It has become an approbrium of Homoeopathic practice that post- nasal and pharyngeal catarrhs are frequently not cured by internal medication. Specialists, treating nose, throat and ear affections are daily receiving patients who have been dismissed by Homoeopathic physicians as incurable, or who have become disgusted with the general practitioner. I grant that one who devotes his exclusive attention to a given subject should be better qualified therein than those engaged in common practice But the question is not one of comparative success in the employment of internal medicine; it is one of contrast between local applications and legitimate Homoeopathy. If the system of Hahnemann is universally true, that is if it is founded upon law and does not constitute a mere rule, it must as assuredly remove a post-nasal catarrh as a sore-throat or a cold on the chest.
There are three modes of defence, one or another of which is invariably employed in defending Homoeopathy against a charge of inefficiency; first, that if one can obtain the similimum, the cure or relief will follow; secondly, a local affection is always a part of a more or less latent constitutional dyscrasia, and therefore cannot be permanently cured until the latter is; thirdly, the failure is claimed to be due to errors in selection or in potency, in repetition or in the administering of drugs singly or in alternation.
To all such illogical proposition, I emphatically object. I believe that the similimum will help, because I believe in the universality of the law, and consequently. I reject alternation of remedies. I accept the law because I think that it is logically deducible from revealed truth. If any one agrees with me here, my strictures do not apply to him. They apply to those who admit the truth of Homoeopathy, because, they have tested it and have been satisfied from experience; and this class includes the entire medical profession. Having proved Homoeopathy, then, in the same manner as did Hahnemann, the only reasonable position is that the system is effective because it cures. When, therefore, it fails, a consistent defence is not paucity of material and knowledge, but an earnest, painstaking and persistent series of experiments instituted as a crucial test.
With all due deference to specialists, they have not carried out this plan. Failing with the means at hand, they have felt compelled to preserve their reputations by resorting to collateral measures; for more is expected of them by the public, than of the general practitioner. Specialists should spare no pains to institute provings. There are many unproved or partially proved plants and minerals which are known to exert some sort of an influence upon the naso-pharyngeal passages. It is incumbent upon those most interested to thoroughly explore the subject and determine what this influence is in each drug. A few years ago we could not readily cure cases, which now, since the introduction of Sanguinaria Nitrated and Antimonium Auratum, are easily relieved.
I propose to enumerate the remedies known to affect the posterior nares, and to offer some suggestions concerning a few not often employed.
The Known drugs are :-
Ant. Sulph. Auratum.
Of these eighty or more drugs, some are so rarely indicated as to be of little value to the general practitioner, several are useful only in acute catarrh, and but a few offer the usual symptoms of chronic catarrh of the posterior nares. These few are:
Alumina Hepar Psorinum
AmmoniumBromium Hydrastis Sepia
Ant.Auratum Kali bichromicum Sulphur
ArgentumNit. Kali Mur. Silica
Calcarea Ost. Mercurius Proto. Lod. Sanguinaria Nit.
Corallium MercuriusBin.Iodium Spigelia
Cinnabaris Natrum Arsenicum Thuja.
Fagopyrum Nitric Acid
The relative value of this group is indicated by the variety of type, reducing those of the highest value to the two Mercuries, Sang, Nitrate,e and Kali Bich, and Kali Mur. a very small armamentarium for so stubborn a disease. But the list could be enlarged if specialists would test known symptoms and publish the results.
For instance, Phos, Nat.Mur., Cistus, Nat.Arsenicum, Alumina, have glazed or varnished appearance of the posterior wall of the pharynx. Why not use one or another of these when such a state of the membrane obtains higher up?
Alumina and Nat.Mur. affect the mucous membranes, causing scanty secretions, the latter drug being distinguished by smarting sensation. Why, then, may not Alumina be often used, especially as in addition it causes, scurf in the nose, plugging of the Eustachian tubes, snapping sound in the ears on swallowing or chewing, and dropping of mucus from the posterior nares.
Kali Mur. Often relieves hawking of mucus from the posterior nares. Why not note carefully its effect upon the catarrh itself and report results at a future meeting? Compare also Paeonia.
When the pharyngeal walls are varicose, Pulsatilla, Hamamelis, Vespa, Nat. Ares, and Phytolacca may be consulted. The first two have relieved the catarrh, though I have been compelled to follow Hamamelis with some other drug to effect a cure.
Vespa, like Nat.Arsenicum, Produces oedema and varicosis. The first caused purulent catarrh of the middle ear, and also recurrent Tonsillitis and ought to be used. The second, with thickening of the mucous membrane, lasting for months and hawking of a thick mucus from the posterior nares, offers a valuable remedy for Winter Catarrh.
Fagopyrum pictures a common and very annoying from of the disease, one in which exposure is sure to increase the catarrh with rawness and dryness, formation of dry crusts, granular appearances of the mucous membrane and an intolerable itching and burning.
Sensitiveness to inhaled air is not especially important in acute catarrh, but is in chronic. It calls for Arsenic, Nat. Arsenicum Corallium, Hydrastis, Lithium, Osmium, Kreosote and probably Fagopyrum.
Dryness of the posterior nares is not only in the latter remedy but also in Alumina, Aesculus, Sinapis Nigra, Wyethia, and a few others.
Aesculus, as well shown by Dr.T.F.Allen, suits colds extending from the posterior nares down the pharynx, with dryness, scraping and burning; at times secreted mucus drops low down and causes choking. Patients are weak, with soft pulse, backache, constipation and Piles. Why should we neglect this and devote our attention to the more familiar Nux? Aesculus would relieve more promptly and more permanently.
Sinapis Nigra has cured dryness of the anterior nares, and has caused dry sensation in the choanae and pharynx. Why not try it when, in addition, there is the characteristic condition of the mucous membranes, viz, dryness, with at most scanty chunks of tenacious mucus secreted?
Wyethia I have never used; it is claimed to have produced and cured pricking and dry sensation in the posterior nares. According to Hale, it is useful in chronic Pharyngitis, removing the granular appearance, and never failing to relieve dryness of the pharynx and burning of the epiglottis.
Penthorum Sedoides belongs to a class of plants that do not act very deeply. Still by reason of their acridity they produce catarrh, skin symptoms, and some of them, Haemorrhoids. The Penthorum ought to be tried when there is a continual feeling, as if the nose were wet, but without coryza. Sense of fulness in nose and ears. Posterior nares feel raw, as if, denuded.
Osmium rivals the more commonly employed Phosphorus. It is highly irritating to mucous surfaces, provoking coryza, sneezing as from snuff; nose and larynx sensitive to the air. Small lumps of phlegm are easily loosened from the posterior nares and larynx.
Like Phosphorus,, it attacks larynx and lungs. Characteristic severe pain in the larynx, worse when coughing or talking; hoarseness.
Ammonium Bromidum is said to be effective when the patient hawks down a stringy, bloody mucus. Here it resembles sanguin. Nitrate and Kali Mur. but is far inferior to either.
If the mucus is of a lemon-yellow color and not very fibrinous, Sulphuric Acid is almost sure to cure. It is only when it is tough and stringy that Kali bichromicum claims precedence.
When hardened clinkers are hawked from the posterior nares, Kali Bich, Cinnabaris, Sepia and Teucrium are serviceable. The latter, suggested by Dr. Walter Williamson, Jr., is needed when very large and irregular masses are hawked down. Cinnabar for dirty yellow lumps.
Saponine causes tough tenacious mucus in the posterior nares, extending into the larynx.
Quillaya, one of the plants from which Saponine is derived, has been quite extensively used in California by Homoeopathists for a cold in the head, contracted during warm, damp weather. Here it rivals Gelsemium both causing general lassitude and tiredness and weakness of the muscles states of relaxation favouring colds.
Dr. August Korndoerfer has made some excellent cures with Spigelia, guided by Hahnemann’s symptoms: “Profuse discharge of mucus through the posterior nares; nasal mucus passes off only through the posterior nares”. I have not been very successful in using it.
But, after all, the majority of cases call for such remedies as Mercurius Iod, Sanguinaria Nitrated, AntimoniumAuratum and Pulsatilla. And it is such accurately fitting remedies as these that I hope to see greatly increased in number by energetic provings, conducted by those whose ability to diagnose disease of the nose qualifies them for the work.
Sanguinaria Nitrate, Given persistently and nasal catarrh needs repeated doses will often help when there are burning rawness and soreness in the posterior nares, and hawking of thick. yellow, sometimes bloody mucus.
Pulsatilla acts better if the mucus is thick, yellow-green and bland; and Mercurius Iodium when there is swelling of the glands of the neck and yellow coating on the dorsum of the tongue.
Antimonium Auratum, proved under the auspices of Dr. C. Neidhard, causes increased mucous secretion. In one prover it aggravated a chronic catarrh with increased discharge of a greenish-yellow mucus, more offensive than before. It is used by Dr. Hugh Pitcairn as a co-relative of the Iodide of Mercury.
Nitric Acid follows when dirty, bloody mucus flows: and Mezereum in mercurialized patients when there are scraping, burning and rawness posteriorly with thin, yellow and bloody discharge.
In Conclusion, I desire to say that, as many nasal catarrhs have a specific origin, no remedy, not active in influencing the cause, can materially relieve the catarrh. In addition to sulphur, Kali Iod, Aurum etc., we should consider Theridion, confirmed by Dr. Korndoerfer as an introductory drug in scrofulous cases Thuja, well-known in Sycosis, and invaluable when the discharge is thick, green or bloody and green and Psorinum, despised by some, but fully-appreciated by others as often superior to sulphur.
For convenience I add a brief repertory, confining myself to the limited region under consideration.
NATURE OF THE DISCHARGE:
YELLOW, Thick: ArgentumNit, Aurum, Nat.Arsenicum Hyd., Calc, C., Berberis, Cinnab. (dirty lumps), Kali Bi, SulphurAc., Nit.Ac., Pulsatilla, Spigelia, Sulphur, Ant. Aurum, SanguinariaNit., Therid., Nat.c., Hepar, Lycopodium Phos, Kali Sulph., Alumina., Rumex, CalcareaSulph., Sumbul, Mez. (thin).
Green: Berberis, Pulsatilla, Thuja, Kali Bi., Natrum carb., Phosphorus, Sep, Mercurius
Plugs, Clinkers, etc.: Teucrium, Kali Bi, Spig, Cinn, Lycopodium, Mang. (yellow or green lumps) Mercurius Iodium (blood-tinged), Nat. Arsenicum
Like Tallow: Coral. Rub.
Irritating, Corrosive : Arsenicum ArsenicumIodium, Cepa, Keros, Carb. Acid.
BROWN: Kali bichromicum (bloody and offensive).
BLOODY: Cantharis (and tough), Arg, Nit, (Yellow mixed with clots), Hyd., Acid nitricum, Sepia (with yellow-green shreds), Sng. Nit., Kaolin, Kali Bi., Lachesis (bloody pus), Phosphorus (in streaks), Sulphur (in threads), Mez.
OFFENSIVE: Aurum,Graph, Mercurius (trickling mucus_), Sulph, Thuja, Nit.Ac., Nat.C., Elaps (relieved a case for me marked by disproportionate foetor), Therid, Asafoetida Lachesis, Kreosotum (old people), Tell. (Herring brine), Ant.Aurum
STRINGY: AmmoniumBromium, Sulphur Ac, Kali Bi, Cinnab., Hyd.,Coccus Cactus grandiflorus Yucca (and greasy-looking).
SCANTY, TENACIOUS; Sinapis, Alumina, Osmium ( large lumps), Nat. Mur ., Phos Saponin (tough, tenacious), Phytolacca
MEMBRANE, DARK: Lachesis, Phytolacca, Ammn. Bromium, Yucca., RED: ArgentumNit.
SCALES, ULCERS: ArgentumNit. (with yellow scales), Kali Bi. (punched) alum.,
CalcareaC. Graphites, Lycopodium, Pulsatilla, Sepia., Silica, Zinc, Psorin., Thuja, Therid., Lachesis, (bloody), Baryta (and behind uvula), Kali Carb. (foul crusts) , Fagop.
Choane:- Too dry: Silica, Sepia, Fagop, Rumex, Sticta, Wyethia, AesculusHip, Alum, Sinapis, Zinc, Sanguinaria
As if too open: Flour. Ac., Iod, Nat.Mur.
Obstructed: Anacardium, CalcareaSulph., Hyd. Iris Verbascum, Kali Iodium
Mercurius, Vespa., Phytolacca, Gelsemium (itching in Eustachian tube, also pain in ears), Nux and Silica (both itching in Eustachian tubes), Kali Bi, Rum (ear feels stopped, voice sounds strange relief in one, but not cure), Alumina (Eustachian tube stooped with mucus), Graphites (Eustachian tube stopped up), Iodium (Catarrh of the Eustachian tube),. Lith Carb.
Crackling Sound on Swallowing:
Nit.Ac. (Eustachian obstruction), Petrol. (Passages dry, whizzing in ears).
Sensitive to Inhaled Air:
Arsenicum, Nat.Ars, ArsenicumIod, Coral., Hyd., Lithium carb.Carb., Osmium, Fagop., Kreosotum, Ferrumphos.
Nose, Feels Wet: Penthorum.
Rawness, Scraping, Soreness:
AesculusHip., Mercurius, MercuriusIodium, Mez., Nux Vom., SanguinariaNit., Nit.Ac. Chlorum, Kreosotum, Iris V., Nat.Arsenicum, Arsenicum, ArsenicumIodium, Ferrumphos. (on inspiration), Mag. Carb, Oxalic, Ac., Phosphorus, Phosphorus, Ac., Osmium, Carbo Veg. (on coughing or swallowing, soreness), Gallic Ac., Penth., Sepia, Nitrum.,
Burning: AesculusHip,. ArgentumNit., Phosphorus, Osmium, Arsenicum ArsenicumIodium, Nat. ArsenicumFagop.
Like a Fine Leaf: Baryta Carb.
Like Something Hanging: Yucca.