The Hepar patient is chilly. He is sensitive to the cold and wants an unusual amount of clothing when in cold air. He wants the sleeping room very warm and can endure much heat in the room, many degrees warmer than a healthy person ordinarily desires. He has no endurance in the cold and all his complaints are made worse in the cold. If he becomes cold in sleep his complaints come on; or if he is out in the cold, dry wind, complaints come on; inflammatory and rheumatic complaints appear. The exposure of hand or foot at night in bed brings on symptoms. He wants the covers drawn close about the neck when in bed.
This patient is also oversensitive to impressions, to surrounding and to pain. What with an ordinary person would only be an ache or disagree able sensation becomes with Hepar an intense suffering. But the pains of Hepar may be very severe, very sharp. Inflamed spots, eruptions, boils or suppurations are full of sharp pains. This is so intense that it is described at times as a sticking and jagging like sharp sticks. The pains in ulcers are often felt like sticks; intense and sharp as if sticks were jagging the ulcer. This sensation is often expressed by the patient suffering from sore throat. He feels as if he had swallowed a fish bone or stick. This is in keeping with the general character, because it is present everywhere, in inflammations, ulcers, pustules, boils and eruptions; all seem to have sticks in them or something jagging. Eruptions are sensitive to touch. This accords with the oversensitiveness of the nerves found everywhere. The Hepar patient faints with pain, even from slight pain.
This remedy belongs to patients that are called delicate, that are oversensitive to impressions. The mind takes part in this oversensitiveness and manifests itself by a state of extreme irritability. Every little thing that disturbs the patient makes him intensely angry, abusive and impulsive. The impulses will overwhelm him and make him wish to kill his best friend in an instant. Impulses also that are without cause sometimes crop out in Hepar. A man may have a sudden impulse to stab his friend. A barber has an impulse to cut the throat of his patron while in the chair. Mothers may have an impulse to throw the child into the fire or an impulse to set herself on fire; an impulse to do violence and to destroy. These symptoms increase to insanity and then the impulses are often carried out. It becomes a mania to set fire to things.
The patient is quarrelsome, hard to get along with; nothing pleases; everybody disturbs; oversensitiveness to persons, to people and to places. He desires a constant change of persons and thing and surroundings and each new surrounding or person or thing again displeases and makes him irritated. With this irritability of temper and physical irritability there is a tendency to suppuration in parts. Localized inflammations incline to suppurate, especially in glands and cellular tissue do we have suppuration and ulcers. The glands of the neck, axilla and groin and the mammary glands swell, become hard and suppurate. First the hard swellings with the feeling as if they had sticks jagging in them, then it becomes highly inflamed and red over the part and ultimately it suppurates, discharges and heals slowly. The bone even suppurates and takes on necrosis and caries. Felons around the root of the nail and ends of the fingers. The nail suppurates and loosens and comes off. Sensation of splinters under the nails, even when they do not suppurate. The nails become hard and brittle. Warts crack open and bleed, sting and burn and suppurate. Hepar is especially useful in felons in such a constitution as described, but sometimes you will have nothing more than the fact that the patient is a scrawny, chilly patient, who is always taking cold and subject to felons I have often had to give Hepar on no better information and have known it to stop the tendency to felons. It also competes with Silica.
The patient is often scrawny, and has a tendency to enlargement of glands. The lymphatic glands are generally hard and enlarged. They are chronically enlarged without suppuration, and at any cold that comes on some particular gland may suppurate.
The catarrhal state is general. There is no mucous membrane exempt, but especially do we have catarrh of the nose, ears, throat, larynx and chest. The Hepar patient is subject to coryza. In some instances the colds settle in the nose and then there will be much discharge, with sneezing every time he goes into a cold wind. The cold winds bring on sneezing and running from the nose, first of a watery character and finally ending in a thick, yellow, offensive discharge. These offensive discharges smell like decomposed cheese, and this characteristic runs through the remedy. The discharges from all parts of the body smell like old cheese. The discharges from ulcers are offensive, and have a decomposed, cheesy smell. It has discharges running through it also that smell sour, and this is also a general because it modifies all things that can be sour. The babies are always sour in spite of much washing. Or it may be noticed by the members of the family that one of the family always smells sour, has a sour perspiration. The discharges from ulcers are sour, and also discharges from mucous membranes. The discharge from the nose becomes copious, and causes ulceration in patches. The throat has a catarrhal condition; the whole pharynx is in a catarrhal state with copious discharge. Throat extremely sensitive to touch; pain as if full of splinters; pain on swallowing. The larynx also is painful on talking; painful as a bolus of food goes down behind the larynx, and painful to touch with the hand. There is a loss of voice, and a dry, hoarse bark in adults, especially in the mornings and evenings. Every time he goes out in the dry, cold wind, he becomes hoarse, loses the voice and coughs. It is a dry, hoarse, barking cough. Inspiring cold air will increase the cough and putting the hand out of bed will increase the pain in the larynx or cough. Putting the hand or foot out of bed brings a general aggravation of all the complaints of Hepar. Putting the hand out of bed accidentally when sleeping will bring on cough, and cause sneezing. The larynx has its catarrhal state, and in oversensitive children this catarrhal state becomes a croup. Sensitive children that are exposed during the day in a cold, dry wind, or cold air, come down next morning with a violent attack of croup. The Hepar croup is worse in the morning and in the evening; evening until midnight. Sometimes cases that at first call for Aconite run into Hepar. The Acon. croup comes on with great violence, worse in the evening before midnight. The child wakes up from its first sleep with a hoarse, barking croup. A dose of Aconite may prove entirely sufficient; or it may be only a palliative. The child goes to sleep and along towards morning, or at least sometime after midnight, there is another attack, which shows that Acon. was not sufficient. Such a case will be controlled by Hepar. When the croup comes on after midnight and the child wakes up frightened, suffocating, rouses up in bed with a dry, hoarse and ringing cough, which rings like a dry whoop, the Spongia will nearly always be the remedy, and again if Spongia palliates it and it is not sufficiently deep and there is a morning aggravation which shows that the trouble is returning Hepar follows. Acon., Hepar and Spongia are closely related to each other and they are truly great croup remedies.
Dry, paroxysmal cough from evening until midnight and sometimes lasting all night, with choking, gagging and crouping; some loose coughing in the daytime; rawness and scraping the larynx; worse in cold air or uncovering hand or foot in bed.
The catarrhal state is sometimes lower down in the trachea, and the trachea becomes extremely sore from much coughing. The patient has been coughing days and weeks and has the morning and evening aggravations; a rattling, barking cough with great soreness of the chest in an oversensitive and chilly patient. The cough is attended with choking and gagging, even to vomiting; it is worse in the cold air, and from putting the hand out of bed. He coughs and sweats. There is much sweating the whole night, without relief. Sweating all night without relief belongs to a great many complaints of Hepar. He sweats easily, so that with the cough and on the slightest exertion he is fairly drenched with perspiration.
It has catarrhal affections of the ear. A sudden inflammation comes on in the middle ear, an abscess forms, the drum of the ear ruptures and there is a bloody discharge and sticking, tearing pains in the inflamed ear. There is first a sensation of stooping up of the ear, then bursting and pressure in the ear, and then perforation of the drum. There is also an inflammatory condition causing a discharge that is fetid, or a bloody yellow, purulent discharge, thick, with cheesy particles and smelling like old cheese.
Hepar sometimes is bad on the oculist. When it is indicated, it cures eyes very quickly, so that the oculist does not have a very long case and it does away with the necessity for washes in the hands of the specialist. From the eyes we have the same offensive thick, purulent discharge. Inflammation of the eyes attended with little ulcers. Ulcers of the cornea, granulations, bloody, offensive discharge from the eyes. The eyes look red, the lids are inflamed, the edges are turned out and the margin of the lid become ulcerated. In all sorts of so-called scrofulous affections, the eye conditions may be covered by Hepar when the constitutional state is present. The constitutional state of the patient is the only guide to the remedy. Many times the eye symptoms are nondescript. You have only an inflamed eye with catarrhal discharge, and for this you could give a large number of the anti-psoric; but when you go into the state of the patient and find these general symptoms, then this remedy will cure. The general symptoms will guide to the remedy that will cure the eyes. You will see that the specialist for the eyes is often limited unless he knows how to secure all the symptoms of the patient and selects the remedy upon the totality of the symptoms.
There are other catarrhal conditions. Catarrh of the bladder, with purulent discharges in the urine and copious muco-purulent deposits. Ulcers of the bladder. The walls of the bladder become hardened, so that it has almost no power to expel its contents, and the urine passes in a slow stream or in drops, or in the male the stream falls down perpendicularly. No ability to expel the urine with force. It is a paresis. There is burning in the bladder and frequent, almost constant, urging to urinate. It has also a catarrhal state of the urethra that resembles gonorrhea, and it has been a very useful remedy in chilly patients with gleety discharge of long standing. Thick discharge of a white, cheesy character. Ulcers and little inflammatory spots along the urethra. There is a sticking sensation here and there along the urethra and when passing urine a sensation of a splinter in the urethra. Copious leucorrhoea with the same offensive, cheesy smell. The leucorrhoea is so copious that she is compelled to wear a napkin, and the napkins, I have been told by women who have been cured by Hepar, are so offensive that they must be taken away and washed at once because the odor permeates the rooms. This horribly offensive odor that is so permeating is often cured by Kali phos. It has really one of the most penetrating of odors, so much so that when a woman suffers from this leucorrhoea the odor can be detected when she enters the room.
A very important sphere for Hepar is after mercurialization. Many old people are waking the street at the present day who have been the victims of Calomel, who have been salivated, who have taken blue pill for recurrent bilious spells, to "tap the liver," until finally they get into a state of chilliness felt, as it were, in the bone. They sweat much about the head, they ache in the bones, and every change of weather to cold, and every cold, damp spell affects them. They are like barometers. Hepar Is the remedy for that state. They go into diseases of the bone easily and are always shivering. While they have periods of aggravation from warmth, as a general rule they are chilly subjects, and feel the cold easily. In the more acute affections of Mercury there is an aggravation from the warmth of the bed, but the old subjects who have been years ago poisoned with it get almost bloodless, and they become chilly; they cannot get clothing enough to keep them warm. They become withered and shrivelled, and have rheumatic affections about the joints. Then it is that the symptoms of Hepar agree and it becomes a valuable antidote to that state of mercurialization. Hepar is also a complement and antidote to potentized Mercury. When Merc. has been administered and has done all it can do as a curative remedy, or when it has acted improperly and has somewhat mixed up the case and it is necessary to follow it with the natural complement or antidote and prepare for another series, Hepar is to be thought of as one of the natural followers of Merc. It is well known that Merc. is not followed well by Silica. Sil. does not do useful work when Merc. is still acting or has been acting. This is the time that Hepar becomes an intercurrent remedy. Sil. follows well after Hepar, and Hepar follows well after Merc., and thus Hepar becomes an intercurrent in that series.
In old syphilitic cases when the symptoms agree Hepar is a very full and complete remedy. It corresponds to the majority of symptoms of syphilis, and it only needs to correspond to the symptoms of the individual patient when he is syphilitic to be indicated. Thus in old cases who have been mercurialized, who have had the symptoms suppressed so that the disease is latent and ready to crop out at any time, Hepar will come in and have a decided effect upon the syphilis and upon the mercury. It will straighten matters out and cause a development that will lead to clear prescribing. In this relationship to syphilis and mercury Hepar is closely allied to Staph., Asaf., Nit. acid, Sil., etc. Especially is Hepar the remedy in those cases of syphilis where great quantities of mercury have been taken, until it is no longer able to suppress the symptoms of the disease; in old cases when the syphilitic miasm attacks the bones of the nose and they sink in, or a great ulceration takes place; those cases you sometimes see walking around the street, with a big patch over the nose or over the opening that leads down into the nasal cavity. When there is severe pain in the region of the nasal bones, the bridge of the nose is so sensitive that it cannot be touched and in the root of the nose there is a sensation as if a splinter were sticking in. For offensive discharge from the nose, fetid ozaena in an old case, which has been mercurialized, who is chilly in his very bones, think of Hepar. It has cured many such cases; it has healed up the ulcers; it has cured the catarrhal state, and it has hastened the healing up of the portions of diseased bone, by hastening the suppuration and has returned the patient to an orderly state.
As we go into the syphilitic affections that lead into the throat, we find ulcers of the soft palate which eat away the uvula, small ulcers which finally unite and destroy the soft palate and then commence to work upon the osseous portion of the roof of the mouth. The odor that comes from that mouth when it is opened to show the throat is extremely offensive; very often like spoiled cheese. The medicines that are especially related, or especially useful in this form of ulceration in old syphilitics, will be Kali bi., Lach., Merc. cor., Merc. and Hepar, but in those syphilitic cases that have been mercurialized Hepar and Nitric acid should be thought of. Nitric acid is very closely related to Hepar; it is just as chilly; it has the sensation of sticks in the throat and in inflamed parts. It has fine ulcers in the throat, upon the tonsils and in the larynx. Nitric acid competes with Hepar. You think of the two together. Both have sensation of a fish bone or stick in the throat.
The cartilages of the larynx become attacked in syphilitic affections and old mercurial affections. When the case is not of syphilitic origin but is of sycotic origin, small or large white gelatinous polypi form in the larynx and they are sore, causing loss of voice, or cracked voice; when they cause choking or uneasiness, Hepar is one of the remedies. Hepar, Calc., Arg. nit. and Nit. ac. and sometimes Thuja are the remedies related to such conditions.
Again, in the earlier syphilitic manifestations, the chancre has the feeling of a stick in it; then comes the formation of a bubo that may be either non-suppurative or a suppurating gland, associated with a chancre or a harmless ulcer upon the penis. These conditions are often indications for Hepar, when the constitutional state is present. Hepar has also sycotic warts. It is useful in old cases of gleet; also when there is a sensation of a splinter in the urethra. In strictures and constrictions of inflammatory character during the inflammation there is a tendency to ulcerate, and with this the sensation of a stick is felt. Arg. nit., Nit. ac. and Hepar run close together for this kind of inflammation, and will cure the inflammatory stricture before it becomes a complete and permanent fibrinous stricture. It is only very rarely that you will be able with your medicines to cure a stricture after it has taken on permanency, after it is many years old, but as long as the inflammation keeps up there is hope. I remember one very old one that was cured by Sepia. I did not know at first of its presence, but prescribed Sepia on the symptoms of the case, and the patient came back with great suffering in the urethra, and then confessed to me that he had gonorrhea and had been troubled for years with a stricture. That inflammation was aroused anew and after it ran its course it really left the passage clear and there was never any more trouble with the stricture. That was a very unusual result. I have many times prescribed for patients with the utmost endeavors to do the same thing, and have cured the patient in other respects, but the stricture would remain. Remember then that Hepar has fig-warts, chronic sycotic discharges, or chronic gonorrhea, offensive, cheesy discharges, the sensation of sticks in the urethra, inflammatory stricture, which will be associated with difficulty in passing urine, to the extent that there is a weakness of the bladder and the urine falls perpendicularly.
Hepar has served a valuable purpose in its ability to establish suppuration around foreign bodies. For instance, a foreign body is under the skin or is somewhere unknown. Perhaps it is the tip end of a projectile after the projectile itself has been taken away, or under the nail a splinter is forming a suppuration. It is so small that it is hardly observed and it is supposed often that the splinter has been entirely removed, but an inflammatory condition starts up. Hepar if indicated by the general symptoms of the patient hastens the suppuration and heals up the finger, for it has all such things. Silica is another remedy capable of establishing inflammation and suppuration and removes little foreign bodies that cannot be located. Of course it is understood that if the physician knows the location of a splinter, he will take such steps as are necessary to remove it, and not wait for the action of a remedy. But at times a needle point breaks off against the bone of the finger of a seamstress, or small portions of the needle may exist where they cannot be found without an immense amount of slashing which the patient refuses. Hepar or Silica will remove it. A little abscess will form, and the little mite will be discharged. Knowing that these two remedies have-this tendency to establish a suppuration wherever there are foreign bodies, it is well to be reminded that if a bullet were encysted in the lungs it would be well, if the symptoms called for Hepar or Silica, to consider whether it might not be injurious to give a remedy that would establish a suppuration. It might be that the bullet is resting in a vital place, in a net-work of arteries, and it would be well not to establish suppuration in this vital region. Deposits of a tubercular character are often located in a place that they can easily tie suppurated out, and the action of the remedy on them would be the same as a foreign body. Hence it is that Hepar, after its administration, will very often abolish a crop of boils all over the economy because in the skin there are small accumulations of sebaceous matter and these will be suppurated out. Sulphur also does this, so that it may be well to be careful and not give Silica or Sulphur, or Hepar too often, or too high, in patients that have encysted tubercle in the lungs. Rokitansky in his numerous post-mortems found a large number of encysted caseous deposits in the lungs, in cases that had lived and out grown these troubles; they had become encysted and therefore perfectly safe and the patient had died of something else. It might be dangerous to administer these medicines that have a tendency to cause suppuration in such, and you should at least proceed cautiously in using them. After you have seen a great many cases you will find that you have killed some of them. If our medicines were not powerful enough to kill folks, they would not be powerful enough to cure sick folks. It is well for you to realize that you are dealing with razors when dealing with high potencies. I would rather be in a room with a dozen Negroes slashing with razors than in the hands of an ignorant prescriber of high potencies. They are means of tremendous harm, as well as of tremendous good.
In contrast with Hepar (although Hepar is a form of Calcarea), Calc. carb. has no such tearing down nature in it. It does not establish inflammation around foreign bodies and tend to suppurate them out, but causes a fibrous deposit around bullets and other foreign substances in the flesh. It causes tubercular deposits to harden and contract and become encysted.
Many excellent homeopathic physicians have said to me, "l do not agree with you as to the danger of Sulphur in phthisical cases. I have cured cases of phthisis with Sulphur." So have I many of them. But I did not refer to curable cases, but to those cases which are well developed and have grave symptoms. It is well to know all the elements in the case; then if you have administered a remedy and killed your patient, you know at least what you have done. It is better to know what you have done if you have killed your patient, than to be ignorant of it and go on and kill some more in the same way.