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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Today I will study with you Carbonate of Potash, known in our nomenclature as Kali carb. This is complementary to CARBO VEG. and similar to it in many forms of disease, particularly in lung inflammations. Sometimes when one fails, the other completes the cure; hence the origin of the complemental relation. We have quite a number of analogues to Kali carb., some of which have been placed on the board. We will have occasion to refer to some of these as we go on. There is also somewhat of a complemental relation between Kali carb. and PHOSPHORUS.
Kali carb. exerts an influence over the manufacture of the blood, quantitatively as well as qualitatively. This is shown in the anaemia which the remedy causes. This is illustrated by the following symptoms : Frequent chilliness; every time the patient goes out of doors, he becomes chilly if the air is in the least cool, not having the normal resistance to temperature; quite consistent with this anaemia, there is throbbing in the bloodvessels all through the body. This not plethora, but only an appearance of plethora. It is associated with local congestions which are really anaemic in origin ; the blood being normal volumetrically, but is not as rich in red corpuscles as it should be. The congestion to the head is associated with humming in the ears. The patient suffers from vertigo when he turns his head rapidly, or from riding in a carriage, or from anything that diminishes the supply of blood to the brain. The patient suffers from weakness of sight, especially following excessive sexual indulgence.
Again, we find Kali carb., by reason of this anaemia, indicated after severe or protracted diseases. It thus becomes useful for the weakness following labor or abortion when we have the following symptoms : There is a very troublesome backache, a weak, lame feeling in the small of the back, which makes walking very difficult to the patient; the patient suffers from cough and frequent sweating at night. You find persistent discharge of blood from the uterus. The urine is loaded with urates. This latter symptom, this excess of urates, shows great waste of tissue, and is evidence of the exhaustion which Kali carb. causes and cures.
You will recall that I mentioned Kali carb. as a drug which causes great exhaustion in the muscular system, and it is frequently in this kind of exhaustion that the urates are excessive in the urine.
Kali carb. acts not only on the voluntary muscles, but on the heart also. The heart becomes weakened when it is indicated, and you thus have a pulse which is irregular or intermittent, or, being rapid, is very weak. Now, this character of the pulse in Kali carb. will qualify every disease in which you may use the drug. It is a characteristic of the drug which lies at the very root of its symptoms; therefore, you will seldom find Kali carb. indicated when there is a full round pulse.
This condition of the urine, in which it is loaded with urates as evidence of exhaustion from disease, is also found under other remedies. Perhaps the best remedy in the materia medica for this symptom, other things being equal, is CAUSTICUM. Remember that this assertion is to be qualified. A symptom of this character has not the same value as a symptom of the mind would have. It is characteristic in its place, and yet, if symptoms more characteristic of the case indicate another drug, then you should not think of using Causticum. Suppose you have a patient whose other symptoms are those of Kali carb., for example, a woman after confinement with backache, sweat, and other symptoms of importance, then you may give Kali carb. with satisfaction. But if you have a patient with no prominent symptoms, and with this excessive deposit of urates in the urine, Causticum will help you out.
Still another remedy for this symptom is SENNA, which is one of the best remedies in the materia medica for simple exhaustion with excessive nitrogenous waste.
The particular combination of symptoms that we have under Kali carb., the sweat, the backache and the weakness, are found in no other remedy. It acts as well with the high as the low potencies.
You may also remember the HYPOPHOSPHITE OF LIME, which come; near to the Kali carb. in the excessive sweating, weakness and pallor of the skin.
You may also remember as akin to Kali carb., PSORINUM, which, as you have already learned, is eminently useful in convalescence from disease when there is great weakness, profuse sweat and in addition a mental state, a perfect hopelessness. The patient despairs of perfect recovery.
Next, let us look at the action of Kali carb. on the nervous system. Viewed mentally, the patient is excessively peevish and nervous and is very easily startled. You often find this in women. They are startled by imaginary hallucinations, they imagine that some one is in the room or some figure comes before the mind and tantalizes them. Especially is this anxiety manifested on any noise as the mere shutting of a door or window, particularly if the noise be unexpected. They are not only startled as many healthy persons would be under similar circumstances, but they are frightened, are driven into a fit of trembling. You will sometimes find the intellect seriously impaired when Kali carb. is indicated. The patient does not seem to care for anything. This indifference is associated with great bodily exhaustion. When questioned, the patient, usually a female, does not seem to know exactly what to say or what she wants. The condition borders somewhat on that of PHOSPHORIC ACID, but still the apathy of the two remedies is not exactly the same. Kali carb. has not a sensorial apathy, but it has exhaustion too great to frame their answers to your questions. You will frequently find these symptoms of the mind calling for Kali carb. in puerperal mania and in puerperal fever.
Again, we find that spasms may occur as a symptom of the nervous system under Kali carb. The patient does not lose consciousness during the convulsions, hence the remedy is not indicated in true epilepsy; but it may be indicated in puerperal eclampsia, the spasms seeming to pass off with eructations of wind.
The spine suffers severely in the Kali carb. patient. In addition to the backache, already mentioned as the result of anaemia or of abortion, we have spinal irritation which, by the way, is just as vague a symptom as is any other of a general character, as headache. You must always know what causes this spinal irritation. Does it come from loss of fluids, from brain troubles, from emotional causes, or what? In the Kali carb. patient you will find it frequently occurring with the uterine symptoms. Thus you will have pressure in the small of the back as though there were a heavy weight pushing down there. There are also bearing down in the uterine region during the menses, burning along the spine, especially along the right side of the spine. This is not a real congestion. It is merely a subjective sensation caused by irritation of the posterior spinal nerves. The backache is worse while the patient is walking. She feels so exhausted that she must drop into a chair or support herself in some way. Sometimes, you find in the morning, a pulsating in the small of the back, quite akin to the pulsations occurring in other parts of the body. Here the drug is quite analagous to SEPIA and the well-known CIMICIFUGA. This pulsating and drawing backache is particularly relieved when the patient lies down. This suggests a comparison between Kali carb. and NATRUM MUR. You will recognize at once the resemblance in the spinal symptoms, the spinal irritation, the backache and the relief from lying down. Natrum mur. has particularly relief by lying flat on the back with firm pressure. Further than this, you will find these two drugs playing into each other’s hands in the treatment of amenorrhoea. Hahnemann says that Kali carb. will bring on the menstrual flow when Natrum mur., though indicated, fails.
I once cured a singular backache with Kali carb. A very nervous patient came under my treatment for dyspepsia. She said to me: “There is something very strange about my case. Every time I eat a meal, I suffer for half an hour or more with most intense pain in the back.” This was certainly an odd symptom. I did not know where in the materia medica to find it. I hunted, and I found under Kali carb. this symptom : Pain in the spine while eating. I gave her Kali carb., which cured her completely.
On the mucous membranes, Kali carb. acts, causing quite a series of catarrhal symptoms. We may give it in coryza with hoarseness or loss of voice. The patient catches cold at every little exposure to the fresh air. This is a very strong symptom of Kali carb. The Kali carb. patient has a tendency to obesity and is rather weak in muscular development. With the catarrhal symptoms of this remedy there often occurs a sensation in the throat as though there were a lump there, which must be swallowed. The neck is stiff and the uvula elongated. There are stinging pains in the throat when swallowing just as marked as under APIS.
Sometimes we have a more chronic form of catarrh in the nose; the nasal passages are obstructed and the patient can only breathe with the mouth open. This obstruction is relieved in the open air, but returns so soon as the patient enters a warm room. There is either a discharge of foetid green mucus or, in the morning, the nose is swollen and red and there is bloody discharge. There is a sticking sensation in the pharynx as from a fish-bone lodged there whenever the patient catches cold. This is a good symptom for Kali carb. You will find it in ALLEN’S ENCYCLOPAEDIA in large type.
Now, in addition to these symptoms, there is almost always accumulation of mucus in the pharynx. The patient “hawks and hems” in the morning. This hawking is found under every alkali, but this one peculiarity, sensation as of a fish-bone in the throat as soon as he “catches cold,” with the hawking, is found under no other remedy. HEPAR, NITRIC ACID, ALUMEN, CARBO VEG., and ARGENTUM NITRICUM all have this sensation as of a splinter or fish-bone in the throat.
In coughs, we sometimes find Kali carb. of use. The cough is of a paroxysmal character, and is accompanied by gagging and by vomiting of sour phlegm and of food. This suggests the use of Kali carb. in whooping cough, in which disease it has been very successful. Boenninghausen has given us a characteristic symptom for Kali carb., namely, a little sac filled with water between the upper lids and eyebrows. You will often meet with that symptom. I would warn you not to confound it with a similar condition which is in no particular pathological at all, and that is a certain looseness of the tissues in this locality occurring in persons advanced in years.
Now for the action of Kali carb. on the lungs. We find it indicated in bronchitis, pneumonia and phthisis pulmonalis. I will give you the symptoms calling for it in these separate states as we go on. The most characteristic symptom of all, and one which runs through the symptomatology of the drug, is stitching pains which are prominently located in the walls of the chest. They are made worse by any motion, but unlike BRYONIA, they come at all times independently of this aggravation. They occur characteristically in the lower third of the right lung, going through the chest to the back. They may occur all over the chest, but that above mentioned is their most frequent site. Then, too, they are erratic and wander all over the body. Here it reminds you of KALI BICHROMICUM, PULSATILLA, and SULPHUR.
Kali carb. is indicated in infantile pneumonia or capillary bronchitis when the following symptoms are present: Intense dyspnoea; although there is a great deal of mucus in the chest, it is raised with difficulty. The child is so oppressed that it can neither sleep nor drink. Breathing is wheezing and whistling in character, and the child has a choking cough. You should here compare Kali carb. carefully with Antimonium tartaricum and thus determine which suits the case best. One cannot be the remedy when the other is indicated.
In phthisis, Kali carb. is indicated when the constitution favors it. The patient has a bloated alkaline look to the face. There are also present these well-defined stitching pains through the chest and over the body, with the puffiness of the upper eyelids. Cough is difficult. The patient cannot get up the sputum. He raises it partly, when it slips backwards into the pharynx. Now if you examine this expectoration, you will find that it is often bloody and that there are little globules of pus scattered through it. There is an aggravation of all the symptoms from three to five o’clock in the morning. This hour of aggravation belongs to all the potash salts. There is also a very stubborn sensation, namely, chilliness at noon.
Kali carb. is indicated in cardiac inflammations, in endocarditis and pericarditis when these sharp stitching pains are characteristic. Do not give it too soon in the case. It is not an early remedy in cardiac disease. It is indicated rather late when there is a deposit on the cardiac valves.
We find these same stitching pains under Kali carb. in backache, a very stubborn form of rheumatism. The same symptom applies in case of impending miscarriage and during labor; sharp stitching pains in the lumbar region shooting down from the buttocks into the thighs. The same kind of pain suggests this remedy in nephritis.
Lastly in connection with the stitching pains, I want to refer you to its application in puerperal fever of the metritic form, that is, when metritis is a prominent condition. There are sharp, stabbing, cutting pains in the abdomen, the abdomen is bloated and distended, and the urine is dark and scanty, the pulse is rapid but feeble, and you have present the state of mind described in the early part of the lecture.
One more symptom and we are done with the drug, and that is its use in dyspepsia. You will find it called for in indigestion, particularly in old persons, in those who have lost a great deal of vital fluids, when there is an empty weak feeling in the stomach before eating and bloatedness after eating, especially after soup or coffee. There are sour eructations, heart-burn, and uneasy nervous feeling when hungry. You see then that Kali carb. is a remedy indicated in a great variety of diseases. It is a drug much neglected in practice, for much the same reason that many other remedies are, because the hurried and careless physician falls into routinism.