, have likewise been experienced from the hydriodate of potash.

A man of forty, who took the hydriodate of potasn for some chronic affection of the bowels, experienced, after every spoonful of a solution of ten grains of the drug in six ounces of distilled water and one ounce of gum arabic, the following symptoms : congestion of the head, vertigo, constriction of the throat, dryness of the mouth, anxiety, continual oppression on the chest, an irritation in the throat

248 KALI IIYJDEIODICUM.

resulting in cough, trembling of the limb and staggering as if he were intoxicated, so that he had to lie down. These symptoms lasted about an hour, when he felt well again ; the pulse was rather tense, hard, not particularly accelerated.

These various symptoms show that, in a certain order of cerebral affections, the hydriodate of potash may be required as a therapeutic agent. It is not improbable that in

ENCEPHALITIS, with tendency to effusion, or even after effu- sion has actually set in (hydrocephalus), this agent may still save life, if other means fail us. Frank relates several cases of acute hydrocephalus where the hydriodate of potash effected a cure.

One was a boy of five ^ars, who had a fall on his head. Eight days after this occurrence, the followin 3 symptom*- suddenly set in : Complete stupor and blind- ness, heat about the head, immobility of the pupils, complete cessation of the secre- tions, hurried pulse and violent convulsions which terminated in permanent opisthotonos. A pretty strong solution of the hydriodate of potash was given in tea- spoonful doses. Very soon the urine began to flow in abundance, and a profuse coryza took place.

The patient recovered.

Another scrofulous boy of two years was attacked with meningitis. After a most fruitless antiphlogistic treatment, all the signs of effusion showed themselves : staring and watery eyes, immovable and dilated pupils, complete blindness, tetanic rigidity of the cervical muscles, boring of the head into the pillow, paralysis of the left ex- tremities, deep sopor, slow pulse, fifty in the minute, whereas it had previously been small and rapid ; frequent crying out and vomiting. The hydriodate of potash was given for three days without any apparent change in the symptoms ; on the third day, profuse urination and a catarrhal discharge from the nose took place, after which the child recovered.

At the commencement of the sickness, a tumor of a stony hardness showed itself on the side of the neck. This was poulticed in the course of the sick- ness, and discharged a copious quantity of good pus, together with a mass of dead cellular tissue.

I look upon the hydriodate of potash as an admirable remedy for congestions of the brain, or inflammatory irritations of the meningeal membranes arising from the suppression of an habitual catarrhal discharge from the nose.

We have seen that this drug may cause violent trembling, to such an extent that the patient may have to lie down. This makes it valuable as an antidote to

MEKCUPJAL TREMORS, and to purely nervous affections, where trembling is a prominent symptom. Even in

HYSTERIA or hysteric spasms this medicine has been employed with excellent effect.

Frank relates the case of a lady of forty-three years, of exceedingly ftful tempera- ment, at times depressed even to desrair, and then again of unbounded hilarity. At times she remained almost without iood. At such times she had violent spasms of the respiratory and abdominal musci.s ; the hearc beat ii regularly, and she was tor- mented by anguish. She uttered piercing cries, complained of sharp pains in the region of the heart, attempted to tear the flesh oft" her breast. These spasms often

KALI IIYDRIODICTJM. 249

continued for weeks; the pulse was feeble, slow, small, and could scarcely be felt. She had been getting worse for the last ten years. All treatment had been unavail- ing so far. She took the hydriodate of potash for three weeks, and remained per- fectly well after this. The case was reported one year after the cure ; up to that period she had continued to enjoy good health.

ORBITAL GROUP.

The hydriodate of potash may be of use in chronic inflammatory affections of the eyes, more particularly when of a scrofulous char- acter; chronic

SOKE EYES, remaining after an acute inflammation, with

oedema of the lids, specks on the cornea, secretion of tears. (Edema of the eyelids is a characteristic effect of this drug in scrofulous individuals.

CHTLO-POIETIC GROUP.

Its action upon the lining membrane of the inner mouth is very remarkable.

STOMATITIS The hydriodate of potash may develop stomatitis resembling in all respects that caused by mercury. In the case of a young soldier, twenty-two years old, the hydriodate of potash oint- ment applied to the jaws, caused the following remarkable group of symptoms: Heat in the whole mouth, violent ptyalism followed by broad, irregular, superficial ulcerations of the mucous lining of the upper jaw, exhibiting a whitish surface as if lined with milk, and narrow, almost colorless edges ; these ulcerations emitted a fetid mercurial odor, and very soon spread along the margin of the tongue, over the inner surface of the cheek opposite the gums, aiid breaking out more especially along the alveolar margin of the gums, which had receded from the teeth, leaving these latter loose and denuded; this inflammation was attended with a general febrile reaction, and the swelling was so considerable that the patient found it impossible to open his mouth ; the tongue, tonsils and the soft parts of the affected side were involved in this affection, and the ptyalism was excessive.

The patient had lost all appetite and sleep, and the pain was so great that he was occasionally attacked with spasms. The patient having never been affected with syphilis, nor subjected to mercurial treatment, this violent phlegmasia of the mouth had to be attributed to the action of the hydriodate of potash.

When it became possible to examine the inner mouth, the impres- sions of the teeth became distinctly visible along the margin of the swollen tongue ; the ulcers in the tongue and cheek were deeper than at first, but no longer exhibited the same ash-colored appear-

250 KALI HYDRIODICUM.

ance ; their edges had become more prominent, indurated and looked bluish ; the gums looked spongy, yellowish-gray, iilcerated ; the teeth were still somewhat loose and the pain of the affected parts was less. Astringent applications soon removed this whole difficulty.

Iodine and its compound, the hydriodate of potash, have been given as antidotes against mercurial stomatitis. In the Berlin hos- pitals, the tincture of iodine is very commonly resorted to for such purposes with astonishing effect. Nevertheless Martin, who reports these and other similar cases in the Revue Medicale, comes to the sapient conclusion that iodine cannot possibly cure ptyalism, because "it would be irrational to attribute an anti-sialogogue prope?'ty to a drug which is in itself capable of producing this effect in the highest degree of intensity and duration."

This shows, as Frank justly observes, to what injustice and ab- surdities a blind adherence to scholastic dogmatism may lead. The curative virtue of iodine in mercurial ptyalism is denied, for no other reason than because it does not square with the stale dogma " con- traria contrariis."

This agent is not without some marked action upon the stomach and bowels. In two women Wallace observed after thirty grains : extreme sick feeling, sensitiveness of the mouth and fauces, colicky pains, vomiting, slight diarrhoea, frequent pulse and exhaustion.

GENITOURINARY GROUP.

This agent causes a copious secretion of a pale and watery urine, and a discharge of mucus from the urethra in both sexes. We may therefore recommend the hydriodate of potash as a remedy for the

ENURESIS NOCTURNA of scrofulous children, or for the enuresis caused by abuse of mercury. It may also prove useful in

IRRITABLE BLADDER, and catarrh of the bladder. In

GONORRHOEA of long standing, with constant urging to urinate, discharge of green, thick mucus, burning pain during urination which caused a spasmodic constriction of the exceedingly sensitive and irritable urethra, the hydriodate of potash, with an excess of iodine, effected a perfect cure after a variety of remedies had been tried in vain for upwards of a year. In

LEUOORRHGEA, as a symptom of scrofulosis, the internal use of this agent, with mild injections of the same, has effected a cure.

RESPIRATORY GROUP.

The hydriodate of potash affects the mucous lining of the whole

KALI HYDEIODICUM. 251

of the respiratory tract with peculiar intensity. It seems to be pos- sessed of a peculiar power to irritate the mucous lining of the frontal sinuses and the Schneiderian membrane. It causes an inflamma- tion of the mucous membrane of the nose and eyelids. Noack and Trinks give the following picture of the hydriodate of potash catarrh: "Catarrhal inflammation of the Schneiderian membrane, in the frontal sinuses and the antrum Highmorianum as far as the posterior nares ; red, swollen nose, with constant discharge of a watery, acrid, colorless liquid from both nostrils, and violent, painful sneezing, swelling of the eyelids with profuse lachrymation and in- jected appearance of the conjunctiva, stinging pain in the ears, red- ness of the face with expression of anguish and uneasiness, horrid throbbing distress in the frontal region, accompanied with a feeling as if the volume of the brain had increased threefold, with tossing about iu the bed, excessive irritability bordering upon rage, loathing which causes one to shake, white coating of the tongue, nasal sound of the voice, violent thirst, and catarrhal fever characterized by heat and dryness of the skin, alternating with profuse sweat, predomi- nance of heat with intercurrent chills, and dark, hot urine.

CHRONIC CATARRH— We see from this statement what an important agent this drug may be in chronic catarrh of the nose and frontal sinuses, with predominance of inflammatory symptoms. In the case of a girl treated by Neuber, a table-spoonful of a solution of thirty grains of the hydriodate in three ounces of mucilage, pro- duced a group of symptoms which resembled an attack of inflamma- tory influenza, viz., vertigo and headache; bloated and flushed face, staring look, oedematous swelling of the eyelids and nose, erysi- pelatous redness of the nose, profuse perspiration in the face, anxiety, labored breathing with rattling of mucous, aphonia, etc. In chronic catarrh characterized by such paroxysms as these, the hy- driodate of potash may be indispensable to eradicate the scrofu- lous element which gives rise to them.

The action of the hydriodate of potash upon the mucous lining of the larynx and bronchial tubes is marked by important and in- structive symptoms ; some of the leading symptoms are the follow- ing : Hoarseness, pain in the chest, cough and slight oppression of breathing, with pain in both eyes. Rough feeling in the trachea, obliging one to hawk ; short and dry cough, occasioned by rough- ness in the throat ; dry cough, with a feeling of soreness in the larynx ; dry and hacking cough, afterward accompanied by a

252 KALI HYDRIODICUM.

copious greenish expectoration ; disagreeable dryness and irritation

in the throat ; waking every night with an oppression on the chest,

loss of voice, and all the symptoms which generally characterize a

violent attack of spasmodic croup ; bloody cough.

BRONCHITIS. — These symptoms justify the use of the hy-

driodate of potash in bronchitis and in laryngeal phthisis.

Frank reports several cases of this affection, where the hydriodate of potash effected a cure. I will quote one of them. A young woman of twenty-eight years, who had had several attacks of inflammation of the larynx, which left her with a chronic cough, blood-streaked expectoration, titillation in the larynx, burning-gnaw- ing pain in the larynx, emaciation, hoarseness, almost complete aphonia, paroxysms of suffocative cough, loose, purulent expectoration which was mixed with saliva and had a fetid smell and a saltish taste ; the burning-gnawing pain on the left side of the larynx was aggravated by pressure, and became an acute stitching pain during deglu- tition; at the root and on the left side the tongue was thickly coated ; the submaxil- lary glands were swollen, pulse frequent and small, colliquative sweats.

Ausculta- tion revealed mucous rale and wheezing in the larynx during an inspiration ; latterly the patient likewise complained of shooting stitches in the upper and left lobe of the lungs. The patient was scrofulous, but had never been affected with syphilis. She was put on the use of the hydriodate of potash in five-grain doses, with a gradual increase until she was able to take thirty grains a day. After using the drug for sixteen weeks without interruption, she was completely restored, except a slight roughness in the sound of her voice, which she did not consider it worth her while to be treated for.

When the case was reported, the patient continued to enjoy good health.

This substance likewise affects the mucous lining of the lungs. While using the hydriodate of potash, Wallace observed in front and low down in the region of the false ribs, an acute pain with some cough and dyspnoea, accompanied with violent fever.

A similar pain has been noticed by other observers. In

PLEUEO-PNEUMONIA, of a scrofulous character, with tendency to the chronic form, this substance may prove of great importance. The mucous membrane is the seat of the inflammation. Dyspnoea, excessive soreness, even to the touch, acute stitches, expectoration of tenacious mucus after a severe fit of cough, are necessarily present. At a later stage of this disease, it may assume the form of

MUCOUS PHTHISIS, with purulent expectoration, constant exhausting cough, night-sweats, colliquative stools, etc. The hy- driodate of potash may prove the most useful, if not curative, at least palliative, agent.

EXANTHEMATOUS GROUP.

This remedy may prove useful in the treatment of various scrofu- lous and syphilitic eruptions and disorganizations. Among them we may mention: Scrofulous ulcers in various parts of the body, irregular in shape, eating deep into the tissue ; after the abuse of mercury. White swelling of the knee, with a feeling of heat in the

KALI NITEICUM. 253

joint ; gnawing, boring pain, causing the patient to seek constantly a new position. Spongy swelling of the knee. Glandular enlarge- ments. After a fall.

Syphilitic ulcers witn fistulous openings, dis- charge of thin, corroding ichor. After mercurial treatment. Atrophy of testes. Chancres, deep, with hard prominent edges ; nightly hone-pains ; falling out of the hair, swelling and caries of hones.

Atrophy of testes. Abuse of mercury. Itching herpes on the face. Pustulous eriqMons on face, head, neck, chest, leaving scars.

KALI NITKIOTTM.

[NITRUM, NITEATE OE POTASH.]

Boil the common saltpetre of the shops, remove the supernatant scum, filter and crystallize. We make a watery solution and after- ward dilute with alcohol.

A robust farmer and his son swallowed by mistake an ounce of saltpetre dissolved in water, in the place of glauber-salt. Soon after, they experienced violent pains in the region of the stomach, with a peculiar feeling of coldness along the spine, and the breaking out of a cold sweat on the forehead, and on the whole body. This was followed by an uncommon feeling of anxiety, trembling of the limbs, nausea, horrid retching, vomiting and purging. The father soon relieved himself by keeping up the vomiting ; next day the son still complained of tearing pains in the bowels, with excessive pain- fulness of the region of the stomach to contact ; pulse rather hard.

A short autiphlogistic treatment relieved him in a few days.

A young girl had swallowed an ounce of saltpetre by mistake for glauber-salt. Besides the ordinary signs of irritation in the throat and stomach, she was attacked with passing blindness, continual deafness and loss of speech, paralysis of the spinal chord, tetanus, etc. Next day the extremities were cold, the pulse small and inter- mittent, the features distorted, and death seemed imminent. But a critical sweat broke out which had a strong odor of nitrate of potash.

In about eight days, she recovered her sight and hearing, but the paralysis of the lower extremities continued for upward of four weeks.

A lady swallowed two ounces of saltpetre by mistake. Soon after, vomiting of the contents of the stomach, and subsequently of pure blood of a bright-red color, partly fluid and partly coagulated. Mucilaginous drinks were administered, but everything was vomited up again, as fast as anything was taken into the stomach. The pulse became bounding and frequent, and a warm, somewhat clammy sweat broke out, accompanied with slight chills. The vomiting of

254 KALI NTTRICUM.

fluid and coagulated blood continued more or less all day. Next day she complained of spasmodic pains in the stomach, not contin- uous, however. Gradually the vomiting ceased ; an injectiou brought away three stools, one of them bloody. The pains in the stomach changed to periodical paroxysms of a burning distress.

The abdomen remained, somewhat painful, and the stools continued to show a few streaks of blood. A fortnight after the poisoning, muscular twitch- ings and involuntary motions became distinctly perceptible. While sitting on a chair, she was suddenly seen starting up in a hurry ; the muscles moved against her will, which she was unable to prevent. She exhibited all the symptoms of chorea.

These symptoms lasted nearly two months. During this period, the pulse remained small, about ninety in the minute ; the left arm and left leg were particu- larly involved ; the patient, who was naturally of a gentle disposition, had become exceedingly irritable. When perfectly composed, she complained of a fixed pain in the back. After the spasms had reached a frightful degree of intensity, they gradually yielded to treatment; the lady was pregnant, and did not recover her former strength until after her confinement.

Mother and child continue perfectly well.

A grocer's wife, of Edinburgh, swallowed a handful of saltpetre dissolved in water. Immediately after, she experienced a violent pain in the stomach and whole body, nausea, vomiting, embarrassment in the head, vertigo, ringing in the ears, trembling of the whole body and excessive chilliness ; at the same time the whole body including the neck and lower limbs began to swell, so rapidly, that time was scarcely allowed to undo her clothes. She recovered in five days. This woman was in the second month of her pregnancy, and mis- carried during the treatment.

It remains for us now to examinine the interesting provings which Professor Joerg and his disciples have instituted with the purified nitrate of potash. This substance was proved in doses of one to sixty grains. The most remarkable effect of the nitrate in these experiments was the increase of the urinary secretions ; the urine was voided more frequently and likewise more copiously than usual. In one or two instances, after a small dose of the drug, the urine looked redder than usual ; generally, it was pale, with reddish clouds floating about in it, or a reddish sediment being precipitated at the bottom of the vessel.

In several of the provers the increased secretion of urine was accompanied with profuse perspiration.

Assman's provings are characteristic. He had been taking scruple-doses of the drug without experiencing any symptoms. He now took sixty grains in an ounce of water shortly after eating a piece of dry bread. In three minutes he experienced a slight, boring pain in the region of the stomach, with a sensation of pressure; this

KALI NITRICUM. 255

pain gradually increased to a dull boring distress. In half an hour he felt a moderate cutting pressure in the intestines, accompanied with emission of a good deal of flatu- lence, urging to stool, heartburn with slight heat over the whole body ; half an hour after, a natural stool, with urging to urinate every half hour.

About noon (four hours after the last dose,) he swallowed another sixty grains in in an ounce of water. This dose was followed by eructations, nausea, yawning, ill- humor, heaviness of the head and pain over the top of the whole head, which only abated somewhat toward evening. His sleep was but scanty and heavy ; next day he complained of loss of appetite with increase of hunger, pressure and burning in the stomach, with single violent stitches in the region of the stomach, weight and fulness in the epigastric region, and a feeling of languor in the whole body. The thirst was considerable.

One hundred and twenty grains produced nearly the same symptoms, in addition to which the submaxillary glands became enlarged, rather hard and painful; suppu- rating vesicles broke out in the face and on other parts of the body ; the pulse be- came full, hard and rapid. An inflammatory irritation of the whole system seems to have been impending. On the third day, he felt free from all medicinal symptoms.

Another experiment with one drachm caused a sensation in the cardiac region as if a pulse were beating at a distance ; the symptoms of cerebral congestion were marked ; rush of blood to the head, with vertigo and an embarrassed feeling in the head; the forehead and cheeks were much warmer, and the hands much cooler than usual. The frontal headache continued moderately after dinner and during the afternoon.

In conclusion, let me now briefly recapitulate the physiologico- therapeutic range of this very useful agent : Cerebral congestions, dizziness, frontal headache, headache over the top of the head ; muscular chorea, depending upon irritation at some point in the spinal cord ; inflammatory neuralgia, characterized by stitches which dart through the whole body; spinal irritation, beginning with a feeling of chilliness down the cord ; hwmatemesis, vomiting of bright- red fluid and coagulated blood, preceded by a feeling of coldness and intense distress in the stomach ; chronic vomiting of blood, with burning and pain in the epigastric region ; bulimia, with loss of appetite ; cardialgia, with feeling of coldness in the stomach, fol- lowed by a burning sensation ; also boring pain in the stomach ; enuresis, with pale urine, depositing reddish clouds ; dropsical oedema of the whole body; restless, heavy sleep; remarkable alteration and sensitiveness of the pulse, fluttering, unequal, hurried.

The nitrate of potash is often used in cases of common gonorrhoea, for which the French use the vulgar but expressive name of chaude- pisse; there is frequent urging to urinate, and some burning during or after urination.

256 KALI PERMANGANICUM.