DIFFERENTIAL MATERIA MEDICA OF NITRIC ACID


Every time that a physician has a patient before him, whether in the consulting office or at the bedside, there are two problems he must solve, two different studies he has to undertake: to make a diagnosis and to select a remedy. And I say a remedy, diagnosis and to select a remedy. And I say a remedy, meaning internal medication, because it is the duty of the practitioner, in my opinion, to begin his treatment with a remedy even if his case falls within the field of a surgical procedure or any other physical aid.


Every time that a physician has a patient before him, whether in the consulting office or at the bedside, there are two problems he must solve, two different studies he has to undertake: to make a diagnosis and to select a remedy. And I say a remedy, diagnosis and to select a remedy. And I say a remedy, meaning internal medication, because it is the duty of the practitioner, in my opinion, to begin his treatment with a remedy even if his case falls within the field of a surgical procedure or any other physical aid. For surgery, as well as any form or method of physiotherapy, should be nothing else but auxiliary measures to the fundamental treatment which is the internal medication.

In making the diagnosis of his case the physician comes to a point when he has to draw his final conclusions from a differential study of the conditions which bear similarity to his case, unless it is to simple as to be diagnosed at first glance.

In studying his case for the selection of the remedy he also has to make a a differential study of remedies in order to find the similimum. It is very seldom that the picture of the case is so clear that none other but the indicated remedy comes to mind.

The success of the prescriber depends on his ability to rapidly establish the differences between the remedies that come to his mind while studying his case, in order to determine which is the one that covers the greatest number of symptoms. And while considering the symptoms it is not only a matter of numbers, but he must also be able to properly distinguish their importance and classify them accordingly.

Thence the study of the materia medica should be by means of comparisons between remedies, that is, a study of a Differential Materia Medica.

Complying with the wishes of our Chairman we must endeavor ourselves to study here the Differential Materia Medica of Nitric Acid.

To make a differential study of a remedy is to bring out its characteristic nature or conditions among all other remedies that may resemble its mode of action. There are two different kinds of remedy relationship: the natural relationship and the clinical relationship. The latter may be complementary, antidotal, inimical, compatible, before and after the given remedy, or incompatible.

We find the natural relationships of Nitric acid among the acids, and especially among the mineral acids.

All acids, cause great debility, but it is greater when producer by mineral acids which also originate a scorbutic state of the system, with manifest tendency to ulcers and low forms of disease: typhoid diseases. Vegetable acids show more of a tendency to produce membrane exudations in the throat.

Besides Nitric acid we have among the mineral acids: Muriatic, Sulphuric, Carbolic, Arsenious, Fluoric, Hydrocyanic, Benzoic, Phosphoric and Picric.

Muriatic or Hydrochloric acid affects mainly: the blood, the mucous membranes, the brain center which regulates the supply of hydrochloric acid to the gastric juice; the Peyers patches in the small intestine, the salivary glands, the skin.

Sulphuric acid acts mostly on the mucous membranes of both the alimentary canal and the respiratory tract.

Carbolic acid affects: the respiratory center in the brain and the peripheral nerve endings, the gastrointestinal mucous membranes, the blood and the skin.

Arsenious acid or Arsenicum album, one of our great polychrests, with a much wider sphere of action, acts – mainly on the nervous system, altering the function of the pneumogastric, the respiratory centers, the fifth nerve, the motor and sensory endings, the vasomotor centers and nerves, the motor tract of the spinal cord, the solar plexus, the ganglia of the heart and the emotional centers, also affecting the functions of the heart and the emotional centers, also affecting the functions of the heart, kidneys, lungs, digestive and generative organs. It also acts on the mucous and serous membranes and the blood.

Fluoric acid has an action principally on the bones, skin and lymphatic glands.

Hydrocyanic or Prussic acid affects the nervous system in its respiratory center; the origin of the pneumogastric, the motor centers including the vasomotor and nerves, the automatic nerve centers of the heart and the peripheric sensory nerves; it also has a disorganizing effect on the blood, destroying its fibrin element.

Benzoic acid acts mainly on the urinary organs producing a strong smelling urine, and on the small joints, heart and bowels.

Phosphoric acid manifests its effects on the nervous system, especially on the motor and emotional centers; on the bones and mucous membrane of the digestive tract and on the generative organs.

Picric acid is characteristic for its action on the central nervous system, mainly causing brain fag and neurasthenia, and for its action on the male sexual organs.

Nitric acid acts more on the mucous membranes, with a special affinity for the mucocutaneous outlets of the body, and the acid sections of the gastrointestinal canal: the stomach and the large intestine, the glandular system, mainly the lymphatic and salivary glands and the liver; the kidneys, the blood, the skin and the bones. So much for the nature relationships of Nitric acid.

The clinical relationships are the most important for the physician, and a good size volume could be written if we were to study all the remedies that by acting on the mucous membranes, the glands, the kidneys, the liver, the skin, the bones and the blood, produce similar conditions to those caused by Nitric acid. The limitations of a paper forbid such undertaking.

We aim only to mention those remedies which, by acting on the same organs or tissues that Nitric acid affects, often come to our mind when taking the case, those remedies from which we must distinguish Nitric acid.

Nitric acid is at once antipsoric, antisycotic and antisyphilitic, and here we think of Causticum; but Causticum, although better suited to dark haired people like Nitric, acid, acts mainly on the respiratory organs, motor nerves, muscles of the bladder and larynx even causing paralysis, and we already know that Nitric acid has a special affinity for the gastrointestinal mucous membranes, the glands, the skin, kidneys, live; and we are more apt to find its lesions on the margins of the outlets.

Mercury is another remedy related to Nitric acid, although it acts better on light haired people; but Nitric acid is more indicated after Mercury, and more so when the latter has been abused. Like Aurum metallicum it has a most brilliant action on syphilitic cases overdosed with Mercury; but Aurum met. mostly when the bones have been affected. Nitric acid has also the found useful in cases largely treated allopathically with potassium iodide. Hepar sulph. is another remedy which is as good an antidote for the abuse of mercury; but “when mercurialization is conjoined with syphilis, Nitric acid is the preferable remedy,” as Farrington says.

Both Mercury and Nitric acid have much pain during and after stool, but the pain of Nitric acid lasts for hours after. The stool in both remedies is slimy and greenish, but is more offensive and more excoriating in Nitric acid, which has besides “borborygmus as if a boiler were working in bowels”, and the patient is physically exhausted after the bowels,” and the patient is physically exhausted after the stool. Here Nux vomica comes to mind because although it may have a great deal of rectal pain before and during the stool, like the other two remedies, it is all gone after the movement.

One of the most outstanding peculiarities of Nitric acid, one that always, when found in a case, focuses our attention to the remedy, one that is always present, it – does not matter where localized, is its aggravation by a slight touch,m but the pain giving always a sensation as being produced by a splinter. Ulcers, which by the way are offensive, granulating, bleeding easily, are characteristically irregular in outline, tending to dip deeply in Nitric acid-and here again, another difference from Mercury which produces flat superficial ulcers-are always painful when touched, giving the sensation of a sharp point sticking into the tissues.

Three remedies have been mentioned as complementary to Nitric acid: Arum triphyllum, Caladium and Arsenicum album, and it is interesting to note that the latter has already been mentioned as one of Nitric acids natural relationships; but the other two bear a mutual natural relationship between themselves; they are plants that belong to the order of the Aracea.

Studying the first of these three remedies, we find that both Nitric acid and Arum triphyllum are very useful in low typhoid forms of diseases with a high degree of toxicity. They are champions in the treatment of malignant types of scarlet fever and diphtheria. Both have very offensive and excoriating discharges from nose and throat; the nostrils and upper lip are raw and painful, but more so when touched in Nitric acid with the splinter-like sensation, while Arum gives us a peculiar symptom which facilitates the differentiation: the child is constantly picking at and boring his finger into his nose.

Eliud Garcia-Trevino