We will take up the study of Ferrum metallicum. The Old School has been giving Iron for anemia throughout all tradition. They have given it in great quantities, in the form of the tincture of chloride, and the carbonate. Whenever the patient became anemic, pallid, waxy and weak, Iron was the tonic. It is true that Iron produces anemia, and it would be astonishing to any one who ever read the provings of Ferrum if the allopaths did not create additional bloodlessness with the doses of Iron they administer. It is true that under the provings, and under those circumstances where Iron has been given in excess, the patient becomes greenish, waxy, yellow and pallid, with a sickly and anemic countenance. The lips become pale; the ears lose their pink color; the skin of the body becomes waxy, and there comes a tendency to hemorrhage, at times with clots, but commonly with copious, thin, liquid blood, very dark. The clots will separate and the fluid parts look brown, dirty and watery. The patient gradually emaciates. He is pallid and waxy; his muscles become flabby and relaxed; he is incapable of endurance. All the muscular fibres become tired from any exertion. Rapid exercise, or any unusual exertion, is impossible. And rapid exertion or motion brings on weakness, dyspnoea, sinking and fainting.
A strange thing running through all the constitutional conditions of Ferrum is that the pains and sufferings come on during rest. The palpitation sometimes comes on during rest, the dyspnea comes on during rest, and even the weakness. The patient is ameliorated by moving gently about, but any exertion tires and causes faintness. Any rapid motion aggravates the complaints. The pains are ameliorated by moving about the house slowly, so that the exertion does not excite or fatigue. In many cases the patient is dropsical. The skin pits upon pressure and is pale, yet the face shows an appearance of plethora. From every little excitement the face becomes flushed. During the chill the face becomes red. From taking wine or stimulant the face becomes flushed, and the patient, though flabby, relaxed and tired, does not get credit for being sick. She fails to get the sympathy of her friend. She is feeble, she suffers from palpitation and dyspnea, she has great weakness with inability to do anything like work, she feels that she must lie down – yet the face is flushed. This is called a pseudo-plethora. The blood-vessels are distended, the veins varicose, and their coatings relaxed. On this account bleeding takes place easily; capillary oozing; hemorrhage from all parts of the body; hemorrhage from the nose, the lungs, the uterus. Women suffer much from hemorrhage from the uterus, especially during and after the climacteric period. Ferrum will be found of great value – when the symptoms agree – in that wonderful anemic state called "green sickness," that comes on with girls at the time of puberty and in the years that follow it. There will be almost no menstrual flow, but a cough will develop, with great pallor. So common is this sickness among girls that all mothers are acquainted with and dread it. In a large practice you will have a number of cases of chlorosis.
Sometimes the early menstrual period is attended with a copious flow, and then a great weakness occurs, and this goes on for a number of years before anything like menstrual regularity is established. In these cases the Old School always used to feed their patients Iron in great quantities, but the more Iron the patient took the worse she grew.
Congestion, tending upward, with red face, hot head and coldness of the extremities. But the heat of the head and face is not at all in proportion to the red appearance. It will be found that this is congestion upward in Ferrum will take place during a chill, in septic fevers or in other forms of fever, and the head is not always hot, but sometimes cool. The face may be red and cool.
Another grand feature of Ferrum is that, like China, it has complaints from loss of animal fluids; from prolonged hemorrhage, with weakness remaining a long time. There is no repair, no assimilation. The bones are soft and easily bent; they take on crooks. Emaciated and feeble children. Dryness of the joints, causing cracking on motion. Sudden emaciation, with false plethora.
Redness of face – a healthy looking bloom – in one who is unable to walk fast on the street, or to stand any exertion. Yet some of the complaints of Ferrum are better from occupation, from doing something, from taking a little exercise, because the complaints come on during rest. Over excitability and sensitivity of the nerves; over-sensitiveness to pain. The sensitive woman who need Ferrum has a flushed face and is often complaining because she gets no sympathy. She does not look sick, yet she puffs on going up stairs; she feels weak and wants to lie down. Restless when keeping still; must keep the limbs moving. Rending pains in the limbs; dull aching in the limbs. These pass off when moving about quietly and gently, like Pulsatilla. But Ferrum is a very cold remedy, and is ameliorated by warmth, except the pains about the neck, face and teeth, which are ameliorated by cold. But most of the pains are ameliorated by heat; the patient wants to keep warm and dreads anything like fresh air or a draft.
Weakness and prostration; weakness even from talking. Prostration with irregular pulse and rapid pulse, or with too slow pulse; palpitation. And then comes paralytic weakness; the limbs give out. Paralytic conditions from anemia or hemorrhage. Fainting spells from hemorrhage. Jerking and twitching of the muscles; chorea; catalepsy.
You may easily imagine something of the character of the mental symptoms, for they are like the physical. The mind is confused and the patient tearful. Depression of spirits; mental weariness and depression. The highest degree of depression and despondency. Anxiety from the slightest cause irritability. The least noise, like the crackling of paper, sets the patient wild. It brings on nervous excitement and restlessness; she must get up and move. Excitement from the slightest opposition. Any sudden or rapid motion, or the least hurry, causes blackness before the eyes; dizziness; things turn in a circle; she must sit down. And with all this the face is red. When alone and at rest, the face becomes pale and cold, but the least excitement bring a flush to the cheeks.
The headaches are congestive in character, with mounting of blood upwards. There is a sense of fullness and distension, with red face. Fullness and distension of the eyes; fullness of the neck. Palpitation of the heart. Exophthalmic goitre. The headaches are ameliorated by pressure. Ferrum wants to be pressed to support the veins. Throbbing like hammers in the head. Every quick motion aggravates the headache. Coughing aggravates the headache; pain in the head and occiput from coughing. These pains are sometimes ameliorated by walking gently. Going up stairs, sitting down, rising from a seat – unless it is done very deliberately – will arouse all the pains of Ferrum. Any sudden motion will bring on hammering and a feeling of great expansion in the head. And then will come more or less shooting, tearing pains. Beating in the back of the head from rising or from coughing, because coughing is a sudden motion. Confusion of mind with hammering headache. Rush of blood to the head. Congestive headaches from excitement; from taking cold; from exposure; lasting three or four days or a week. The face is flushed and perhaps cold, the head somewhat hot, but not as hot as would be expected.
Redness of the eye; engorged vessels. Great weakness, dyspnoea and palpitation. Writing – a mental operation – causes the headache to reappear. Great sensitiveness of the scalp. The patient must let the hair hang down. Mental disorders and headaches accompanying or following hemorrhages, and in lying-in women. Bloated appearance about the eyes. All sorts of disturbance of vision from congestion. Venous stasis; swelling of the eyelid; pus-like discharge. Over-sensitiveness to sound; ringing in the ears.
The symptoms of the nose are numerous. Colds and catarrhal troubles, ending in nosebleed. Nosebleed on slight provocation, with headaches at the menstrual. Scabs form in the nose. Extreme paleness of the face; face becomes red and flushed on the least emotion. Flushed face with dropsy of the lower limbs; flushed face with chill. Thirst during the chill is a striking feature of Ferrum. During the menstrual period there are violent pains, and as soon as the pain starts the face becomes flushed.
Nothing taken into the stomach digests, and yet there is no special nausea. It is the exception to find nausea in Ferrum. Food goes into the stomach and is vomited without nausea – simply emptied out. Sometimes there are eructations of food by the mouthful, like Phosphorus. Phosphorus was the remedy with all the old masters for spitting up of food by the mouthful until the stomach was empty. Canine hunger. It says in the text: "Double the amount of an ordinary meal in the evening was hardly sufficient." All food tastes bitter; solid food is dry and insipid. After eating there are eructations. Heat in the stomach; regurgitation of food. Spasmodic pressure in the stomach after the least food or drink, especially after meat. Aversion to meat, to eggs, to sour fruit. Aversion to milk and to his accustomed tobacco and beer. Sweet wines agree, but sour wines and all sour things disagree. The tongue feels as if burnt. As soon as the stomach is empty vomiting ceases until he eats again. Vomiting of food, immediately after midnight. Vomitus tastes sour.
Ferrum is occasionally indicated during pregnancy. A few weeks after becoming pregnant the woman commences to throw up her food by the mouthful. There is no nausea but the face is flushed and the woman is flabby and weak. She vomits without becoming sick. Fullness and pressure in the stomach; pressure in the stomach after eating. Ferrum is an unusually interesting remedy because of this peculiar stomach. It is like a leather bag; it will not digest anything. Fill it up and it empties itself just as easily as it was filled.
Ferrum has a troublesome diarrhea, with acrid watery excoriating stool. Morning diarrhea. Many of these patients are old sinners with broken down constitutions, who have suffered long from constipation. Chronic constipation with ineffectual urging and hard, difficult stools.
Relaxation runs through the remedy. From this relaxation there is prolapsus of the rectum, vagina and uterus. Dragging down in the lower part of the body, as if the organs would come out and sometimes they do come out.
The bladder is also relaxed. Its sphincter is weak, and there is no regularity of its muscular action. Hence, we have involuntary urination from sudden motion, from walking, or from coughing. In little children the urine dribbles all day. Just as long as the child plays the urine dribbles and keeps the clothing wet, but this is better while keeping perfectly quiet. The bladder is so relaxed and tired that it cannot hold the urine, and as soon as it is partially filled it allows its contents to escape. This relaxation runs through the remedy and gives it character, just like a human being. You know what each one of your friends is likely to do on every occasion. So it is with a remedy. You ought to know what it is most likely to do, in order to know what it will accomplish in curing the sick.
Weakness and relaxation of the genital organs is common to Ferrum. The menstrual flow comes in for its share. Copious, watery flow; hemorrhage or suppression – amenorrhoea – no flow at all, only a leucorrhoea. Suppression of the menses with great nervous excitement; with flushed face; with weakness and palpitation. Prolapsus of the vagina. Insensibility of the vagina during coition. Metrorrhagia. Menses too soon, too profuse and lasting too long.
Difficult respiration; pains and disturbances in the chest. Difficult breathing, with a sense of a great load on the chest. Suffocating fits at night; catarrhal conditions of the respiratory tract; congestion of the chest; dyspnea. Spasmodic cough, such as we find in whooping-cough, coming on in violent paroxysms. Cough after every meal, with gagging, emptying the stomach of its contents. Cough felt in the head. Cough worse from the abuse of brandy, tobacco or tea. Cough coming on after the loss of fluids, as after hemorrhages. Chest troubles following uterine hemorrhage, and after other hemorrhages. Coughing up blood; bleeding from the lungs, Persons debilitated by secret vices, with a tendency to go into tuberculosis.
Palpitation of the heart from fear, excitement, or exertion. Rapid action of the heart, or sometimes slow action. Fatty degeneration of the heart. Pulse accelerated toward evening. Pulsations throughout the body, feeling like little hammers.
Rheumatic pains in the extremities, ameliorated by heat and by gentle motion; aggravated by cold, by exertion, or by rapid motion. Pains through the deltoid muscles are spoken of more prominently than pains in other parts, but these pains are no more striking than the pains anywhere in Ferrum. Tearing pains through the limbs. Inability to raise the arm; paralytic pains – that is, pains that are benumbing. Pains that make him feel as if he were going to lose the power to move the part. Violent pains in the hip-joint are just as common as the pains in the shoulder. Lippe says, "Rheumatism in the left shoulder," but it is just as common in the right. Rheumatic pains in the deltoid muscle of either side. Violent pain in the muscles and along the nerves. Pinching in the right deltoid; boring in the right shoulder; aggravated by motion and by the weight of the bed-clothes; ameliorated by heat. Tearing and stinging pains. The Ferrum pains come on in the night, because the patient attempts to keep still in bed. Rest brings on the Ferrum pains. When moving gently about in the daytime he will not have so much pain. Coldness of the limbs; add again, heat of the soles and palms – they change about. With all this weakness and prostration dropsical conditions come on, so that the feet and hands become bloated.
Evening chill or chilliness with fever, cold hands and feet and red face. Icy cold feet with the chill. Chill ameliorated after eating. Thirst with the chill. Copious sweat which stains yellow. All symptoms worse while sweating. Strong-smelling night sweats. All the febrile symptoms are better by slowly moving about. In intermittent fever after the abuse of quinine.
We read in the text that Ferrum is a remedy for diarrhea in the last stages of consumption. Well, sometimes it is – if the patient is prepared to die. Ferrum will stop the diarrhea, but after it is stopped the patient will not live long. The diarrhea is not usually painful. It is annoying, but it is painless, and the night sweats are painless. Do not suppress them; they had better be let alone. Let the patient go on to a peaceful termination. The best remedy for diarrhea in the last stages of consumption is Saccharum lactis in the crude form, given in very small quantities and repeated often as is required by the patient and the bystanders.