It takes a long time for this remedy, in the proving, to develop its symptoms. It is a very deep-acting medicine, and an antipsoric, antisyphilitic and anti-sycotic. It is insidious in its action and its symptoms are slow in approach; it is like the deepest and slowest and most tedious diseases, the miasms, and hence it is suitable in the very slowest and lowest form of disease. While it has in its nature some febrile action, it is not for this purpose that it is oftenest called for; its most typical febrile action is very slow and insidious. It corresponds to overheated states of the system, old cases of nightly fevers, coming on week after week and year after year.
It is an unusually hot-blooded remedy at times, and again it has conditions of coldness. In the evening and night great heat seems to evolve from the body without increase of temperature. The skin becomes very hot. That patient is often worse from warm things, worse from covering, worse from warm air; suffocates somewhat like Puls. in a warm room. He wants to loathe the face and head in cold water; such bathing is grateful. The feet burn and are put out of bed in the night; he hunts around in bed for a cool place for the feet and hands. The soles perspire, and the palms perspire, and the sweat is acrid, making the parts sore; excoriation from the sweat between the toes. The perspiration is offensive; offensive, acrid sweat between the toes. Burning, unusual heat and acridity are words that modify a great many symptoms; an acrid lachrymation or other discharge from the eye; acrid discharge from the nose, acrid sweat, etc. Sensation of burning and burning pains in parts; heat evolved from the body as a chronic state. Aggravation from heat, from outward heat and from inward heat, belongs to this remedy. It is a strong feature of this remedy to be worse from drinking tea and coffee. Warm drinks bring on a diarrhea, or flatulence, or disturbance in the stomach, and cause indigestion to manifest itself in various ways. The symptoms are worse standing and sitting and better in the open air.
It is a remedy of great depth of action. It so disturbs the functions that there are peculiar outward signs in the nails, in the hair, in the skin; they are all imperfectly developed. Whenever such is the case, we know that a remedy has great depth of action and that it is very long acting. It forms little incrustations here and there upon the skin that seem to have no tendency to heal. A crust forms, but there seems to be no healing beneath the crust. The hair loses its lustre; it falls out, and if examined closely under the microscope it is seen to be necrosed; little ragged ulcers will be found along the course of the hair. The ends of the hair are dry, the hair mats and splits and breaks, becomes ragged in masses and lusterless. The nails are crippled, likewise corrugations in the nails; the nails grow too fast and grow awkwardly; that is, they are deformed and crippled, too thick in some places, and too thin in others; break easily, brittle. There is a tendency to breaking down of a slow character, where the circulation is very feeble, and the skin is near bone or cartilage, as in the cartilages in the ears, and in the cartilages of joints. Ulcers develop over the tibia. There is feeble circulation in the hands and feet, and they become cold. In the evening the extremities burn and are feverish, because that is the time of the feverish state; but in the morning and in the daytime there is coldness of the extremities. The patient is pallid and sickly, and at times becomes waxy and dropsical; oedema of the extremities, and particularly of the lower extremities; edema of certain parts; edema of the prepuce. When a debilitated subject, one suffering from bone and cartilaginous troubles, contracts gonorrhea, with it he will have enormous swelling of the prepuce, and nothing seems to act upon it. Fluoric acid will cure edema of the prepuce with gonorrhea in such a subject. Cannabis sativa has the same symptom, but it is especially useful in robust cases. Fluoric acid will prevent the manifestation of disease in sycotic subjects, will prevent formation of fig-warts. It cures fig-warts. It produces hardened, dry warts, and dry crusts upon the skin, and crusts not unlike rupia. It is useful in syphilitic rupia.
Bone affections stand out prominently. Necrosis, especially of the long bones, but also of the bones of the ear. It creates an offensive acrid discharge charge from the ear. It establishes an offensive ozaena, an acrid discharge, with necrosis of the nasal bones. It is very analogous to Sit., and it is one of the natural followers of Sil. where Sil. has been too frequently repeated by persons who do not know that Silica does its best in a single dose and that it is a long acting and slow medicine. It not only antidotes the abuse of Sil., but also follows Sil. After practicing a while you will be surprised to observe the pendulum-like action between heat and cold in various complementary remedies. To make that clear I will illustrate it by using the series in which this remedy is set and to which it naturally belongs. You take a patient who is hot-blooded, who is always suffering from the heat, from too much clothing and too warm a room especially in the evenings, a patient that is tearful and sad, and may be a blonde. Why you say, I am trying to describe a Pulsatilla patient. Well, yes; anyone can see that. Puls. is a hot-blooded patient, but after using that remedy a while you notice that the patient goes to the other extreme and becomes chilly, and wants much clothing; the heat is taken out of the case. Sil. is the natural follower of Puls., and you would be astonished to know how often a patient leaving Puls. runs toward Sil. goes deeper into the case, it does more curing, and it is the natural chronic of Puls. Other remedies of course follow Puls., but Sil. more frequently than any other medicine. Now, that is the second step; the patient has gone from a warm to a cool state; the overheated state has been lost and he has gone into Sil., but when Sit. has been administered for a while it cures the cold estate, and removes the chilliness of the patient (remember, however, that Sil. has at times something of Puls. in it; in some of its complaints it is worse from being over-heated) and the patient under Sil. goes back to the warm state again, becomes hot-blooded, wants the warm covers thrown off, wants to be lightly covered. Then it is that this medicine comes in the series. Fluor. ac. follows Sil. as naturally as Sil. follows Puls. They exist in threes. There are other remedies that exist in threes, but the most common ones you will think of will be Sulph., Calc. and Lyc., Sulph., Sars. and Sep., and Coloc., Caust. and Staph., which often follow each other and rotate in this way. Do not let these facts make you give a routine remedy unless the symptoms agree, but it does help to remember that remedies are somewhat similar. It is true that Puls., Sil. and Fluor, ac. are similar all along the line as to the nature of their symptoms. Puls. corresponds to more acute disturbances, or to the earlier stages of chronic disease, the more active or violent operations of chronic disease. It will take off the wire edge of the disease, and it will be followed by some medicine that is complementary to it, always to be determined by the symptoms that arise. There are cases that would be greatly injured by so deeply acting a remedy at Sil. if given in the beginning, that is, the suffering would be unnecessary; but if you commence with Puls. you can mitigate the case and prepare it to receive Sil., providing the two would appear to be on a plane of agreement. A very serious case had better first receive Puls., and the way pacing paved by that remedy follow it up
Think of the remedy, then, in vicious bone diseases, in necrosis and caries. in fistulous openings, fistula leading to the teeth, fistula lachrymalis and fistula in ano; in calcareous degenerations; in deformity of the nails, hair and teeth; in affections of the thigh bones and leg bones, with chronic fistulous openings leading to bone discharging pus which excoriates the parts all around.
The Patient is over-sensitive; is made worse if the bowels do not move regularly; is distressed if the menstrual flow is slightly delayed; suffers if the call to urinate cannot be immediately attended to, hence, as in the text, "headaches better by micturition." That symptom is all that is given in the text; but remember something that is analogous to it, viz.: If the call to urinate be not attended to the headache will continue to grow worse until the urine is voided. That is a peculiar symptom, and it sometimes leads to the study of Fluor. ac. Violent congestive headache with heat and fullness. Violent occipital headaches, worse from motion.
Now, if we take into consideration its great depth of action. We will see furthermore that it is suitable in some brain diseases. In persons who have overworked, who have been working day and night to establish a business, or to keep it up, and when there has been constant use of the brain it is suitable. In mental depression and melancholy, with great sadness, in young men who have destroyed the nervous system by vicious practices, by secret vice. It is particularly suitable for that disorder of the human economy where men have continuously changed their mistresses. There is a state in which a man is never satisfied with one woman but continually changes and goes from bad to worse until he is a debauchee. If a young man cannot keep away from women, he is not so bad off if he will only keep to one, but he goes from one to many, until he stands upon the street corners and, in his lust, craves the innocent women that go along the street. Fluoric acid is suitable in that state, like Picric acid and Sepia, and these medicines are particularly suited to that condition of enfeeblement of the mind and that disorder of the human economy that makes man so low, that we have the state described as "low mindedness." It takes that form in one who is a sort of debauchee, running after all sorts of things to tickle his fancy but it takes another form in a man who stays at home with his good wife. He takes an aversion to his children and to his dearest friends and his wife, that is, he has lost that true and noble and orderly affection and friendship and companionship which ought to exist, and he fights against it. An orderly man considers his wife his best friend and he would rather stay with her than go anywhere else. To him there is no place like home. Now, when man arrives at the state when he wants to go somewhere else, that he wants to go away from home, that he is disturbed at home, that everything annoys him at home, that he no longer loves his children as he once did, he needs Fluoric acid. "Feeling of indifference towards those he loves best." The Sepia state, is like this, but Sep is more frequently indicated in women. The woman will say, "Doctor, there is one thing that I regret very much, and that is, I do not seem to enjoy my children, my home, my companions, my husband and my friends. There is a sort of alienation. Such is the way it is told where it is Sepia. In the man it is more commonly Fluoric acid, in the women more commonly Sep., but this need not necessarily be so. Sepia corresponds more closely to the condition of the uterus and ovaries, and such conditions, as the woman alone can have. (Compare Calcarea.)
Fluoric acid has with this state an overwhelming sexual erethism. He is kept awake nights by erections. This state of desire forces itself upon him, not only when he is with the opposite sex, but at all times. At times, at the beginning of a gonorrhea, this condition of priapism and intense uncontrollable sexual desire, with swelling of the foreskin, is overcome by Fluoric acid. There are times when this priapism demands Canth., but that remedy differs wholly in its nature from this.
Reticence and silence; sitting and saying nothing. This reticence is like Puls., and often belong to the insane who sit in the corner and say nothing all day, never uttering one single word, and hardly answering when spoken to. A patient sits in the corner and says nothing and does nothing, eats when food is offered, is led to her room when the time comes, resists nobody, answers nothing; such a state is found in Pulsatilla, and is closely allied to this remedy. There is some insanity in it, but especially the fatigue, and mildness of a tired brain. Mental exhaustion from overwork or from vices.
It is suitable after Sil. in the spinal affections that are attended with paralysis, trembling and numbness in the soles of the feet. It will often stop the progress of structural nervous diseases and prevent the case from getting worse.
An excellent and very useful feature of this remedy is its ability to produce varicose veins and varicose ulcers. The veins become varicosed anywhere, but particularly upon the lower limbs, especially following pregnancy. Hemorrhoids protrude after a stool; the anus and rectum protrude, and there is some bleeding, because of the hemorrhoidal condition. Varicose conditions with very old ulcers upon the lower extremities; the varicose veins ulcerate. You Might predict what kind of ulcer and what kind of a margin Fluoric acid would produce. We see the feebleness of its circulation, we see its tendency to create hard crusts, and hardened, horny skin and eruptions. We might now easily assume that the inflamed borders of an ulcer would become indurated, hard and glassy. The margins of ulcers are indurated and the ulcer is an old, indolent ulcer. Parts once broken will not close up. Union will not take place between the broken ends of bones, there is no repair. From bones and from ulcers, we have the fetid, acrid thin, watery discharges, or at times very scanty discharges, but acrid, burning the parts all around, raising eruptions and scurfs around the ulcers. From the feebleness of the circulation one might, suppose that numbness would naturally be present, and it is true. The ears become numb, the scalp becomes numb, there is a sensation as if the back of the head were made of wood. The scalp loses its sensation, the hair falls out and crusts form. The extremities become numb and there is numbness of the feet and hands extending upwards; numbness, with or without dropsy; numbness in spinal affections; numbness in brain diseases. Numbness of the limb not laid on. "Crusta lactea; dry scales; itches very much, bald places. Caries of the temporal bone; discharges offensive smelling pus periodically." "Whole left side of the head retarded in growth, left eye seems smaller." That is a clinical state, but it is significant.
Its use in syphilis must not be overlooked. In old cases with exostoses, caries and necrosis, cases that have been mercurialized, and treated by other drugs until ulcers have developed or those affections of the nose that we have often observed in syphilitic states. He blows small pieces of bone out of the nose; great pain in the nose; nasal bones all destroyed, and the nose becomes flat as though only a soft piece of flesh with perforations. The uvula is eaten off and the tonsils become honeycombed by syphilitic ulcers. Lingering, low forms of ulcers and eruptions. The teeth decay or break off or ulcerate at the roots; fistulous openings from the root of the tooth, continuing to discharge. Many a time has this remedy taken away that ulcer of the root, closed up that fistulous opening, cured the pain, saved the tooth.
"Craves cold water and is continually hungry." Often that "all gone" sensation in the stomach. Is always eating and is relieved from eating, but like Iodine it does not last long, for soon he becomes hungry again. Such medicines are very deep. We see that they go to the very root of assimilation and nutrition.
Chronic ulcers of the throat not necessarily syphilitic, but it is particularly useful in the old forms of syphilis; not generally so suitable in the earlier ulcers as in those that are associated with the tertiary forms, with debilitated states, with brain disease, with nervous symptoms that go on for years when the patient is supposed to be cured. Very often the trouble will come back in the throat, and the ulcers consist of little gummatous growths. Sil. especially covers such a condition, and Sil. is also one of the most useful medicines for rooting out Mercury. In potentised form Sil. and Merc. are inimical, yet the high potencies of Sil. will antidote crude Mercury.
This patient craves pungent, spicy, highly seasoned things. The appetite must be tickled; there must be some inducement to eat. At times the appetite is changeable in spite of the fact that he is overwhelmingly hungry; he cannot eat, yet he is better when the food is in the stomach, better after eating.
The most vicious kind of chronic diarrhea with this low feeble constitution, in insidious complaints. "Morning diarrhea." The itching of the anus is sometimes intense; protrusion of the anus during defecation; profuse hemorrhage after stool; constipation with piles; itching around and in anus, in perineum, etc.
This drug is also suitable in the dropsy of drunkards. They are very often liver dropsies. Old cicatrices become red around the edges, surrounded by itching vesicles, itching violently; squamous eruptions upon the body; dry, cutaneous eruptions upon the body, very scaly.
"Sensation as if a burning vapor were emitted from the pores of the body." Especially under the covers there is this sensation of great heat, tremendous, like steam. It is not in fever. He has no fever but it is a chronic state of giving out heat without thirst, or increase of temperature