Nitricum acidum
Boy, 4 years old
This is an acute case of a boy who came a few
days ago with diarrhea
and vomiting and was cured with Phosphorus. Now he comes for aphthae, there are plenty of aphthae
in his mouth.
A: In June he had a high fever, he didn't want to
eat anything. Then he started to vomit yellow. He vomited after drinking and
eating. He cried a lot, slept a lot, was very pale and he was very thirsty, but
nevertheless he had to vomit immediately after drinking.
He was very thirsty, but he had to vomit
immediately after drinking. Do you know the rubric?
Look on page 532:
STOMACH, vomiting, drinking, after
drinking, after : Acon., alum., Ant-c., ant-t., apoc., arn., ars-i., Ars., bar-c., bell., bism., bor., Bry., bufo., cadm., calc., camph., canth., cham., chel.,chin-a., chin., cina., cocc., colch., con.,
crot-t., cupr., dig., dros., dulc., eup-per., ferr-ar., ferr-i., ferr-p., ferr., hep., hyos., iod., ip., kali-ar., kali-c.,kreos., lyc., merc-c., merc-cy., merc., mez., nat-m.,
nit-ac., nux-v., olnd., op., Phos., plb., puls.,
rhod., rhus-t., sars., sec., sel., sil., sul-ac., sulph.,Tab., verat-v., Verat., zinc.
In Phosphorus usually they vomit after 5 or 10
minutes, after it has warmed up in the stomach. Vomiting immediately after drinking is rather Arsenicum, Bismuthum, Bryonia alba and Cadmium sulphuricum.
Do you know in which cases Cadmium sulphuricum is indicated?
In cancer, in stomach
carcinoma.
And how is the vomitus?
Like coffee grounds, the vomit looks like
coffee grounds.
Bismuthum is also in
the rubric and you know Bismuthum also as a remedy
for complaints of the stomach.
By which symptom do you recognize Bismuthum?
Audience: Rubbing ameliorates.
A : Yes. They have
enormous pain in the stomach, they are fainting with
the pain.
Look in the rubric on page 513:
STOMACH, pain, fainting, with: Bism ...
They want to have their back rubbed very
strongly, because the pain becomes much better.
Question: ... (not
understandable)
A : You don't find
"rubbing amel." in the Repertory, you have
to know this. It is typical for Bismuthum states,
with perforations of the stomach.
All right. This boy
vomited everything he drank and ate and he was very thirsty. That's why he got
Phosphorus with a good result.
A: It improved spectacularly but then he
started to cry and cry and he had vesicles on his tongue. This was on June 12.
He had vesicles everywhere in his mouth, on his tongue, his gums, with a lot of
saliva. He stopped vomiting and he received Lycopodium
clavatum. It was so bad that he couldn't drink or eat
anything.
He didn't want to drink anything at all for
half a day. This is a few days ago.
In fact, these were not aphthae,
but ulcers.
This is a very important point. If a child
comes with aphthae in his mouth you can take the
following rubric on page 397:
MOUTH, aphthae
APHTHÆ : Acet-ac., aeth., agar., all-s., alum., anan.,
apis., arg-m., ars-i., Ars., arum-t., asim., aur-m., aur-s., aur., Bapt., berb., Bor., brom., bry., calc.,canth., caps., carb-ac., carb-an., carb-s., carb-v., caul., cean., cham., chin-a., chin., chlor., cic., clem., cocc.,
corn., cub., dig., dulc., ferr., gamb., hell.,hep., hippoz., hydr., iod., jug-c., kali-ar., kali-bi., kali-br., kali-c., Kali-chl., kali-i., kali-s., kreos., lac-c., lac-d., lach., lact-ac., lyc., mag-c., Merc-c.,Merc., Mur-ac., myric., nat-a., nat-c., nat-h., nat-m., nit-ac., nux-m., Nux-v., ox-ac., phos., phyt.,
plan., plb., ran-s., sal-ac.,
sanic., sars., sec., sil.,staph., Sul-ac., Sulph., ter., thuj., vinc.
Don't forget to take a look in the child's
mouth, whether these are really aphthae.
At the beginning we also started from this
rubric, but it didn't help much. It was not Borax veneta,
nor Sulphuricum acidum, there were no essential indications for these remedies.
Until we looked in his mouth and saw that these were ulcers, these aphthae were ulcerated. This difference is very important. These ulcers were very painful, so painful that this child
couldn't eat anymore.
Look at the rubric on page 428:
MOUTH,ULCER,painful : Ars., fl-ac., kali-bi., merc., mur-ac., nat-m., Nit-ac., petr.
MOUTH, ulcers, painful: Ars,
fl-ac, kali-bi, merc,
mur-ac, nat-m, Nit-ac, petr
Which of these remedies is complementary to
Phosphorus?
Audience: Arsenicum.
A : Yes, and Arsenicum album also has this kind of vomiting as you know.
Arsenicum
in cases of cancer, in necrosis of the bones with metastasis or in the disease
of M. Kaler, multiple myeloma. It is a remedy
that comes into play in near death situations, in people with cancer, who are
dying and they start vomiting coffee grounds. It might be Arsenicum,
very chilly, very anxious, restless and pale.
A: It really looked yellow,
there was pus at the base of the ulcer. They were really ulcers. He didn't want
to eat, to drink, he was weeping, was in a bad mood and he always wanted to be
carried on the arm. You were not allowed to touch him.
Under the rubric "ulcers" you will
find a subrubric on page 428:
MOUTH, ulcers,
white ulcers: Cic,
sul-ac
Sulphuricum acidum is one of the most important remedies in aphthae in old people, usually in those who have dentures.
The aphthae are situated under the dentures. It is
also important in children, and it is complementary to which remedy we need in
children?
In Pulsatilla
children with an aphthous stomatitis
you have to think of Sulphuricum acidum.
Do you know the remedy or don't you?
It is also indicated in women with flushes of
heat who are always in a hurry. They can't sit still while eating, they always
have to run about to put the soup, the potatoes, the vegetables and so on on the table. They don't have time to sit down. It is a
very important remedy in cancer, in uterine carcinoma.
Up to now we cannot say which remedy he needs.
We know that Phosphorus helped him a lot, therefore he might need Arsenicum now, but also Sulphuricum
acidum is a possibility.
A: Is there something remarkable in this
child? How far away do you live from here?
MP: In G.
A: How far is this away from here? How long do
you drive with the car to get here?
MP: About half an hour.
A: In the car he was doing well.
MP: He always wanted to go out and in the car he was quiet.
A:
This is strange.
MP: The evening before yesterday we drove
around because of him, because I became really nervous from his crying. He
always wanted to sit on my lap. My husband didn't feel well either. We can't
sleep at night and we become very nervous ourselves.
This
is very strange. They put the child in the car, drove about and he didn't cry
anymore.
Which rubric is this?
You find this rubric on page 1397:
amel. : Ars., brom., kali-n., Nit-ac., phos.
GENERALITIES, riding in a wagon, or on the
cars
amel: Ars, brom, kali-n, Nit-ac, phos
Here you see again Arsenicum,
Nitricum acidum and also
Kali nitricum.
MP: Yes, then he was quiet. But now he is much
better.
A: The day before yesterday we gave him a
remedy, because of the ulcers, also on the lips here, which had a particular
appearance and because he didn't eat or drink. Yesterday you came back for a check up. On the mental level he was doing better, but he
didn't eat yet. Now, I see that he is eating again. Yesterday I told you you should drive about with him in the car and try to give
him something to drink. Have you tried this?
MP: No.
The danger in this child was the dehydration,
because he did not eat, nor drink. Therefore I advised the parents to drive him
around in the car and meanwhile to give him something to drink, but they didn't
do it.
MP: My sister-in-law did. He wanted to go out
and we told him, "If you want to go out you have to drink something."
After we said this a few times to him he drank. He also drank somewhat today.
A: Now the worst thing has passed. The moment
he starts eating and drinking again, it is better. Today we only want to check
how he is doing. He has also bled a little bit.
MP: Yes, also during the day yesterday. You
could see that his lips were completely tense. Maybe they cracked while
drinking.
FP: Now, he is doing fine.
Can you decide yet which remedy he needs?
What is the
differential diagnosis between the two remedies?
Arsenicum and Nitricum acidum. Indeed up to now you can't decide which of the
remedies he will need.
MP: Is he in a bad mood from the medicines?
A: It might be. We cannot say that this child is anxious in
the dark?
MP: No.
A:
He wept from pain, but he didn't have anxieties, did he?
MP: No.
A: And you always had to be with him?
MP: No, we didn't have to.
A: All right. Yesterday we repeated the remedy
again. He was in a bad mood and last night it was better.
MP: Yesterday he also got something to put in
his mouth. I put it in his mouth twice, but he became really rebellious.
A: But I gave you the remedy in a tube to take
home. Rubbing was only locally.
MP: That's it.
A:
You also told me that suddenly he had fits of pain. The pain came in fits, it
lasted about 1 or 2 minutes. He woke up from them and they were already gone.
This
means that the child was sleeping, startled suddenly, was crying and then
everything was gone. What does this mean?
Audience: That the pain came suddenly.
A : Yes. He was crying, then the pain was gone, he slept for
one hour and then suddenly the pain appeared again.
You find this rubric on page 1377:
GENERALITIES, pain appear suddenly and
disappear
suddenly
and disappear
suddenly : Arg-n., asaf., aster., Bell., canth., carb-s., eup-pur., fl-ac., ign., Kali-bi., kalm., lyc.,
mag-p., merc-c., Nit-ac., phyt.,sabin., spig.
This is a very important rubric which you have to have in
mind. Here you don't find Arsenicum.
Another important
negative symptom for Arsenicum is that he is not
afraid in the dark or while being alone.
He received Nitricum
acidum M and the next day he was clearly better on
the mental level, but not on the physical. We were doubting whether maybe
it was Arsenicum, but the amelioration while driving
a car was so clear and he didn't have the typical paleness of Arsenicum nor any other anxieties, so that we stuck to Nitricum acidum and repeated it
in M potency. Then he improved very quickly.
You see that you have to repeat a few times in acute
cases when you don't see any progress. You could also say that you
had to wait, but in this case there was a big amelioration after the remedy was
repeated and the next night he slept very well. If you are sure about the
remedy you can repeat it in acute cases without hesitating, if necessary.
A: Suddenly he started crying, he cried a
little bit and then it was over.
MP: Yes.
A: This sudden appearance is also strange.
FP: His body reacted to the remedy yesterday
evening.
MP: Yesterday the pain appeared again and he
cried at 1:30, 2:00 a.m. for the last time. He slept very well. He slept through the
night until morning. I woke up at 6:30 a.m.
because he was awake, but I didn't hear him in
the meantime.
Don't forget this remedy in ear pain. The
child is crying and suddenly it is over. These are stitching pains, but of
course the child can't describe it this way. Nitricum
acidum is a splinter pain, stitching pain, which
appears suddenly. The children cry suddenly, they cry
all at once, and when they come into your practice they are better - because
they have been riding in a car.
I had a patient with 39° fever which disappeared
while riding in a car. You can't explain this, but this is a fact.
You also know that Nitricum
acidum children always are discontented, they are
never satisfied.
? It could be, it could be Nitricum acidum, because she has a feeling of hate, an expression of
hate in the eyes. Nitricum acidum
is the man or the woman who never laughs: the most complaining remedy,
self-pity
There are indifferent Phosphorus patients who already progressed
a long way and at the the end they become indifferent
to everything. But
this man is reserved and withholding, therefore I didn't think of Phosphorus,
but of which other remedy?
Audience: Nitricum acidum.
A: Yes, Nitricum acidum in cases with bloody diarrhea and a strong fear of cancer. When they have this kind of diarrhea what do they do to improve this diarrhea?
Audience: Riding in a car.
A
: Yes, the the
diarrhea improves when they are riding in a car, but not only the diarrhea
improves, riding in a car ameliorates Nitricum acidum in general, all the complaints. This is a clear
modality of Nitricum acidum. But in Nitricum acidum normally we see
cracks and painful stool. They have
diarrhea, but often also constipation with hard stool and cracks in the rectum.