Lactic Acid. (Lacticum Acidum.)
By Constantine Hering — The Guiding Symptoms of our Materia Medica
Lactic Acid. H 3 H 5 O 3 .
An acid, discovered by Scheele, in sour milk, the result of spontaneous fermentation of sugar of milk under the influence of casein. It is also met with in many vegetable products which have turned sour.
Introduced by Reisig, whose 15th dilution was first proved by Swan. Subsequent provings by Fincke (30th), Allen, (pure acid, 30th dil.), and Swan (200th). See N. Am. J. of Hom., 1871, and N. Y. J. of Hom., vol. 1, p. 337.
CLINICAL AUTHORITIES.
- Diabetes mellitus , Kirkland, U. S. Med. Inv., Aug., 1875, p. 166 ; (2 cases) Kitchen, Raue's Rec., 1874, p. 213 ; Cantani, Primavera, Raue's Rec., 1874, p. 213 ; Morning sickness during pregnancy , Swan, Hah. M., vol. 6, p. 74 ; Williamson, Raue's Rec., 1872, p. 12 ; Foot sweat , Schmucker, Raue's Rec., 1874, p. 17 ; Swelling of bone , H. K., vol. 22, p. 10.
MIND [1]
Great discouragement. θ Pregnancy.
Averse to business or what formerly was pleasant to do ; lazy ; dislikes to read or think ; finds fault, is sarcastic, exacting.
Memory affected ; cannot remember a thing an hour after it has happened.
SENSORIUM [2]
Vertigo : when turning head suddenly ; on stooping.
Sensation as if blood was trickling down from front to back part of head, at 8 P. M.
Head feels very large, confused, as if tossed on a rough sea ; nausea like seasickness.
Congestion, as if blood would burst out at forehead or eyes.
Tightness and fulness in head ; on stooping it seemed as if blood would burst from nose.
INNER HEAD [3]
Dull pain in forehead, extending into eyes ; desire to close eyes.
Sensation of fulness in forehead, as if brain was too large.
Dull aching pain over left orbital region, < bending forward.
At 10 A. M. pain in forehead, over eyes, and fulness on top of head, as if it would burst, < afternoon, and extended into left eye.
Pain in temples in afternoon and on awaking in morning, with depression of spirits.
Sharp, darting pain in left side of head, from temporal to orbital region.
Pain in head and back all night.
Severe pain in forehead and all through head, with chill.
Tightness and heat over head, particularly in forehead.
Congestion of head, painless, with strong pulsation of vessels of neck.
OUTER HEAD [4]
Head sore to touch.
Fulness and tension over whole head, with sweat on scalp.
Fine miliary eruption on scalp.
Painful pimples on left occipital protuberance.
Desire to have head lie high.
SIGHT AND EYES [5]
Hyperesthesia of retina, steady aching in and behind eyeball.
Dark clouds pass before eyes ; cannot see letters on blackboard ; smoky appearance of room.
Pupils dilated.
Fulness as if blood was forcing its way out of eyes ; feel as if they would burst out of head, < turning head.
Could not bear to shut eyes, as if cornea was sore.
Pain through right eye, with nausea.
Marked protrusion of eyes ; pupils dilated ; feels tired.
Sharp pain in left eye, < while reading, with photophobia, direct light painful.
Severe pain in head above eyes, extending into eyes.
Tough mucus in inner canthus of each eye.
Peculiar twitching across right upper lid and in eyeball.
Jerking of left upper lid.
HEARING AND EARS [6]
Disturbed and troubled by noise.
Roaring in left ear on rising in afternoon ; singing, snapping in left ear.
Pain from parotids into ear ; stiff feeling in parotids.
SMELL AND NOSE [7]
Great sensitiveness of smell.
Erysipelatous redness of left cheek and left side of nose, with small sore vesicles on nose, in morning.
(In sick :) Nasal catarrh, with copious thick, yellow, mucous discharge. θ Leucorrhœa.
Epistaxis every morning ; greenish yellow stools, with tenesmus.
Sensation as if a quantity of mucus lodged in posterior nares ; discharge of clear viscid mucus after hawking, does not > entirely.
Severe coryza, stopped nose, sneezing, thick mucus from head to throat, yellow ; dead sweet taste.
Feeling as if blood would spurt from nose ; fulness in head.
UPPER FACE [8]
Congestion of blood to face and head.
Erysipelatous redness on left cheek and side of nose ; small vesicles on nose in morning.
TASTE, SPEECH, TONGUE [11]
Tongue dry, parched, sticky. θ Diabetes mellitus.
Thick white coating on tongue.
Yellow coating on tongue, with bad taste in morning.
Sores on tongue ; tongue raw and red.
Taste : fetid ; metallic ; sour ; acrid, with nausea ; like copper ; peculiar, on back part of tongue.
INNER MOUTH [12]
Very sore mouth ; canker sores.
Child had been fretting forty days, cried on taking any food into its mouth, which was inflamed, and tongue and lips studded with little white blisters with a red base.
Mouth very dry ; roof dry, feels burnt.
Copious salivation. θ Pregnancy.
Much saliva in mouth tasting salty.
PALATE AND THROAT [13]
Elongation of uvula ; rawness of pharynx from posterior nares, left side, down to œsophagus, with sensation of a quantity of mucus lodged in nares and larynx, causing hawking, which does not relieve entirely.
Dryness of posterior fauces, with hawking of mucus.
Great dryness of throat, with hoarseness and dry cough.
Accumulation of mucus in throat, not loose, but as if filling up ; rawness in upper pharynx.
Hawking of thick, yellow, tasteless mucus from upper part of pharynx ; dead sweet taste.
Constriction and soreness in throat, with difficulty in swallowing solids.
Fulness in throat, which keeps him swallowing frothy mucus ; lump or fulness feels like a small puff ball ; not > by swallowing.
Fulness in fauces ; burning in fauces, throat and œsophagus ; can hardly force solids into œsophagus, fluids more easily.
Constricted feeling low down in throat, with slight nausea.
Sensation of plug in throat.
Sense of constriction in throat ; rough and dry.
APPETITE, THIRST. DESIRES, AVERSIONS [14]
Voracious appetite and great thirst. θ Diabetes mellitus.
Apparent indifference to food, very little satisfies.
EATING AND DRINKING [15]
Uneasiness in stomach after food and drink. θ Diabetes mellitus.
Eating generally relieves symptoms.
Food sours ; eructations ; flatus ; indifference to food.
After eating : nausea ; retching, waterbrash, uneasy in stomach. θ Diabetes.
Smoking aggravates all symptoms.
Sensation as if all food was lodged under upper end of sternum, which oppresses and distresses for hours.
HICCOUGH, BELCHING, NAUSEA AND VOMITING [16]
Belching, with taste of ingesta.
Waterbrash, with continued profuse discharge of saliva.
Eructations of hot, acrid fluid, which burns from stomach to throat.
Nausea : after getting up in morning ; like seasickness, with headache ; with pain through right eye ; with cough ; followed by backache ; after eating, copious saliva (pregnancy) ; < from any motion ; constant.
Morning sickness, particularly in pale, anemic women, who lose much blood during menses.
SCROBICULUM AND STOMACH [17]
Feeling of emptiness and sinking at stomach. θ Diabetes mellitus.
Slight depression and constriction in cardiac region, > by bending chest forward.
Burning and weight in stomach < by smoking.
Faintness in stomach, passing off leaves nausea.
HYPOCHONDRIA [18]
Left hypochondrium sensitive to touch, with pain as from soreness behind lower end of sternum.
ABDOMEN AND LOINS [19]
Pain across bowels and lower right side, 11 A. M.
Sharp pain in lower part of left side, lasting a short time.
Dull pain in left groin over hip bone.
Bearing down pain in upper part of abdomen.
Pain across lower abdomen as with menstruation, which is not the case.
Jerking and sharp cutting in muscles, awakes with a scream at 12 P. M.
Pain over crest of left ilium, extending forward.
STOOLS AND RECTUM [20]
Bowels very costive, stool once a week, feces hard, black. θ Diabetes mellitus.
Greenish yellow stools with tenesmus. θ Epistaxis.
Soft, mushy stool.
Sharp pain across lower abdomen before stool ; diarrhœa.
Aching pain in anus.
URINARY ORGANS [21]
Distress and pain in renal region ; urine high colored, clear ; frequent pain in region of kidneys.
Urine in large quantities, passed frequently. θ Diabetes.
Urine deep brownish red, with much reddish sediment.
Urine so copious, seemed as if "turning into urine" ; also with sore, stretched feeling in bladder.
Urinates frequently, day and night ; attempt to retain it causes pain.
Voracious appetite ; great thirst ; frequent and profuse saccharine urine ; skin harsh and dry, no sweat ; bowels very costive, stool once a week, feces hard, black ; tongue dry, parched, sticky ; feeling of emptiness and sinking at stomach ; debility ; chilliness, especially extremities ; weariness in extremities ; aversion to exercise ; uneasiness in stomach after food and drink. θ Diabetes.
Man, æt. 62, phlegmatic, dark complexion, dark hair and eyes, had dropsy several times ; great weakness, restless during night ; severe aching pains in feet and legs, preventing sleep ; frequent voiding of foamy, strong smelling, dark urine ; quantity from eighteen to twenty pounds in twenty-four hours ; in morning urine contained a large amount of salt, in evening a large excess of sugar ; violent thirst day and night ; unable to walk further than a few rods. θ Diabetes mellitus.
MALE SEXUAL ORGANS [22]
In the morning annoying erections, but loins ache too much to attempt coition.
Dreams of sexual intercourse, with erections, no emission.
Seminal emissions three successive nights.
FEMALE SEXUAL ORGANS [23]
Aching pain in region of right ovary, < by rapid walking or exercise.
Great heaviness and dragging down in lower abdomen, as if womb was down.
Pain as if menstruating ; sitting with feet high relieves uterine soreness.
Menses : seventeen days late ; scanty ; in morning, pain across small of back and in lower part of abdomen ; flow commenced 11 P. M., with distress across lower part of abdomen ; were scanty, pale ; two days too early, more profuse than usual ; great itching of vulva during flow.
Leucorrhœa : stains yellow as saffron ; was stopped, nasal catarrh ensued.
PREGNANCY. PARTURITION. LACTATION [24]
During pregnancy : morning sickness ; salivation ; nausea and vomiting.
Morning sickness in pale, anemic women, who lose large quantities of blood during menses, which usually last from five to eight days.
Nausea and vomiting of sour substances ; sour taste ; no desire for breakfast, food seems to come almost up into mouth ; faintness in stomach ; diarrhœa. θ Pregnancy.
Waterbrash of hot sour fluid ; hot, acrid eructations, which burn from stomach to mouth ; mouth full of water ; burning in stomach ; nausea > by breakfast ; gone sensation low down in stomach. θ Pregnancy.
VOICE AND LARYNX. TRACHEA AND BRONCHIA [25]
Hoarse, hard, dry cough, sensation of dryness of throat, with spasmodic, painful contractive sensation.
For an hour and a half after rising voice entirely without control, whispering and speaking when expecting to speak loud ; croaking and deep hoarse voice.
Dryness and burning of larynx.
Great dryness, with hoarseness and dry cough ; dryness and rawness extending to larynx ; rim of glottis particularly affected.
Spasm of glottis, awaking from sleep and causing severe pain and suffocation.
Expectoration seemed to be secreted just inside of glottis.
Aphonia, with dryness of glottis.
Hoarse, hard, dry cough, sensation of dryness of epiglottis, with spasmodic contractive sensation.
Great dryness of throat, hoarseness and dry cough.
Dryness, scratching and burning in throat ; tearing in larynx and trachea, with hoarseness ; difficult expectoration of grey tasteless mucus, or so tough that air can hardly pass through it ; horrible dreams of abysses, and restless sleep ; croup sound not heard. θ Croup.
RESPIRATION [26]
Saw-like rasping sound of respiration.
Frequent deep sighing inspirations and expirations.
COUGH [27]
Spasmodic ringing cough, from irritation in throat.
Hoarse, hard, dry cough ; dry sensation of glottis, with spasmodic contractive sensation ; hoarse, sensitive to cold air.
Cough, with nausea, constricted feeling in throat.
Spasmodic, ringing cough, from hot eructations, < smoking.
Constant cough, < in Spring and Fall, with foot sweats.
Secretes large quantities of saliva, which in morning contains greyish lumps ; afterwards expectoration yellowish and salty.
INNER CHEST AND LUNGS [28]
During afternoon sharp pain in back part of left breast, at 6 P. M. a similar pain in right breast, sore to touch.
Pain in back part of left breast during day, at intervals.
At intervals, during morning, pain in back part of right breast, till 11 A. M., when pain extended to axilla, which feels sore to touch.
Pain as of soreness behind lower end of sternum.
Severe cutting or sticking pain in upper third of right side, < from motion, > with arms close to side.
Rheumatic pain in right side of neck and right breast, < stooping head.
Left side of chest sore and painful.
Left lung and back of breast sore all day.
Sharp pain darted through lower part of right breast, 1 P. M., continuing at intervals through afternoon.
HEART, PULSE AND CIRCULATION [29]
Sharp pain around heart, causing palpitation.
Pulse : 90, feverish ; 62, small, feeble.
NECK AND BACK [31]
Stiff neck, also down between scapulæ and across shoulders.
Pain in edge of trapezius, at occipital and clavicular insertions ; flabby, weak feeling ; hard to raise head, can do so, however, when erect.
Pain in lower part of back and head all night ; pain to shoulders, < right.
Backache length of spine.
Aching and sore pain across small of back.
Darting across right side of small of back, < stooping, passing away gradually.
UPPER LIMBS [32]
Pain in shoulder on moving arm, with soreness in side.
Rheumatic pains in both shoulders, running up muscles of neck to mastoid and ears.
Slight rheumatic pains in wrist joint.
Right index finger swollen, bright red spots, one between first and second and other between second and third joints, latter itched and burned like a bee sting, on eleventh day looked like a blister.
LOWER LIMBS [33]
Sore to touch along right sciatic nerve on getting out of bed ; pulsating slightly, but constantly.
Rheumatic pains in knee joint on moving leg.
Pain in knee joints like neuralgia, at times extending to toes, with a thrill as if foot had been asleep.
Stinging in joints and weakness of knees.
Laming stitch in right patella on going down stairs.
Knees weak on going down stairs, feels for another step at bottom, with vertigo.
Cramp in calf early in morning, after rising, part feels sore.
Pain in left great toe, afterwards pain in left thigh.
Profuse inoffensive sweating of feet.
LIMBS IN GENERAL [34]
Articular rheumatism.
Sweat acrid and profuse ; urine clear or high colored and frequent, profuse or scanty ; rheumatic soreness in muscles of chest, back and extremities ; rheumatic inflammation of elbows, knees and small joints of upper and lower extremities, < at night and from motion ; fever, with headache and flushes of heat.
REST. POSITION. MOTION [35]
Desire to have head lie high.
Stooping : vertigo ; as if blood would burst from nose ; pain in side of neck < ; pain in right side of small of back <.
Bending forward : pain over orbital region < ; constriction in cardiac region >.
Sitting with feet high : uterine soreness >.
Arms close to side : cutting pain in side >.
Can stand only with difficulty : tired.
Hard to raise head : pain in edge of trapezius.
Getting out of bed : right sciatic nerve sore.
After rising out of bed : knees feel sore.
Going to bed : itching.
Turning head suddenly : vertigo ; as if eyes would burst out of head.
Motion : nausea < ; cutting pain in side < ; of arm, pain in shoulder < ; of leg, rheumatic pain in knee joint ; inflammation of extremities < ; during and after, very tired.
Exercise : aching in right ovary < ; aversion to.
Going down stairs : laming stitch in right patella ; knees weak.
Walking : rapidly, aching in right ovary < ; weakness and trembling of whole body ; cannot walk farther than a few rods ; great weakness.
NERVES [36]
Great weakness ; trembling of whole body while walking.
Debility, weariness of limbs, aversion to exercise. θ Diabetes mellitus.
Tired all over, can stand only with difficulty.
Very tired on waking, with aching of limbs as if he had not slept.
Spasms of different muscles ; rigor of body.
Tired as if he had walked a great distance, during and after motion ; eyes protrude.
Intermittent hysteria ; nauseated in morning when swallowing, and gets < until 9 A. M., when she vomits large quantities of tough phlegm, sometimes had to remove it with finger, lasting till 9 P. M.
SLEEP [37]
Stupid, drowsy all day, restless all night.
Restless all night, could neither sleep nor lie.
Sleepless : with vertigo ; with backache.
TIME [38]
Morning : pain in temples ; redness of cheek and nose ; yellow coating on tongue, with bad taste ; after rising, nausea ; urine contained a large amount of salt ; annoying erections ; pain across small of back and lower part of abdomen ; saliva contains greyish lumps ; cramp in calf ; nauseated.
At 8 A. M. : spots on legs brightest.
At 10 A. M. : pain in forehead, over eyes ; fulness on top of head.
At 11 A. M. : pain across bowels.
Noon : cold and chilly.
From 9 A. M. till 9 P. M. : nausea <, with vomiting of tough phlegm.
Day : left lung and breast sore ; stupid and drowsy.
Afternoon : fulness on top of head < ; pain in temples ; roaring in left ear ; sharp pain in back part of left breast ; sharp pain through lower part of breast, at intervals.
From 1 to 4 P. M. : fever, with severe headache.
Evening : urine contained large excess of sugar.
At 6 P. M. : pain in right breast ; slight fever.
At 8 P. M. : as if blood was trickling down from front to back part of head.
Night : pain in head and back ; restless ; inflammation of extremities < ; cold.
At 12 P. M. : cutting in muscles, awakens with a scream.
TEMPERATURE AND WEATHER [39]
Warmth : burning on legs <.
Going quickly from warm to cold, or vice versa ; red, burning spots on legs <.
Cold : burning on legs < ; itching and burning in left half of body, leg, arm and hand.
Cold all night, even when well covered.
Cold air : sensitive to.
Bathing > headache.
Shuns damp weather.
FEVER [40]
Cold and chilly at noon, transient.
Chilly, mostly on limbs.
Chill : after pain in small of back and forehead, over eyes.
During chill : pain in head extended all through head and eyes ; pain in back.
Flashes of heat.
Slight fever at 6 P. M.
Fever, with severe headache, from 1 to 4 P. M.
Sweat of feet and hands, from noon till evening, every day.
ATTACKS, PERIODICITY [41]
At intervals : during day, pain in l. breast ; during morning, pain in right breast till 11 A. M., when pain extended to axilla.
Every morning : epistaxis.
Every day, from noon till evening ; sweat of feet and hands.
Day and night : urinates frequently ; violent thirst.
Three successive nights : seminal emissions.
Once a week : stool.
Spring and Fall : cough <.
For one hour and a half after rising : voice entirely without control.
For hours : distressed by sensation as if food was lodged under upper end of sternum.
LOCALITY AND DIRECTION [42]
Right : pain through eye ; twitching across upper eyelid ; pain across bowels and lower part of side ; aching in region of ovary ; pain in breast ; cutting in side ; rheumatic pain in side of neck and breast ; sharp pain through lower part of breast ; pain in shoulder ; darting across side of small of back ; index finger swollen ; sore along sciatic nerve ; laming stitch in patella.
Left : dull aching pain over orbital region ; fulness from head into eye ; sharp pain in side of head ; painful pimples on occipital protuberance ; sharp pain in eye ; jerking of upper lid ; roaring in ear ; singing, snapping in ear ; erysipelatous redness of cheek and side of nose ; rawness of pharynx from side of posterior nares ; hypochondrium sensitive to touch ; sharp pain in lower part of side ; dull pain in groin ; pain over crest of ilium ; pain in back part of breast ; side of chest sore and painful ; lung and back of breast sore ; pain in great toe ; pain in thigh ; creeping and stinging in half of body.
SENSATIONS [43]
As if blood was trickling down from front to back part of head ; head as if too large ; as if tossed on a rough sea ; as if blood would burst out at forehead and eyes ; as if blood would burst from nose ; as if brain was too large ; as if top of head would burst ; as if blood was forcing its way out of eyes ; as if eyes would burst out of head ; as if cornea was sore ; as if a quantity of mucus lodged in posterior nares ; as if blood would spurt from nose ; mouth as if burnt ; lump in throat like a small puff ball ; as of plug in throat ; as if all food taken was lodged under upper end of sternum ; as if turning into urine ; as if womb was down ; pain as if menstruating ; pain as of soreness behind sternum ; as if foot had been asleep ; tired as if he had not slept or had walked a great distance ; heat as if femur would explode.
Pain : in forehead over eyes ; in temples ; in head and back ; through right eye ; from parotids into ear ; behind lower end of sternum ; across lower abdomen ; over crest of left ilium ; in region of kidneys ; across small of back ; in lower part of abdomen ; in back part of left breast ; back part of right breast, extending to axilla ; in edge of trapezius, at occipital and clavicular insertions to shoulders ; in knee joints ; in left great toe ; in thigh.
Severe pain : in forehead and through head ; in head, above eyes, into eyes ; in glottis.
Tearing : in larynx and trachea.
Sharp darting pain : in left side of head, from temporal to orbital region.
Darting : across right side of small of back.
Sharp cutting : in muscles ; in upper third of right side.
Sharp pain : in left eye ; in lower part of left side across lower abdomen ; in back part of left breast ; darted through lower part of right breast ; around heart.
Laming stitch : in right patella.
Bearing down pain : in upper part of abdomen.
Cramp : in calf.
Rheumatic pain : in right side of neck and right breast ; both shoulders, up muscles of neck ; in wrist joints ; in knee joints.
Rheumatic soreness : in muscles of chest, back and extremities.
Stinging : in joints.
Severe aching pain : in feet ; in legs.
Aching pain : in anus ; in loins ; in region of right ovary ; length of spine ; across small of back ; in limbs.
Steady aching : in and behind eyeball.
Dull aching pain : over left orbital region.
Dull pain : in forehead into eyes ; in left groin ; over hip bone.
Burning : in fauces ; in stomach ; of larynx ; in throat ; of spots on fingers.
Intense heat : in femur.
Heat : in head.
Soreness : of mouth ; in throat ; of left side of chest ; left lung and back of breast sore all day ; in side.
Sore, stretched feeling : of bladder.
Spasmodic, painful, contractive sensation : in throat.
Distress : across lower part of abdomen.
Uneasiness : in stomach.
Creeping and stinging : in left half of body, arm, hand, leg.
Gone sensation : low down in stomach.
Sinking feeling : at stomach.
Weakness : of knees ; of whole body.
Constriction : in throat ; in cardiac region.
Heaviness and dragging down : in lower abdomen.
Weight : in stomach.
Fulness : in head ; in forehead ; in throat ; in fauces.
Tightness : in head ; in forehead.
Tension : over whole head.
Stiff feeling : in parotids.
Twitching : across right upper lid and in eyeball.
Dryness : of tongue ; of posterior fauces ; of throat ; of larynx ; of glottis ; of epiglottis.
Great itching : of vulva ; of spots on fingers ; in various parts.
TISSUES [44]
Swelling of bone.
Chronic osteitis ; exostosis, especially of thighs ; chicken breast.
Articular rheumatism ; dissolves many tissues.
Kidney affections ; croup ; diphtheria ; morning sickness of pregnancy ; emaciation ; rheumatism.
TOUCH. PASSIVE MOTION. INJURIES [45]
Touch : head sore ; hypochondrium sensitive ; right breast sore ; axilla sore ; along sciatic nerve sore.
Pressure : spots on legs brightest.
SKIN [46]
Skin hard and dry, no sweat. θ Diabetes mellitus.
Itching : on various parts, and redness on covered parts ; on going to bed.
Hive-like elevations on back ; itching and redness on other parts.
Several blotches bright red on legs, slight burning, no itching, > warmth, < cold and going quickly from warm to cold, or vice versa ; brightest 8 A. M. and on pressure ; centre remains bright longest.
Itching and burning on going into cold air, with creeping and stinging in left half of body, arm, hand and leg.
Skin harsh, dry, no sweat. θ Diabetes mellitus.
STAGE OF LIFE, CONSTITUTION [47]
Large doses disagreed with melancholic, choleric constitution, dark hair and eyes.
Anemic, pale women.
A baby, dark eyes and hair ; epistaxis every morning.
Boy, æt. 16, suffering six months ; diabetes mellitus.
Young woman, healthy, brunette, two months pregnant with first child ; morning sickness.
Man, æt. 62, phlegmatic, dark complexion, dark hair and eyes, has had dropsy several times ; diabetes mellitus.
RELATIONS [48]
Antidoted by : Bryon . (relieved sharp pain upper third right side, but soreness remained).
Compatible : meat diet in diabetes mellitus.
Incompatible : coffee increases symptoms.
Compare : vegetable acids (all cause weakness and thinning of the blood) ; Acon., Act. rac., Bellad., Cauloph., Ipec., Nux vom., Phos. ac . (diabetes), Pulsat., Rhus tox., Psorin . (great discouragement).