Hepar Sulphuris

Hepar is a medicine that has its place in even the smallest of homoeopathic domestic medicine cases : it is one of the nursery medicines for colds — coughs — croup — glands, etc.

Hahnemann's Hepar Sulphuris Calcareum is prepared according to his directions : " a mixture of equal parts of finely powdered oyster shells and quite pure flowers of sulphur, kept for ten minutes at a white heat." From this our potencies are prepared.

Hepar is a powerful medicine, affecting both mind and body : a first-class irritant of temper — nerves and tissues : till the prover is distraught by a word — a touch — a breath of air — so hypersensitive is he to environment physical and mental. And, of course, it is just this touchiness and hypersensitiveness that provide a valuable clue to the employment of Hepar in many diseases.

Until the inwardness of the two drugs is grasped, there is a great tendency to use Hepar for Silica, and Silica for Hepar : they have so many points of resemblance. They both affect skin, glands, suppurations, till, in treating an abscess one is apt to think, " H'm ? Silica ? Hepar ? " — as if it were a mere tossup between them.

They both have unhealthy skin, which festers instead of healing. One sees this so often in the children that come to the Out-Patient Department of our Hospital, where one or other according to symptoms, cures.

They both have sticking pains — as the fish-bone or splinter sensation in throat, more especially Hepar. (Arg. nit., Kali carb., Nit.-ac. have this also.) In both, with the unhealthy skin every little injury suppurates. Both are chilly : but here they part company : because Hepar is better in wet weather — better in warm wet weather : while Silica suffers in wet weather — from wet feet, from cold wet weather : and is better when it is warm and dry. Both perspire profusely : Silica (with Calcarea) has profuse head sweats at night, and its foot sweats are apt to be very offensive : the intolerable " smelly feet " that one comes across : also offensive axillary sweat while Hepar has sour, profuse general sweats night and day which do not relieve.

So alike are these two remedies, Silica and Hepar, that the one may be used to antidote the other, as when a blunder in prescribing has been made, and Silica has been given after Mercury with alarming recrudescence of the bad symptoms : then Hepar comes in and " straightens things out ". We have seen this !* [* " It is well known to physicians that Merc. is not followed well by Silica. Sil. does not do useful work when Merc. is still acting, or has been acting. Sil. follows well after Hepar, and Hepar follows well after Merc. and thus Hepar becomes an intercurrent in that series of medicines." Kent .]

Both have swellings, inflammations and suppuration of all the glands of the body : but the gland suppurations of Hepar are sudden and rapid : while those of Silica are slow, and very slow to heal — till Silica is administered.

The discharges of Hepar are offensive : smelling (characteristically) of old cheese ; ulcers very offensive, smelling like old cheese, and very sensitive. Hepar has horribly offensive leucorrhoea, " the odour can be detected when she enters the room " : while the Silica " smelly " feet leave their aroma in all the rooms and passages through which their unfortunate owner has passed.

" Hepar promotes and regulates suppuration in a remarkable manner (second only to Silica) but is generally required at an earlier stage than Silica." ( Farrington .)

But the genius of the two remedies is dissimilar, because their mentalities are as wide as the poles.

Silica, with its want of self-confidence ; its lack of " grit " ; its timidity ; its sufferings from anticipation — as when having to appear in public. . . .

Hepar — sensitive beyond all bounds of reason : Irritable — impetuous. Sensitive to draughts ; to air ; ulcers so sensitive that they cannot bear the lightest touch (Lath.) ; sensitive mentally — even to sudden murderous impulses.

Nash says of Hepar : "Its strongest characteristic is Hypersensitivenes s to touch, pain and cold air.

" The patient is so sensitive to pain, that she faints away, even when it is slight.

" If there is inflammation or swelling in any locality, or even eruptions on the skin, they are so sensitive that she cannot bear to have them touched, or even to have the cold air blow on them. . . . This super sensitiveness to pain runs all through the drug. It is mental as well as physical, for the slightest cause irritates, with hasty speech and vehemence.

"Next to this is the power of Hepar sulph. over the suppurative stage of local inflammations. It comes in only when pus is about to form, or is already formed. If it is given very high before pus is formed, and not repeated too soon or often, we may prevent suppuration and check the whole inflammatory process. But if pus is already formed, it will hasten the pointing and discharge and help along the healing of the ulcer afterwards. . . .

The most rapid pointing, opening and perfect healing. I ever saw was in the case of a large glandular swelling in the neck of a child, under the action of the CM. potency. Hepar has a general tendency to suppuration, for even the eruptions on the skin are liable to form matter, and slight injuries suppurate (Sil., Graph., Merc., Petrol)."

In regard to " skins" H. C. Allen (Keynotes) supplies a valuable tip. " The skin eruptions of Sulphur are dry, itching, and not sensitive to touch ; while in Hepar the skin is unhealthy, suppurating, moist, and intensely sensitive to touch."

But Hepar also has its sphere in the respiratory system, and in the nerves connected with the respiratory system.

It is one of the celebrated " Boenninghausen's Croup Powders ", sold for many years in our chemists' shops under that name a packet of five powders, all in the 200th potency : they were numbered, Aconite, Spongia, Hepar, Spongia, Hepar (should so many be required to cut short the attack). Anyone acquainted with these alarming attacks, a bolt from the blue in the middle of the night, will see the appropriateness of the remedies. .

Aconite, sudden difficulty of breathing in the night, with the Aconit fear and terror, after a chill from a cold, dry wind.

Spongia. Hoarseness : difficulty of drawing the breath, as if a cork were sticking in the larynx, and the breath could not penetrate through the narrowed orifice of the larynx. Hepar, suffocative cough, excited not by tickling, but by tightness of the breath ; dry, deep cough, from suffocation when breathing. Also " Springing from bed, crying for help, felt that he could not get his breath."

Hahnemann says that " Homoeopathy has found the most remarkable remedial employment of Roasted sponge " (Spongia tosta — Spongia), " in that frightfully acute disease membranous croup . . . The local inflammation, however, should first be diminished or removed by the exhibition of an extremely small dose of Aconite. The accessory administration of a small dose of Hepar sulphuris will seldom be found necessary." And in a footnote he adds, " The smaller the drug-doses in acute and in the most acute diseases, the more quickly do they effect their action." (Mat.

Med. Pura — " Spongia ".)

Hepar sweats with the cough. Weeps with, or before the cough. Cough from the least exposure of any part of the person to cold — to air — to draught. Breathing is rattling, anxious, wheezing (in bronchitis) even to threatened suffocation — almost asthmatic.

In asthma, Nash contrasts Hepar with Natrum sulph. with this diagnostic difference, which is very valuable : Hepar is worse in dry cold weather and better in damp : Natrum sulph. exactly the opposite of this : — extremely sensitive to damp. Nash says : " There is no other remedy that I know that has the amelioration so strongly in damp weather."

Hepar is a great remedy for ears and for threatening mastoid troubles. One remembers one's first acquaintance with Hepar in this connection.

A child with offensive ear discharge . .a hesitation — ? Merc. — ? Puls.?

But a doctor-woman who had learnt her Homoeopathy in India under Dr. Younan , a great prescriber, suggested Hepar — which personally one would not have, then, thought of, and a dose of Hepar 200 had an amazing effect on the case. It is thus that one learns Materia Medica ! And one remembers another, later, ear case, during the war, when surgical persons were not " as common as pilchards at Loo ", as Kipling might put it.

It was a girl with a very high temperature who came to Casualty one day, with ear trouble, and a tender — very tender, mastoid. She got Hepar CM and when she reported a day (or a couple of days) later it was no case of handing her over for surgery, because the whole thing had absolutely subsided in the most astonishing way.

Again, one does not usually think of Hepar for gastric ulcer. But one case, with a recent history of hematemesis, and a craving (surely unusual in that disease) for vinegar and pickles, cured up rapidly under Hepar, which has that craving. (The remedy had to - be repeated once later, after an attack of flu.)

We will go to Kent for a few more hints in regard to Hepar.

" Hepar sometimes is bad for the occulist. When it is indicated, it cures eyes very quickly, so that the oculist does not have a very long case, and it does away with the necessity for washes in the hands of the specialist. . . . Offensive, purulent discharge " (Arg. nit.). " Inflammation with little ulcers " (Tub., etc.) . . .

" A very important sphere for Hepar is after mercurialization. Syphilitic affection : ulcers of soft palate and osseous portions of roof of mouth . . . (Nit. a.). But everywhere the ' stick sensation', the offensiveness, and the extreme tenderness.

" Sweating all night without relief belongs to a great many complaints of Hepar.

" Inspiring cold air will increase the cough and putting the hand out of bed will increase the pain in the larynx or cough. Putting the hand or foot out of bed is a general aggravation of all the complaints of Hepar."

" The mind takes part in this oversensitiveness, and manifests itself by a state of extreme irritability. Every little thing that disturbs the patient makes him intensely angry and abusive and impulsive. The impulses will overwhelm him and make him wish to kill his best friend in an instant. Impulses also that are without cause sometimes crop out in Hepar " — impulses to do violence . . . to burn, to destroy . . . "

Black letter symptoms.

Constant pressive pain in one half of brain, as from a plug or nail (Thuja).

Epistaxis (Vipera, etc.).

Great swelling of the upper lip.

Sticking in throat as from a splinter on swallowing, and extending towards the ear on yawning.

Great desire for vinegar.

Nausea.

Abdomen distended, tense.

Buboes, abscesses of inguinal glands.

Stool soft, yet passed with great exertion.

Clay-coloured stool.

Urging to stool, but the large intestines are wanting in peristaltic action, and cannot expell the faces which are not hard ; only a portion of which can be forced out by help of abdominal muscles.

Very difficult passage of scanty, not hard, faces, with much urging.

Micturition impeded : obliged to wait before the urine passes, and then it flows slowly.

He is never able to finish urinating ; it seems as if some urine always remains behind in bladder.

Weakness of bladder ; urine drops vertically down, and he is obliged to wait awhile before any passes.

Paroxysms of cough, as from taking cold, with excessive sensitiveness of the nervous system, as soon as only the slightest portion of the body becomes cold.

Dyspnaea.

Abscess of axillary glands.

Bruised pain in anterior muscles of thigh. Swelling of knee.

Drawing pain in limbs.

Cracked lines and chaps in hands and feet.

The ulcer bleeds on being merely gently wiped.

Eroding pain in ulcer.

Sensitiveness to open air.

At night the pains are worst.

Dreams of fire.

Night sweat.

Unhealthy, suppurating skin ; even slight injuries maturate and suppurate.

Soreness and moisture in folds between scrotum and thigh.

Perspires easily on every, even slight motion.

Catarrhal fever with great sensitiveness of skin to touch, and to the slightest cold.

Constant offensive exhalations from the body.

Among Hahnemann's symptoms are these other peculiar ones which may prove diagnostic :

The slightest thing put him into a violent passion, and he could have murdered anyone without hesitation.

Cross : and had such weakness of memory that he required three or four minutes to remember anything, and when at work thoughts often left him all at once.

In the evening frightful anxiety ; thought he must be ruined, and was sad to that degree that he could have killed himself.

In the morning after waking, he had the visionary appearance of a deceased person, which frightened him ; also imagined he saw a neighbouring house in flames, which terrified him.

When the smallest member becomes cool, there immediately occurs a cough, as from a chill and oversensitiveness of nervous system.

Suffocative cough, excited by tightness of breath.

At night, from 11 to 12, violent cough.

Before midnight he sprang out of sleep, full of anxiety, called for help, felt he could not get his breath. (Hepar is one of the great croup medicines.)

Even small wounds and slight injuries suppurate, will not heal, and become ulcers.

Hahnemann says : " Belladonna removes many of the sufferings caused by Hepar, where the symptoms correspond."

Hering (Guiding Symptoms) has put in black type a few more Hepar symptoms as being particularly diagnostic.

Purulent conjunctivitis, with profuse discharge and excessive sensitiveness to air and touch.

Gums and mouth very painful to touch, bleed easily.

Mercurio-syphilitic diseases of gums.

Hasty speech and hasty drinking.

Chronic tonsillitis, especially when accompanied by hardness of hearing.

Is never able to finish urinating, it seems as if some urine always remains behind in bladder.

Larynx sensitive to cold air.

Croup, after exposure to dry cold winds.

Croupy cough, with rattling in chest but no expectoration.

Paroxysms of cough, with excessive sensitiveness of nervous system, as soon as the slightest portion of body becomes cold.

Coughs when any part of the body is uncovered.

Tenacious mucus.

Habitual bronchial catarrhs, with loud rattling of mucus.

Pulmonary abscess, empyema, pyothorax.

Great chilliness in open air.

Ailments from cold, dry wind.

Cannot bear to be uncovered.

Desires to be covered even in a warm room.

Sensitiveness to open air, with chilliness and frequent nausea.

Sweats easily by every, even slight motion.

Cold clammy, often sour, offensive sweat.