(HNO)3. Dilutions. Ten minims of the acidum nitricum of the British Pharmacopoeia in 60 minims of water make the 1x attenuation of the British Homoeopathic Pharmacopoeia. Dilutions after the 2x are made with alcohol.
NITRIC ACID is equally corrosive as sulphuric acid, but is safer to use, as it does not diffuse so readily in the tissues. It stains the skin and tissues a bright yellow or yellow-brown colour.
The principal action of nitric is on the mucous membranes, and is especially affects the muco-cutaneous orifices. It causes the lips to be dry and swollen, with cracks at the corners of the mouth. The mouth and gums are covered with superficial ulcers which bleed and are very tender to touch. Neuralgic pains occur in the gums and teeth, and the gums are soft and spongy. The tongue is sore and covered with blisters, and the papillae are swollen. It feels scalded, is sensitive to touch, the tip and edges are red, the centre brownish. There are salivation, a constant sour taste in the mouth, and unquenchable thirst. Burning pains come on in the mouth, throat and epigastrium, then vomiting, often long lasting, with expulsion of bloody mucus, or the vomiting may be followed by repeated retching. Or there may be simply nausea with chilliness. Drinking causes increased pricking pain in the stomach, and vomiting, and there is belching of large quantities of gas. These stomach symptoms seem to be mainly caused by the direct irritant action of the drug. The abdomen is distended with flatus and is very tender; there are borborygmi and abdominal cramps.
Nitric acid causes dysenteric inflammation of the large intestines with the symptoms of dysentery, viz., frequent bloody evacuations, pain and tenesmus, protruding haemorrhoids, which crack and bleed and are very sore when touched; fissures. The pain during the passage of stool is stitching or pricking, and a sore or burning pain remains afterwards. The stools are of blood or bloody mucus, passed with much straining.
In the respiratory system we get a pricking, tickling sensation in the nose, with frequent sneezing, ulceration in the nostrils, passive epistaxis of dark blood. Respiration is laboured and impeded, and a constant and violent cough comes on with whistling inspiration, the cough coming in paroxysms and being either dry or with expectoration of green, slimy sputum or bright red blood. It is accompanied by burning in the chest as of a rope drawn round, and by much muscular soreness in the chest walls.
The pulse becomes slow, irregular and feeble.
In the urinary sphere there is burning pain in the bladder, with frequent calls to urinate, and scalding pain. The urine is scanty and of a strong hippuric odour. In severe poisoning the urine is suppressed and acute Bright’s disease is produced.
Head.-Nearly all the provers experienced headache, a full sensation in the head and a feeling as if intoxicated. When more severe this becomes a “bursting” pain, felt mostly in the forehead and sides of the head, and is relieved by wrapping the head up warmly. There may also be dull pains in the bones of the head and darting pains extending from the forehead to the jaws and ears. Soreness of the scalp as from ulceration.
The mind is excitable, the patient is easily startled and frightened, irritable, vexed at trifles, inclined to weep, despondent and averse from mental exercise. The mind remains clear, delirium ensuing only in the very severe or fatal cases.
In the eyes there are severe lachrymation and wavering of objects, and the eyes smart and feel hot and excoriated.
In the ears are ringing and a stopped-up feeling.
The face is pale, with turgid swollen veins-a bluish- coloured pinched face. There are pricking pains in the face and temples, as if prodded with some sharp instrument. Pigmented warty spots occur on the face.
Nitric acid causes fever, accompanied by chilliness and shuddering, even when near a hot stove. There are drawing pains in the back and limbs, rheumatic drawing pains from the knee to the groin. The hands and feet are cold and perspiring.
There is much drowsiness from nitric acid in the day time, from which the patient wakes up hungry, but he is restless and sleepless at night, tossing about in bed, or getting out to walk the floor. He wakes from sleep with headache and pain in the neck. Right supraorbital pain may accompany the day drowsiness.
The general therapeutic sphere of nitric acid is indicated by the above pathological conditions produced by it, but they do not cover the whole field of its usefulness for it has been found to be an antidote to the poison of mercury in conjunction with syphilis and to cure many complaints brought on when syphilis and gonorrhoea have been overdosed with mercury, especially those occurring in the mucous membranes and at the mucocutaneous orifices and adjacent parts of the genital tracts. It seems both to supplement and antidote mercury in these cases. Thus it is useful for chancres on the genitals, for mucous patches and condylomata, for itching in the urethra, left behind after gonorrhoea, for old cases of gleet when there is pain as of a splinter sticking in on urinating and a whipcord-like feeling of the urethra, for chronic vaginal leucorrhoea which is tenacious, flesh-coloured or green, and offensive; and for very sensitive caruncles at the orifice at the urethra. It is a good remedy for haemorrhage following abortion or confinement and for continued flow at the climacteric; for menorrhagia when the menses are too soon, and the discharge like bloody water, or dark and thick, or when, after the menses, there is a muddy watery flow for several days that excoriates the parts.
Eyes.-Nitric acid is useful in syphilitic iritis with frequent relapses that have been treated with mercury, in syphilitic ophthalmia and ulceration and recent opacities of the cornea, in ophthalmia neonatorum and gonorrhoeal ophthalmia. The pains are pricking and sticking.
Ears.-It is also useful in inflammation of the middle ear and obstruction of the Eustachian tubes, for foetid discharge following scarlet fever, and for deafness when the patient hears better while riding in cars or trains.
It is of service also in caries of the mastoid process and of the facial bones, especially of the malar bone; in syphilitic nodes on the tibiae with pain at night, and in syphilitic ozaena with ulcerated nostrils.
Mouth and Throat.-It is likewise useful in stomatitis and sore throats produced by mercury, as well as for these conditions occurring in patients when mercury has not been given. In sore throat the indication is pricking pain like a splinter on swallowing (alum, hepar, arg. nit.). In toothache either hot or cold things aggravate.
In gastric affections for which nitric acid is suitable there is a desire for fats, pungent things, herring, chalk, and earth; and aversion from bread and meat. There is usually thirstlessness. There is pain at the cardiac end of the stomach on swallowing. The drug has been used in ulceration of the stomach.
Its much more frequent and effectual employment has been for dysentery and fissures of the rectum. In dysentery there is severe tearing and splinter-like pain during evacuation, and burning and smarting for some hours afterwards. Constipation is often present and is low dilution nitric acid will often relieve it, whether a fissure is present or not.
In high potency it has been found useful in the exhausting diarrhoea of phthisis, and has been used for enlarged liver and in chronic hepatitis, and has gained some reputation for these conditions used in solution in a bath, but nitro-muriatic acid is preferred by some.
Respiratory.-Nitric acid is a good remedy in frequently repeated colds with sneezing from every draught of cold air, in chronic laryngeal affections, for chronic laryngeal cough without expectoration and with a stinging, smarting sensation as if a small ulcer were there, generally felt on one side; coincident constipation is an indication in this laryngeal cough. The cough is worse in winter, in a warm room, at night before midnight, and when lying down; it comes on during sleep, is dry and barking, and arises from tickling in the larynx. It is often loose in the day and dry at night (puls); though rattling and loose by day, there is no expectoration.
In phthisis also it is useful when there is suffocating dyspnoea, and when the chest walls are sore to touch, with sharp stitches through the chest to the right shoulder, when there are frequent haemorrhages of bright blood and the sputa are purulent, offensive, green and blood-stained.
The characteristic headache of nitric acid is a sensation of constriction as if the head were bandaged, or as if put in a vice from ear to ear. The headache is worse from noise, better from wrapping up, and from the rhythmic vibratory movement of riding in a carriage. The head is sensitive to the least jar, to pressure of the hat, and to combing. The hair falls out in profusion and the scalp is extremely sensitive, especially the part lain on. Eruptions on the scalp with splinter-like pains. Exostoses may be benefited by it.
In the fever for which nitric acid is indicated the heat comes in flushes, and is only on the hands and feet, and there is thirstlessness during all stages. Sweat is apt to be strongly smelling, especially in the axillae and on the feet.
In kidney diseases the indications are haematuria, with frequent strangury, and the odour of the urine is strong -like horses’ urine- or very offensive.
In the skin, nitric acid is useful for foul ulcers, with exuberant granulations and splinter pain on being touched; for warts, especially on the upper eyelids and the backs of the hands, and for a sensation as of a splinter under the yellow curved nails. Offensive sweat occurs on the hands and feet.
It antidotes both mercurius and kali iodatum.
1) Complaints arising from mercurio-syphilis. Syphilitic bone pains. Exostoses.
2) Pains, like splinters, occurring on touch or motion.
3) Complaints brought on by bodily rather than by mental sufferings.
4) Affections of the muco-cutaneous outlets; warts at orifices, pains after stool. Condylomata. Fissures.
5) Sensitiveness, both mental and bodily: especially sensitive to touch (hepar, sil.)
6) Haemorrhages from mucous membranes depending or superficial ulceration.
7) Offensive urine, smelling like horses’ urine (benz. ac.)_
8) Strongly smelling sweat.
9) Restlessness after midnight (ars., sil., sulph.)
10) Depression of spirits worse before menstruation and at night.
11) Discharges are offensive, thin, excoriating, often bloody. Dysentery.
12) Patient hears better in a noise, but is very sensitive to noises, & c.
13) Aggravation from both heat and cold (antim. crud., merc., ipec.)
14) Persons or swarthy complexion with black hair and eyes; lean persons of rigid fibre; brunettes.
From touch, pressure of the hat, eating, milk or fat food, exertion of mind or body, both extremes of warmth and cold, noise, jerking and at night, winter, lying (cough).
From lying down, riding in a carriage (deafness), and from sympathy.