HAHNEMANN points out that this medicine is more beneficial to individuals with a rigid fibre (brunette), than to those with a lax fibre (blonde). And, indeed, it is one of the drugs that, suggested by the appearance of the patient-brown eyed-makes one at once consider Nitric acid as a possible remedy: of course, symptoms must agree, but they so often do. In out-patient work, where one has to “get along”, the symptom- complex, desire for fat, desire for salt, chilliness, indifference, puts you on to Nit. ac. in Materia Medica; to find, more often than not, that the rest of the symptoms fit the patient, and that you have got the curative remedy. In the desire for fat and salt, Sulphur only, in the Repertory, competes with Nitric acid, but in lower type. The Repertory gives us very few fat-cravers, Nit. ac. being the one in black type: they are usefully memorized, viz. (Ars.), (Hep.) NIT. AC., Nux and Sulph. But, among these, Ars., Hep. and Nux have not the salt craving: while the mentality of Nitric a., as it seems to us, is more that of Sepia: but Sepia loathes fat, and does not crave salt. Here is the little Nit.a. symptom-complex which helps one to the drug, in rapid work: one cannot miss it!- Nit.a., besides its craving for fat and salt, in its full development, is- Chilly. Depressed. Indifferent. Intolerant of sympathy. Sensitive to noise-pain-touch-jar. Irritable: suspicious: obstinate: restless. Fears death. Worse: wind; thunder, wet. Has profuse sweat of hands and feet. Some years ago, after one of our post-graduate lectures, a doctor from “the other end of nowhere” asked help of the lecturer in regard to a child-patient of his, with inveterate constipation. She was found to have the Nitric acid cravings for salt and fat, and the lecturer proceeded to read out to the astonished doctor, from Allen’s Keynotes, the Nitric acid symptoms. “But-do you know the child?” Of course he did not: but he knew Nitric acid; and these symptoms suggesting the drug, the rest fell into line. That is how one gets through an over-crowded out-patient afternoon; a little symptom-complex suggests a drug, and you look it up, and are happy to find that you are “there”. Hahnemann tells us that Nitric acid is more useful for persons who suffer from diarrhoea (Puls.); but Clarke says that it is one of the remedies that has been most useful to him for constipation. Clarke was always insistent about this:- that while positive symptoms are all-important, negative symptoms are less so. For instance, the fact that a person cannot kneel without faintness, or giddiness, or whatever it may be, suggests Sepia- the only drug that appears in the Repertory as “worse kneeling”. But the fact that she can kneel without suffering in such ways does not contra-indicate Sepia. You will find that symptom is very few Sepia cases: though I think you will find it under no other remedy. (By the way, this “worse kneeling” means the patient: not his inflamed and swollen knees. That would be a common symptom in arthritis and not helpful in the choice of the remedy.) Another almost unmistakable feature of the Nitric acid sufferings, is the character of its pains:- not only sticking, but SPLINTER-LIKE. Wherever the pains occur, in bone, in mouth, in nose, in anus, the sensation is “a SPLINTER”: especially when the sore part is touched or pressed. Clarke, in his Dictionary of Materia Medica, has a brilliant little article on Nitric acid, introducing its provings. Here he points out, in regard to the sticking pain as from splinters-“This is a grand keynote of Nitric acid, and will serve to indicate it wherever it is found. It requires a touch or movement to elicit it. When it occurs in the throat it requires the act of swallowing to set it up; in the anus, the passage of the stool; in ulcers, the touch of a dressing. It may occur in any part of the body: in in-growing toenails. (Magnetis Polus Australis.) Then, the localities affected by Nitric acid, to torture or to cure, are very striking and definite. It selects orifices: situations where mucous membranes are merging into skin- endothelium into epithelium. The eyes, the nose, and (especially) the mouth, with lips, tongue, gums, tonsils, extending down the throat. Then, passing by the digestive tract without much malice, it vents its spleen on the rectum and anus, the urethra and the genitalia, with, always ulceration, fissures, stitching, splinter-pains, bleedings and offensiveness. As Guernsey says, “This remedy so closely resembles Mercury in many points, that it is often very difficult to distinguish between the two.” And therefore, since we prescribe on symptoms, and since the antidote to any drug or to any disease is always the drug of most-like symptoms, Nitric acid is found to be the most useful remedy to counter poisonings and sicknesses from abuse of Mercury. And again, since the symptoms of Mercury and syphilis are almost indistinguishable, Nit. a comes in also, as will be seen, for the treatment of that disease. Nit.a. again, is like Merc. in offensiveness. It has offensive mouth and saliva: offensive sweat in axillae and feet: offensive moisture about anus: offensive, strong-smelling urine (urine that smells like that of the horse is characteristic): with (a peculiar symptom) “it feels cold as it passes”. Here the only other remedy is Agar, in lowest type. Another painful symptom heads straight for Nit.a.:- not only painful stool, but pain for hours after stool. The anus suffers frightfully with Nit.a. There are not only haemorrhoids-painful haemorrhoids, but fissures, which gape and bleed and are exquisitely painful. To have to examine the rectum of a Nit.a patient is a terror to doctor as well as to the victim. One remembers, years ago, being asked to go across Great Ormond Street to see a lady who was in agony with pain in anus, and who had applied to the Hospital to send one of its homoeopathic doctors. The remedy was Nit.a., which she got, with speedy relief, and on enquiry next day one heard that she was all right. And here we will quote NASH. He says:- “No remedy has a more decided action upon the anus, and one very characteristic symptom is, ‘great pain after the passage of stool, even soft stool’. He walks the floor in agony of pain for an hour or two after a stool (Ratanhia). In dysentery this symptom distinguishes this remedy from Nux vom. which is relieved after stool and Merc. which has tenesmus all the time, or before, during and after stool. Nitric acid helps in all Hahnemann’s “Chronic Diseases”,- syphilis, gonorrhoea (sycosis) and that other one which he terms “psora”, as well as in Mercury poisonings and overdosings. In syphilis one has seen its magnificent work in acute and chronic cases. One was very interested in a patient who recently reappeared after some twenty years’ absence from hospital. She had originally come for leucoplakia, which had been cured by Nitric acid in homoeopathic dosage. She is now eighty, healthy- looking and robust: doctors sitting by guessed her age as sixty!- and, tell it not in Gath! her “Wassermann” is still positive! One recalls Hahnemann’s contention that syphilis, untreated by the methods of the schools, is not such a deadly disease: and this woman, young looking and vigorous, complaining only of something trivial (one has failed at the moment to remember her name of discover her notes) has had no treatment all these years! well, for the sake of our worried Old School brethren, we will put it at this, “The exception proves the rule.” Clarke says that Nit.a is also an antidote to overdosing with Potassium iodide: and he says that Burnett cured brilliantly a case of action mycosis, with Nitric acid, which, since it had been going the round of the schools, would doubtless have been much dosed with that drug. For sycosis (? gonorrhoea) Hahnemann suggests that two remedies will be found useful-Thuja and Nitric acid: given according to symptoms, and each allowed to complete its work before-the symptoms changing-the other is made to follow. In this way only Hahnemann alternates. See HOMOEOPATHY, Vol. IV, pp. 202,203, in regard to Rhus and Bryonia in war typhus. Another use, to which Clarke alludes, for Nitric acid, is in lung troubles-pneumonia and phthisis. Inhaled, among all the acids it is the only one that produces a very rapid and fatal inflammation of the lungs-Clarke gives a case:- and in the provings quite a number of its symptoms suggest phthisis. Hence, wherever the key symptoms are those of Nit.a., that drug should be considered in pneumonia and phthisis. One remembers a case, years ago, in dispensary days, where Nit.a. did surprisingly good work for a consumptive patient. But, somehow, it is not one of the drugs one readily remembers for lungs, acute or chronic: though Kent has it in italics for “inflammation of lungs”. I do not know why, but one gets a sort of affection for Nitric acid. It is so dramatic and has such definite and intense characteristics and actions. One hopes that this little picture may help others to a closer acquaintance with “a very strong personality” among our drugs.
BLACK LETTER SYMPTOMS
Depressed and very anxious in the evening. Anxiety, as if engaged in a lawsuit or quarrel exciting uneasiness. Anxiety about his disease, with fear of death. Morbid fear of cholera. Anxious about his illness: constantly thinks about past troubles. Mind weak and wandering. Hopeless despair. Nervous, excitable, especially after abuse of Mercury. Vexed at least trifle. No disposition to work, to perform any serious business. Great weakness of memory. After continued loss of sleep, long-lasting anxiety-over- exertion of mind or body from nursing the sick [Compare Cocc.]- great anguish of mind from loss of dearest friend. VERTIGO on rising in the morning: had to sit down. Heaviness, obtusion, fullness in HEAD. HEAD as if surrounded with a tight bandage. Sensation, “head in a vice from ear to ear over vertex.” Painful tension inside head extending to eyes: with nausea. Head very sensitive to pressure of hat: () riding in carriage or train [Compare Graph.]: with induration tonsils: after abuse of Mercury: syphilitic.) Violent itching in NOSE. Nose bleed. (When eating small pieces of food get into posterior nares: are not got down till swallowed with saliva [Compare Gels.] Nasal catarrh; acrid, watery at night, yellow, offensive; corroding: with swelling upper lip. With scarlet fever, diphtheria; or syphilitic. (Ozaena: green casts every a.m. with ulcers; syphilitic, involving upper lip, which is swollen and honeycombed with ulcers.) Ulceration of nostrils, scurfy; of inner nose with frequent bleedings. Corners of MOUTH ulcerated and scabby: with sticking pain. Cracking in articulation of jaw when chewing and eating. Foul, cadaverous smell from mouth. Ulcers, mouth, with sticking pain as from a splinter: within cheeks: edges of tongue; deep eating: at first lardaceous, later discolored, dark, dirty, putrid, destructive: syphilitic. Mucous membrane gets between teeth easily bitten: swollen, ulcerated: with pricking pains: especially after abuse of Mercury; aphthous, covered with white or thin yellow-grey membrane. Saliva; profuse; fetid, acrid, makes lips sore; bloody. Swelling of parotid and submaxillary glands with loose teeth and bleeding gums, after abuse of Mercury. Looseness of teeth when chewing. [Compare Merc.] Putrid smell from mouth. Small painful pimples on sides of tongue. THROAT. A morsel sticks in pharynx when eating, as if pharynx constricted. Swallowing very difficult: distorts face and draws head down: cannot swallow even a teaspoonful of fluid: causes violent pain extending to ear. Tonsils red, swollen, uneven with small ulcers; yellow streak; white patches. Stinging pains in swollen throat. Sticking, painful sore throat. Longing for fat: herring: chalk: lime: earth. (Calc.) Bread disagrees. Jaundice: pain, region of LIVER; urine scanty and strong- smelling. Awakened at midnight with crampy pains in small intestines: chilly: pain worse if moved. Stitches, region of liver. Abundant flatulence: rumbling in abdomen. Nausea after a MEAL. Sweat all over after a meal. Eructations before and after a meal. Constant desire for STOOL: unsuccessful. Colic, sometimes drawing, before stool. Profuse discharge of blood during stool. Burning of the varices of ANUS. Itching of the rectum. Burning: itching; of the anus. Moisture. Sticking in rectum and spasmodic contraction in anus, during stool, lasts many hours. With stool pain, as if something in rectum would be torn asunder. Diarrhoea: great straining, but little passes: as if stayed in rectum and could not be expelled: with soreness and rawness of anus. Constipation: painful, hard, difficult irregular stool: stool in hard masses: with every stool protrusion of haemorrhoids with profuse bleeding: great pain during and after stool, as though there were fissures of anus. Piles bearing down on standing. Hemorrhoids: constant pressing out: painful or painless: prolapsing with every stool. Needle-like stitches in orifice of URETHRA. Ulcers in urethra: bloody mucous or purulent discharge. SEXUAL ORGANS much affected: with small itching vesicles: ulcers exuding an offensive moisture: bleeding when touched: sharp stitches. Condylomata: fetid: bleeding when touched: moist: resembling cauliflower: on thin pedicles: oozing: after abuse of Mercury. Gonorrhoea: discharge yellowish or bloody: bloody mucus:- horrible pain. condylomata abut genitals and anus. [Thuja.] Itching, swelling and burning. Haemoptysis. COUGH: dry, barking; tickling in larynx and pit of stomach with complete ptosis of both eyes from coughing. Chronic dry, laryngeal, with stinging smarting, as if small ulcers were in larynx, generally felt on one side. Sputum seems to stick like glue: greenish-white casts as if from air cells: expectoration by day and dark blood mixed with coagula; or yellow, acrid pus of offensive odour. Pain low down in lungs as if something were tearing away. HEART, fourth beat intermits: alternate hard, rapid, and small beats. Want of breath, palpitation of heart and anguish when going upstairs. Sudden want of breath and palpitation when walking slowly. Panting breathing. Stitches in and between scapulae. Neuralgic pains up back, especially left side. Herpes between fingers. Paronychia (applied in its incipiency). Drawing all limbs, stretching being very agreeable. Stitches in all parts of the body: drawing pains in all parts of body, suddenly appearing and disappearing. Tearing in bones of lower extremities, especially at night. Syphilitic nodes upon shin bones, with severe nightly pains. o WEAK: almost constantly obliged to lie down. Loss of breath and speech. Weakness: trembling: shocks on going to sleep. Depressed. Great debility, heaviness and trembling of limbs: (