Phosphorus was considered by the older writers of our school as the nearest specific for pulmonary tuberculosis, it has been styled the "King of phthisical remedies." Yet it is not wise to ask too much of Phosphorus. The choice of this remedy must be most carefully made, and it is also the universal testimony that its dose should not be too often repeated. Baehr says that no other remedy causes haemoptysis so easily as Phosphorus. Study the remedy for every case; in fact, it seems to be an accepted dictum that Arsenicum, Sulphur and Phosphorus should never be used in tuberculosis unless most carefully indicated.
Phosphorus corresponds especially to phthisis in the rapidly growing young, who are brilliant in mind, but who have a hereditary tendency to lung troubles, who are chicken thoraxed, tall and phthisical, and to those who take cold easily owing to a general relaxation of the system.
The chief symptoms are the following: Great hoarseness with evening aggravation, weak chest, cough, copious sputum and hectic fever. Especially has it blood-streaked expectoration and tightness across the chest.
The hoarseness is continual and accompanied with soreness in the larynx and trachea; it is aggravated by talking, and sometimes it amounts to complete loss of voice, There are pains in the apex of the left lung, and the patient cannot lie on the left side. The oppression of the chest is worse at night, forcing the patient to sit up. The cough may be short and dry, worse from change from warm to cold air or from lying on the left side or back.
The expectoration is mostly in the morning, and is white and tough, and perhaps blood -streaked. Cavities form rapidly, there is constantly increasing hectic fever and flushing of the face towards evening, and another useful symptom is a burning between the shoulder blades.
Ammonium muriaticum. Has a coldness between the shoulder blades, and this symptoms may call attention to it in phthisis.
Phosphorus also has a diarrhoea, which may still further indicate it in the later stages of tuberculosis; it shown by the intolerance of the rectum to the presence of the faces; as soon as anything enters the rectum is expelled. Increased sexual desire in phthisis is also a good Phosphorus symptom.
Calcarea may be distinguished from Phosphorus as follows:
CALCAREA
Scrofulous and fat.
Swelling of upper lip.
Worse in open air.
Not over-sensitive to pain.
PHOSPHORUS
Slender and overgrown, narrow chested.
Better in open air.
Over-sensitive to pain.
The treatment of tuberculosis by neucleins is an indirect way of giving Phosphorus, as all neucleins contain a large. amount of phosphorus.
Calcarea carbonica Calc
In the treatment of tuberculosis it is of paramount importance to administer the proper constitutional or basic remedy; it is a constitutional disease and requires a constitutional remedy rather than one directed to the isolated symptoms. Calcarea suits pale, sallow, non-resistant patients of a leuco-phlegmatic temperament, and those whose constitutions have been broken down by frequent and profuse menstruation, or by frequent miscarriages. Patient takes cold easily, and it corresponds especially to the third stage of the disease, when large cavities are forming .
Its special seat of action seems to be the middle third of the right lung; loud rales are heard all over the chest, more over the middle of the right lung. The cough is loose and rattling, or short and dry in the evening; there is much soreness of the chest and great fatigue and shortness of breath on going upstairs or on making any ascent whatever. The chest feels as if beaten, and there is persistent painless hoarseness. The expectoration is of purulent yellowish green and bloody matter. There is great repugnance to animal food; a diarrhoea which is worse in the evening, in which meat will pass undigested; there is a great emaciation, sweat, suppression of the menses in females, and these symptoms would indicate the remedy in incipient phthisis in young girls of an anaemic type.
It possesses the following symptoms of the tuberculous dyscrasia which, on constitutional grounds, lead to its selection:
1. Nosebleed.
2. Throat symptoms, irritation and rawness.
3. Eruptive skin conditions, freckles, spots itching, pimples.
4. Sweat from least exertion profuse and exhaustive.
5. Predisposition to take cold easily. Most of its symptoms are worse from cold (do not send Calcarea patients to cold climates).
6. Mental state of hope.
7. Eye and ear symptoms.
8. Falling of hair.
9. Fullness across the chest with spitting of blood.
Calcarea phosphorica will suit better when the emaciation is more rapid, and more marked, where there is greenish purulent expectoration, headache and languor; in short, some meningeal complications.
Calcarea iodata. This remedy is preferable, when glandular complications are present, in young subjects who grow rapidly with tickling, teasing cough, rapid pulse, high fever, and rapid hepatization; it corresponds more exactly to the miliary form of tuberculosis.
Sepia. Hirschel claims that this remedy stands next to Calcarea in dry, fatiguing, tickling coughs. It has many symptoms of the tuberculous cachexia.
Tuberculinum or Bacillinum. These remedies have been used by homoeopaths for some fifty years and many favorable results have been observed. Dr. Burnett, of London a very careful observer, has reported many cases cured and benefited by Bacillinum; the indications, however are not clear. Dr. R. F. Rabe thinks the indications are somewhat similar to those of Pulsatilla. A feature seems to be the desire of the patient to be in the open air. Others have been specially successful with the different preparations.
Nitric Acid Nit-ac
Being a powerful anti-tubercular remedy before cavities are formed, is most useful in phthisis; it has sudden rush of blood to the chest, hectic fever, soreness of the chest, frequent haemorrhages profuse and of bright red blood, dyspnoea, hoarseness which is much worse in the morning, diarrhoea which is also worse in the morning and sharp stitching through the right chest to the scapula. There is a weak heart and much palpitation.
The sweat is worse at night and towards the morning, particularly exhausts the patient, thus showing the acid debility so characteristic of the drug. The skin is cold towards morning, there is a tickling cough which annoys the patient all night; sometimes the cough is dry and sometimes loose and rattling; the rales are loud; the expectoration is offensive, dirty green, bloody and decidedly purulent. Nitric acid gives a greater predominance of throat symptoms than almost any another remedy. As all Nitric acid symptoms are aggravated by warmth, do not send such patients to warm climates.
Lycopodium and Pulsatilla have smooth and yellowish green expectoration.
The Nitric acid patient is thin, with dark hair and eyes, and may be easily distinguished from Calcarea as follows:
CALCAREA
Patients fat, light, hair, blue, eyes.
Diarrhoea worse mornings.
Cough generally loose.
Worse in cold weather.
Better in warm air.
NITRIC ACID
Patient thin, dark hair and eyes.
Diarrhoea worse evenings.
Cough generally dry.
Worse in warm weather.
Worse in warm air.
Silicea Sil
In suppurative stage of tuberculosis, Silicea is one of our principal remedies; it is especially indicated by a low grade of vitality where the patient finds it impossible to keep warm. It is an excellent constitutional remedy and corresponds well to the slow phthisis mucosa of old people. The cough at first is dry, racking, but afterwards loosens; there is copious rattling in the chest and expectoration of offensive muco-pus.
The purulent character of the expectoration indicating abscess formation in the lungs is characteristic, and it is more profuse after exertion. There are large cavities in the lungs, profuse night sweats and hectic or suppurative fever. There is no better remedy in the treatment of exhausting night sweats. Some seventy cases were treated with satisfactory results by the later Dr. E. R. Snader.
Phellandrium is a remedy which has a horribly offensive expectoration, and it is useful in the last stages of phthisis, but the expectoration of Silicea is more purulent.
Iodine sits only after the expectoration has become purulent, and it is especially useful if tuberculosis is the result of scrofulosis. If diarrhoea be present, Iodine does not generally act favorably.
Silicea is a remedy for what is termed "stone cutter's consumptions," where there are profuse night sweats and a pale, waxy skin. Offensive perspiration is also an indication for Silicea. Convulsive cough, like that of Drosera, but the tickling is lower in the larynx and suprasternal fossa, while that of Drosera is in the upper part of the larynx and throat Jousset recommends the 30th dilution.
Stannum metallicum Stann
Although the mentally low-spirited and depressed condition of stannum does not correspond with the mental condition usually found in phthisis, yet it is often times a most useful remedy. It corresponds especially to catarrhal cases which are engrafted upon a scrofulous habit. There is marked hectic fever, chills at 10 A.M. flushed and hot in the evening aggravation on every exertion and profuse sweat at night, worse about 4 or 5 in the morning.
Weakness is a grand characteristic, and must be present; the patient is so weak that he cannot talk more than two or three minutes at a time. Hoarseness is common. The cough is paroxysmal, and seems to be most frequently caused by mucus in the chest. The expectoration is profuse and of yellowish or yellowish-green, sweetish mucus. An abundant secretion of mucus and an empty feeling in the chest are keynotes for Stannum. A blood-streaked expectoration is a contra-indication.
Lycopodium has a grayish and salty expectoration.
Balsam Peru is a useful remedy in catarrhal phthisis, with a copious purulent expectoration.
Coccus cacti Coc-c
Is also useful in catarrhal phthisis, with ropy phlegm and sharp, stitching pains under the clavicles.
Yerba santa or Eryodiction Californicum, a California plant, has been successfully used in bronchial phthisis with night sweats, emaciation, intolerance of food, and it will often cause a free expectoration of the mucus, and thus relieve the asthmatic breathing. Phthisis resulting from bronchial catarrhs.
Remember that Stannum suits neglected catarrhs which threaten to pass into phthisis.
Sulphur Sulph
Is best adapted to the early stages of phthisis when there is an increase of blood to the chest, beginning dullness over the apices of the lungs on percussion and diminished chest motion. The guiding symptoms are hot feeling of the body, desire for air, flushes of heat and pain from the left nipple through to the back.
After tubercles have become deposited, Sulphur is a dangerous remedy to use; indeed, Baehr does not look with favor on Sulphur in tuberculosis. The cough is mostly dry, worse in the evening, excited by talking, with occasional profuse discharges of mucus; there are profuse night sweats and the perspiration is offensive; there is emaciation, weakness and languor and burning of the soles and palms.
Unless Sulphur be cautiously used it may rouse and ignite the dormant tuberculous spark and hasten the disease; this fact seems well established. It should be used in the higher potencies.
Arsenicum Ars
Is another remedy that must be used cautiously in tuberculosis. It effects on the blood is similar to the tuberculous process, and its pathogenesis is hectic; the fevers, sweats, diarrhoea, dyspeptic symptoms and debility make it similar in general to phthisis. It corresponds well to the tuberculous cachexia. The symptoms calling for its use are these: Utter prostration, emaciation, thirst, hectic, oppressed breathing and sharp pains, darting in character and aggravated by motion.
The cough is worse at night on lying down and in the morning on rising; the paroxysms of cough are long and lasting and ushered in with dyspnoea; the expectoration is profuse, greenish and salty, there is throughout much apprehensive anxiety. By remembering that it is not on local symptoms that a homoeopathic prescription should be made Arsenicum will be correctly chosen.
Arsenicum iodide is very closely allied to tubercular manifestations and the profound prostrations, rapid irritable pulse, recurring fevers and sweats, emaciation and tendency to diarrhoea indicate it. Patient is cachectic; hacking cough; cavities; hectic fevers, night sweats; great debility.
Sanguinaria Sang
Pictures phthisis florida; it has the hectic fever worse about 4 p.m., the bright circumscribed flush on the cheeks, the dry cough caused by tickling in the larynx and upper part of the chest, and a great characteristic of the drug is a burning and fullness in the upper part of the chest as if full of blood. There are sharp stitching pains in the right lung about the nipple, soreness of the chief muscles and dyspnoea.
It is a remedy in incipient phthisis in the pretubercular stage as well as in the second and third stages; there is a chronic dry cough the cough may be loose, but the expectoration is difficult; worse lying down. In the later stages it comes in when the sputa and breath are offensive, even to the patient himself; it renders the expectoration easier even to the patient himself; it renders the expectoration easier and the breathing freer. Persistent coldness of the extremities and burning in the chest are good symptoms for sanguinaria.
Ferrum metallicum. Haemorrhages in the incipient stage of phthisis florida. There is a general haemorrhagic tendency with inter-scapular pains.
Lachesis. Tuberculosis following pneumonia.
Bryonia Bry
Nearly all cases of tuberculosis have at some -period of their course pleuritic complications, and although Bryonia is rarely, if ever, of use in true tuberculosis, yet it may ofttimes be the proper remedy in the fibroid or interstitial form with these pleural complications.
The chief symptoms calling for its use are these: a teasing dry cough as if the head and chest would burst, or as if coming from the epigastrium, forcing the patient to sit up; sharp stitching pain in the sides; painful larynx; perspiration and pains at the apices of the lungs. Inability to take a deep breath on account of these sharp pains is an important indication.
Kali carbonicum Kali-c
Hahnemann says that patients suffering from ulceration of the lungs can scarcely get well without the use of this antipsoric. Like Bryonia, it has stitching pains through the chest, with dry cough and much difficulty in raising the expectoration; it seems to come up part way and slip back, or files in lumps from the mouth while coughing.
The expectoration is profuse, purulent and perhaps bloody; the cough is worse from 3 to 5 in the morning and the patient is apt to be chilly, especially in the middle of the day; there is much whistling respiration which prevents sleep, and a marked symptoms is weakness of the chest.
It is especially the remedy when cardiac or dropsical symptoms complicate, and the patient is bloated, has puffiness of the eyelids, etc. Incipient phthisis in women who have become run down from over-lactation may indicate the remedy. It is also a valuable remedy in the later stages.
Zopfy recommends Kali hydroiodicum and Cannabis sativa in tuberculosis; his sixty years' experience verified their use. He used the Ix of each in alternation, and asserts that no remedies in the entire materia medica have such an influence in lessening the cough the expectoration, the colliquative sweats and the hectic fever.
Drosera Dros
The therapeutic action of Drosera in tuberculosis is an important one. Jousset recommends it highly as a curative remedy. Drosera is a remedy in the first stages and often corresponds to incipient phthisis in young girls. There is a paroxysmal cough frequently ending with vomiting, worse at night on lying down; profuse expectoration yellow and bitter in the morning, diarrhoea, suffocative hoarseness and gastric irritation and vomiting brought on by coughing. It suits the tubercular disposition and Hahnemann considered it the only remedy in laryngeal phthisis.
The characteristic cough is a deep sounding, hoarse barking one, is accompanied with pains in the chest and has a nocturnal aggravation; the cough is paroxysmal and the expectoration is at the end of the paroxysm. Laurocerasus is useful in the dry teasing coughs of consumptives at night; the expectoration has little specks of blood in it.
Codeine also corresponds to these dry teasing coughs which annoy the patient night and day. It is a homoeopathic as well as a palliative remedy.
Conium is a useful medicine in tuberculous tendencies which is shown by its action on the glands. It has a hacking cough worse at night on lying down.
Dulcamara Dulc
Is one of our best remedies in catarrhal phthisis. There are pains in the sides at every slight cold the patient takes; in fact, there is a disposition to take cold, and any damp weather is a common cause. The cough is generally loose, with an abundant muco-viscid expectoration, which is tough and greenish. There is also a violent oppression of the chest.
The cough of Dulcamara is worse from lying down, from warmth of the room and is better in the open air. Chronic coughs following measles may indicate Dulcamara.
Senega has also a loose cough and mucous rales.
Lycopodium Lyc
Is a useful remedy when phthisis follows neglected pneumonia and there is an incessant cough, day and night, with expectoration of large quantities of yellowish pus which tastes salty and smells foul, or is yellowish with chest pain; there are hectic, night sweats and rattling breathing. The emaciation is about the upper part of the body. Suspected phthisis in young men is an indication given by Hughes.
There is a peculiar irritation to hawk, with tickling in the throat. The dry continuous cough causes pains in the sides of the abdomen. There is an early morning acid smelling sweat and the hectic afternoon fever, hot hands and burning soles. Constipation and debility. Few remedies are so valuable in mitigating the cough, the gastric irritation, the exhaustion, the intercurrent attacks of pleurisy as Lycopodium. It is a real vegetable Sulphur, and there is no better for loose cough in which the patient raises whole mouthfuls at a time.
Sticta, according to Hering, is also a useful remedy in the croupy or dry racking cough of consumption. A proving of this remedy by the writer emphasized its value in dry racking coughs.
Digitalis. Baehr claims this remedy to be the most reliable one to subdue the hectic fever of the disease.