Antimonium crudum

THE PREPARATIONS OF ANTIMONY.

Antimony: Depresses the heart and circulation; Increases sweat; Mucous membranes—catarrhs; Nausea, vomiting, purging, fainting, collapse; Skin—rash; pustules.

We take up for study to-day two of the preparations of antimony, Antimonium crudum and Antimonium tartaricum. The term Antimonium crudum does not imply that it is the metallic antimony but that it is the ore, the form in which it is most frequently found in nature. Antimonium tartaricum is a compound salt, the tartrate of antimony and potash. There are other Antimony preparations used in medicine, but we shall only consider the above-named as they are the most important.

Antimony exerts a depressing influence on the heart and circulation. Respiration too is disturbed by it, and in the majority of cases, perspiration is increased. The next important seat of action of antimony is the mucous membranes, particularly that of the alimentary canal. It causes nausea, vomiting and purging, with faintness and relaxation. The vomited matters you will find at first to consist of mucus and food. Later they contain bile, and finally blood. It is not because antimony has a special effect on the liver that we have this bilious vomiting, but because it causes a regurgitation of bile. Cramps occur in the limbs. These are accompanied by purging and thus you have a perfect picture of collapse such as you find in cholera or cholera morbus. Now, the emetic properties of antimony are not local. Experiments have been made by which the stomach has been exterminated, a bladder placed in its position, and antimony injected into the blood. Retching will ensue, and yet there is no stomach. It acts through the pneumogastric nerves.

Antimony will cause convulsions. This convulsive action is traceable to disturbance in the circulation at the base of the brain.

The lungs become engorged with blood by any preparation of antimony. It is said that hepatization of a portion of the organ may follow poisoning by it, especially by its tartrate. This has been doubted of late. It has been claimed that this so-called hepatization was in reality atalectasis.

You also find antimony causing emphysema, particularly of the borders of the lungs.

Animals fed on antimonic acid will have fatty degeneration of the liver, heart, etc.

The skin is attacked by the antimonies. The irritation they here produce is rather slow and tardy, but the result is very characteristic. There will be, at first, slight redness; this is followed by development of papules, and these papules become pustules. Pustular eruptions are very characteristic of antimony, particularly of the tartrate. These pustules resemble the eruption of small-pox, so much so that Antimonium tartaricum has been suggested as a remedy in that disease.

Antimony is particularly useful when pustules appear about the genital organs, whether they be syphilitic or not.

While the preponderance is in favor of Antimonium tartaricum for pustulation, Antimonium crudum carries off the palm for horny excrescences and callosities on the feet and hands.

We will now consider

Antimonium crudum.

Antimonium crudum: Bryonia, Ipecac., Nux vomica, Pulsatilla; Chamomilla; Sulphur, Arsenicum, Hepar; Ranunculus bulbosus; Aethusa cynapium.

In the above schema I have placed no complementary remedy to Antimonium crudum. Scilla has been said to be complementary to it, but I have not satisfied myself that such is the case.

When Antimonium crudum is indicated, we find mental symptoms quite prominent. It is frequently used in children when they are cross and peevish. They will not even permit themselves to be looked at. If an adult, the patient is sulky or sad, almost like the Pulsatilla patient. In some cases, there is a slightly erotic condition of mind, connected with sexual erethism. The patient becomes ecstatic and fancies that some beautiful female is the object of his sentimental love.

In children, this peevish mental state is associated with nausea, hot and red face and irregular pulse. The child is particularly cross when washed in cold water, but not so much in warm water. Now, the symptoms often occur in children in association with gastric symptoms.

The gastric symptoms of antimony are very well marked. It is suited to gastric catarrh, whether it be developed from cold or from improper food. In the first place, the tongue is coated white, and this coating is apt to be spread uniformly over the whole dorsum of the tongue. It has well been compared to a coat of whitewash. The tongue may be dry, and often is so, as in Bryonia. Sometimes, we find this white coating assuming a slightly yellowish tinge, especially on the back part of the tongue. At other times, you will find the borders of the tongue sore and red; often, there is in the pharynx an accumulation of yellowish mucus. There are nausea and vomiting; the latter is very prominent, and occurs as soon as the child eats or drinks. Antimonium crudum is especially useful in vomiting from overloaded stomach; from eating indigestible substances; after the abuse of fat food, acids, sour wines, vinegar, etc., or from the excessive heat of summer. The vomited matters contain food; or, in the case of very young children, they consist of curdled milk. The appetite is impaired. There may be colic, in which case, there is almost always a deposit of lithic acid in the urine. The bowels are affected also; there is often diarrhoea; the stool is watery and contains little lumps of faecal matter. This diarrhoea is made worse by vinegar and other acids, by cold bathing and by overheating. If there is constipation, as there may be and often is when vomiting predominates, the stools will consist of white, hard and dry lumps that look like undigested curd. In older persons, particularly in the aged (for Antimonium crudum suits both ends of life), we have an alternation of constipation and diarrhoea: the stool, in constipation consisting of hard, dry lumps; that in diarrhoea, of water mixed with faecal lumps.

Now let us make some distinctions between Antimonium crudum and its concordant remedies. Aethusa cynapium is our mainstay for vomiting of curdled milk in infants during dentition, or at other times. The vomited matter comes with a " rush," and the vomiting exhausts the little patient. He then falls into a sleep from which he awakens hungry. In Antimonium crudum, the child is hungry as soon as it rids itself of the milk. Aethusa is suited to severe cases that have been prostrated by a long course of bad diet, by summer complaint or by the irritation of teething. I have known Aethusa to relieve the pain and soreness in the gums of teething children when vomiting is a prominent symptom.

Like Antimonium crudum, Ipecacuanha has vomiting after a meal, after coughing and after acids; and hence it is suited to similar cases. But the Ipecacuanha usually has more nausea than has the other. Vomiting and retching predominate in Antimonium crudum, and nausea in Ipecacuanha. Then, too, the latter remedy usually has clean or slightly coated tongue; whereas the former requires a thick white coating of that organ.

Bryonia is similar to Antimonium crudum. It has white tongue, dry mouth and constipation. It is suited to gastric catarrh from overeating in persons of irritable temperament. The Bryonia tongue is a little different from that of Antimonium crudum, in that it is white down the middle, the edges not being coated. Then, too, the Bryonia stool is large, hard, dry and brown. If there is diarrhoea, the stool is offensive and watery, and smells like old cheese.

Still another remedy is Pulsatilla, Here we find resemblances in the state of mind. We have both remedies called for in gastric ailments from the use of pork. But Pulsatilla has not the characteristic vomiting of Antimony, and the stool of Pulsatilla is usually greenish, or yellowish-green, and slimy. It is especially suited to cases after indulgence in mixed diet, ice-cream, cakes, pastry, etc.

Antimonium crudum acts upon the skin, producing thick, horny callosities in this tissue. It is often indicated in eczematous eruptions, when the skin is of this character.

It also has a marked action on the nails, causing deficient growth. If, after an accident which has split the nail, the latter does not heal readily, but grows cracked and thick, Antimonium crudum will make it grow as it should. I have also used the drug successfully in the treatment of split hoof, in the case of my own horse.

Children in Antimonium crudum often have a crusty sort of eruption, in which the crusts are of a honey-yellow color. They are thick, just as we have seen with the callosities. The affected portions of the skin crack readily. This is particularly well-marked about the nostrils and corners of the mouth. Now, I know of one case of diphtheria cured by Antimonium crudum when the symptoms were these: The child was very cross; whining and crying simply because it was looked at; this was especially so on awaking from sleep; there wore, also, these crusts around the nostrils and in the corners of the mouth. Antimonium crudum not only removed these but cured the diphtheria.

The eyes are inflamed. They are worse from any bright glare, as the sunshine, or the glare of a bright fire, here reminding you of Mercurius. It is distinguished from Graphites by the fact that the rawness is confined to the canthi, whereas under Graphites the inflammation involves the whole border of the lids.

On the female genital organs Antimonium crudum has some action. It is useful in prolapsus uteri when there is constant bearing-down feeling, as if something were pushing out of the vagina, and tenderness over the ovarian region, particularly when the menses have been suppressed by cold bathing. The leucorrhoea is watery and contains little lumps.

There is one more use of Antimonium crudum to mention and we are done with it, and that is in adults who are tormented with gout. It is especially useful when gout has become constitutional. There will be gouty nodes in many of the joints. It here helps, provided there are the gastric symptoms characteristic of the remedy present, but not otherwise.