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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Graphites is not a pure carbon. Even the purest specimens of it contain some iron. You will note that I have placed beneath it two complements, namely, Arsenicum and Ferrum. It has many symptoms in common with Ferrum, acting complementary to that drug, and many more allying it to Arsenicum.
It is a relative of Ferrum, principally in this class of symptoms, particularly in anaemia or chlorosis of females. There are irregularities in the distribution of the blood, and pallor of both skin and mucous membranes.
It is complementary to Arsenic in many of the skin symptoms, in affections of the glands, burning in internal parts, and other symptoms akin to it. Besides these complementary remedies, Graphites has quite a number of concordant remedies. It is antidoted by ARSENICUM, and in some of its gastric symptoms by NUX VOMICA. Arsenicum, you thus see, holds two relations to Graphites; one of antidote and one of complement. It is complementary in one series of effects, and antidotal in another. Arsenicum antidotes especially the mental symptoms of Graphites.
The Graphites patient is sad and full of grief, particularly if a female. She has an anxious, apprehensive state of mind, which compels her to move about from place to place. She has forebodings of some imaginary accident or mishap which is about to take place; it makes her anxious and restless; she cannot be kept quiet. It is this group of symptoms which Arsenicum antidotes. We find this anxious, apprehensive state of mind in Graphites to be a very important symptom. You all know how important in making a homeopathic prescription the mental symptoms are. We find this apprehensiveness, this low-spiritedness, qualifying many of the Graphites conditions. We see it in the chlorosis, in the skin symptoms, in the inflammations of the eye, etc., as you will discover later on.
We find Graphites acting best in constitutions in which there is a tendency to obesity. This obesity I would have you remember is not a healthy, solid flesh, that belongs to a full-blooded, strong, hearty individual, but it is that kind of fat which you find under CALCAREA OSTREARUM, showing improper nutrition. We find the two remedies running close by each other in such fat but not healthy individuals. The Graphites constitution is also one in which there is deficient animal heat, owing to the defective oxygenation of the blood. These patients are always cold, whether they are in or out of doors. In the case of chlorosis, the Graphites patient has these symptoms: There is a tendency to rush of blood to the head, with flushing of the face, just exactly similar to that which belongs to FERRUM. The patient feels a sudden shock about the heart, and this is followed by rush of blood to the head. She thinks she has heart disease. On lying down at night, the patient experiences throbbing all through the body. That is not due to true plethora. The blood is decidedly “watery,” and if you were to examine it microscopically you would find an excessive number of white blood-corpuscles. The menstrual flow in these cases is too late, too pale, and too scanty. The mucous membranes are apt to be pale, just as you find under Ferrum. The lips will be pale. The patient suffers from leucorrhcea, which is watery and quite profuse, sometimes excoriating the parts over which it flows.
Now, you may say, how are we going to distinguish this from PULSATILLA ? Like Graphites, Pulsatilla has late and scanty menses, with pale or dark flow in chlorotic or anaemic patients; also in patients who are apt to be chilly, and who are low-spirited, crying at every imaginary trouble. How will you distinguish between these remedies? The main distinction lies in this: The Graphites patient always has some skin symptoms to aid us, Pulsatilla scarcely any. The Graphites patient has a rough, harsh, dry skin, with very little tendency to sweat. Little pimples, whether containing pus or not, appear on the body, and are apt to be worse at the menstrual periods. While in Pulsatilla there is strong tendency to diarrhoea, in Graphites there is strong tendency to constipation. These symptoms are sufficient to always enable you to distinguish between these two closely allied remedies.
Next, as most important in our study of Graphites, I wish to call your attention to the action of the remedy on the lymphatic glands, and also upon the skin. It produces enlargement of the lymphatic glands of the neck and of the axillae, and also of the inguinal and of the mesenteric glands. This, together with marked skin symptoms, calls frequently for its use in scrofula. Now, we find it running parallel with CALCAREA OSTREARUM, SULPHUR, and SILICEA in scrofulosis, particularly of children. We find the abdomen large and hard. The children thus affected suffer from diarrhoea, with stools which are thin, offensive, and contain partially digested food.
In inflammation of the eyes, of a scrofulous character, we have no remedy, not even CALCAREA, SULPHUR or ARSENIE, that excels Graphites. The cornea is apt to be covered with superficial ulcers, or again, it may be inflamed. There is thickening of the eyelids, particularly along the edges, which are covered with scurf or scales. The lids may be agglutinated or not, but the grand characteristic which makes the choice of Graphites certain is this: The blepharitis is worse in the angles of the eye, in the canthi. There is tendency for the edges of the lids to crack and bleed. If that is present you need not hesitate to use Graphites. The thickening of the cartilages of the lids may be so great as to produce ectropion or entropion. Then, too, the eyelashes become wild, turn in towards the ball of the eye and irritate the conjunctiva. Hardened styes may appear along the edges of the lids. Graphites also affects the vision. Letters appear double and run together. An eczematous eruption appears about the eyes, on the cheeks, on and behind the ears, on the top of the head and down the occiput. It may also be scattered here and there over the surface of the body, particularly in the bends of the joints. Behind the ears it assumes the form of intertrigo, being moist and sticky. If the child lies on its ear, the ear will be glued fast to the head. Sometimes you find Graphites indicated in phlyctenular ophthalmia. Little vesicles form on the cornea and on other parts of the eye, producing profuse, burning lachrymation. These tears are mixed with pus, which is thin, and excoriates the cheek over which it flows. The discharge from the nose, which is partly from the eye by the way of the puncta lachrymali, is also thin and excoriating, and you find cracks and crusts around the nostrils quite in harmony with the condition of the borders of the eyelids.
I would now like to mention briefly a few of the distinctions between Graphites and its allied remedies. PETROLEUM or coal oil is similar to Graphites in many of its symptoms. It has an eruption very much like that of Graphites and is particularly indicated when the most marked symptom is an intertrigo behind the ears. If the child is old enough he will also complain of aching and other painful symptoms in the back of the head. The main distinction between the two remedies is that Graphites pictures more of a herpes and Petroleum a pure eczema.
In prescribing CALCAREA OSTREARUM, the local symptoms, particularly those of the eyes, do not help you much. They are too general. They are just the symptoms of scrofulous ophthalmia. But you would be aided in your selection of the drug by its general symptoms, sweat of the head and cold, damp feet (which are not prominent under Graphites). You may also remember that Calcarea ostrearum is the best remedy for the results of scrofulous ophthalmia, rather than the acute symptoms themselves. It is best suited to the opacities of the cornea and the thickening of the lids.
ARSENICUM has the same burning, excoriating discharge from the eyes but is distinguished by this: The lids are spasmodically closed. Otherwise the symptoms are provokingly similar.
SULPHUR will help you when the edges of the lids are redder than natural, while under Graphites the edges of the lids are paler than they ought to be.
EUPHRASIA is useful in phlyctenular ophthalmia with excoriating discharge, etc. But although the discharge is excoriating under Euphrasia it is thick and purulent, while it is thin under Graphites.
MERCURIUS is also useful in scrofulous cases, especially when the patient is worse at night and from the heat and glare of the fire. Mercury is decidedly preferable if syphilis complicates scrofulosis.
HEPAR is very similar indeed to Graphites. It is preferable when there is throbbing in and about the eye. Now if the child is not old enough to tell you if there is throbbing in and about the eye, you will notice that there is pain and you will see evidence of the formation of pus; for instance, suppurating styes form on the lids. Hepar suits the suppurative process better than does Graphites. You will also notice that the Hepar child will not allow anything to press on the eye, because the parts are so sensitive.
Graphites is said to prevent the return of erysipelas when that disease becomes constitutional. The affected parts feel hard and tough, and if it be the face that is involved, are very much distorted. There are burning, stinging pains, as we found under Apis. It usually commences on the right side and goes to the left. It is particularly useful when Iodine has been abused.
Still further, you must remember the use of Graphites in the removal of cicatrices. This remedy seems to have the property of causing the absorption of cicatricial tissue. It was long ago noticed in workers in graphite, that wounds on the hands healed and the cicatrices disappeared very rapidly. Dr. Guernsey has made use of this property of the drug for the removal of cicatrices that form after mammary abscess. Professor Korndoerfer greatly relieved a child’s eye by the remedy. The child had been operated on, and cicatrices formed which contracted more than the surgeon expected they would. Graphites so far relieved the case that the parts assumed their normal position.
We next have to speak of the action of Graphites on the digestive organs, and here it is allied particularly to the other carbons, Carbo veg. and Carbo animalis. We find the patient complaining of disagreeable taste in the mouth in the morning, as though he had been eating eggs. This symptom is more marked here than in any other carbon. The patient is worse from all meats. This symptom you find under Pulsatilla, Ferrum, and, in fact under all chlorotic remedies.
Things nauseate and disgust the patient. After eating, the stomach becomes distended with wind. There is burning pain in the stomach; also a crampy, colicky pain—a real gastralgia, in fact. The patient wakes up at night gasping for breath; sudden dyspnoea, which is temporarily relieved by eating. The gastralgia is also relieved by eating. In this respect it again resembles PETROLEUM, which has gastralgia relieved by eating. The same symptoms you will also find under CHELIDONIUM and ANACARDIUM. The abdomen is greatly distended from flatulence, and with this distended abdomen we have rush of blood to the head. The liver is apt to be hard and enlarged, with extreme tenderness to the pressure of the clothing after eating. The bowels are usually constipated. The characteristic stool is this: The stools are covered with mucus or contain shreds of mucus. That is a very characteristic symptom of the Graphites. I think that it is also of CASCARILLA. The patient suffers from haemorrhoids, which burn and sting; the anus is so extremely sore that the patient is. very much annoyed when sitting. Fissures form in the anus. Graphites is here one of our best remedies.
Now we have several similar remedies here. First, LYCOPODIUM. This has this distension after eating, with great accumulation of flatus, but this flatus is not rancid or putrid as it is under Graphites. That is a sufficient distinction between the two remedies.
Again, we have this list of remedies: RATANHIA, PCEONIA, NITRIC ACID and SILICEA. RATANHIA is an excellent remedy for fissure of the anus, and is to be recommended when there is great constriction of the anus. Stools are forced with great effort and the anus aches and burns for hours after stool.
PAEONIA is also useful for fissures of the anus with a great deal of oozing, thus keeping the anus damp and disagreeable all the time. This is associated with great soreness and smarting.
NITRIC ACID is also a remedy for fissure of the anus, particularly when there is a feeling as if there were splinters or sticks pricking the anus. Now Graphites is distinguished from all these by the fact that they have more or less tenesmus or constriction of the anus, while Graphites has little or none.
SILICEA is also a remedy for fissure of the anus. The patient tries to force a stool, but it will not come out. The stool partly descends and then slips back again.
Now the mucous membranes: Graphites is useful in nasal catarrh when there is extreme dryness of the nose. You often find this in scrofulous cases. This alternates with the discharge of lumps, or clinkers, as they are sometimes called. At other times, the discharge is very offensive and bloody. You notice how the offensive character of the discharge shows itself in these carbons. The borders of the nostrils are sore and scabby, and crack readily. Here you have a resemblance to ANTIMONIUM CRUDUM, to CALOAREA, and to ARUM TRIPHYLLUM. The sense of smell is too acute. The patient cannot bear the odor of flowers. There is cracking or roaring in the ears when swallowing or chewing. This tells you that there is catarrh of the Eustachian tubes. On examining the ear with the speculum, you will find the membrana tympani not perforated, but quite white. The ears are apt to be too dry, and there is a lack of natural secretion (just as you found under Carbo veg.), with hardness of hearing, better from riding in a carriage. It is not the riding that improves the hearing but the noise made by the carriage.
Graphites may also be used in chronic sore throat with sensation as of a lump in the throat. This is worse after empty swallowing. Here it is similar to SULPHUR and CALOAREA OSTREARUM.
The cough of Graphites is not very characteristic. It is a dry cough with a great deal of strangling, making the face red and the eyes water. It is worse during deep inspiration.
On the male genital organs, Graphites acts quite prominently. We find it producing uncontrollable sexual excitement, and violent erections. The most important symptom of Graphites is impotence. There is a want of sensation during coition with ho discharge of semen.
It also acts on the female organs. We find affections of the left ovary with enlargement of that gland, and with scanty delayed menses, chilliness, constipation and coexistent eruptions. The uterus is displaced under Graphites. The os is far back and presses against the posterior wall of the vagina, hence the remedy is indicated in anteflexion and in anteversion. With this, there is bearing down extending into the hypogastrium. The leucorrhoea is watery and profuse, sometimes coming in gushes. Often, with these symptoms there exists an eczematous eruption about the vulva.