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Homeopathic Materia Medica by Farrington
( )Today we begin the study of the chemical elements termed halogens ; Iodine, Bromine, Fluorine and Chlorine are the elements in this group. As a group, the halogens may be remembered by this great characteristic symptom, they all act upon the larynx and bronchial tubes, and in fact upon mucous membranes generally. They are decidedly irritating to the mucous membranes, producing violent inflammation, rawness and excoriation, as anybody can testify who has once inhaled the fumes of Chlorine, Iodine or Bromine. They all produce spasm of the glottis and this is most marked, has proved most characteristic in Chlorine, although they all have it. They all tend to produce pseudomembranous formations on the mucous membranes. All excepting Chlorine, tend to produce croupous membranes; Chlorine tends more to diphtheritic membrane than pure croupous. All of the halogens act upon the glandular system producing enlargement, induration and even abscess in glands. Thus we find them all useful in scrofulosis, especially Iodine, which leads the list. Cyanogen also belongs to this group chemically, although it is properly considered as belonging to organic chemistry. It has many similarities to these drugs, and, like Chlorine, is useful in diphtheritic deposits. Thus we use Hydrocyanic acid and Amygdala persica (which contains hydrocyanic acid) for diphtheritic sore-throat, and we may use the Cyanide of Mercury for some of the worst forms of diphtheria. The same is true to a less degree with Cyanide of Potassium. These general characteristics of the halogens lead you at times to say, "This patient needs one of the halogens, which shall it be?" To answer that question we must study these four elements separately and by comparison.
I will first call your attention to BROMINE. Bromine produces a rather peculiar effect on the mind, causing a sort of vertigo, which is worse from running water. Moving rapidly by the patient produces this vertigo. It is associated with a peculiar anxious state of the mind. Now this anxiety belongs to all of the halogens. It hardly originates in the mind, probably coming from some defect in the body itself. It is a common symptom in heart and lung affections, and it is probably thence that the symptom springs. This anxiety is expressed in this way: The patients expect to see objects jump around them or they think that somebody is about them, and they turn around to see if such is the case. This is an effect of Bromine, and those of you who are familiar with Bromide of Potassium will recognize whence it gets its anxiety. The vertigo is relieved by nose-bleed, showing at once that it is congestive in character. Another symptom showing you that there is congestion under Bromine is this: After dinner, there is a sensation deep in the brain as though a fit of apoplexy were impending. The patient feels as if he would lose his senses.
The Iodine mental condition is more marked than that of Bromine. It is a decided erethism, during which the patient is very excitable, and restless, moving about from place to place, now sitting here, now sitting there, he fears that every little occurrence will end seriously. In his anxiety, he shuns everyone, even his doctor. He has a great dread of people. At times, he becomes quite excited and delirious, with vertigo, red face and anxiety.
Next the lymphatic system. Like all the other members of this group, Bromine attacks the glands, and causes enlargement and induration of the glands. Hence it is called for in scrofulosis. It is particularly suited to scrofulous patients, children usually, when the parotid gland or glands are indurated, when there is a tendency to suppuration with excoriating discharge, and persistent hardness of the gland around the opening, and undue amount of warmth or heat in the gland. I have merely mentioned the parotid gland for purpose of illustration. Bromine also affects the mammary gland, for cancer of which it has been a very useful remedy. You may perhaps remember that I told you the other day, that it was similar to CARBO ANIMALIS.
Like Carbo animalis, it has induration of the glands in the axilla with burning pains. But Bromine also has cutting pains. The breast is hard and on palpation, a dull subdued sort of throbbing may be felt in it. Sometimes, the drawing or cutting is so marked that it feels as if a string were pulling from the gland into the axilla.
The testicles are acted upon by Bromine. We find them swollen, hard and perfectly smooth. The pain is worse from jarring. The glands are unduly warm and hot. You will find that glandular affections yield to Bromine especially in persons of light complexion, with fair skin and light blue eyes. I mention this symptom here to make use of it in a few moments as a symptom of comparative value. I do not mean to say that every scrofulous child with blue eyes must have Bromine, but I do mean that this symptom is of use to enable us to distinguish Bromine from the other halogens.
The tonsils, too, are affected in Bromine. Thus we find them deep red and swollen and covered with a network of dilated bloodvessels. They are worse when swallowing and are accompanied usually with swelling of the glands externally. There is a feeling of rawness in the throat with this tonsillitis. This, too, as you know, is common enough in scrofulous children. There is a strong temptation to excise the tonsils, but this is not good practice, for you can often cure this trouble by internal medication. In some cases, this enlargement of the tonsils may be looked upon as a forerunner of tuberculosis.
We find Bromine indicated in enlargement of another gland, namely the thyroid gland, and curing what has been termed bronchocele or goitre.
We next have to speak of Bromine in its action on mucous membranes. Beginning with the nose, we find that it is useful in coryza or in nasal catarrh, when the discharge is profuse, watery, and excoriating. The nostrils, alternately, seem to be stopped up. There is a peculiar headache associated with this coryza, a heavy pressure in the forehead which seems to be pushing the brain down and out at the root of the nose. The nose is very sore inside and also around the alae. This is a decidedly smarting soreness just such as you would expect the fumes of ' Bromine to make. Later, ulcers form in the nose, with the escape of crusts or scabs which are blown out and which are always bloody. Every attempt to wipe the nose is followed by a discharge of crusts and blood. This you know is common enough with scrofulous children.
Coming now to the throat and lungs, we find Bromine indicated in spasm of the glottis, sometimes called laryngismus stridulus. This is a very difficult disease to cure. It is often central in its origin. It commences by sudden closure of the glottis. The child turns blue in the face, and its body becomes convulsed. One spell ceases only to be followed by another. In the second stage, general convulsions appear, followed by emaciation. The trouble may be reflex from dentition, or from indigestion or from enlargement of the thymus gland. If it can be found to be the result of enlargement of the thymus gland, evidently then IODINE would be indicated. When it has been caused by retarded dentition, I think that CALCAREA PHOSPHORICA promises better than anything else. Dr. Dunham records a case that had been given up by an allopathic physician, but knowing the symptoms of Chlorine, which above all other remedies will produce this spasm of the glottis, he generated some Chlorine and allowed the child to inhale the fumes, with almost instantaneous relief and final cure. All the halogens are useful in this condition, but Chlorine is here the best of them all. Their symptoms differ but little so far as the local symptoms are concerned. We may also think of SAMBUCUS, ANTIMONIUM TARTARICUM, BELLADONNA, LACHESIS, ARSENICUM,, and in some cases, PHOSPHORUS.
LACHESIS is particularly indicated when the patient awakens from sleep with it.
IGNATIA, whenever a cross word or correcting the child brings on the spasm.
Another remedy is CUPRUM, especially when the spasms are general and the child clenches its thumbs.
IPECACUANHA may be of some use in some cases, but I have no confidence in it.
Nor have I in SAMBUCUS, because under Sambucus, I think the trouble is more in the chest, whereas with Cuprum, the halogens, Calcarea phos., Lachesis and Belladonna, the trouble is in the larynx itself.
This spasm of the glottis often comes in the course of croup, in which disease Bromine may be the remedy when inspiration seems to be exceedingly difficult; the child is suddenly aroused from sleep as if choking. These symptoms are at least relieved by a drink of water, which seems to quiet the spasmodic condition. In membranous croup Bromine is indicated by the following symptoms in addition to the spasm already referred to: The child has at first a deep, rough voice, which, in the evening, amounts almost to aphonia. The child cries with a hoarse, husky voice. The membrane seems to come up from the larynx into the throat. Every inspiration seems to provoke cough, especially every deep inspiration.
Breathing is hoarse, rasping and whistling, as though the child were breathing through a sponge or through some loose metallic substance which is vibrating. This is caused by the vibration of membrane as it is deposited more or less uniformly over the interior of the larynx. Later, there is rattling in the larynx. When the child coughs it seems as if the larynx were full of loose mucus.
ANTIMONIUM TARTARICUM is very similar to Bromine, in croup. It has rattling and wheezing extending down the trachea as well as in the larynx.
Now I wish to say a few words about other remedies in connection with croup, especially concerning ACONITE, HEPAR, SPONGIA and KAOLIN. KAOLIN is a kind of porcelain-clay, a combination of lime and silica, and has proved very useful in membranous croup. The relation which these remedies hold is this :
ACONITE is useful in the beginning of croup, whether spasmodic, catarrhal or membranous. It is indicated by the child suddenly arousing from sleep as if it were smothering. There is great restlessness. The skin is hot. There must be some anxiety present. Breathing is dry. There is no sound of mucus. Pretty soon the child seems better and falls asleep and then will be aroused again. Aconite is especially indicated in these cases if these symptoms have followed exposure to dry, cold winds. Do not stop your remedy too soon. If you do, while the child will be better in the morning the symptoms will return with renewed violence the next night, and before you know it the mucous membrane of the larynx and trachea will take on fibrinous exudation and you lose your patient.
You will need to change to SPONGIA when you have these symptoms present: Breathing during inspiration is hard and harsh, as though the child was breathing through a sponge. The cough has a decidedly hard barking, ringing, sound. The sputum is scanty as yet. Spongia follows Aconite, especially after exposure to dry, cold winds, and in light-complexioned children with blue eyes. The symptoms are usually worse before midnight. Suppose this fails you, then you may have recourse to HEPAR SULPHURIS CALCAREA.
HEPAR usually has its symptoms worse after midnight and towards morning. The cough has the same harsh, croupy sound, but there is a great deal of moisture with it. That is the indication for Hepar. It, too, is worse from exposure to dry, cold winds. Sometimes all these drugs fail and we have to resort to the halogens, especially to Bromine and Iodine.
I have already given you the symptoms of Bromine; let me tell you how to distinguish it from Iodine. IODINE is particularly indicated after the failure of Hepar, when the membrane has formed ; inspiration is exceedingly difficult, both from spasm of the throat and occlusion of the lumen of the larynx by the membranous formation. Inspiration is wave-like, or in jerks. The cough is moist but harsh, just as you found under Hepar. The voice ig almost extinct from the hoarseness. The. child grasps its throat to relieve the pressure, throws its head far back so as to straighten the route from the mouth to the lungs and favor the passage of air. It is particularly worse in the morning. Iodine is especially adapted to dark-complexioned children with dark hair and eyes. This in itself is a great distinction between Iodine and Bromine. That is why I spoke of the use of Bromine in light-complexioned children, because this fact has been proven to be a good distinction between these two drugs, and hence, as a comparative symptom, is one of great value to you. Iodine is particularly adapted to cases that come from damp weather. Long-continued damp cold weather will produce just such a cough as Iodine will cure. Do not change your remedy in these cases too often. Do not change your remedy on account of alarming symptoms that spring up, UNLESS YOU ARE CERTAIN THAT THEY INDICATE A CHANGE.
KAOLIN has been used successfully for membranous croup even when the membrane dips down deep into the trachea. There is extreme soreness of the chest. The patient does not want anything to touch him. He will not permit you to use steam or hot cloths, because the chest is so sore.
Returning to the study of Bromine we find it useful in affections of the lungs. It is indicated in asthma, when the patient feels as if he could not get air enough into his lungs, consequently he breathes very deeply. The explanation of this lies not only in the lungs, but also in the constriction of the glottis. Although the patient expands his chest well, air does not go in on account of the narrowness of the opening in the larynx. It is especially indicated in asthma coming on, at or near the seashore.
We also find Bromine useful in pneumonia, particularly when it affects the lower lobe of the right lung, hence lobar pneumonia. We often find nose-bleed as a concomitant symptom when Bromine is indicated in these cases. The patient also has the symptom just mentioned under asthma, "seems as if he could not get enough air into the chest;" while there seems to be plenty of mucus, the patient does not appear to be able to expectorate it.
We also find Bromine indicated in tuberculosis of the lungs, particularly when the tubercular deposit is more manifest in the right lung. The patient suffers frequently from congestion of the head and chest, which is relieved by nose-bleed. Notice how often that symptom occurs under Bromine. There is also pain in tha mammary region going up into the axilla. The eyes seem to be affected along with the chest symptoms giving rise to a chronic conjunctivitis.
Bromine produces a very characteristic picture of uncomplicated hypertrophy of the heart, by which I mean, muscular enlargement without valvular lesion. The patient finds it difficult to exert himself on account of the oppression about the heart. He has palpitation when he begins to move and when he gets up from a sitting to a standing posture. The pulse is full, hard and rather slow, which is just the character that belongs to an over-active enlarged heart. It has cured many cases of this hypertrophy of the heart. I think it was Dr. Thayer, of Boston, who cured many cases of this trouble with Bromine. It may also be used in cardiac asthma, especially when the asthmatic paroxysms are better at sea than on land.
(Note: here Professor Farrington refers on the previous page to the asthma of Bromine, as coming on at or near the seashore, and here he speaks of cardiac asthma better on sea than on land. Both may be right, for being AT SEA differs from being AT THE SEASHORE, where you may have land breezes.)
You here find Bromine similar to ACONITE, but it lacks the anxiety of that remedy. Both remedies are suited to uncomplicated cardiac hypertrophy, but Aconite has fear and anxiety. The patient fears that he will drop dead in the street.
It is also similar to ARNICA and RHUS TOX., both of which remedies have uncomplicated hypertrophy of the heart from over-exertion.
Now compare Iodine with Bromine in chest affections. Iodine is also indicated in pneumonia, more so perhaps than Bromine. It is especially useful when the disease localizes itself, that is when the plastic exudation commences. There is a decided cough with great dyspnoea, difficulty in breathing, as though the chest would not expand (and here the trouble is situated in the chest itself), and blood-streaked sputum. You will find some portions of the lungs beginning to solidify. You may also give it later in the disease, after the stage of hepatization, in the stage of resolution, when instead of absorption and expectoration of the exudate, slow suppuration appears with hectic fever and emaciation ; the patient feels better in the cool open air than he does in the warm room.
Phthisis pulmonalis sometimes calls for Iodine. You here find it indicated in young persons who grow too rapidly, who are subject to frequent congestion of the chest, who are rather emaciated, and who suffer from dry cough, which seems to be excited by tickling all over the chest. The patient cannot bear the warm room. Expectoration is tough and blood-streaked. There is a well-marked feeling of weakness in the chest, particularly on going up stairs. The patient has a very good appetite, and is relieved by eating.
The nearest remedy to Iodine here is PHOSPHORUS, which is also well adapted to phthisis in the rapidly-growing young.
Iodine is also indicated in enlargement of the heart, whether or not accompanied by disease of the valvular structures. There is palpitation of the heart, particularly after any manual labor. It is suited especially to dark-complexioned persons, with dark hair, etc. The heart feels as if it were being squeezed by a firm hand. At other times, there is excessive weakness in the chest, with "goneness" or exhausted feeling. The patient can scarcely talk or breathe, so weak does he feel. This shows that Iodine acts on the connective tissue. In valvular affections, there is a purring feeling over the heart, just such a sensation as you get when stroking a cat.
SPIGELIA has that same purring, vibrating feeling over the region of the heart.
Now let me give you the difference between Iodine and Bromine in scrofulous affections. Iodine causes induration of the glands more marked than does Bromine. They are hard, large and usually painless. There is a characteristic of Iodine which is universal, and that characteristic is torpidity and sluggishness. The very indolence of the disease is suggestive of Iodine. It also produces atrophy of the glands. The mammae waste away and the testicles dwindle. We find it indicated in scrofulosis of children, when they emaciate rapidly despite a ravenous appetite. They are hungry all the time. They cry for their dinner, they feel better while eating, and yet they do not gain any flesh. They are always better in the open air and worse from any confinement in the warm room. The mesenteric glands are enlarged and you have what is known as tabes mesenterica. This indicates Iodine, particularly when you have these other symptoms present together with excessive mental irritability.
We find Iodine causing a rather singular diarrhoea. In such cases the spleen is enlarged, quite hard, and very sensitive to the touch. The liver, too, must be affected, because the stools are whitish; sometimes they are wheylike. This last symptom you will often find connected with obscure disease of the pancreas. Iodine has such an affinity for glandular structures that it, no doubt, attacks the pancreas as well as other glands.
We also find Iodine affecting the ovaries. It is indicated in ovarian dropsy. In such cases as this, the single fact that Iodine has helped in ovarian dropsy, must not lead you to give Iodine in every case of that trouble. Other remedies have proved themselves useful. APIS, COLOCYNTH and other drugs, have cured cases, and they have sometimes failed. If the whole picture of the patient calls for Iodine it is your duty to give that drug, but not unless such is the case. It must be given for weeks or months before it will bring about absorption of the tumor.
We also find Iodine indicated in cancer of the uterus, particularly with profuse haemorrhages. The leucorrhoea is characteristic, being yellowish and very corrosive. This, in conjunction with the other Iodine symptoms, sallow, tawny skin, ravenous appetite, etc., makes Iodine the remedy which will relieve many cases and cure some.
In this connection we have other remedies to remember, and notably among these, HYDRASTIS, which has cured epithelioma, and may be a remedy for uterine cancer. I have, however, had no personal success with it. It has been used both externally and internally, when indicated by symptoms which have already been given you in another lecture; especially has it marked goneness at the epigastrium, and palpitation after every motion.
There is a substance, or remedy, known as LAPIS ALBUS. It is one of Grauvogl's remedies. He, at one time, went to a certain spring, the waters of which, it was claimed, would cure tuberculosis, scrofulosis, and even cancer. On examining the spring Grauvogl noticed that the water had gradually worn a crevice in the rocks. He took away a piece of this rock over which the water was falling, and made triturations of it. With this he cured several cases of goitre, and also several cases of scirrhus. This rock has been analyzed, but the analyses differ so that I hardly know which one to, recommend.
Both Iodine and Bromine are of some use in ulcers. Iodine, for instance, is useful in ulcers rather of a scrofulous form, with spongy edges, and discharges of a bloody, ichorous, or even purulent character.
Now, Bromine is somewhat similar. It is useful in ulcers which have a carrionlike odor, with threatening gangrene. The surrounding skin has a greenish-yellow hue. That is the form of ulcer to which Bromine is especially adapted.
When Iodine has been abused, and has produced symptoms, Hepar is the proper antidote.
Now, a few words about CHLORINE. I do not know much about it as a medicine. It may be given in a crude form by allowing the gas to be absorbed by ice-cold water, and thus it may be prepared for the cases to be enumerated. Chlorine, and in fact all its combinations, seem to have a special affinity for mucous membranes. Hence we find it indicated in catarrhs. Chlorine produces a watery discharge from the nose, with thin, excoriating coryza, making the nose, both inside and about the aláe, sore. On examining the mouth, you find it, too, affected with a low grade of inflammation. Chlorine here produces small, putrid-smelling ulcers. These are aphthous in character. You find the mouth filled with yellowish-white aphthae.
Chlorine is indicated in scorbutic states of the blood; and so are all the chlorides. We find under Natrum mur. and Kali chloricum the same kind of stomacace, with excessive fïetor of the breath.
We find Chlorine also acting on the nervous system, probably through the blood. It is indicated in typhoid conditions; the patient has a fear of becoming crazy, or that he will lose his senses. He is very forgetful; he cannot remember names, etc. There is a constant fear of some impending disease. There is also, under Chlorine, a peculiar painful sensation in the vertex; this sensation passing down the left side of the body. This is a precursor of typhoid fever. It is worse after eating. In such cases, Chlorine will often modify the fever.
Chlorine is also indicated in impotence. When this impotence has been produced by inhalations of the fumes of Chlorine, Lycopodium is the proper antidote.
Of the use of Chlorine in spasm of the glottis, I have already spoken.