Picricum acidum

Picric acid causes at first some congestions. These are soon followed by weariness and mental inactivity, showing how intensely the remedy attacks the vital forces. This weariness progresses from a slight feeling of fatigue on motion to complete paralysis. It is accompanied by indifference and want of will-power, and desire to lie down and rest. Animals, poisoned with this acid, were affected with paralysis of the hind legs, with slow breathing and great muscular weakness. At the autopsies made on them, the cortex cerebri, the cerebellum, medulla oblongata and spinal cord were found reduced to a soft, pulpy mass, that was dark brown in color, and loaded with little shining, greasy particles. The urine was rich in phosphates and uric acid, and poor in sulphates and urates. Albumen and sugar were also found in the urine. The liver was full of fat granules.

These symptoms and pathological observations bespeak the use of Picric acid in diseases of the brain and spinal cord. To give it, we need not wait until paralysis has set in. We may find it useful in typhoid conditions and also in conditions of brain fag when the mind has been over-worked. In the latter affection, brain fag, Picric acid is one of our best remedies.

It is also useful in neurasthenia. You will find dull headache with aggravation from the slightest attempt at using the mind. This may be in the forehead or in a still worse place, in the occiput, and may then extend down the spine. The patient complains of feeling constantly tired and heavy. Any attempt to study brings on anew these symptoms of the brain, and also develops burning along the spine and very great weakness of the legs and back, with soreness of the muscles and joints. Sometimes sleep is restless and disturbed by priapismic erections. With these, of course, there will be frequent seminal emissions. Sometimes you will find severe pains in the neck and occiput going up to the supraorbital notch or foramen, then extending down into the eyes. There are hot feeling in the lower dorsal region, and aching and dragging in the lumbar region, which is worse from motion. On awaking from a sleep the patient has a tired aching in the lumbar region. The legs are heavy and, at the same time, weak. With this heaviness of the feet he sometimes complains of dull frontal headache. Sometimes he complains of numbness and crawling in the legs, with trembling and with pricking, as if from needles. He has tingling of the lips, formication about the head, and crawling as of ants over the surface. The least exertion causes prostration. He also has vertigo, worse when he stoops, walks or goes up-stairs. He has headaches, with dull, throbbing, heavy, sharp pains, worse from study or movement of the eyes, and better from rest, the open air, or binding the head tightly. The pupils are dilated. Sparks appear before the eyes, which may even smart and burn. Thick matter forms in the canthi. The eye symptoms are worse from artificial light. Accompanying the congestion of the head is nose-bleed. The nose is full of mucus. The patient can breathe only when the mouth is open. The saliva is either frothy or stringy. The taste in the mouth is like that of the acid itself, sour and bitter. The throat feels rough and scraped; better from eating and worse from empty swallowing, and worse after sleep. There is thick, white mucus on the tonsils. On swallowing, the throat feels so sore that it almost seems as if it would split. Sour eructations may accompany the frontal headache. Now, these gastric symptoms may accompany the brain fag. Nausea, which is worse about five o'clock in the morning and worse when attempting to rise. He also complains of pressure and weight about the stomach. He wants to belch, but does not seem to have the power to do it. The irritating effect of the drug is further shown by diarrhoea with stools which are thin, yellow and sometimes oily, with a great deal of burning and smarting at the anus, with prostration and unsuccessful urging to stool. The kidneys are congested. The urine has an abnormally high specific gravity, and contains sugar. It is also albuminous. The conjunctivae are yellow, just as you find in jaundice. Papules appear on the face and turn into small boils. The feet are apt to be cold. These, then, are the main symptoms of Picric acid. Now, let us study those of a few of its related remedies.

Phosphorus, like Picric acid, causes fatty changes in the blood, kidneys, brain and spinal cord. Both remedies meet in sexual excesses and priapism, and both may be indicated in brain fag; both have congestive vertigo and crawling and tingling sensations here and there over the body. The distinction lies principally here: Phosphorus causes more irritability with the weakness, as displayed by over-sensitiveness to all external impressions. Hence, the senses are too acute, or, if failing, there are present photopsies; loud noises in the ears; sensitiveness to odors; electric changes in the atmosphere: head weak; cannot think, with aggravation from loud noises. Phosphorus also has backache, with feeling as if the back would break on any motion, and with burning spots in the back, better on rubbing. Sexual excitement is very strong, but the erections are not so intense as under Picric acid, although the lasciviousness is more marked. Even when, in extreme cases, all irritability has ceased, the history shows that it once characterized the case.

Nux vomica resembles Picric acid, somewhat, in the brain fag and in the gastric symptoms, in the sour eructations, in the aggravation towards morning, and in the inability to study.

Oxalic acid, more than Phosphorus, resembles Picric acid in the extreme picture of spinal softening. There are weakness about the loins and hips, of course, extending down the legs, and numbness in the back. Picric acid has more heaviness and Oxalic acid more numbness. The legs are apt to be bluish and cold. The patient complains of paroxysms of dyspnoea. Another symptom, and one indicative of spinal meningitis, is intense inflammatory pain all through the back. A general symptom of Oxalic acid is pains coming in small spots, and greatly aggravated on thinking of them.

Another remedy closely related to Picric acid is Sulphur. This causes congestion of the lumbar spine. So intense is this congestion that paraplegia, with numbness and tingling, results. Heat in the spine. There is retention of urine.

Phosphoric acid suits cerebro-spinal exhaustion from over-work.

The least attempt to study causes heaviness, not only in the head but in the limbs; numbness; vertigo; confusion of thought; tingling; formication, especially in small of back; back and legs weak, yet no pain, except a subjective sense of burning; emissions even during stool; genitals relaxed.

Argentum nitricum has backache, worse when first rising from a seat and better from moving about, with trembling weakness of the limbs; vertigo, with fear of projecting corners, etc.; bones at sacrum give out; limbs tremble; impotency; organs shrivelled.

Alumina is indicated in cases somewhat like those calling for Picric acid, but is distinguished by the pains in the spine as though a hot iron had been thrust into the part. The patient staggers when walking in the dark. He also has painful feeling about the soles of the feet.

Silicea is quite similar to Picric acid. It is useful in nervous exhaustion, where the patient dreads any exertion either of body or mind. When he is warmed up to his work, he can get along pretty well. He also has numbness in the toes, fingers and back, and the constipation peculiar to Silicea.

Zinc causes nervous exhaustion. Its backache is worse at the last dorsal vertebra, and is worse while sitting; burning along the spine; formication in the calves; weak limbs; weak back and limbs, with goneness when hungry, especially at 11 A.M. All the nervous symptoms are worse from wine.

Of the remedies which cause violent erections you may compare the following: Cantharis, Phosphorus, Capsicum, Agaricus, Pulsatilla, Platinum, Opium, Ambra grisea, Zincum, Physostigma, Petroselinum and Mygale.