E. A. Farrington was born in Williamsburg, NY, on January 1, 1847. In 1866 he graduated from the Homeopathic Medical College of Pennsylvania. In 1867 he entered the Hahnemann Medical College, graduating in 1868. He entered practice immediately after his graduation, establishing himself on Mount Vernon Street.
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Causticum is evidently a potash preparation, but its exact composition I do not know. Hahnemann was not able to define it, and chemists since his time have not been able to tell of what it is composed. Nevertheless it is a unique remedy, and is one that we cannot do without in practice. The drug is conveniently studied under the heads placed on the board.
It has a tendency to cause paralysis and spasmodic symptoms, rheumatism, affections of the mucous membranes, and diseases of the skin and organs generally. You will recall the fact that there is an inimical relation between PHOSPHORUS and Causticum. These remedies do not follow each other well, although indicated in the same class of diseases. This is to be remembered particularly by those who use the higher and medium potencies.
The main power of Causticum is the first one on the list, the paralytic weakness which the drug exhibits. This paralytic tendency is a genuine potash weakness. Causticum is especially suited to patients who are timid, nervous and anxious, and full of fearful fancies, particularly in the evening at twilight, when shadows grow longer and fancy more rife. The child, for instance, is afraid to go to bed in the dark. This applies not to the unfortunate child who entertains these fears by reason of faulty education, but to the child who is afraid as the result of nervous disease. As an adult, the patient is apprehensive that something is about to happen, or he feels conscience stricken as if he had committed some crime. When closing his eyes, he sees frightful images. This is no new symptom to you, as you will recall it for several remedies. The patient, especially if a woman, is apt to be tearful and melancholy. The face is a correct picture of the mental condition, and is expressive of this low-spirited state. The face is apt to be sallow and sickly looking. The patient is either taciturn and distrustful, or is inclined to fits of anger, with scolding. This is, as you know, by no means dissimilar to the Phosphorus, and yet you must not make the mistake of giving one, when the other is indicated. Memory fails. Any attempt at mental labor is followed by untoward symptoms, such as stitches in the temples when reading or writing, feeling of tension in the head and scalp, particularly in the forehead and about the temples. This is worse in the evening, and also on awakening from sleep. Here again it is very similar to Phosphorus, which also has that feeling of tension. The patient also has a rather odd sensation, and one that is not frequently met with, and that is a feeling as though there were an empty space between the brain and the cranial bones. This is relieved by warmth. As odd as this symptom may seem to you, it is not too uncommon for you to make note of. Our materia medica is not over-rich in this direction, and so we ought to utilize every such symptom that we can get.
The vertigo of Causticum is that which belongs to an excited brain and spine, such as we find in the incipiency of paralysis, and even of locomotor ataxia. There is a tendency to fall either forwards or sideways. There is with this vertigo a constant feeling of anxiety and weakness of the head. The sight is bedimmed as though the patient were looking through a fog. Now concomitant with these brain symptoms you have the following symptoms, one or two of which ought to be present in order to make the picture complete. The skin in these cases is apt to be dry and hot, and there is almost always constipation, which constipation is quite characteristic. It is attended with a great deal of urging, probably from defective expulsive effort in the rectal muscular fibres, with redness of the face and fulness of the bloodvessels. This symptom is very common in weak persons and in children when they are nervously debilitated.
Very characteristic of the drug is paralysis of single parts or of single nerves. Thus you may have to use it in paralysis of the facial nerve, particularly when it is the result of exposure to dry cold winds. It may also be called for in ptosis, when the result of the same cause. Causticum is still further called for in paralysis of the tongue, when deglutition and speech are more or less destroyed, paralysis of the lips, and in glosso-pharyngeal paralysis. In this last-named disease, you cannot expect much improvement from any remedy. The larynx and the bladder may be attacked. These are illustrations of the local palsies which come within the range of Causticum. These paralyses may be caused either by deep-seated nervous disease, or, very characteristically, by exposure to cold, particularly to the intense cold of winter, when the patient is of the rheumatic diathesis.
ACONITE, like Causticum, is useful in paralyses which are traceable to exposure to cold, especially to dry cold winds. Aconite suits well in the beginning, and Causticum more when the paralysis has become chronic and refuses to yield to the Aconite.
RHUS TOX. and DULCAMARA compare favorably with Causticum for paralysis of rheumatic origin, provoked by exposure to a damp and cold atmosphere, particularly when there have been changes from tolerably warm to cold and wet days. Dulcamara is suited to the beginning of such cases, and not when the trouble becomes chronic. Rhus tox. is suited to chronic cases.
You may also find Causticum indicated in paralysis which arises from apoplexy ; it is not called for, for the immediate results of the stroke, not for the congestion, nor for the exudation, but for the remote symptoms, when, after absorption of the effused blood has taken place, there yet remains paralysis of the opposite side of the body.
Causticum may be applied in diseases of children. It is suited to children of a scrofulous habit in whom, though emaciated generally and particularly about the feet, the abdomen is large and tumefied. They are slow in learning to talk. There is a tendency to scrofulous inflammation of the eyes, scabs form about the tarsi, the conjunctivae become injected, and the cornea inflamed. There is a constant feeling as of sand beneath the eyelids. An eruption appears about the scalp, especially behind the ears, making this portion of the skin raw and excoriated. The discharge is slight in quantity and sticky in character. Often there is otorrhoea, purulent in its character. The child stumbles when it attempts to walk. The cause of this symptom will be found in disease of the brain or spine. These cases do not recover rapidly. There is defective nutrition in the whole nervous system. You must instruct your patients that hygienic measures must be observed in conjunction with medicinal, and that you can promise a cure if they will but be patient with you.
Other remedies which may be thought of here are, first, SULPHURIC ACID, which is a good remedy for this weakness or giving way of the ankles; another is SULPHUR, and still another, SILICEA.
Still further, as illustrating the paralytic effect of Causticum, we find it causing aphonia or failure of the voice. This may or may not be catarrhal. It is associated with great weakness of the laryngeal muscles, which seem to refuse their office. This is often the case in phthisis and in laryngeal troubles, whether of a tubercular nature or not. The paralytic tendency is further illustrated in the cough. The patient is unable to expectorate. Just as under SEPIA, DROSERA, KALI CARB., ARNICA and a few other remedies, the patient succeeds in raising the sputum so far, when it slips back into the pharynx. The remedy also has this as characteristic: The patient cannot cough deep enough for relief. In addition to these paretic symptoms in catarrhs you may also add the following: Rawness and burning down the throat and trachea, feeling as if these parts were denuded, and hoarseness with aggravation in the morning. At this time, also (consistent with the action of the potash salts generally), there is accumulation of mucus in the fauces and larynx. The sputum often tastes greasy and soapy. Drinking cold water seems to relieve the cough. Accompanying the cough you find pain over the hips, and this is very characteristic, and, too, the cough is often associated with involuntary spurting of urine. This last symptom is very characteristic of Causticum. It is also found under NATRUM MUR. and SCILLA.
In the laryngeal symptoms it is necessary to make a distinction between Causticum and PHOSPHORUS. One point of difference is that Phosphorus often has evening aggravation of the hoarseness; Causticum has aggravation in the morning. Both have this nervous weakness. One symptom I have often found indicating Phosphorus, and that is, extreme sensitiveness of the box of the larynx. The patient dreads to cough, because it aggravates the laryngeal soreness. He dreads to talk for the same reason. Relief from cold drinks is found only under Causticum.
More similar to Causticum yet, is CARBO VEG. Here you can make no mistake, because both drugs follow each other well. If you do make the mistake of giving one of these when the other is indicated, you will not injure your patient any more than from the delay caused by your imperfect selection. Both remedies have this rawness and soreness down the throat; both have hoarseness, Carbo veg. having aggravation in the evening and Causticum in the morning. The former is indicated after exposure to damp evening air; the latter after dry, cold, severe winter weather.
EUPATORIUM PERFOLIATUM is very similar to Causticum in that it causes hoarseness worse in the morning. Both remedies are indicated in influenza with aching all over the body, but Eupatorium has more soreness in the chest than it has burning and rawness.
In the hoarseness of singers or those who exert their voices a great deal, Causticum resembles GRAPHITES and SELENIUM.
In some cases, when Causticum fails in chronic hoarseness worse in the morning or evening, SULPHUR is an all-sufficient remedy.
Still another kind of cough for which you may give Causticum is one which improves up to a certain point and then remains stationary, getting neither better nor worse.
Causticum is a good remedy for buzzing and roaring in the ears, or tinnitus aurium, when sounds reecho unpleasantly in the ears. A voice which is of an ordinary tone, sounds loud, and reechoes in the ear with unpleasant confusion. “When Causticum is the remedy, these symptoms may be concomitant with catarrh of the throat involving the Eustachian tube. They may also be symptoms of Meniere’s disease, of which affection I once cured a case with Causticum.
There is a drug which you may compare here, and that is SALICYLIC ACID, which has caused and cured Meniere’s disease.
You may also compare CARBON BISULPHIDE and the well-known CINCHONA.
We find Causticum indicated in involuntary urination or enuresis, especially in children. It is especially called for when the accident occurs during the first sleep. The trouble is aggravated in the winter and ceases or becomes more moderate in summer. The urine is especially liable to escape involuntarily during the day in winter, as the result of any excitement.
For nursing women we may use Causticum when over-exertion or loss of sleep threatens their supply of milk. This makes them very low-spirited, and they are apt to have this sallow, sickly complexion which is characteristic of Causticum.
Causticum may be used in spasmodic diseases, even in convulsions. Thus it may be used in epilepsy, particularly in LA PETIT MAL. When walking in the open air, the patient falls, but soon recovers. During the unconscious stage, the patient passes urine. It may even be used when the attacks are of a convulsive nature, especially when they recur at the new moon. Now you are not to consider that the moon has anything to do with these epileptic attacks. It is only the laws which govern the relation of the planets, which regulate the tides and have to do with the periodicity of nature generally that also apply to the moon and to the disturbances within the human body; so it is that some symptoms are worse at new moon, others at full moon; some at the rise and others at the fall of the tide. It does not, therefore, follow, because the patient is worse every time at new moon, that the moon causes the aggravation. Causticum is moreover indicated in epilepsy when it is connected with menstrual irregularities, and also when it occurs at the age of puberty. In these symptoms Causticum is closely allied to CALEAREA OSTREARUM.
Causticum is indicated in chorea when the right side of the body is affected more than the left. The muscles of the face, tongue, arm and leg are all involved in the disorderly movements. When the patient attempts to speak, words seem to be jerked out of the mouth. The patient is anxious and restless in bed at night. He must sit up and change his position. He involuntarily throws the head about, and finally he falls asleep exhausted. During sleep the legs and arms are constantly “on the go.”
Lastly, we may be called upon to use Causticum in rheumatism, especially when the joints are stiff and the tendons shortened, drawing the limbs out of shape. It is frequently indicated in what has been termed rheumatoid arthritis. Rheumatic pains attack particularly the articulation of the jaw. They are worse from cold and are relieved by warmth.
Now you will have to distinguish Causticum here from several other remedies. RHUS TOX. also has rheumatism from exposure to cold. Some of the distinctions between it and Causticum I have already given you. There is yet another good one. Rhus tox. has restlessness and relief from motion all the time. In Causticum the restlessness only occurs at night.
GUAIACUM is to be preferred to Causticum and follows that remedy well when, in either gout or rheumatism, there are contractions of the tendons, drawing the limbs out of shape, aggravated by any attempt at motion, particularly if there are well-developed gouty nodosities in the joints.
COLOCYNTH is to be remembered for articular rheumatism when the joints remain stiff and unwieldy. The pains in the affected parts are of a boring character.
Causticum also acts on the skin, one of its most characteristic symptoms being warts. It is useful in the cure of these hypertrophies of the papillae when they occur on the hands or face. I remember once giving Causticum to a child who had two warts on the under eyelid. At the end of the third week after taking the remedy there was a string of warts over the inner canthus of the other eye. I believed that these resulted from the Causticum. Of course, I stopped the medicine. At the end of several weeks more, all the warts had disappeared, and the child has had none since. This shows you that Causticum really produces and cures warts.
Causticum may be called for in colic after the failure of Colocynth. The pains are of a griping, cutting character, and are relieved by bending double. Particularly do you find pains of this character suggesting the drug in menstrual colic. Previous to the menses, these colicky pains appear, and are associated with tearing pains in the back and limbs. All the sufferings cease entirely at night.