About the first thing we see in the study of an Ant-t. patient is expressed in the face. The face is pale and sickly; the nose is drawn and shrunken; the eyes are sunken and there are dark rings around the eyes. The lips are pale and shrivelled. The nostrils are dilated and flapping, and there is a dark, sooty appearance inside of the nostrils. The face is covered with a cold sweat and is cold and pale. The expression is that of suffering. The atmosphere of the room is pungent, more pungent than fetid or putrid, and makes you feel that death is in it. The family is disturbed; they are going hither and thither, and the nurse is in an excited and busy state, and you enter upon this scene to make a homeopathic prescription. It is one of excitement and one that you cannot act rapidly in, but one in which you must make a very quick prescription. These things will interfere somewhat with your thinking at the time that you must do the best thinking and the most rapid thinking.
Now, in what kind of cases do we find this state and appearance, where all the features and symptoms conform to the nature of the remedy? First, in catarrhal patients, in broken down constitutions, in feeble children, in old people. Catarrhal conditions of the trachea and the bronchial tubes.
Our ears being open we hear coarse rattling and bubbling in the chest. If you have ever been in the room of the dying you have heard what is called the death rattle. It is coarse like that. Now and then there is expectoration of a mouthful of light-colored, whitish mucus. The condition is one in which the chest is steadily filling up with mucus, and at first he may be able to throw it out; but finally he is suffocating from the filling up of mucus and the inability of the chest and lungs to throw it out. It is a paralytic condition of the lungs. It may occur in cases of grippe. At first it may be a case that comes on quite rapidly, running a rapid course. It may be a case that produces early prostration, that is, in three or four days or a week. The first few days of the sickness will not point to Ant-t. So long as the reaction is good and his strength holds up you will not see this hippocratic countenance, sinking, and coldness and cold sweat. You will not hear this rattling in the chest, because these symptoms are symptoms that indicate a passive condition. Ant-t. has weakness and lack of reaction. Hence we see that it is suitable in those cases that present this state, or in such patients as are so feeble, when they are taken down, that they at once enter upon a passive or relaxed state. In cases of bronchitis with pneumonia, inflammation of the trachea, inflammation of the air passages in general, the inflammation is likely to be attended with dryness or a scanty flow of mucus. If this be violent in a few days it will reach a state of relaxation and weakness. But the first state does not indicate Ant-t. Such medicines as Bry. and Ip. come in for the first period, and your impression is, when administering those medicines, that they will be sufficient for the whole case, and they will be, except in those states wherein this weakness is present from the beginning, or where there is lack of ability to react sufficiently from your remedy to recovery under it. Then comes in a second remedy, and that is the time when this medicine begins its operation.
Ip. has some of this coarse rattling, but it is attended with great expulsive power of the lungs. This medicine has the coarse rattling that comes after many days. Ip. has it the first days of the sickness. This remedy has the coughing and gagging and retching, but in the stage of great relaxation, prostration and coldness. It seems as if he will die. When you hear him cough you are at once impressed with the idea that there must be some profound weakness in his lung power. We know that it is in the power of the lungs to produce an expulsive action with the deep inspirations. They have no such power in Ant-t. The chest is full of mucus and it rattles; the cough is a rattling cough, but the mucus does not come up, or only a small quantity comes up, but it does not relieve him. His chest is full of mucus, he is suffocating and he is really passing away, dying from carbonic acid poisoning due to a lack of expulsive power. In cases of pneumonia; when first coming down with a chill, it may be a very violent attack, such an attack as from its violence produced prostration early, that is, after three or four days. It is not indicated in the beginning during the chill, and during the high grade of inflammation, but during the stage of exudation. But the violence of the attack leads him to a state of prostration, or he is already feeble as if he were old, and therefor he becomes easily relaxed and prostrated from the disease. Altogether unlike Acon., Bell., Ip. and Bry., for they come down with violence – the very opposite is present in Ant-t. Little fever, cold sweat, coldness, relaxation, hippocratic aspect. So it is the remedy that closes out the scene with the severe cases of bronchitis, pneumonia; most of these cases die in an Ant-t. state. This patient is an old gouty patient, debilitated from long illness, always shivering, pale, with enlarged joints. Every spell of wet weather brings on a catarrhal state of the chest, larynx and trachea which runs into a state of copious secretion of mucus. He is in bed at once, prostrated, with coarse rattling. In children that have frequent attacks of bronchitis, from cold wet weather. No sooner do they get over one cold than another cold comes on. The acute stage is never violent with them, but they keep having these passive rattling colds. Recurrent rattling in the chest. Chilly, and pale. Those florid children that do not look sick when they have a cold, are more or less vigorous, who have rattling in the chest, but do not come down with weakness and are not prostrated from it, but keep on rattling, they call for Kali-s. That is quite a distinguishing feature, the weakness at once speaks for this remedy. In very old people this weakness occurs, old broken down people who have for years had catarrh of the chest. Every sharp cold spell in the winter brings on catarrh of the chest, with thick white mucus, and attended with great dyspnoea, driving him to bed. He must sit up in bed and be fanned; cannot lie down because of the difficult breathing, and filling up of the chest. Ant-t. will ease him over a number of these attacks before he dies. When the mucus is yellow and purulent in one of these old people, Ammc. will tide him over a good many winters. We see a good many old people that suffer from catarrh of the chest during the winter; they have had it for years, and do not expect to be any better. When the expectoration is yellow Ammc. will pull them through, and Ant-t. when it is white and attended with prostration, sweat, coldness, pallor and blueness of the face. These are the principal uses of this remedy in practice.
It has many pains and aches. To a great extent Ant-t. builds upon the Ant-c. basis. It forms its chest symptoms to a great extent upon that basis. Many of the symptoms are like Ant-c.; many symptoms are worse when warmed up, and from too much clothing. You will see this patient sitting up in bed with no clothing around the shoulders or neck, and the night-gown wide open in order to breathe. Suffocates if the room is too warm. It gets that from the Ant-c. It is worse from bathing in cold water, like Ant-c. The mucous membranes are covered with thick white mucus, like Ant-c. Also he does not want to be meddled with or bothered.
Everything is a burden. The child when sick doesn’t want to be touched or talked to or looked at. Wants to be let alone. The infant is always keeping up a pitiful whining and moaning. Many times the respiration is a moaning respiration. Rattling and moaning. Always in bad humor, that is, extremely irritable when disturbed. Any disturbance seems to increase the breathing and is an annoyance and makes the patient irritable. No wonder the patient is wonderfully anxious, because from his appearance we would say that he must have the feeling that he is dying. He looks as if he were sinking, and if he does not get relief soon he certainly will die, for there is a filling up of the chest that is suffocating him, and the feeling is that of suffocation, dyspnoea, which is steadily increasing. The wings of the nose move as in Lyc. Lycopodium competes with it very closely and resembles it very much.
There are many headaches laid down under Ant-t., but Ant-c. is more likely to work out for Antimonium headaches, while this medicine is more likely to work out for Antimonium chest troubles. Both of these remedies have very decided gastric symptoms. Constant nausea, vomiting and indigestion. Ant-t. with its difficult breathing is sick at the stomach. Loathes everything, loathes food; vomits even water. He has also a docile state and if allowed to be quiet, in spite of all the sufferings he will fall into a sleep, or go into a state of inability to feel. He will cough and sleep, and snore through the dyspnoea, so that it is in many ways like Ant-c., but Ant-c. has nothing like the copious flow of mucus from mucous membranes that are inflamed. It has nothing like the passive state of the whole economy. It is not so desperate in its provings, and not so dreadful to look upon.
Clinically Ant-t. has been confined in its use mostly to the mucous membranes of the chest, but it has the same passive conditions of all the mucous membranes of the body, discharges of white mucus from the eyes. "Eyes prominent, glaring. Dim, and swimming. Gonorrheal ophthalmia." But the rheumatic conditions furnish another form of this remedy, another phase of it like Ant-c. The joints are affected, take on a passive, slow infiltration and become dropsical; dropsical swelling of all the joints. Gouty infiltration of the joints, and these are especially bad during the cold, wet weather. Eye symptoms of this gouty character. Eyes infiltrated along with the joints, so there is a gouty state of the eyes. The gouty state affects the whole body. The mucous membrane is pale instead of being red and inflamed; it is pale and relaxed, and it appears to ooze; mucus forms upon it very readily. This is the state that occurs in the chest. It is not that burning rawness found in Ars. and the more acute remedies, although there is a state of prostration and the anxiety and cold sweat which resembles Ars.
Then this gouty state affects the teeth. His teeth are all rheumatic. "Rheumatic pains in the teeth," with rheumatic pains in the joints. Teeth are sensitive. "Teeth covered with mucus. "
With all the complaints the stomach gives out, and there is nausea, inability to digest and loathing of food. Vomiting of everything taken into the stomach; vomiting of even a spoonful of water. In most complaints this remedy is thirstless. It is an exception that it has thirst. Generally in these attacks of dyspnoea the friends of the patient stand around with a very strong desire to do something, if it is only to hand a glass of water. This patient is irritated by being offered a swallow of water. He is disturbed, and shows his annoyance. The child will make an offended grunt when offered water. Thirstlessness with all these bronchial troubles, with copious discharge of mucus and great rattling in the chest. Sometimes there is an irresistible desire for cold things in the stomach, but it is the exception. "Desire for acids or acid fruits," and they make him sick. Troubles brought on in the stomach from vinegar, from sour things, from sour wine, from sour fruits, as in Ant-c. Aversion to milk and every other kind of nourishment, but milk especially makes the patient sick, causing nausea and vomiting. The stomach and abdomen are greatly distended with flatulence. The abdomen is tympanitic. With the stomach symptoms and bowel symptoms there is this constant nausea, but it is more than a nausea, it is a deadly loathing of every kind of food or nourishment, a nausea with the feeling that if he took anything into the stomach he would die; not merely aversion to food, not merely a common nausea that precedes vomiting, but a deadly loathing of food. The weakness takes on an increased anxiety, and he increasingly suffocates when he is offered food. Kind-hearted people very often want him to take something, for perhaps he has not taken any food all day, or all night; but the thought of food only increases the dyspnoea, increases his nausea, his loathing and his suffering. Vomiting is not an easy matter in this remedy. The vomiting is more or less spasmodic. "Violent retching. Gagging and retching and straining to vomit. Suffocation, gagging, though great torture" The stomach seems to take on a convulsive action, and it is with the greatest difficulty, after many of these great efforts, that a little comes up, and then a little more, and this is kept up. "vomiting of anything that has been put into the stomach, with quantities of mucus" Thick white, ropy mucus, sometimes with blood. "Vomits slime, with great exertion. Vomiting large quantities of mucus. Vomits tenacious mucus." "Vomiting of slime, with bile. A tough, watery mucus, then some food, then bile. " But the principal thing vomited is the thick, white, ropy mucus, flowing from the mucous membranes everywhere. Tough and stringy; can be drawn out in strings. The patient is often choked while this thick, ropy, white mucus is expelled from the esophagus and mouth. The mouth fills up with it. It is a tremendous effort, a spasmodic effort, for this patient to rid the stomach of its contents, which is mucus, or mucus and bile. Early in the vomiting it is mucus, and after much straining there is a regurgitation of bile into the stomach, and the continuing of vomiting is from bile. The great straining also induces a flow of blood into the stomach, and the contents of the stomach will be streaked with blood. Ulceration of mucous membranes everywhere. It has ulcers in the nose and in the larynx, and ulcers that bleed. Bleeding ulcers in the stomach, and so there is vomiting of blood.
Like Ant-c., it has been useful in old drunkards. Old drunkards sometimes take on a debilitated form and take frequent colds. After getting over a big debauch, having been many days on one of their times, they become relaxed and cold, and take cold, and the chest fills up with mucus, and they are vomiting, suffocating and vomiting. "Rattling of mucus in the chest of old drunkards." Ant-t. is sometimes required. Ant-c. when the trouble is confined mostly to the stomach. Ant-t. when the chest symptoms are present with growing anxiety and the coldness and the prostration; prostration from long drinking. Old gouty patients, old drunkards; old broken down constitutions. In children also that have broken down constitutions, as if they had grown old. These take cold in the chest, with great rattling of mucus, and require this remedy.
Very commonly there is anxiety in the stomach, it is not always described as a pain, but an anxious feeling, a deathly sinking, an indescribable sinking in the stomach as if she was going to die. "Anxiety in the stomach, with nausea." A passive congestion of the liver, with vomiting and bile.
The remedy is also full of cutting pains, cutting like a knife. Pinching in the intestines. Colicky pains. Distension of the abdomen. The abdomen may be distended with serum, or it may be distended with flatus. "Sharp, cutting pains, as with knives. Most violent pains in the abdomen." Dropsy is one of the natural conditions of all forms of Antimonium. I remember an energetic horse doctor feeding all the horses Black antimony when the epizootic was upon the land, going through all the stables. I learned that he was giving Black antimony to all horses and I left instructions that mine should not have any medicine except what I gave. Nearly all the horses that he treated ended in dropsy, and were laid up for days and weeks with the legs wrapped up. It was a proving of Antimonium. Ant-t. is full of it. It was a common thing, formerly, for old broken down constitutions to be put on Ant-t. at the end of pneumonia and fevers, but they almost always had bloating of the feet for three or four months after getting up. If they did not have that, they had "fever sores." Antimonium is a common cause of the "fever sore," the lingering indolent ulcer that forms upon the legs following old fevers in broken down constitutions. Sometimes they never get rid of them. They certainly never get rid of them unless they fall into the hands of a prescriber of our school.