IODINEThis remedy, in all of its complaints whether acute or chronic, has a peculiar kind of anxiety that is felt both in mind and body. It seems also that this state of anxiety is attended with a thrill that goes throughout his frame unless he removes it by motion or change of position. The anxiety comes on when trying to keep still, and the more he tries to keep still the more the anxious state increases. While attempting to keep still, he is overwhelmed with impulses, impulses to tear things, to kill himself, to commit murder, to do violence. He cannot keep still and so he walks night and day. This remedy carries the same feature with it into the Iodide of Potassium, so that it makes the Iodide of Potassium patient walk. But there is this difference, the Kali iod. patient can walk long distances without fatigue, and the walking only seems to wear off his anxiety, whereas in Iodine there is great exhaustion; he becomes extremely exhausted from walking and sweats copiously even from slight exertion. Iodine corresponds to those cases in which it seems that there is some dreadful thing coming on; the mind threatens to give out. Insanity threatens, or the graver forms of disease are threatening, such as are present in the advanced stages of suppressed malaria, in old cases of chills, in threatened phthisis, especially abdominal.
Hypertrophy runs through the remedy. There is enlargement of the liver, spleen, ovaries, testes, lymphatic glands, cervical glands, of all the glands except the mammary glands. The mammae dwindle while all other glands become enlarged, nodular and hard. This enlargement of the glands is especially observed among the lymphatic glands of the abdomen, the- mesenteric glands.
There is this peculiar circumstance also in Iodine, viz., that while the body withers the glands enlarge. That is peculiar and will enable you to think of Iodine, because the glands grow in proportion to the dwindling of the body and the emaciation of the .limbs. We find this state in marasmus. There is withering throughout the body, the muscles shrink, the skin wrinkles and the face of the child looks like that of a little old person, but the glands under the arms, in the groin and in the belly are enlarged and .hard. The mesenteric glands can be felt as knots. We see the same tendency hi old cases of malaria coming from the allopaths in which Quinine and Arsenic have been extensively used and the chills have kept on; the face and the upper part of the body are withered, the skin looks shriveled and yellow; a diarrhoea has come on, the liver and spleen are enlarged and the lymphatic glands of the belly can be felt. Even in the earlier stages, when these states are only threatening, we may look forward and see that the case is progressing toward an Iodine state.
Now take a patient that is suffering from intermittent fever brought on from malaria, or damp cellars. The patient grows increasingly hot; it is not always a febrile heat, but a sensation of heat; he wants to be bathed in cold water, wants the face and body cooled by cold sponging; he suffocates and coughs in a warm room, dreads heat, sweats easily and easily becomes exhausted. It is in this kind of a constitution that acute complaints will come on, such as acute inflammatory conditions of the mucous membranes and gastritis, inflammation of the liver, inflammation of the spleen, diarrhoea, croup, inflammation of the throat. The throat even becomes covered with white spots and is tumid and red, and this extends down into the larynx; it may even have a deposit upon it like diphtheria. Iodine has cured diphtheria, when the exudation resembling the diphtheria exudations was present in the stool. A constitution tending this way may bring on croup with an exudate, and we can see that it is going towards Iodine. In every region of the body peculiar little things come out. If we do not see to the full extent the constitution of the remedy, we will not recognize the tendency of the patient when progressing unfavorably.
The mental state of this patient is that of excitement, anxiety, impulses, melancholy; he wants to do something, wants to hurry; he has impulses to kill. In this it is very closely related to Arsenicum and Hepar. The Arsenicum and Hepar patients also have impulses to commit murder without being offended and without cause. The sensitiveness to heat will at once decide, for while Iodine is warm-blooded the Arsenicum and Hepar patients are always chilly. The impulse to do violence is sudden. There are remedies that have peculiar impulses, impulses without any cause. These impulses are seen in cases of impulsive insanity; an insanity in which there is an impulse to do violence and strange things, and when the patient is asked why he does these things he says he does not know. The patient may not be known to be insane in anything else; he may be a good business man. Remedies also have this. These things are forerunners. It is recorded under Hepar that a barber had an impulse to cut the throat of his patron with the razor while shaving him. The Nux vomica patient has an impulse to throw her child into the fire, or to kill her husband whom she dearly loves. The thought comes into her mind and increases until she becomes actually insane and beyond control and the impulse is carried into action. A Natrum sulph. patient will say, "Doctor, you do not know how I have to resist killing myself. An impulse to do it comes into my mind." Iodine has the impulse to kill, not from anger, not from any sense of justice, but without any cause. An overwhelming anger is often a cause for violence but the impulses are not of that sort in Iodine. While reading or thinking placidly at times a patient may have an impulse to do himself violence, and this finally grows until the end is a form of impulsive insanity.
The Iodine patient becomes weak in mind as well as in body; he is forgetful, cannot remember the little things, they pass out of the mind. He forgets what he was about to say or do; goes off and leaves packages he has purchased. The forgetfulness is extensive. But with all these states, do not forget one thing, that the patient is compelled to keep doing something in order to drive away his impulses and anxiety. The anxiety is wearing and distressing unless he keeps busy. Though mentally prostrated, he is compelled to keep busy and to continue the work, which increases the prostration of mind. You tell a man who is threatened with softening of the brain, from overwork, from anxiety and labor in literary work, "You must stop working, you must rest." "Why," he will say, "If I do I would die or go mad." Such a state comes under Iodine and Arsenicum, but there is one grand distinction by which the two remedies are seen to part company at once. The Iodine patient is warm-blooded, wants a cool place to move in, and to think in, and to work in, whereas the Arsenicum patient wants heat, wants a warm room, wants to be warmly clothed, and suffers from the cold. Iodine suffers from the heat. So that while the restlessness and anxiety, which are both of body and mind in each remedy, loom up before the mind as one, if the patient is a hot-blooded patient we would never think of Arsenicum; if a cold-blooded and shivering patient we would never think of Iodine.
Among the generals we first mentioned was the tendency to enlarged glands. Iodine has often cured a group of symptoms coming in the constitution that I have named, viz.; enlargement of the heart, enlargement of the thyroid and protruding eyeballs. Now, if you have one of these patients (suppose it has been sent to you by somebody who knows no better than to call it exophthalmic goitre), those things that are so essential to the name of the disease, as they call it, would not be an indication for the remedy, but the indications would be found among those circumstances that I have given you that are outside of the projection of the eyes, the enlargement of the thyroid, the hypertrophy of the heart and the cardiac disturbances. If the patient is emaciated, is sallow, suffers from heat, has enlarged glands, and the other symptoms of this medicine, you may expect after its administration an ultimate cessation of the group of symptoms that are selected to name the disease by.
Brain troubles, acute and chronic, sometimes call for Iodine. The head throbs, the body throbs, there are pulsations all over, and the throbbing extends to the finger ends and the toes; throbbing in the pit of the stomach, heavy pulsations felt in the arms, pulsations in the back, throbbing in the temporal bone. There are congestive headaches with violent pain. The head pains are aggravated from motion, but the patient is relieved from motion. The patient moves because his anxiety is relieved by motion, but every motion increases the head pains and the pulsation. Such distinctions are necessary. To distinguish between what is predicated of the patient and what is predicated of a part is an essential in the study of the Materia Medica. Everything that is predicated of the patient is general, everything that is predicated of a part is particular. The two may be opposite, and hence the student of the Materia Medica will sometimes be worried because he will find aggravation from motion and relief from motion recorded under the same remedy. It is only from the sources of the Materia Medica, i. e., the provings, and from the administration of the remedy that we may observe what is true of a part and what is true of the whole. We find at times a patient wants to be in a hot room with the head out of the window for relief of the head. In that case the head is relieved from cold and the body is relieved from heat. This is a typical symptom of Phosphorus, which has relief from cold as to the head and stomach symptoms, but aggravation from cold as to its chest and body symptoms. So, if the Phosphorus patient has vomiting and head symptoms, he says: "I want to go out in the open air and I want to take cold things into my stomach;" but if he has chest symptoms and pain in the extremities, he says: "I want to go into the house and keep warm." And just as we see this in patients it is so in the study of a remedy; we must discriminate.
As you may expect, all sorts of eye troubles are present in this debilitated constitution. The so-called scrofulous affections of the eyes, with ulceration of the cornea, catarrhal troubles, discharge from the eyes, enlargement of the little glands of the lids, come along with the emaciation and yellow countenance in the constitution described. Optical illusions in bright colors. An oedematous state is in keeping with Iodine. There is oedematous swelling of the lids and oedematous swelling of the face under the eyes Iodine has also oedema of the hands and feet, and carries this tendency with it into the Iodide of Potassium, which has oedematous swellings like those we find in kidney affections. It is capable of putting a stop to cases of Bright's disease in the early stages.
Another grand feature that runs through the complaints of Iodine is hunger. He is always hungry. The eating of the ordinary and regular meals is not sufficient. He eats between meals and yet is hungry. Moreover the complaints are better after eating. All the fears, the anxiety and distress of Iodine increase when he is hungry. There is pain in the stomach when the stomach is empty, and he is driven to eat. While eating he forgets his complaints, because it is like doing something, it is like moving, his mind is upon something else. He is relieved while eating and he is relieved while in motion. In spite of the hunger and much eating he still emaciates. "Living well yet growing thin," was one of Hering's key-notes of Iodine. As in Natr. mur. and Abrotanum, he emaciates while he has at the same time an enormous appetite. The nutrition is so disturbed that there is no making of flesh, and hence the emaciation.
The catarrhal condition of the nose is worthy of notice. The Iodine patient has loss of the sense of smell. The mucous membrane is thickened; he takes cold upon the slightest provocation; is always sneezing, and has from the nose a copious watery discharge. Ulceration in the nose with bloody crusts; he blows blood from the nose. The nose is stuffed up so that he cannot breathe through it. This increases every time he takes cold, and he is continually taking cold, hence he becomes a confirmed subject of catarrh. I have described the general state. The patient is the first to be thought of. His constitution is the first thing to know, i. e., what is true of the patient as a whole. After that we can find out what is true of each of his parts. The mucous membrane of the nose is constantly in a state of ulceration, or has a tendency to ulceration. Sometimes these little ulcers are deep.
There are aphthous patches along the tongue and throughout the mouth. The whole buccal cavity is studded with aphthous patches. I have mentioned already the tendency to exudation; white velvety, or white-greyish or pale ash-colored exudations come upon the sore throat, all over the mucous membrane of the nose and all over the pharynx. The pharynx seems to be lined with the velvety, ash- colored appearances. With these throat symptoms and the tendency to ulceration it has a wide range of usefulness in throat affections. It is useful in enlargement of the tonsils when the tonsils are studded with exudations and in the constitution described. Enlarged tonsils in hungry, withered patients. We often see one who is subject to quinsy progressing toward the Iodine state. He is always suffering from the heat like a Pulsatilla patient; at times in the earlier stages, before any organic changes have taken place, you may mistake Iodine for Pulsatilla. But if you watch the patient you will observe the tendency to emaciation and see that the two remedies soon part company. They are both hot, they are both irritable, they are both full of notions. The Pulsatilla patient is far more whimsical, more tearful, has greater sadness, and has constant loss of appetite, while the Iodine subject wants to eat much. The Pulsatilla patient often increases in flesh, although growing increasingly nervous. The Iodine patient becomes thin, has a ravenous hunger, cannot be satisfied, suffers from his hunger; he must eat every few hours and feels better after eating; he has also great thirst. If he goes long without eating, no matter what the complaints are, the suffering will increase. Any of the complaints of Iodine will likely be increased by fasting.
Iodine has also an indigestion that comes from overeating. The food sours, he is troubled with sour eructations, with much flatulence, with belching, with undigested stools, with diarrhoea, watery, cheesy stools, and he digests less and less. The digestion becomes more and more feeble until he digests almost nothing of what he eats, and yet the craving increases. He vomits and diarrhoea comes on and so he increasingly emaciates; because it is like burning the candle at both ends. It is not surprising that he is extremely weak, because he is assimilating very little of what he takes. The articles of food act as foreign substances to disorder his bowels and stomach. Now, with this trouble going on, the liver and spleen become hard and enlarged, and the patient becomes jaundiced. The stool is hard, lumpy and white, or colorless, or clay colored, sometimes soft and pappy; there seems to be little or no bile in it. This stage gradually increases until hypertrophy of the liver comes on. Finally the abdomen sinks in and reveals this enlargement of the liver and the enlarged lymphatic glands. These are very knotty and as hard as in tabes mesenterica. Iodine is indicated in the tubercular condition of the mesenteric glands with diarrhoea, emaciation, great hunger, great thirst, withering of the - mammary glands, a dried beef-like or shriveled appearance of the skin and sallow complexion. If the remedy is given early enough, before the structural changes have occurred, it will check the progress of the disease and cure.
This is a very useful remedy in the chronic morning diarrhoea of emaciated, scrofulous children. When the constitutional state is present it is primary to the varying kinds of stools that it is -possible for the patient to have. So if you have a marked state of the constitution, a case in which there are a great number of general symptoms for you to associate the remedy with, the little symptoms of the diarrhoea cease to be important. The constitutional state in that patient is that which is "strange, rare and peculiar." Almost any kind of diarrhoeic stool will be cured if the constitutional state is covered by the remedy. When it is an acute diarrhoea and it occurs in a vigorous constitution, and there is nothing but the diarrhoea, then it is necessary to know all the finer details, and the characteristics of the diarrhoea become the rare, "strange" and "peculiar" features.
Incontinence of urine in old people. In the male with all these constitutional symptoms Iodine is especially suited when the testes have dwindled, when there is impotency, when there is flowing of semen with dreams, when there is loss of sexual instinct or power, or with an irritated state, an erethism of the sexual instinct; also when the testes are enlarged and hard, indurated and hypertrophied like the other glands, or when there is an orchitis, an inflammation and enlargement of the testicles.
Swelling and induration of the uterus and ovaries. Iodine has cured tumors of the ovaries in such a constitution as I have described. It has cured the dwindling of the mammary glands and caused them to grow plump with an increase of flesh upon dwindling patients.
Its nature to produce the catarrhal state is illustrated in the leucorrhoea that it produces. Uterine leucorrhoea with swelling and induration of the cervix. Uterus enlarged, tendency to menorrhagia. Leucorrhoea rendering the thighs sore. The discharges of Iodine are acrid. The discharges from the nose excoriate the lip, the discharges from the eyes excoriate the cheek, the discharges from the vagina excoriate the thighs. The leucorrhoea is thick and slimy and sometimes bloody; "chronic leucorrhoea, most abundant at the time of the menses, rendering the thighs sore and corroding the linen."
This remedy has a cough that is violent; it has grave and severe difficulties of respiration, dyspnoea, with chest symptoms. Croupy, suffocating cough in this delicate constitution. Again we say if you do not hold in mind the constitutional state while reading these very numerous respiratory symptoms, you will not be able to apply- them because they are extensive and include a great many so-called Complaints and would give you difficulty in individualizing them.
Now, there is one more complaint that I wish to call your attention to. In old gouty constitutions, with enlargment of the joints, the history is that the patients were once in a good state of flesh, but they have become lean, and although they are hungry, the food does not seem to do them good. The joints are enlarged and tender. Many gouty constitutions want a warm room, but the Iodine patient wants a cool room. His joints pain and are aggravated from the warmth of bed. He cheers up in a cool place and likes to be in the open air. He is growing increasingly weak; he is generally ameliorated on moving about and eating, he has the anxiety of body and mind. Iodine will put a check on his gouty attacks and cause him to go on comfortably for a while.