Causticum is a very searching medicine, suitable in old, broken down constitutions, suffering from chronic diseases. Only occasionally is it indicated, in acute diseases. Its complaints are such as are progressive, slow, and accompanying a declining state of the economy. Gradual decrease of muscular power, a paralysis. Paralysis of the esophagus, paralysis of the throat, such as occurs after diphtheria; paralysis of the upper eyelids; paralysis of the bladder; paralysis of the limbs, of the lower limbs; great lassitude, muscular relaxation, indescribable fatigue and heaviness of the body. And there is a tremulousness, a quivering, jerking, twitching of the muscles, twitching in sleep.
The next most striking feature is found in the tendons, which become shortened, resulting in a temporary or permanent contracture, and the limb is drawn up. Tendons of the forearms contract, and there is gradually increasing flexion. Sometimes a whole muscle will harden and shorten, so that it can be felt by the hand as a hard ridge. Contracture of muscles and tendons.
Closely related to this is a rheumatic state of the tendons and ligaments about the joints, sometimes with swelling, but always with pain and ending in a shrivelling of the joint, a tightening up of the joint so that it becomes anchylosed. Great stiffness of the joints, and while this is going on the patient is growing weaker, is running into a state of melancholy, of hopelessness, anxiety and fear. Constantly present in his mind is the hopelessness, and a feeling that something is hanging over him, that something is going to happen. These are general features of Causticum. They all go to make up one picture, they are inseparable.
Another kind of progressive trouble in Causticum is hysteria. Gradually increasing hysteria. Hysterical cramping. The woman loses all control of herself and says foolish things. Her nervous system becomes extremely sensitive to noise, touch, excitement or anything unusual. Starting from the slightest noise; starting in sleep, twitching and jerking; the child is easily startled, or acts as if startled without cause.
The paralytic weakness is associated with the rheumatic diathesis. The rheumatic states are peculiar. The patient himself can endure neither heat nor cold. They both aggravate his rheumatic conditions, his nervous conditions and himself in general. His pains are ameliorated by heat, but they are aggravated in dry weather. Great deformity of the joints; they are enlarged, soft and infiltrated, always worse in dry weather; more pains and aches during dry weather. Rheumatism that affects both the muscles and the joints. This patient is also aggravated by exposure to cold, dry winds. Many an individual who has gone from the low lands of the East up into Colorado will come down with rheumatism from the cold, dry winds. Let such a patient as I have described take a ride in the cold lake wind and he will have paralysis of the side of the face exposed to the wind. A long drive with the east wind coming against the face. The next day that side of the face will be paralyzed. Such a paralysis will almost always recover under Causticum.
Rending, tearing, paralytic pains; pains that benumb; pains that fairly take the life out of him, they are so severe. And they are likely to remain in one place for a long time. Causticum has often greatly mitigated the lightning-like pains of locomotor ataxia.
Now, with all these sufferings the patient is slowly growing weaker, till at length he can no longer walk, he can no longer sit up, he is so tired and weak that he must lie down. He is tired in body and mind. It is a paralytic fatigue.
Convulsive symptoms. Cramps, now here, now there. If frightened he is almost sure to have some form of convulsive condition. The woman with tendency to hysteria will have hysterics from fright; nervous girls that are more inclined to chorea, will start with jerking of muscles and will keep it up day and night. Chorea even at night. Localized chorea, jerking of single parts, chorea of the tongue or of one side of the face.
Epilepsy in young persons at the age of puberty, from fright, from being chilled or exposed to some great change in the weather. Epilepsy, chorea, paralysis, hysteria worse during menses. We see that Causticum is a deep medicine. Worse from exposure to cold, dry wind. It also has rheumatic complaints aggravated in the warm, damp days, in wet weather, but this is not so striking.
Any one of the complaints that I have mentioned may be brought on by bathing in cold water. A long, dry, cold spell will aggravate the rheumatic troubles, getting wet or becoming chilled by bathing will start them.
Causticum has cured insanity; not acute mania with violent delirium, but mental aberration of the passive kind, where the brain has become tired. The constitution has been broken down with long suffering and much trouble, and finally the mind is in confusion. At first the patient recognizes his inability to do anything and then comes this foreboding that something is going to happen. He is unable to think, and consequently unable to carry on his business. He is going into imbecility. Full of timorous fancies. "Timorous anxiety," overwhelmed with fearful fancies. At every turn there is fear that something is going to happen. Fear of death, fear that something will happen to his family. Always anticipating some dreadful event. That is a striking feature of the Causticum mental state. It is found in old, broken down mental cases, after prolonged anxiety; after a prolonged struggle of some sort. Anxiety before falling asleep. In addition to this, the Causticum patient lacks balance. Everything excites him. The more he thinks about his complaints the worse they become. Mental and other ailments from long-lasting grief and sorrow. The injurious effects of fear and prolonged vexation. Tired from vexations of business.
The suppression of eruptions is apt to bring out mental symptoms. Mental exhaustion, hopelessness, despair, appearing after the suppression of an eruption with zinc ointment. He was fairly well while he had the eruption, but when it disappeared his mind gave out. Eruptions on the side of the head and face, and extending over the whole head. Thick, crusty eruptions covering the whole occiput. When these eruptions are suppressed in children, chorea is apt to follow. In the adult there will be trembling, paralytic weakness and the mental state, sometimes pains in the nerves. The driving in of a facial eruption will frequently result in facial paralysis. The healing of an old ulcer with stimulating lotions and ointments will have a similar result. Then he also suffers from violent headaches, congestive, pulsating headaches; violent stitches in the head, worse in the evening. But the headaches are, as a rule, nondescript; only occasionally do we find a Causticum headache standing out by itself. It will usually be associated with rheumatic and gouty conditions which also affect the scalp. The scalp contracts and tightens up in places like the Contracture in other parts. Rheumatic headaches; sometimes the pain is so severe as to cause nausea, and vomiting. Blinding headaches followed by paralysis.
Torticollis. The head is sometimes drawn to one side by the shortening of the muscles of the neck. Causticum is a curative remedy in this shortening of the tendons and muscles.
Causticum is rich in eye symptoms. Very often the patient says that the eyelids feel so heavy that he can hardly hold them up. This gradually increases until it becomes an actual paralysis. Sometimes there is the appearance of a veil before the eyes; foggy vision. Flickering before the eyes. Air seems full of little black insects. Then, again, large black or green spots are seen. After looking at the light a green spot appears and remains in the field of vision for a long time. Diplopia. And the vision gradually grows weaker until it is lost. Paralysis of the optic nerve. Lachrymation; tears acrid, burning; ulceration, copious discharges from the eyes, agglutination of the lids, paralysis of the eye muscles. Causticum cures scrofulous ophthalmia with ulceration of the cornea; chronic, purulent ophthalmia of psoric origin. The cornea is covered with little veins.
Another very strong feature of this medicine is its tendency to grow warts. Warts on the face, on the tip of the nose, on the ends of the fingers, on the hands. Hard, dry, horny warts come out on various parts of the body.
It is a natural feature of this remedy to produce copious, thick, tough, gluey discharges from mucous membranes. The catarrhal troubles creep up the Eustachian tube, from the nose and throat into the ear, resulting in roaring, cracking noises and reverberations in the ear. There is great accumulation of ear wax; deafness of catarrhal origin and deafness from paralysis of the auditory nerve. Severe, dragging pains in the ear.
The nasal catarrh is very troublesome. Old, atrophic catarrh with accumulation of crusts throughout the whole nasal cavity; post-nasal catarrh with ulcerations, granulations and copious, thick, yellow or yellowish-green discharge; nose-bleed; frequent attacks of acrid, watery coryza. Much itching of the nose. A wart grows upon the tip of the nose.
The pains in the face are violent. Neuralgic pains from exposure to cold. These pains often accompany the facial paralysis. Tearing pains in the face, stitching pains, pains of a rheumatic character.
Ulcerations about the mouth and nose. Fissures about the lips, the wings of the nose and the corners of the eyes. Fissures seem to form upon the least provocation. Fissures of the anus, of the skin about the joints. Old cases of salt rheum with fissures in the bends of the joints. Fistulous openings with indurated walls.
The gums become scorbutic and settle away from the teeth, bleeding and ulceration of the gums. Violent, tearing pains in the roots of the teeth from riding in the wind. Old rheumatic subjects suffer all through every dry spell with toothache. Stitching, tearing, pulsating pains in the teeth; even in the sound teeth on drawing in cold air. Frequently recurring abscesses of the gums. Putrid sour or bitter taste in the mouth.
When the paralytic condition affects the tongue then we have stammering. There is also the condition of complete paralysis of both the pharynx and esophagus. Hence Causticum is useful in the results of diphtheria when it has been maltreated or when the remedy has not been sufficient to cure the disease. The food goes down the wrong way or enters the larynx or the post-nares. Paralysis of the organs of speech, paralysis of the tongue, awkward at talking, awkward at chewing; bites the tongue and cheeks while chewing. Post-diphtheritic paralysis is a serious condition and only a few remedies can cure it. Causticum is one of them. Lachesis and Cocculus are also important. Dryness of the mouth and throat; rawness of the throat; must swallow constantly on account of a sensation of fullness in the throat, a nervous feeling in the throat. This is often a forerunner of paralysis. The Staphisagria patient when excited will keep up a constant swallowing and this goes on until it becomes a source of great annoyance. Burning in the throat; jerking in the throat; constantly scraping thick, tough mucus from the larynx. Study the sounds that patients make in order to ascertain where the mucus comes from. The presence of hoarseness shows that the trouble is in the larynx.
The Causticum patient sits down to the table hungry, but on seeing the food his appetite vanishes. The thought, sight or smell of food takes away the appetite. This is a common symptom in the pregnant woman. Although hungry, on sitting down at the table, she cannot eat. Kali carbonicum has an empty, all-gone feeling in the stomach, with aversion to food. China has canine hunger, but loathes the sight of food.
Thirst after eating; thirst for cool drinks with aversion to water; desire for beer, smoked meats, pungent things, aversion to sweet things and delicacies. Most remedies that have loss of appetite have desire for sweet things, pastry, etc. The symptoms of thirst with aversion to drinking is very much like Lachesis. The two run very closely together in the paralytic condition of the throat.
There is a queer sensation in the stomach as if lime were slaking there. Trembling in the stomach; burning. Bread causes a sensation of heaviness and pressure; coffee seems to aggravate all the symptoms of the stomach, but a swallow of cold water relieves. Many symptoms in this remedy are made better by a swallow of cold water. The violent, spasmodic cough may be stopped at once by a drink of cold water. Cold water seems to tone up the paralytic condition. Warm water applied to the hands brings on pains in these old sensitive spinal conditions. Cold washing is their only relief.
Causticum has belching, nausea, vomiting, distension and violent pains in the stomach. Pinching colic. In the rectum there is the same tendency to paralytic weakness that is found in other parts of the body. It is inactive and fills up with hard feces, which pass involuntarily and unnoticed. Aloe has involuntary dropping of little, hard balls, especially in children. Even when old enough to understand about such things, they will pass little balls unnoticed.
On account of the paralytic condition the stool passes with less straining while the patient is standing. Retention of urine except when standing; unable to pass it in any other position is Sarsaparilla. Constipation, frequent, unsuccessful urging to stool. The stool is tough and shining, and is passed with great difficulty and exertion.
Fissures in the anus; itching and stitching in the rectum, excessive itching day and night; hemorrhoids; pulsating in the perineum; fissures and hemorrhoids pulsate and burn like fire. The hemorrhoids become infiltrated and hardened.
This remedy has two kinds of paralysis of the bladder, one affecting the muscles of expulsion and the urine is retained, and the other centering upon the sphincter vesicae, and then the urine is passed involuntarily. "He urinates so easily that he is not sensible of the stream and scarcely believes, in the dark, that he is urinating, until he makes sure by sense of touch." Causticum is unconscious of the stream as it passes. It is a very useful remedy in children that wet the bed. Especially is it a wonderful remedy in the woman. The urine escapes involuntarily when coughing. Retention of urine in the woman. Retention after labor. Paralysis of the bladder. A woman who is too greatly embarrassed to pass through a crowd of observing men to the closet at the end of a railroad car, at the end of the journey finds that she is unable to pass the urine. Retention of urine from straining the muscles of the bladder. If the patient is chilled at the time the remedy – it may be Rhus. Rhus and Causticum are the two great remedies for paralytic weakness of muscles from being overstrained, or from being overstrained and chilled.
Great weakness at the time of the menses. Anxious dreams before menstruation; melancholy; cramp-like spasms; pains in the back. The woman suffers from many annoyance s during menstruation. just about the time for the flow to start violent cramp-like pains come on. In a woman who is nursing a child the milk almost disappears in consequence of fatigue, night watching and anxiety. The nipples get sore and crack, another instance of the tendency to form fissures.
The Causticum patient has trouble with the voice. You remember, when we were going over the symptoms of Carbo vegetabilis, I told you that the hoarseness was worse in the evening. Now observe that the hoarseness of Causticum is worse in the morning. He gets up in the morning with a hoarse voice; if it is an ordinary case. after moving about and expectorating a little mucus, it is better. Sudden loss of voice from paralysis of the vocal cord. It sometimes begins with the morning aggravation, gradually increasing until it lasts all day and all night.
The Causticum cough is a hard cough and racks the whole body. The chest seems full of mucus and he feels if only he could cough a little deeper better he could get it up, and he struggles and coughs until exhausted or until he finds out that a drink of cold water will relieve. But it must be ice cold. The cough is hollow, it sounds as if he were coughing into a barrel. It is relieved by expectoration if it can only get deep enough to reach the mucus. Sometimes such a cough precedes quick consumption. It is a deep acting medicine; it cures phthisis, especially mucous phthisis or quick consumption. "Cough with a sensation as if the patient could not cough deep enough to start the mucus; produced by tickling, accompanied by rawness. Cough wakens her from sleep in the evening and the morning. Cough relieved by a swallow of cold water. Cough worse by bending forward. Continual, annoying cough; with each cough escape of urine." Influenza with tired aching of the limbs as if they had been beaten. "Whooping cough in the catarrhal stage." Great soreness and tightness of the chest, oppression of the chest; it feels as if a load were upon it. It seems to be filling up with mucus, and the patient coughs until he raises a mouthful and then he feels a little better for a time. Pale as death, covered with sweat. There are many symptoms in the back. Pain and stiffness; stiffness on rising from a seat. Stiffness in the limbs, through the hips and in the back, so that he rises up from sitting or the recumbent posture with great difficulty. In most cases the pains and aches are ameliorated by the warmth of the bed and by applied heat. Only the pains in the fingers are sometimes brought on by heat.