Kali bichromicum — bichromate of potash — is recognised, as Kent admits, "by most physicians by the copious ropy mucous discharges from all mucous membranes". Boericke makes the same secretion the remedy's badge: "a tough, stringy, viscid secretion is produced, which condition is a very strong guiding symptom for this drug."
But the remedy is far more than a catarrh medicine. Clarke — whose colleague J. J. Drysdale introduced it to the materia medica in 1844 — names four pre-eminent keynotes: the stringy mucus "which adheres to the part and can be drawn out in strings"; "the occurrence of pain in small spots"; "punched-out, perforating ulcers, occurring on skin, mucous membranes, and affecting bones"; and "alternating and shifting conditions: pains wander from part to part; rheumatic pains alternate with gastric symptoms, or with dysentery; headache alternates with blindness."
Boger's Synoptic Key sets the tempo: "Slow, deep processes; little fever, but great weakness" — Boericke agrees that it is "more adapted to subacute rather than the violent acute stage", with "anæmia and absence of fever" as characteristics.
This guide profiles Kali bichromicum for clinical study from Boericke's Materia Medica, Boger's Synoptic Key and General Analysis, Kent's Lectures and Clarke's Dictionary. The originals can be read in full — Clarke's Kali bichromicum, Boericke's Kali bichromicum and Kent's Kali bichromicum — through Similia's free digital materia medica.
The Kali Bichromicum Constitutional Type
Boericke: "It is especially indicated for fleshy, fat, light complexioned persons subject to catarrhs or with syphilitic or scrofulous history." Clarke repeats the type — "especially suited to fair-haired, fat persons, especially fat, chubby children; fat, sluggish people" — and Boger compresses it to "Sickly, chilly and cachectic. Fair, fat and sluggish."
The affinities are Boericke's opening line: "the mucous membrane of stomach, bowels, and air-passages; bones and fibrous tissues", with kidneys, heart and liver also affected. Kent adds the temporal signature: "Many of its symptoms are aggravated about 2 or 3 A.M., like Kali carb", with most of the symptoms worse in the morning, and a periodicity precise enough that "it has neuralgia every day at the same hour."
Mental and Emotional Picture
A deliberately thin chapter. Kent explains why: "There are very few mental symptoms owing to the fact that the remedy has been proved only in crude form. It needs to be proved in potencies to bring out the mental symptoms." In practice the remedy is chosen on its generals and particulars, not on a mental portrait — itself a useful thing to know at the repertory.
Indifference and indolence. What little is recorded points one way: Boger's mental line is simply "Indifferent. Indolent." Clarke observes that "indolence" characterises many of its conditions — indolent ulcers, indolent inflammations — the psyche and the tissues moving at the same sluggish pace.
Prostration. Clarke: "Kali bi. causes great prostration, discomfort, debility, and desire to lie down." Kent matches it: "a feeling of great weakness and weariness. When the pain has passed off, if in the limbs, the limbs are felt very weary. Great prostration and cold sweat."
Physical Affinities
Nose and Sinuses
The remedy's capital. "Snuffles of children, especially fat, chubby babies. Pressure and pain at root of nose... Septum ulcerated; round ulcer. Fetid smell. Discharge thick, ropy, greenish-yellow. Tough, elastic plugs from nose; leave a raw surface... Chronic inflammation of frontal sinus with stopped-up sensation" (Boericke), with loss of smell and violent sneezing. Kent describes the daily struggle: the patient "must blow the nose constantly without success, but finally blows out large green crusts or scabs from high up in the nose" — Boger's "green clinkers". Kent adds a strange sequence worth knowing: when the septal scabs are removed "there comes photophobia, then dimness of vision, followed by hard frontal headache", and in chronic cases "perforation of the septum".
Head and Eyes
"Headache over eyebrows, preceded by blurred vision. Aching and fullness in glabella. Semilateral headache in small spots" (Boericke). The vision-headache alternation is among the remedy's most confirmed oddities — Boger: "Blindness, then pain over one eye, < cold, > pressing on root of nose"; Clarke: "blindness followed by headache, the sight improving as the pain becomes worse... This is very characteristic and has led me to many cures." Clarke also records the sun-headache: shooting "from root of nose to external angle of eye begins morning, increases to noon, and ceases towards evening." The eyes themselves show ropy yellow discharge, granular lids, and corneal ulcers with "no pain or photophobia" — Boericke notes "slight pain, with severe ulceration or inflammation" as the reverse of Conium.
Mouth, Tongue and Throat
"Tongue mapped, red, shining, smooth, and dry... Feeling of a hair on tongue" (Boericke) — Clarke localises the hair sensation "chiefly on the back part of the tongue and in the left nostril". Boger: the tongue "glistens; cracked, smooth or heavy, lemon yellow cast; pains when protruded". The throat shows the "uvula relaxed, œdematous, bladder-like", deep ulcers, and discharge "tough and stringy"; the patient "hawks thick mucus; must wipe it away".
Stomach, Abdomen and Stool
Beer is the anamnestic key: "Nausea and vomiting after beer... Desire for beer and acids" (Boericke); Kent: "he craves beer, which makes him sick", making it "a very useful remedy in nausea and vomiting of drunkards and beer drinkers." Digestion suspends — "Load immediately after eating. Feels as if digestion had stopped" — with the "round ulcer of stomach" and the strange, repeatedly verified "vomiting of bright yellow water". The alternation rule governs: "Gastric symptoms are relieved after eating, and the rheumatic symptoms reappear." Stools are "jelly-like, gelatinous; worse, mornings", or Boger's "gushes of brown, frothy water, then burning and tenesmus"; dysentery alternates with rheumatism, and Kent notes the seasonal split — "In hot weather it has diarrhoea and dysentery; in winter it has chest troubles and catarrh of the air passages."
Respiratory
"Metallic, hacking cough. Profuse, yellow expectoration, very glutinous and sticky, coming out in long, stringy, and very tenacious mass" (Boericke); "true membranous croup, extending to larynx and nares", the cough with "a brassy sound" and "pain at bifurcation of trachea on coughing; from mid-sternum to back". Clarke extends the false-membrane theme to "casts of the bronchial tubes in fibrinous bronchitis".
Joints, Back and Skin
"Pains fly rapidly from one place to another... Wandering pains, along the bones; worse cold. Left-sided sciatica; better, motion... Pains in small spots" (Boericke) — Kent's wandering rheumatism from joint to joint, with cracking joints, bruised bones and "cutting through loins; cannot walk". Clarke adds the curious diagonal pains — right mamma and left elbow, right knee and left shoulder. The skin bears the remedy's signature lesion: "Ulcer with punched-out edges, with tendency to penetrate and tenacious exudation."
Urinary Organs
"After urinating a drop seems to remain which cannot be expelled" (Boericke) — Boger: "A drop remains after urinating" — with ropy mucus in the urine and nephritic states with scanty albuminous urine and casts.
Key Modalities
Worse from:
- Morning — and 2–3 a.m. (Boger; Kent)
- Beer and alcohol
- Cold, damp; open air; spring; suppressed catarrh (Boger)
- Hot weather — the paradox: a chilly patient whose rheumatic and bowel complaints come in summer
- Undressing — Boericke lists it for the cough; Clarke: "undressing < cough"
- After sleep; rest — Clarke: "Most symptoms are < at rest and > by motion"
Better from:
- Heat — Boericke's one-word general; Kent: "All the pains and his cough are relieved from the warmth of the bed"
- Motion (the sciatica and most pains)
- Pressure — including pressing on the root of the nose for the eye-headache
- Eating (the gastric pains — while the rheumatism returns)
Keynote Symptoms
- Ropy, stringy, adhesive discharges — drawn out in strings from nose, throat, chest
- Pains in small spots that a fingertip could cover
- Wandering pains flying rapidly from place to place; diagonal pains
- Punched-out, deep, perforating ulcers — skin, mucous membranes, septum, stomach
- Pressure and fullness at the root of the nose; frontal sinus stopped up
- Tough elastic plugs and green crusts from the nose
- Alternations: rheumatism with gastric symptoms or dysentery; headache with blindness
- Headache preceded by blurred vision, sight returning as pain worsens
- Feeling of a hair on the tongue; mapped, glazed tongue
- Vomiting of bright yellow water; ailments from beer
- Jelly-like gelatinous stools, worse morning
- 2–3 a.m. and morning aggravation; chilly, yet complaints in hot weather
Clinical Applications
Chronic sinusitis and nasal catarrh. The remedy's defining territory: post-nasal dropping, ropy greenish-yellow discharge, septal crusts and ulceration, snuffles of fat chubby babies, loss of smell, frontal-sinus pressure — "chronic atonic catarrh" in Boericke's phrase.
Croup and fibrinous bronchitis. False membranes with hoarse metallic or brassy cough; tenacious stringy expectoration; the 2–3 a.m. croup hour (Clarke).
Gastric ulceration and beer-drinkers' dyspepsia. Round ulcer of the stomach, suspended digestion, bright-yellow watery vomiting; Kent notes it "palliates" even malignant gastric ulceration, relieving pain and vomiting.
Wandering and small-spot rheumatism. Joint pains that shift rapidly, alternate with catarrh or diarrhoea, and localise in thumb-sized spots; left sciatica better from motion.
Migraine and sun-headache. Periodic one-sided headaches in small spots, preceded by dim vision, better from pressure and warmth.
Ulceration. Deep punched-out ulcers wherever found — Clarke records Nash's permanent cure of perforating palatal ulceration with the 30th.
Ophthalmic catarrhs. Ropy discharge, granular lids, indolent corneal ulcers with disproportionately little pain.
Differential Diagnosis
Kali bich vs. Pulsatilla. Boericke cross-references Pulsatilla at the wandering pains, and Clarke's relationship notes name it for "wandering rheumatism". Both produce thick yellow catarrh; but Pulsatilla's discharge is bland and creamy, never stringy, and its patient is worse in a warm room and better in open air — the reverse of the chilly Kali bich patient whose cough eases in the warmth of the bed. Clarke even lists Pulsatilla among the dynamic antidotes for the wandering pains.
Kali bich vs. Hepar sulphuris. Two chilly catarrhal-suppurative Kali-adjacent remedies that meet at the nose — Boger's Synoptic Key notes the bridge of the nose under Hepar with a cross-reference to Kali bich. Hepar is hypersensitive in every fibre: splinter pains, faints from pain, furious temper, cheese-like discharges. Kali bich is comparatively indolent, with few mental symptoms, painless deep ulcers, and the ropy string as its signature.
Kali bich vs. Mercurius corrosivus. In dysentery and ulceration. Mercurius corrosivus is the violent acute: incessant, never-satisfied tenesmus with scalding, bloody stools. Kali bich's dysentery is subacute — brown frothy gushes, jelly-like mucus, tenesmus after stool — arriving in hot weather and alternating with rheumatism, in a patient with little fever.
Kali bich vs. Kali carbonicum and Causticum. Clarke: "The Kali parallels must be sought chiefly in Causticum and Kali carb." All three share stitching pains, the small hours aggravation (Kent: "about 2 or 3 A.M., like Kali carb") and aggravation after coition; Kali bich is separated by its stringy secretions, small-spot pains and the beer signature.
Repertorisation Tips
These rubrics carry Kali bichromicum in high grade:
- Nose; DISCHARGE; viscid, tough, ropy
- Nose; DISCHARGE; plugs, clinkers
- Nose; PAIN; root; pressing
- Generals; PAIN; spots, in small
- Extremities; PAIN; wandering, shifting
- Head; PAIN; blindness; preceded by
- Expectoration; VISCID, stringy
- Mouth; HAIR; sensation of, on tongue
- Skin; ULCERS; punched-out
- Stomach; VOMITING; yellow water, bright
- Generals; FOOD and DRINKS; beer; agg.
- Stool; GELATINOUS, jelly-like; morning
- Generals; ALTERNATING states
- Generals; NIGHT; 2 a.m.; agg.
Anchor on the secretion — if the discharge is stringy and adhesive enough to be drawn out, few remedies compete — then confirm with the small-spot pains, the alternations and the morning/2 a.m. time-line. Where the mental picture is silent, as Kent warns it will be, let these generals and particulars carry the analysis. Our beginner's guide to repertorisation sets out the method in more detail.
Deepening Your Study
- Boericke gives the tissue affinities, the fat fair catarrhal constitution and the complete catalogue of stringy-discharge particulars
- Boger's Synoptic Key supplies the slow deep processes, the green clinkers, and the punched-out ulcer described from life
- Boger's General Analysis condenses the generals: sticky-stringy, lumpy discharges, pains in spots, wandering shifting pains, 2 a.m.
- Kent's Lectures develop the alternations, the beer dyspepsia, the small-spot pains — and the honest caveat about the scanty mental proving
- Clarke's Dictionary holds Drysdale's pioneering work, the four pre-eminent keynotes, and the richest store of clinical confirmations
You can read all of these side by side for any remedy through Similia's free digital materia medica. To place Kali bichromicum among its peers, see the guide to the essential polycrest remedies, or read how materia medica and repertory work together in case analysis.
