KALI CARBONICUM [Kali-c]:

-M.L.Tyler.

Introduction:
KENT says: "The Kali carb. patient is a hard one to study, and the remedy itself is a hard one to study." And Farrington says that "Kali carb. is indicated in a great variety of diseases, but is a drug much neglected in practice", perhaps because, except in a few of its uses, as in asthma and pneumonia, it does not appeal strongly enough to the imagination, and therefore is not--so to speak--"on the spot". To begin with, then, the Kali carb. patient is not one to arouse enthusiasm: a tiresome patient, irritable and sensitive to the last degree--especially when rendered so by ill-health and sickness. "Never at peace." Never wants to be alone. Full of imaginations and fears. "Fear of the future, of death, of ghosts; fear that something is going to happen." "Does not seem to care for anything" a drab, uninteresting, wearisome sort of person; the "Here she comes again!" with a groan, patient: especially if "she" happens to be "he". Not the patient who fires your interest, or stirs your pity. Nevertheless one of a big crowd. Here there are no outstanding mental symptoms to catch the imagination and make prescribing easy: but Kali carb., so sensitive, so frightened, so unhappy and unflourishing, needs badly the help that the remedy can confer. Nerves so sensitive--so on edge! So easily frightened that, with Kali carb., "startled" means "frightened to death". Peevish, nervous; and, a curious symptom, very characteristic of Kali carb., any bang, shock, or bad news is felt in the stomach: fear is felt in the stomach. One remembers an aunt who, if you told her someone had cut his finger, would exclaim. "Oh, you gave me such a pain in my knee!" With Kali carb. it is in the stomach. Kent says a patient of his expressed it thus, "Doctor, I don't have a fear like other people do, because I have it in my stomach. If a door slams I feel it right here" (epigastrium). Kent talks of the "insidiousness of Kali carb." in the onset of its complaints, and "its nondescript appearance". Poor Kali carb!--not only nervous and on edge, but very chilly: "has not the normal resistance to temperature". Catches cold from every exposure to open air: gets the "fish-bone in the throat sensation"* * Fish-bone, or splinter sensation in throat, ARG. NIT., DOL., HEP., KALI C., Nit-ac., Sil., etc. "From becoming cold, Kali c." only. whenever he gets cold, and has in particular a "stubborn sensation of chilliness at noon". Kent says: "Kali carb. is always cold: always shivering. If he covers up and warms the painful part, the pain goes to some other place: if he covers up one part, the pain goes to the part uncovered." And yet this is the one drug given in the Repertory for "perspiration of painful parts". And with all the coldness, Kali carb. has "burning pains which compare with those of Arsenicum". "Haemorrhoids burn like fire: sensation of a red hot poker thrust into anus." But here you differentiate: the Ars. burnings are relieved by heat; one doubts whether any other remedy has that; whereas the burning haemorrhoids of chilly Kali carb., Kent says, are "temporarily relieved by sitting in cold water"; so it is not difficult to diagnose between the two. One remembers a young prescriber so pleased because he had grandly relieved the haemorrhoidal condition of a patient, where a fine prescriber of much experience had failed. It was Ars. that cured, when he once discovered that their pain was burning in character, and relieved by heat. People in these days love to inject, or remove piles: the older homoeopaths used to cure them. But among the most notable characteristics of Kali carb.-- indeed that which often first draws attention to the drug in many conditions, is its STITCHING PAINS. Pains STITCH, burn, CUT LIKE KNIVES--often extorting cries--in any part of the body. They resemble the pains of Bryonia, but here again, there need be no confusion between the drugs: for with Kali carb. the pains are worse during rest, worse from cold, from pressure, from lying on the affected side; while, with Bryonia the contrary obtains: for Bryonia is better during rest, worse from the slightest movement, better from pressure and from lying on the affected side, and generally worse from heat. For instance, in pleurisy and pleuro- pneumonia, where they are both capable of rendering yeoman service, with Bryonia the pains are worse from movement, worse from respiration which means movement, while with Kali carb. they stitch independently of movement: pains that extort cries between breaths, and at any time. But, and one cannot say it too often, one remedy will not do for another, even where they both have stitching pains in excelsis; the conditions--the "modalities"--must also agree. Homoeopathy may be difficult because it demands careful differentiation where first-class work is to be done; but is it not the more interesting?--and truly its triumphs more than compensate for the time and care expended. So, get it right! Though the stabbing pains of Kali carb. and Bryonia affect often the self-same localities--pleura, peri- cardium, joints, etc.--it should never be difficult to distinguish between them, because in Bry. so long as the patient is still he is at comparative peace: whereas in Kali carb. they occur alike during motion and at rest, and especially when at rest: Bryonia is worse from motion and heat; Kali carb. motion or no, but from cold. And Kali carb., unlike Bry., is intensely sensitive to pressure and to touch. Kali carb. shrieks when startled, and shrieks with its stitching and stabbing pains which are everywhere: they transfix all tissues and organs--even eyeballs. One remembers trying to find the remedy for a patient with queer stitching pains in fingers and toes, and it came out Kali carb. Hahnemann tells us, that "STITCHES are the most characteristics symptoms of Kali carb." This remedy has a paroxysmal cough with gagging and vomiting, hence its value in whooping-cough. We quote (p.78) from Boenninghausen (friend and disciple of Hahnemann) an account of an ancient epidemic of whooping-cough, where the symptoms were not those of Drosera, which failed, while Kali carb. proved curative: the curious symptom that suggested its use being a bag- like swelling between the upper lid and the brow. This swelling seems peculiar to Kali carb. "It is not a bulging and sagging of tissues as in old age, but a definite little sac, that looks as if filled with fluid." Kali carb. affects the whole chest with its stitches and inflammations, heart, lungs, and the serous membranes that envelop them; also the muscles of the chest wall. It chooses especially the right lower lobe in pneumonia, its rivals here being Merc. and Phos. But the indications for Merc. are the offensive mouth and sweat (we will give a little case), and those of Phos. are--thirst for cold drinks (not tolerated by Kali carb.); great constriction of the chest; patient has to lie on the right side; expectorates bright-red blood, or rust coloured, or purulent sputum which may have a sweetish taste. Kali carb. is useful also in peri- and endocarditis, with the characteristic stitching pains. One remembers one of those unforgettable cases, previously recounted, to which we shall again refer in a moment, because it belongs to the Kali carb. drug-picture and emphasizes it. And now ASTHMA. Kali carb. is one of our very great asthma remedies. Here the patient cannot lie down: must sit up, bent forward. Must lean forward with head on knees. Terrible attacks of asthma with aggravation at 3 a.m. Wakes at 3 a.m. with difficult, wheezing breathing. By the way, the drug has a queer sensation of a lump rolling over and over on coughing, rising from right side of abdomen to throat, and back again. How curative Kali carb. can be in asthma, the symptoms absolutely agreeing, we showed in a LITTLE CASE in HOMOEOPATHY, Vol. II, p.24. Here a severe case of asthma was cured with one prescription of Kali carb. 6, 12, 30 on three consecutive days. Four years later (in sending another asthma patient), her report was that she "had never had another attack". We gave the working out of that case, to show how the drug may be "got at". The TIME AGGRAVATIONS of Kali carb. are very striking and definite, and have often led to the consideration of the drug. At 2 a.m. awakened with stomach pains or dry cough. Between 2 and 4 a.m. awake with all ailments. 3 a.m. asthma: terrible attacks. Or dry cough. Or whooping cough. Or stitching pains awaken him: must get up and walk. Aggravation regularly. 3 a.m. is the bad hour for Kali carb. 3 to 4 a.m. the diarrhoea is worse. 5 a.m. suffocating and choking cough. (Nat. sulph.) 9 a.m. headache worst. 10 a.m. gets hungry and faint. Noon, chilliness, "a stubborn sensation" But one sees that the early morning hours are hours of especial suffering for Kali carb. In the abdomen Kali carb. has repeated attacks of colic, which suggest Colocynth, the patient being doubled up with the pain.* *Here "Kali carb. is usually associated with gall bladder disturbances, Colocynth with bowel troubles and diarrhoea." Colocynth cures again and again: but Kent says where the attacks recur, the patient needs Kali carb. to end the trouble: in the same way as when Bell. has cured again and again, the finishing touch will come from its "chronic", Calcarea. There is a poor little elderly woman who comes up to out-patients, and who from time to time gets these colicky diarrhoeas which Colocynth cures, but which recur. She is a typical Kali carb. when one comes to think of it! and at her next visit one will go over her symptoms again with a view to perhaps prescribing Kali carb. for a more all-round, and prolonged amelioration. One must also mention, "anaemia with throbbing all through the body". "Heart weakened with irregular and intermittent pulse." "Kali carb. is seldom indicated with a full, round pulse." "Dyspepsia in the aged, with empty weakness before food, and bloatedness after eating--and especially after soups and coffee." (Bloating is a strong feature of Kali carb.) "Nephritis with the Kali carb. stitching pains." It is sometimes difficult to lay one's hand on illustrative and telling hospital cases--even to remember them: but some can be traced, Here are three :-- Man of 65, admitted December 8th, 1917. Pleuro-pneumonia right base: prune-juice sputum. Stabbing pains, especially right chest, extorting cries, with, and also independently of respiration. Temperature to 104; Respiration to 40. Severe rigor on the 6th, and no sleep since, for the pains. Shouts with them. Lies on left side. Wants to be very warm. Kali carb. 30, two-hourly. Pain stopped in two hours--"His first good night." Highest temperature on the 9th, 102; then down. Rapid recovery. The symptoms in italics are those of Kali carb. (N.B.--Bryonia stabs occur with respiration, i.e. on movement.) Kali carb. and Carbo veg. are "complementary" remedies: the one taking up the case where the other has done its part. We gave the following case under Carbo veg., but will give it again here: A small girl practically in articulo mortis, with endocarditis, pericarditis with effusion and also pleuro-pneumonia with pleural effusion. Carbo veg. brought her back to life; she was cold, unconscious, gasping her last gasps: then Kali carb. took up the case and pulled her through. Case of rheumatic heart in a small boy. He got Kali carb. 200 and had a distressing aggravation for a few hours, screaming out with his pains, which nearly drove the Ward Sister out of her wits. However, it cleared up--heart and all: so the result was good. But Kent warns against Kali carb. in at all high potencies in gout, for instance--but he is speaking about old chronic cases, "where the remedy should have been given years before." But it is not a bad plan to start Kali carb. fairly low, say the 30th, or lower; and then go up. The closer the prescribing, and the more a patient needs a drug, the more chance there is of an initial aggravation.
BLACK LETTER SYMPTOMS FROM VARIOUS SOURCES.
Puffiness, swellings between eyebrows and lids, like a sac. Nose swollen, hard, red from tip to root. Swelling of face, especially over eyes. Stitches in middle of eye. Difficult swallowing: food descends oesophagus slowly and small particles of food easily get into windpipe. Desire for sleep, during a meal. Dyspepsia of aged persons rather inclined to obesity, or after great loss of vitality; repugnance to all food; constant chilliness, cold hands and feet, on sweat however great the heat. Stitch pain in right abdomen, worse from motion. Cutting pain left upper abdomen, extending from lower left chest, where there is a sticking at the same time. Inflammation, soreness, stitches and tingling as from ascarides in varices of rectum. Anal fistula. Menses too early, scanty, of pungent odour, acrid, covering thighs with an itching eruption. Violent colicky pain in abdomen before menses, constipation during. Pressing and bearing down of pregnant females, as if a load were falling into the pelvis. (Sepia, Lil. tigr. etc.) Violent pains in the small of the back in pregnant females. Impending abortion with pains from back into buttocks and thighs; discharge of coagula: habitual; during the second or third month. Labour pains insufficient. Violent backache: wants back pressed. (Sepia.) Bearing down from back into pelvis. The pains are stitching and shooting, or they are in the back, shooting down into glutei muscles or pass off down thighs. Difficult wheezing breathing. Asthma: must lean forward with head on knees: worse in a.m. Terrible attacks of asthma, worse at 3 a.m. Cough at 3 a.m., repeated every half-hour. Cutting pain in chest; in evening; after lying down; does not know how she shall lie; worse lying on right side; in a.m.; in lower part of chest, especially in left side: moving into epigastrium and leaving a stinging sensation in left chest. Stitches in sides of chest on inspiration. Sticking pressure in left chest on breathing. Persons suffering from ulceration of lungs can scarcely get will without this antipsoric. Hahnemann. Insufficiency mitral valves. Tendency to fatty degeneration of heart. Sharp pains in small of back, with very acute labour-like pains running through to front at intervals of a few minutes, occasionally shooting down to glutei muscles. Backache while walking: feels must give up and lie down. Back: sharp stitching pains awaken him at 3 a.m., he must get up and walk about; pains shoot from loins into nates. Stitching and shooting pains in back, shooting down into gluteal region or hips. Great tendency to start--starts with a loud cry. Cannot bear to be touched: starts when touched ever so lightly, especially on feet. Sensation of lump rolling over and over on coughing, rising from right abdomen to throat and back again. Liability to cold: inability to perspire: or great inclination to sweat: night sweats. Frequent exhaustion: feels she must lie down, or sit. Debility and desire to lie down. Wakes about 1 or 2 a.m., cannot sleep again. Awaking about 2 a.m. and 4 p.m. with nearly all ailments, but especially those of throat and chest. Pains stitching, darting, worse during rest and lying on affected side. (The opposite to Bry., whose stitching pains are better from rest, and from lying on affected side.) Oppression of breathing accompanies most complaints. Anaemia with great debility, skin watery, milky-white.

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