Hepar Sulphuris Calcareum
από E. B. Nash — Leaders in Homoeopathic Therapeutics
Hypersensitive to touch, pain, cold air; fainting with the pain.
General tendency to suppurations; even slight injuries or scratches on the skin suppurate.
Tendency to croupy exudations (larynx and kidneys; any mucous membrane).
Atony; stools passed with great difficulty, even when soft; urine flows slowly, must wait for it, then drops vertically down without force.
Sour diarrhoea; whole child smells sour.
Coughs; croup, bronchitis, consumption; < when exposed to least cold air.
Modalities: < exposure to dry cold air; > in moist wet weather.
Like Sulphur, Hepar is adapted to the psoric, scrofulous diathesis.
This remedy standing half-way between those two great anti-psorics, Calcarea carb. and Sulphur, has some very strong characteristics which guide to its use in a variety of ailments. Its strongest characteristic is its hypersensitiveness to touch, pain. and cold air. The patient is so sensitive to pain that she faints away, even when it is slight. If there are inflammation or swelling in any locality, or even eruptions on the skin, they are so sensitive that she cannot bear to have them touched, or even to have the cold air to blow upon them. This is like China off., only that while the latter is sensitive to the lightest touch it can bear hard pressure. (Remedies especially < in cold air are Arsenicum alb., Calcarea ost., Hepar sul., Nux vomica, Psorinum, Silicea, Tuberculinum.) This supersensitiveness to pain runs all through the drug. It is mental as well as physical, for the slightest cause irritates with hasty speech and vehemence. Next to this is the power of Hepar sulph. over the suppurative stage of local inflammations. It comes in only when pus is about to form, or is already formed. If given very high in the first case (that is before pus is formed), and not repeated too soon or often, we may prevent suppuration and check the whole inflammatory process. But if pus is already formed, it will hasten the pointing and discharge and help along the healing of the ulcer afterwards. I am not at all sure, as is generally taught, that it is necessary to give it low to hasten suppuration. The most rapid pointing, opening, and perfect healing I ever saw was in the case of a large glandular swelling on the neck of a child, under the action of the c. m. potency. Hepar has a general tendency to suppuration, for even the eruptions on the skin are liable to form matter, and slight injuries suppurate. (Graphites, Mercurius, Petroleum.) This remedy is also very valuable in diseases of the respiratory organs. I have found it very useful in cases of chronic catarrh, when the nose stopped up every time the patient went out into the cold air. He says it seems as if I get a new cold every time I get a breath of fresh air (Tuberculinum). It is relieved in a warm room. In croup it has been, ever since Bœnninghausen prescribed his celebrated five powders, one of our standard remedies. We do not use the five powders as Bœnninghausen did in a certain order, but only use them according to indications. Hepar croup is accompanied with rather loose cough, with wheezing and rattling. Cough as if mucus would come up, but it does not. It is seldom indicated at first; but oftener comes in after Aconite or Spongia. Like Aconite it seems most effectual in those cases brought on by exposure to dry cold air; but the Aconite croup comes on in the evening after first sleep and Hepar in the early morning hours. This tendency to croupy exudations on mucous membranes seems characteristic of Hepar and is not confined to the respiratory organs. Kafka uses it on the ground of its ability to control such conditions in post-scarlatinal dropsy, to prevent or cure, and claims great success for it. I believe it to be one of the best prophylactics in such cases, for the reason that during and after the desquamative stage the skin is unusually susceptible to the effects of chill in cold air, and this is in accordance with the leading characteristic of this remedy. It fortifies the patient against such atmospheric influence.
In croup, as in other affections of Hepar, the cough, difficult breathing and all other symptoms are aggravated by the least breath of cold air, which the little patient must be carefully guarded against. Travelling downward the larynx is attacked, then the bronchi, and even the lungs, and the formation of croupy exudates will take place if not checked by the remedy. The breathing in all these cases becomes rattling, anxious, wheezing, even to threatened suffocation, so that the patient seems asthmatic. In these cases it is often able to relieve, especially if this condition follows a hard cold and the acute inflammatory. symptoms have been controlled by Aconite or some other indicated remedy.
In chronic asthma, Hepar often resembles Natrum sulphuricum, but there is this diagnostic difference, which is very valuable. The Hepar asthma is worse in dry cold air and better in damp, while Natrum sulph. is exactly the opposite, like Dulcamara. There is no other remedy that I know that has the amelioration so strongly in damp weather as Hepar sulphur. One characteristic must not be forgotten, viz.: “Coughs when any part of the body becomes uncovered.” (Baryta and Rhus tox.) This is found in croup, laryngitis, bronchitis and consumption, and not only is the cough worse, but the whole case is aggravated. Then, again, it must be remembered that this is one of our strongest anti-psorics, and for that reason should be thought of for all respiratory ailments for which it has such a strong affinity, especially when such ailments have followed a suppressed or retrocedent eruption on the skin.
In accordance with its great power over all suppurative processes, it should come to mind in abscess of the lungs, of course in all cases when indicated by the symptoms in toto. Upon the throat we have Ist, “sticking in the throat, as from a splinter, on swallowing, extending to the ear, also on yawning.” “Sensation as if a fish bone or splinter were sticking in the throat” (Argentum nitricum, Dolichos and Nitric acid), but probably the condition where Hepar is oftenest of use in throat trouble is in that distressing complaint, quinsy.
Here, as in croup, it is not generally indicated in the beginning. Having had much success and experience in this disease, I may here give the results of the application of several remedies and their indications:
Belladonna.—High fever, great swelling, and redness, headache, throbbing carotids.
Mercurius vivus.—Either side, fœtid breath, flabby, moist, indented tongue, and sweat without relief.
Mercurius proto-iodatus.—Same symptoms, but begins on right side, and tongue thickly coated yellow at the base.
Lachesis.—Left side extending to right, great sensitiveness to touch, and aggravation after sleep.
Lycopodium.—Begins right side, extends to left, with tongue swollen and inclined to protrude from the mouth, and stuffing up of nose.
Lac caninum.—Alternates sides, one day worse on one, and the next on the other.
Hepar sulph.—When notwithstanding all other remedies the case seems bound to suppurate and there is much throbbing pain. Now with each of these remedies I have aborted many cases in old quinsy subjects, who never expected to, and were told by old school physicians that they never could get well, without suppuration, and in the end have cured them of all tendency thereto. I will add here that Hepar sulphur. is also a good remedy in chronic hypertrophy of tonsils, with hardness of hearing. In these cases which are generally very intractable, Baryta carbonica, Lycopodium, Plumbum, and others are also to be consulted according to indications.
Upon the alimentary canal Hepar has a decided influence. We have already noticed its action upon the throat. The stomach is inclined to be out of order, and there is a “longing for acid things.” (Veratrum alb.) This is often the case in chronic dyspepsia and Hepar helps. This condition of the stomach is sometimes found in marasmus of children. It is often accompanied by diarrhoea, and a very important feature is that the diarrhoea is sour; indeed the whole child seems to smell sour no matter how much it is bathed. The sour stool is also very prominently under Magnesia carbonica and Calcarea carbonica. Then there is another condition of the bowels, namely, a kind of atony. The stools are passed with great difficulty, even though they are soft and clay-like, as they sometimes are under this remedy. This state of atony is also found in the bladder.
“Micturition impeded, he is obliged to wait awhile before the urine passes, and then it flows slowly for many days.” “He is never able to finish urinating; it seems as if some urine always remains behind in the bladder.” “Weakness of the bladder, the urine drops vertically down and he is obliged to wait awhile before any passes.” This inability to expel makes one think of Alumina and Veratrum album and Silicea. Again, Hepar sulph. is a great “sweat” remedy, either partial or general. It may, for instance, come in after Mercurius in rheumatism, in which the patient “sweats day and night without relief,” and Mercurius does not help. So, too, with quinsy, and in large boils and swellings; and by the way Hepar sulph. is one of our best remedies after Mercurius, either in homœopathic practice, or as an antidote to old school poisoning. So also is it the leading antidote to Iodide of Potassa poisoning from the same source. We could not well do without this valuable remedy.