Leading Articles.

The Tissue Remedies.

W. E. KINNETT, M. D., PEORIA, ILLINOIS

Related entries: ElTh-Jan1908 (2nd paper) - ElTh-Feb1908 (CalcFluor) - ElTh-Mar1908 (3rd paper) - ElTh-Apr1908 (4th paper)

(Third Paper)

Kali Sulphuricum

While I have not used the sulphate of potassium as often as I have other of the tissue remedies, it is a very important remedy. It is just as positive in its action as any of the others, but is not called for as often.

Dr. J. M. Scudder recommended this salt in doses of from five to ten grains three times a day in a glass of water, where the skin is dirty, tissues full and sodden, and skin scaly, and where wounds heal slowly, or inflame and suppurate.

This remedy acts on the epithelial covering of both the cutaneous and mucous membranes, and in diseases that are characterized by yellow discharges. We have the main indications for it in the tongue, where there is a slimy, yellow coating; slimy, thin, yellow or greenish discharges from any of the mucous membranes; scaly desquamations from the epithelium or epidermis. This remedy is one of the oxygen carriers, and a companion remedy with iron, and as such is indicated in cases where the patient feels better in the open air and worse in warm rooms or in the evenings. Many patients lie awake for hours until they are exhausted because of not having enough oxygen in the blood. The kali sulph. patient feels worse in the evening with rise of temperature.

Coughs that are better in the cool air and worse in a warm atmosphere are benefited by it. A suffocative feeling, with a desire for fresh air, calls for it. It is an excellent remedy in scaly conditions of the epidermis. It aids desquamation in eruptive diseases, cures dandruff and dry, itchy eczemas. In wandering, shifting muscular pains of a rheumatic or neuralgic character, worse in the evenings or heated rooms, and in cases of long standing rheumatism with debility and soreness of muscles this remedy sometimes works wonders.

Dr. Palmer, in his "Diseases of the Digestive Organs," states that "This remedy has the yellow tongue and a sensation of fulness and pressure at the pit of the stomach; water gathers in the mouth. It is a very good remedy in chronic catarrh of the stomach where the tongue is slimy and coated yellow. In all these cases where the water accumulates in the mouth, natrium muriaticum should be prescribed with it. Pain that commences in the stomach and wanders through the intestines and finally settles in the right hip just above the crest of the ilium, will be relieved by this remedy."

This is an old remedy and I am not studying it in the older sense but as one of the tissue remedies and in small doses. The dose of this remedy is from two to five grains of the 3x trituration either in powder, tablets or solution.

Magnesium Phosphoricum

It is stated that this remedy is found in the muscles, nerves, bone, teeth, brain and blood corpuscles. It is more abundant in the white nerve fibers and seems to act mostly on these fibers, and when a deficiency of this salt occurs these fibers contract and produce one form of cramps or spasms. This occurs sometimes in tissues of the stomach and causes the walls of the stomach to contract, and producing pain. If it were not for the gas that forms at these times and helps to prevent a collapse, the pain would be intense. Belching of gas that does not relieve is a prominent indication for this remedy. Magnesia phos. is indicated and in some cases acts better combined with calcaria phos.

Magnesia phos. is a curative agent in spasmodic conditions—a typical antispasmodic. Magnesia phos. and kali phos. are very closely related in their action on nerve tissue. Kali phos. acts on the gray fibers and magnesia phos. acts on the white fibers, and when we remember that these two kinds of fibers are very closely allied we can understand why they work so well together. This remedy acts in opposite conditions from ferrum phos. Magnesia phos. relaxes tissues while the iron contracts them. When we realize that all pain is caused by impingement of a nerve or nerves, and that this remedy relaxes tissue we can better understand how it acts, and yet we are not so much concerned as to how it acts as that it does act.

This drug is indicated in all sharp, cutting, lancinating pains, convulsions, spasms of all kinds unless caused from mechanical pressure, without reference to the name of the disease. Name it what you will, we are treating conditions. It acts well in all the neuralgias, and their names are legion. It acts best where heat relieves and cold increases the pain. Perhaps a few clinical cases will fix this more permanently on the mind of the reader.

Some years ago when I was practising in the country and while passing a home, a lady came out with her head thoroughly wrapped in a large woolen shawl, under which was a large bread and milk poultice covering a very badly swollen face. She asked me if I had my tooth forceps with me, and on being informed in the negative, began crying, and said she did not know what to do as she had not slept for two days and nights because of toothache. She could not go to the village to have the offending member extracted.

I gave her some ferrum phos. in small doses and magnesia phos. in much larger doses, each to be taken in hot water every half hour till relieved. Two days afterward I passed that home again, when to my surprise the same lady came skipping out and wanted to know what my bill was, and what I gave her as she wanted a lot of it to keep for future emergency. She stated that after taking the second dose she experienced marked relief and in two hours was free from pain. The next day the swelling all left her face and she felt as well as though she had never had the toothache. There was no abscess in this case. This occurred very soon after I commenced the study of these remedies and I have treated many similar cases since and the results while as positive, were not so surprising.

Mrs. H. P. brought her year-old baby to my office stating that the child had had a severe diarrhea for four or five days and some vomiting. That every few moments, it would have severe cramping pains and scream and draw up its legs and arms in a spasmodic condition. These spasmodic conditions had no connection with the bowel movements which were thin and green in color. On examination I found an excess of temperature of four degrees, tongue coated white. I gave ferrum phos. for temperature and kali muriate, and magnesia phos. for the spasmodic condition. Inside of twenty-four hours the child had entirely recovered.

I was called to see Mrs. B., a farmer's wife, who had just returned from a visit to some relatives, one of whom was a physician. While there, she was taken with a severe attack of sciatica. The physician relative treated her for several days with no apparent relief. She was brought home on the train and carried to her home, and when I got to the chair-side, for she could not lie down, she would scream with pain when moved the least, and sometimes when she was not moved.

1 put the patient on magnesia phos. and kali phos., in alternation, in ten-grain doses of the 3x trituration, in hot water every half hour. This was in the evening. The next morning she stated that she was no worse and perhaps some better, but was taking nothing but sweetened water. My evening visit found her entirely free from pain and we moved her to her bed, where she slept all night and next day she was up and dressed and free from pain, although a little sore. She has had no return of the trouble, and ten years have passed since then.

Possibly this is enough of my own cases. I will give you a case or two from that staunch eclectic therapeutist, Dr. John Fearn, of Oakland, California. "In an obstinate case of singultus, magnesia phos. worked like a charm. The patient was suffering from typhoid fever. The fever had subsided nicely and the patient seemed to be doing well when this unpleasant feature commenced; the hiccough was almost continual, and so violent in character that the patient was shaken till he was sore for three days. I tried all the remedies I could think of with no satisfaction. Finally I put him on magnesium phosphate. The result was remarkable; when I called the patient was so much better that as I went into the room he said, 'Doctor, why did you not give me that medicine before?' After the medicine was laid aside for a while the trouble partially returned, but it was not nearly so violent; it resembled a sobbing, and this yielded speedily to the remedy."

The same writer says: "A patient sought my services a little while ago for the relief of acute sciatica. In a few days he was much relieved and thought the worst passed. I cautioned him to avoid taking cold and bade him continue the treatment. In about three days more he again called, and said, 'Doctor, I thought I was cured, but the last two nights and today I have suffered terribly.' The pain was not continuous, and yet it was not a periodic pain. It was a sharp, shooting pain, with a sense of constriction occupying the hip joint, the region of the sciatic nerve and the right hypochondrium. It was not regular in its action nor constant, but would come without warning and leave without saying goodbye; in short, it was spasmodic in character.

"Remembering from experience that magnesium phosphate is antidotal to this spasmodic character of pain, I gave him the 3X in small doses every two hours. The condition was removed-the pain completely relieved."

"In another case a lady about six months advanced in pregnancy suffered with spasmodic pain radiating from the umbilicus, to the pubes, not constant, but coming and going, and quite severe. Remembering that such a condition can be removed with magnesium phosphate I gave it here; results very satisfactory, as in other cases."

One more case, and I am through with this remedy. This is from another stalwart eclectic, Dr. W. N. Holmes, of Nashville, Tennessee, and it was published in the Transactions of the National, but all readers, of this journal are not members of the National and do not get the Transactions. This was written at my request and reads like a romance.

"Some eight years ago, having been then for some years troubled with a restless, nervous, uneasy feeling in the back of my head and neck, I was attacked one night, after retiring, with very severe pain, one and a half inches to the right and half an inch below the occipital protuberance. If I had been pierced by a nail, the pain could not have been worse. After waiting a few moments, hoping that it would pass away, I arose, got my chloroform bottle and proceeded to burn the surface over the seat of pain. This relieved it for only a few moments, when it returned with greater violence. I battled with it through the night, and sent for a doctor next morning. He came and soon exhausted his skill to no purpose, then another and another. This pain continued for five weeks. The patient was growing feeble and anxious. I scratched a letter to my nephew, Dr. D.W. Holmes, of Bellevue, Texas, telling him that my time was about up, describing to him my condition. He wrote as follows: 'Take five grains of magnesia phosphate in a swallow of hot water. In fifteen minutes repeat this and continue till you have taken four doses, when the pain will be gone. Then take kali phosphate, five grains before each meal, for sixty-days, and your head will be entirely well and your mind as clear as when you were twenty years old.'

"Knowing that no one could find the medicine in my office but myself, I arose, dressed myself, and proceeded to the office, with the forlorn hope that I might be, at least, benefited. I very soon had the remedy and with my pen knife I guessed at a five-grain dose, and instead of warm water, I laid the medicine on my tongue, being a 2X trituration, and washed it down with water from a bucket that had been standing in the office for the past five weeks. I took a seat and waited for fifteen minutes to take another. Before the fifteen minutes were up, I experienced a very peculiar sensation in the painful area—a sensation of antagonism between two forces, the one endeavoring to continue the pain, the other, with mandatory vehemence, repelling the effort of the first. This, I soon began to enjoy with supreme delight, as I could feel every paroxysm grew lighter. I waited another fifteen' minutes, when, to my gratification and utter astonishment-the pain was entirely gone.

"I subsequently found that by weight I had taken ten grains instead of five. Returning to my home, my wife asked me how I felt. I told her that I was as well as I had ever been in my life. I sat down and read till time to retire, with perfect immunity from pain. Before retiring, I took another dose and no one ever slept more profoundly, calmly, and sweetly, than did I that night. The next day I drove seven miles to see a patient."

Natrium Muriaticum

I will admit that it is a difficult proposition to reconcile the medicinal influence obtained from triturations of sodium chloride, and in many cases almost as difficult as the coffee, tobacco and whisky problem. Many people, and many physicians as well, do not seem to realize that the very commonest things of life are often very potent for good as well as evil. So it is with chloride of sodium. About 70 per cent of the weight of our bodies is water, and if it were not for the presence of natrium muriate in the system we could not live. It is the power that this salt has to use water, that renders it of so much value to animal and vegetable life. When we take too much salt with our food we are continually drinking water to preserve the proportion the superabundance of salt in the system demands; and, again, when there is too little chloride of sodium, the fluids within the body call for it in many ways. It makes its appearance in many different channels, as in watery pimples or blisters, frothy, watery bubbles on the tongue, excessive flow of tears, excessive flow of saliva, watery secretions from the nose, vomiting of this watery fluid, waterbrash not acid, and in any condition where there is an excess of watery exudate.

At one time especially in the South, chloride of sodium was used in the treatment of ague, and in many cases with marked success where quinine and many other well known antiperiodics had failed. I presume that many of my readers will at once take issue with me when I say that in ague there is an excess of water in the blood. I make this statement with all due respect for the mosquito, who is blamed, like some people, for deeds never committed. I learned this when a boy, but never saw anything written about it, until I found it in works on the tissue remedies. Will it be out of place for me to relate here a case before I write further of this remedy?

When I was a boy I had the ague, as nearly everybody did in those days, and had been treated by physicians, and with patent medicines, and by the neighbors, without success. I continued to have "chills and fever" every day or every other day. My parents were away from home for a day and that day an old friend of my father's came to visit him and decided to remain until he returned. About ten o'clock in the forenoon I began my usual "stunt" of stretching and yawning and crawling up to the fire.

The visitor asked me what was the matter and I told him that I was getting ready to have the ague. He said there was no need of that for he could stop the chill coming and cure me. Those of you who have "been there" know what blessed news that was. He asked me if we had any good cider vinegar and some eggs, and I assured him that we had plenty of both. He took an ordinary tumbler, filled it two-thirds full of strong vinegar, broke into it an egg, and thoroughly stirred it. He then told me to drink the whole at one dose.

It was an awful looking mixture, but it did not taste badly. Immediately after swallowing the potion he put me in bed and covered me up well, and in a few minutes I was in one of the most profuse sweats that could be imagined. I verily thought I would drown, but in due time the sweating ceased and I felt fine, in fact, better than I had for months. I did not have my chill or fever and ate a good dinner and never felt better. He further said: "Three times a day take a glass of water with a very small pinch of salt in it, and your ague will not return," and it did not.

David Harum said: "Do unto others as they would do unto you, but do it fust."

And it is the same way with the ague. The chills and fever, the "forming, cold and hot stages" are preliminary to the fourth or "sweating stage," and if by any means you can cause the sweating stage to appear "fust," you will not have the other three stages. Try it. You can by any of our good remedies produce profuse diaphoresis before the chill comes, and no chill will come. The next old fashioned case of ague you are called to treat and you are there just before time for the chill, give the patient a good dose of jaborandi or pilocarpine, or the vinegar mixture, put him to bed and sweat him thoroughly, and, my word for it, he will not have the chill and fever which are Nature's manner of getting rid of the excessive water. Pardon me for this long digression, but it may suffice to impress upon you the effect of an excess of water in the blood in some cases.

Many people take salt in excess and produce diseases that are hard to cure. Many of the symptoms calling for this remedy are almost directly the opposite of those already mentioned. We now know that drugs act differently in different sized doses. Ipecac for instance is emetic in large doses and quiets nausea in small doses. So, natrium muriate has a dual action. It is demanded when the fluids are in excess, and also for the extreme opposite—a dry condition. Given a case of sun stroke, and it is one of the best if not the best remedy we have. Again, in delirium tremens a like condition exists, and here again we have the remedy in natrium muriate. In headache with dryness of some of the mucous membranes and excessive secretion from others it equalizes the distribution of the water in the system.

Some cases of long standing constipation are readily relieved by it when the above conditions prevail. Loss of smell, with dryness of the pharynx, great thirst, excessive dryness of the skin, are indications for this remedy. Many conditions are produced by an inordinate use of this drug, such as changes in the vocal chords, sore throat constipation or chronic diarrhea, abscesses, deposits, and skin affections with dryness where the patient sweats easily. The symptoms of scurvy and the sodium chloride habit are almost identical.

This has been used in cholera and checks the watery vomit and abates the watery discharge from the bowels. (American Dispensatory.) I would think that cholera and choleraic diarrheas would be benefited by the use of the normal salt solution introduced into the cellular tissues, or in bad cases, into a vein, directly into the bloodstream, although I have never tried it.

Many cases of fever with dry tongue and excessive watery discharges are quickly relieved by it and in many cases it means the difference between life and death. Small and frequently repeated doses of the 3x natrium muriate will quickly relieve this condition. Even those cases where these conditions are caused by taking too much of the crude salt will be relieved by small doses in an attenuated form, just as small doses of rhus toxicodendron will relieve cases of rhus poisoning—a fact well known.

Delirium occurring in any case from whatever cause, with a slimy, frothy appearance of the tongue with watery secretions will be relieved by this remedy. This indication is the "key note " for this remedy. A case in point is the following: Mr. E. A. had delirium tremens with the above conditions (and most of them do) in which our ordinary remedies seemed to be of no avail. He was relieved in a short time by five grain doses of natrium muriate 3x. The next day the patient seemed in good condition and had slept well the night before. We see the provings of this theory in the action of one-half grain doses of pilocarpine in these conditions given hypodermatically. This will sober up these old drunkards quickest of any thing that I know of, but it is too severe and not curative. This remedy produces such profuse diaphoresis, equalizing the water in the system, which gives the immediate relief, but only acts for the time being. This proves the theory of the unequal balance of the water in the system. The next case of delirium tremens you have, study it carefully for these conditions, and if it is "too utterly too too" that it can not be managed without having several to hold the patient or having him tied, try the pilocarpine treatment which will sober him up in a way that will surprise you, and then follow it up with the natrium muriate to get the system in perfect condition -minus the whisky.

Another case: I was called to see Mr. R. L. a young man suffering from sun stroke. He had been working in the harvest field. When I arrived found him lying in the shade of a house, where he had been carried, on a pallet, unconscious, twitching of the muscles, face flushed, labored breathing and rapid pulse. I at once determined to rely on natrium muriate alone, and gave him ten grains of the 3x trituration dry on the tongue every fifteen minutes. I remained an hour, when he could swallow liquids, and then gave him the same dose in solution every hour. He slept well that night. The next day he came to the village, and the next day went to work again. No other medicine was given him.

Our next paper closes the consideration of the Tissue Remedies for this time.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.