KALI CARBONICUMThe Kali carb. patient is a hard patient to study, and the remedy itself is a hard one to study.
It is not used as often as it should be, and the reason is that it is a very complex and confusing remedy. It has a great many opposite symptoms, changing symptoms, and thus it is related to patients that withhold their symptoms and have many vague symptoms.
The patient is whimsical, irascible, irritable to the very highest degree, quarrels with his family and with his bread and butter. He never wants to be alone, is full of fear and imaginations when alone "fear of the future, fear of death, fear of ghosts." If compelled to remain alone in the house he is wakeful, sleepless, or his sleep is full of horrible dreams. He is never at peace, is full of imaginations and fear. "What if the house should burn up!" "What if I should do this or that" and "What if this and the other thing should happen !"
He is oversensitive to everything, sensitive to every atmospheric change; he can never get the room at just exactly the right temperature; he is sensitive to every draft of air and to the circulation of air in the room. He cannot have the windows open, even in a distant part of the house. He will get up at night in bed and look around to see where that draft of air comes from. His complaints are worse in wet weather, and in cold weather. He is sensitive to the cold and is always shivering. His nerves feel the cold; they are all painful when it is cold. The neuralgias shoot here and there when it is cold, and if the part affected be kept warm the pain goes to some other place. All his pains change place and go into the cold part; if he covers up one part, the pain goes to the part uncovered.
This remedy is full of sticking, burning, tearing pains, and these fly around from place to place. Of course Kali carb. has pains that remain in one place, but usually the pains fly around in every direction. Pains cutting like knives. Pains like hot needles, sticking, stinging and burning. These pains are felt in internal parts and dry passages. Burning in the anus and rectum, described as if a hot poker were forced into that passage; burning as with fire. The haemorrhoids burn like coals of fire. The burning of Kali carb. is like that of Arsenicum.
Again from studying the text it will be seen that it is a common feature of this medicine to have its symptoms come on at 2, 3 or 5 o'clock in the morning. In Kali carb. the cough will come or have its greatest < at three or four or five o'clock in the morning. The febrile state will occur from 3-5 in the morning. The patient, who is subject to asthmatic dyspnoea, will have an attack at 3 o'clock in the morning, waking him out of sleep. He will wake up with various symptoms and remain awake until 5 o'clock in the morning, and after that to a great extent they are relieved. Of course, there are plenty of sufferings at any time in the twenty-four hours, but this is the worst time. He wakes up at 3 o'clock in the morning with fear, fear of death, fear of the future, worries about everything and is kept awake for 2-3 hours and then goes to sleep and sleeps soundly.
His body is cold and requires much clothing to keep it warm, but in spite of the fact that he is cold he sweats copiously; copious, cold sweat upon the body. Sweats upon the slightest exertion, sweats where the pain is, sweat over the forehead; cold sweat on the forehead with headache.
Neuralgia of the scalp and the eyes and the cheek bones in association with the nervous shooting pains. Violent pains here and there in the head, as if the head would be crushed. Cutting and stabbing in the head. 'Violent congestive headaches as if the head were full. Head hot on one side and cold on the other; forehead covered with cold sweat.
It has catarrhal congestive headache. Whenever he goes out in the cold air, the nose opens up and the mucous membranes become dry and burn; when he returns into a warm room the nose commences to discharge, and the nose stuffs up so that he cannot breathe through it, and then he feels most comfortable; so that it has stuffing up of the nose in a warm room, and opening up of the nose in the open air.
When the nose is open so that he can breathe through it, that is the time the head is most painful; it is painful to the cold air and the cold air makes it burn. The cold air feels hot. All these patients suffer from a chronic catarrh and when they ride in the wind the catarrhal discharge ceases and then will come on a headache, and thus he has headache from riding in the cold wind. Whenever the discharge ceases from taking cold in a draft on comes headache, and as the discharge becomes free again the headache is relieved. Neuralgic pains in eyes and scalp and through the cheek bones from a cessation of chronic catarrhal discharge, and when the discharge starts up again, these pains cease.
With the chronic catarrh of the nose there is a thick, fluent, yellow discharge; dryness of the nose, alternating with stuffing up. The one who suffers from a chronic catarrh will also have the discharge in the morning, which will fill up the nose with yellow mucus. In the morning he blows out and hawks up dry, hard crusts that fill up the nasal passage, clear over into the pharynx and down into the throat. These crusts become dry as if they were partly formed upon the mucous membrane and when they are blown out there is bleeding. The bleeding starts from where the crusts are lifted up.
He is subject to sore throat, is always taking cold, and it settles in the throat. He is also subject to enlarged tonsils and with these has enlargement and chronic hardness of the parotid glands one or both. Great knots below the ear, behind the jaw. These grow and become hard, and at times painful; shooting, darting pains when he is moving about in the open air. When air strikes these enlarged glands they are sore and painful, and he is ameliorated by going into a warm place. The acute colds extend into the chest, but Kali carb. has been found most suitable in the chronic catarrh of the chest, chronic bronchitis.
The chest is very often affected in just the same way as the nose. There is the dryness and dry barking, hacking cough in cold air, but a copious expectoration of mucus when it becomes warm, and that is the time he is most comfortable, for the expectoration seems to relieve him. He suffers mostly from a dry, hacking cough with morning expectoration. The cough begins with a dry, hacking, increases gradually and sometimes very rapidly to a violent, spasmodic cough with gagging or vomiting, and when coughing it feels as if his head would fly to pieces. The face becomes puffed, the eyes seem to protrude and then there is seen that which is commonly present in Kali carb., a peculiar sort of a swelling between the eyelids and eyebrows that fills up when coughing. Your attention is called to that peculiar feature, for although there may be bloating nowhere else upon the face that little bagging will appear above the lid and below the eyebrow. It fills up sometimes to the extent of a little water bag. Such a swelling has been produced by Kali carb., and sometimes that symptom alone guides to the examination of the remedy for the purpose of ascertaining if Kali carb. does not fit all the rest of the case. Boenninghausen speaks of an epidemic of whooping cough in which the majority of cases called for Kali carb., and this striking feature was present. No remedy should ever be given on one symptom. If you are led to a remedy by a peculiar symptom, study the remedy and the disease thoroughly to ascertain if the two are similar enough to each other to expect a cure. Any deviation from that rule is ruinous and will lead to the practice of giving medicines on single symptoms.
Dry, hacking, incessant, gagging cough with whooping, blowing of blood from the nose, vomiting of everything in the stomach, and expectoration of blood-streaked mucus, is a whooping cough that will be commonly cured by Kali carb., but especially if there is present that peculiar and striking feature of a bag-like swelling below the eyebrow and above the lids, puffiness of the eyes.
There are some cases of pneumonia that need Kali carb., in the stages of hepatisation (like Sulp.). Again, when pneumonia has passed away think of Kali carb. if every time the patient takes a little cold it settles in the chest with these symptoms that I have described. There is sensitiveness of the body to weather changes, to cold aid and to wet, a continuous dry, hacking cough, with gagging, the aggravation from three to five in the morning, and the patient has flying neuralgic pains. These symptoms gradually increase and the patient dates them back to his pneumonia. He says: "Doctor, I have never been quite well since I had pneumonia." The catarrhal state has settled in his chest and there is a chronic tendency to take cold. These cases are threatening to go into phthisis and will hardly be likely to recover without Kali carb. In this tendency for catarrhal states to locate in the chest, Kali carb. should be thought of as well as Phosphor., Lycopod. and Sulphur.
Another general state that belongs to this remedy is a tendency to dropsies. It has dropsies all over the body. The feet bloat- and the fingers puff; the back of the hands pit upon pressure, the face looks puffy and waxy. The heart is weak. I can look back upon quite a number of cases of fatty degeneration of the heart in which I could have prevented all the trouble with Kali carb. if I had known the case better in the beginning. These cases are insidious, and the indications calling for Kali carb. must be seen early or the patient will - advance into an incurable condition. That peculiar. state of weakness and feeble circulation that finally ends in dropsy and many other complications have their likeness in Kali carb. There is an insidiousness about Kali- carb. in the approach of all of its complaints.
He has a sort of nondescript appearance, he is withered, has much dyspnoea upon going uphill or even walking on the level. Examination of the lungs shows them to be in very fair condition, but finally complications come on, there is a break down and organic changes and you look back over these cases and say, if I had only seen in the beginning of this case what I see now it seems as if the patient ought to have been cured. We learn the beginnings of remedies as we learn the beginnings of sicknesses. It is a prudent thing for a homoeopathic physician to glance back over a case that he has failed on, or someone else has failed on, to study its beginnings and see what the manifestations were. This kind of study to the homoeopathic physician is as delightful as post mortems are to the old school.
The teeth present a peculiar state. The gums take on a scorbutic or scrofulous character. The gums separate from the teeth and the teeth decay and become discolored and loose, so that they have to be extracted early in life. He suffers from pain in the teeth whenever he takes cold from riding in the wind and raw weather. The pains come on even when the teeth are not yellow or decayed; stitching, tearing, rending pains in the teeth. Offensive smell from the teeth; pus oozing out from around the teeth. The mouth is full of little ulcers, little aphthous patches. The mucous membrane is pale and ulcerates easily. The tongue is white with offensive taste; coated gray, with sick headaches.
While many of the symptoms of Kali carb. are aggravated after eating, some symptoms are relieved after eating. There is throbbing in the pit of the stomach when the stomach is empty. There is also throbbing all over the body, pulsation to the fingers and toes; there is no part that does not pulsate, and he is kept awake by this pulsation. Pulsation even when there is often no feeling of palpitation in the region of the heart. It has also violent palpitation of the heart.
Kali carb. fits many old dyspeptics. After eating he feels as if he would burst; so bloated is he. Great flatulence; belches wind up wards and passes flatus downwards; offensive flatus. The belching up is also attended with fluid eructations, sour fluids that set the teeth on edge; they excoriate, or cause smarting in the pharynx or mouth. Pain in the stomach after eating; burning in the stomach after eating. Gone feeling in the stomach, that is not even relieved by eating. A peculiar condition in Kali carb. is a state of anxiety felt in the stomach, as though it were a fear. One of the first patients I ever had expressed it in a better way than it is expressed in the books; she said, "Doctor, somehow or other I don't have a fear like other people do, because I have it in my stomach." She said when she was frightened, it always struck to her stomach. "If a door slams, I feel it right here" (epigastric region). Well, that is striking, that is peculiar. It was not long before I developed another feature of Kali carb. By a little awkwardness on my part my knee happened to hit the patient's foot as it projected a little over the edge of the bed, and the patient said, "Oh!" Sure enough that was Kali carb. again, for you will find in Kali carb. a patient that is afraid and everything goes to the stomach and when touched upon the skin there is an anxiety or fear or apprehension felt in the region of the stomach. You might imagine that it is connected with the solar plexus, but the symptom is the all in all to the physician. A Kali carb. patient is so sensitive in the soles of the feet that the mere touch of the sheet brings a sensation of thrill throughout the body. Hard pressure is all right, it does not disturb, but something that comes unawares excites. The Kali carb. patient is over sensitive to all the surrounding things, over sensitive to touch; shivering from the simplest and lightest touch, even when hard pressure is agreeable. Violently ticklish in the soles of the feet. I have often examined the feet when a patient would shiver and draw up the feet and scream out, "Don't tickle my feet." I had probably touched is so lightly that I did not know that I had touched it at all. In Lach. also gentle touch is painful, while hard pressure is agreeable, but here it is not so much the ticklishness. In Lach. the abdomen is so sensitive that the touch of the sheet is painful. I have seen Lach. patients using a hoop to keep a light sheet from touching the abdomen. You may know then that you are in the realm of Lachesis, and that it is like those persons who are unable to bear the slightest touch upon the neck and suffer from uneasiness on wearing a collar. All that, however, is different from this state of ticklishness. I have seen patients who are really so sensitive in the skin that I would not dare touch it; unless they knew just where I was going to touch. "Now I am going to feel your pulse, hold still." If I were to touch the hand, or reach out to-feel the pulse without warning there would be a thrill. Such a state is in keeping with Kali carb. These things often have to be dug out by observation in -studying the nature of provings, and associating things. These things that run into the oversensitive- ness of patients are of great value clinically. The capabilities of our Materia Medica are something wonderful, but they could be developed much more rapidly if a number of homoeopathic physicians would make application of the Materia Medica with accuracy and intelligence, observing what they see and relating it literally. At the present day there is only a very small number of homoeopathic physicians that can come together in a body and say things that are worth listening to, a shamefully small number when we consider the length of time Hahnemann's books have been before the world.
There are many old chronic liver subjects who talk about nothing else but the liver. Every time they go to the doctor's office ice they talk about the liver, and about a condition of fullness in the region of the liver and pain through the right shoulder blade and up through the right side of the chest, with a good deal of oppression and distension; vomiting of bile and a good deal of stomach disorder, fullness after eating; attacks of diarrhoea, alternating with constipation lasting for many days with great straining at stool. Periodical bilious attacks, when a constipated state is present; cannot lie down at night; difficult breathing at night or at 3 o'clock in the morning, especially when it is in a patient over-sensitive to cold, damp weather, one who wants to sit by the fire all the time. These liver subjects are often thoroughly cured by Kali carb. Sometimes they have been resorting to all sorts of liver tappings, taking such medicines as purge or cause vomiting, drugs that really aggravate the trouble. Kali carb. goes to the bottom of these cases, and roots out the evil.
In the abdomen we have many Kali carb. symptoms. Persons subjected to repeated attacks of colic, cutting pains, with distension, with pain after eating, constipation or diarrhoea. Colic, with cutting, tearing pains, doubling him up, coming on every little while. Tremendous flatulence. When the attack of colic is on it might remind you of Colocynth or of some other of the acute remedies that cure colic in two or three minutes, but you will find that these acute remedies that relieve colic so speedily when given the second or third time do not produce so marked an effect. You will find it necessary to hunt for an antipsoric, a remedy that will control the whole case. In the study of the colic alone during its attack you only get a one-sided view of the case, and after the colic is over (say he has been cured by Colocynth) you now study the patient and go over the case, and behold all the symptoms are covered by Kali carb. After giving that remedy you may expect that the patient will not have another attack. Such is the nature of Kali carb. It is deep-acting, long-acting, goes deep into the life. It cures conditions due to psora, or to the suppression of eruptions in childhood, or to the closing up of old ulcers and fistulous openings with a history of troubles ever since. All these wandering pains and the chilliness are again relieved by eruption, by the outbreak of discharges; by haemorrhages, by ulcers that eat in deep and flow freely and fistulous openings.
"Cutting in abdomen, as if torn to pieces." "Violent cutting, must sit bent over pressing with both hands, or lean far back for relief; cannot sit upright." "Cutting and drawing like false labor pains." There is great coldness with the pains, with the cutting in the abdomen; he wants heat, hot drinks, hot water bags. A chronic coldness is felt in the abdomen, cold externally and internally. It would sometimes be cruel to give a dose of Kali carb. when the colic is on, 'because if the remedy fitted the case constitutionally, if all the symptoms of the case were those of Kali carb., you would be likely to get an aggravation that would be unnecessary. There are plenty 'of short acting remedies that would relieve the pain speedily, and at the close of the attack the constitutional remedy could then be given. If the patient can bear the pain to the end, it is better to wait until it passes off without any medicine. That sometimes is cruel, and then the short acting medicines should be given. All recurrent troubles, those that come periodically, or after eating certain articles, or from exposure, or with a periodicity that belongs to time all these states are chronic; they are not acute troubles. They are simply a small portion of a chronic miasm, a side view, and all such cases must have a constitutional remedy sooner or later. You can, it is true, relieve violent pain at the first visit, but then you must look deeper and prevent your patient having more trouble. Otherwise, if you should give Bell. or Colocynth or any medicine that simply fits the colic, the trouble will come back again; you have not cured your patient; you have only palliated. But, on the other hand, you take such a colic as is described here and Kali carb. fits just these symptoms alone and does not fit the whole constitution of the patient. Then it is that a constitutional and long-acting remedy like Kali carb. acts in fullness. It does not take the usual long -time to act and is not attended with an aggravation.
"Abdominal muscles painful to touch; swelling of glands." In the abdomen, also, following troubles in the bowels, or following peritonitis, we have effusion into the peritoneal sac, which is usually associated with dropsy of the extremities, but not always. In liver dropsies especially is this remedy useful.
It has a great many complaints of the rectum and anus and of the stool. It has most persistent and enormous haemorrhoidal tumors that burn, that are extremely sensitive to touch, that bleed copiously, that are extremely painful, making it impossible for him to sleep. He is 'compelled to lie upon the back and hold the nates apart, because the pressure: is very painful to the external piles. The piles cannot be put back; there is great distension and swelling inside. Haemorrhoids that come out after stool and bleed copiously and are very painful; they must be pushed back, and long after going to bed they burn like fire. There is great aggravation from stool, which is hard and knotty and requires great straining to expel. Fistulae of the anus. Burning temporarily relieved by sitting in cold water.
It has chronic diarrhoea and also diarrhoea alternating with constipation. Many times where there are numerous particulars, we have to rely upon the generals that are characteristic of the remedy. The text gives much less of diarrhoea than has been developed by clinical uses. "Diarrhoea painless, with rumbling in the abdomen and burning at stool, only by day; chronic cases with puffiness under the eyebrows." a gives few symptoms, but it is a large and extensive remedy in diarrhoeas that are chronic. In old, broken down subjects, in weakly, pallid subjects, with poor digestion, with great flatulence, with much distension, with disordered liver.
Then the kidney, bladder and urethra come in for their share of trouble, which is of a catarrhal nature. Discharges from the bladder, purulent discharges of a thick, tenacious, copious mucus deposited in the urine. In keeping with this there is much burning; burning in the urethra, during and after micturition. "Urine flows slowly with soreness and burning." Kali carb. runs very close to Natr. mur. in many of its old, long-standing bladder troubles.
In old cases of gleet and long-standing cases of urinary troubles that follow gonorrhoea these two medicines are useful, both suitable in the scanty, white, gleety discharge that remains. In both the urination is painful. In Nat. mur. the burning is after urination. Where there is scanty, gleety discharge and the burning is very marked and only after urination, and the patient is extremely nervous and fidgety, Natrum mur. will cure. If the burning is during and after urination and you have the broken- down constitution we have described, then the remedy may be Kali carb. Some of these old cases are entirely painless, having no pain either during or after micturition. Then you get an entirely different class of remedies. The old chronic discharges following a gonorrhoea are as troublesome for the young doctor as anything that will ever fall- into his hands. The remedies -are numerous, the symptoms are scanty, and many times the patient has not been long under the doctor's care, therefore he does not know the patient's constitutional state well and the patient can only tell him of the discharge. "Nothing but the discharge, doctor." You cannot get his mind on his symptoms; he has forgotten that he wakes at 3 o'clock in the morning and cannot get to sleep until 5 o'clock, he has forgotten all the nervous manifestations. With the patient you have had under control, whose constitutional state you get before this condition comes, you ought not to have much difficulty.
One of the evidences that the Kali carb. patient is of a weakly constitution and is on the road to a break-down is that all of his symptoms are aroused and brought into action after coition, after sexual excitement. Now you will take notice in practice and remember it, that coition is a natural thing with man, when it is carried on in order, and when that which is natural is followed by prostration, and this has been so for a long time, there is a break in the constitution, there is something radically wrong. All the symptoms are likely to be worse after coition in Kali carb. He has weak vision, weakness of the senses, tremulousness, and is generally nervous; he is sleepless, and weak, and he shivers and trembles for a day or two after coition. Similar symptoms are observed in the woman. In spite of the fact that the patient is weak, the sexual desire is excessive. It is not orderly. There is a sexual erethism, which is not under the command of the will, and in the male he is subject to copious and frequent pollutions, nightly dreams, sexual prostration. Young men who have abused themselves, or who have indulged excessively in sexual pleasure, go into marriage with weakened genitals, incapacitated; and then there comes a disgust, and it is not strange that there are so many divorces in the world. When the patient is young, some of this trouble can be overcome by living an orderly life and correct homoeopathy.
In Kali carb. there are many complaints affecting the male genital organs; uneasiness and sensitiveness of the testicles. One is in a state of swelling and hardness. Itching and smarting and annoying sensations in the scrotum and sensations that constantly remind the patient that he has genital organs. Constant irritation calling his attention to the genitals, brought on from abuse, from vice, from excesses. Phosphorus is a medicine that is abused in this sphere. Many physicians look upon it as one of the great remedies for the weakness of the genital organs. In Phos. the genital indications are extreme excitement, too active erections, a disorderly strength of the genital organs. Beware of giving it in impotency or in weakness, as this is often associated with very feeble constitutions, and Phos. not only fails to cure, but seems to add to the weakness. - It is -a weakness that you will learn is a vital weakness. Phos. will set patients to running down more rapidly who are suffering from a vital weakness, who are always tired, simply -weak, always prostrated and want to go to bed.
The female has a great friend in Kali carb. It is full of her complaints and has many symptoms likely to be found -in a sick woman. It is useful in cases of uterine hemorrhages that have been incessant in pale, waxy, haemorrhagic women incessant haemorrhage following an abortion. She has been curetted and has had all sorts of treatment, but still that oozing keeps right on. At the menstrual period the flow is very copious and clotted, and then after a prolonged menstruation of ten days or so, during which she has had a copious flow, she settles back into a state of oozing and flowing Until next month and then it rouses up into another ten days of copious menstruation. Kali carb. has cured a number of cases of fibroid tumor long before it was time for the critical period to cure. You must remember that there is natural tendency for a fibroid to cease to grow at the climacteric period, and afterwards to shrivel, and that ' this takes place without any treatment, but the appropriate remedies will cause that haemorrhage to cease, will cause that tumor to cease to grow and after a few days there will be a grand shrinkage in its size.
Kali carb. is often a remedy for vomiting in pregnancy, but to find out when it is the remedy for vomiting of pregnancy we have to go to the whole constitutional state. Vomiting of pregnancy is not cured, although it may be temporarily relieved; by Ipecac.; as this is a medicine that corresponds merely to the nausea itself. In a large number of instances gagging and nausea are only a second or third grade symptom in the remedy that will cure. The condition really depends upon the constitutional state, and the remedy, that is to cure must be a constitutional remedy. Sulphur, Sepia and Kali carb. are among the remedies commonly indicated. Sometimes Arsenic is needed. Of course, if a pregnant woman has simply disordered her stomach and has 'vomited bile a few times the remedy might be Ipecac. 'When a pregnant woman has no constitutional symptoms at all, and upon examining the case you find nothing but the nausea; overwhelming deathly nausea, with continuous vomiting day and night, a single dose of Symphoricarpus rac. will help. That is prescribing upon very limited information, and should only be done in circumscribed or one-sided cases. It is not a long acting remedy it is .not a constitutional remedy and acts very much like Ipecac.
At times you will go into the confinement room when the woman has pains in the back below the waist line. The pains in the uterus are very weak, they are not sufficiently epulsive to make progressive in the labor, the kind of pain that makes the woman utter the cry, "My back, my back!" The pains extend down the buttocks and legs. Pains in the back as if the back would break. Under- good' prescribing these pains are changed into contractions; which prove sufficient to expel the contents of the uterus. When you hear such things you will look back over the history of the case. You will look back for weeks as the roman has "been drawing near the end of gestation and see that the vague things, the chilliness and other features in her constitutional state for which you have been trying to find a remedy now culminate at the time of her confinement into a class of pains. Had you seen that six weeks before and given her Kali carb. you would have prevented the severe labor. It is a severe labor, a prolonged labor; the uterus appears to be weak, and the pains are feeble; they are all-in the back, and do not go to the center of operation as they should. Now, this same kind of a pain may deceive you in taking another form. The pains begin in the back, and appear to go to the uterus and then run up the back, which would turn you aside entirely from the Kali carb. pain into a pain that would indicate Gelsemium. Sometimes these pains are so severe that they actually seem to prevent rather than encourage the contractions of the uterus; when - the contractions of the uterus cease, and the woman screams out and wants her hips rubbed, and screams out with pain in each side of the abdomen rather than in the center, pains in the region where the broad ligaments ought to be, Actaea racemosa will make the pains regular. Puls. is the medicine for absence of marked contraction in cases inclined to do nothing; in a case that is inactive, when the os is sufficiently dilated and the parts relaxed, and the prediction is an easy and simple labor, but the patient does not do anything. It is a state of mildness or inactivity. Puls. will very often cause in five minutes a very strong contraction of the uterus, sometimes almost in a painless way.
"The back aches so badly while she is walking that she feels as if she could lie down on the street," etc., etc. The pain seems to take the force and vigor all out of the patient. After delivery there is a tendency to prolong the flooding, rousing up at every menstrual period, as described.
Weakness of the heart; cardiac dyspnoea; the breath is short and the patient cannot walk or must move very slowly. It is the coming on of a fatty heart: With the suffocation and dyspnoea the breathing is so short that the patient cannot stop to take a drink or eat; the breathing is rapid, not deep, but weak. Dyspnoea with violent, irregular palpitation of the heart, throbbing that shakes the whole frame, pulsation that can be felt to the ends of the fingers and toes. Violent pulsations; patient cannot lie on the left side; accompanied by stitching pain through the chest and cough. In old asthmatic patients with weak pulse, with the same pulsations and palpitation and cannot lie down. The only position it seems that he can find any comfort in is leaning forward, with his elbows resting upon a chair. The attack is violent and continuous, especially worse from 3 to 5 A. M., and worse from lying in bed. He is aroused at 3 o'clock in the morning with these asthmatic attacks. Asthmatic dyspnoea, when the state is that of humid asthma or filling up of the chest with mucus, coarse rattling in the chest, loud, rattling breathing. In patients who always have rattling in the chest, rattling cough, stuffy breathing; with every rainy spell or misty spell, or in cold, foggy weather, the condition becomes that of a humid asthma; asthmatic breathing, with much weakness in the chest, worse from 3 to 5 in the morning. The patient is pale, sickly and anaemic, and complains of stitching pains in the chest.
The cough of this medicine is one of the most violent coughs of all the medicines in the Materia Medica. The whole frame is racked. The cough is incessant, attended with gagging and vomiting, comes on at 3 o'clock in the morning, a dry, hacking, hard, racking cough. "Suffocative cough and choking cough at 5 A. M. Great dryness in the throat between 2 and 3 A. M." Think of Kali carb. when, after troubles like measles, a catarrhal state is left behind, due to lack of reaction, the psoric sequel. The cough following measles is very often a Kali carb. cough. Kali carb., Sulphur, Carbo veg. and Drosera are perhaps more frequently indicated than other medicines in such coughs as follow measles or pneumonia.
The expectoration is copious very offensive, tenacious, lumpy, blood-streaked or like pus, thick yellow or yellowish-green. Very often it has a pungent, cheesy taste; strong taste, as of old cheese. Catarrh of the chest. Dry cough day and night, with vomiting of food and some phlegm, worse after eating and drinking and in the evening.
Nothing is more striking in Kali carb. than the wandering stitching pains through the chest, and the coldness of the chest. The great dyspnoea, the transient stitches, the pleural stitches are important features of this remedy. A great number of the cases in which Kali carb. is suitable are those where the troubles has spread from catarrhal origin and from the lower portion of the lungs upwards. It is not so commonly indicated in those cases where the dullness has begun at the apex of either or both lungs. It will very often ward off future sickness where the family history is tuberculous. Do not be afraid to give the antipsoric remedies when there is a history of tuberculosis in the family, but be careful when the patient is so far advanced with tuberculosis that there are cavities in the lung, or latent tubercles, or encysted caseous tubercles. Your antipsorics might rouse him into a dangerous condition. Do not suppose, however, that it is dangerous to give Sulphur because one's father and mother have died of phthisis. Sulphur might be just the remedy to prevent the child from following the father and mother. Kali carb. is often suitable, and will act as an acute remedy in the advanced stages of phthisis in cases in which it was not indicated primarily as a constitutional remedy. In such instances it will act as a palliative in phthisis, whereas if it were indicated primarily as a constitutional remedy it would do damage in the last weeks. The fortunate thing is that a great many homeopaths are not able to find the homoeopathic remedy. If the patient has yet lung space enough to be cured, Kali carb. will do wonders where the symptoms agree.
I- want to warn you in one respect concerning Kali carb. It is a very dangerous medicine in gout. When you get an old gouty subject who has big toe joints and finger joints, and they are sore and inflamed every now and then, you might think that Kali carb. covers the case very suitably; he is disturbed in just such weather, the is pallid and sickly, his complaints come on at 2 to 3 o'clock in the morning, he has the shooting pains. But these gouty patients are often incurable, and, if so, to undertake to cure them would be a dreadful calamity, because the aggravations would last so long. If you give Kali carb. to one of these incurable patients in very high potency it will make your patient worse, and the aggravation will be serious and prolonged, but the 3oth may be of great service. Kali iod., when it is indicated in the gouty state, acts as a soothing and palliative remedy. But Kali carb. seems to be a dreadful medicine to handle, it is sharp and a two-edged sword. Do not undertake to give medicine with a view to curing these old cases of gout when the nodosities are numerous. Do not give that constitutional medicine that should have been administered to these patients twenty years ago, because there is not reaction enough in the life of the patient to turn him into order, and he will be destroyed. It seems paradoxical to say it, but to cure him is to kill him. The vital action that is necessary to restore him to health would practically tear his framework to pieces. You need not believe these things, you are not obliged to. But think about them, and some day after practicing awhile and making numerous mistakes in attempting to cure incurables you will admit the awful power of homoeopathic medicines. They are simply dreadful. In old gouty des, in old cases of Bright's disease, in advanced cases of phthisis where there are many tubercles, beware of Kali carb. given too high.
While studying the text book, look over the sensations. They are very numerous. Of course, those most striking are the stitching, and tearing pains, shooting, sticking and wandering pains.