Calcarea carbonica, carbonate of calcium. Triturations made with the pure carbonate or the inner scaly layer of oyster shells (calc. ostrearum).
THE SALTS OF CALCIUM are relatively insoluble and are therefore but slowly absorbed, and when administered in bulk are largely passed out with the faeces. A small quantity is absorbed, some of it being re-excreted into the bowel, some into the urine, and a portion being appropriated by the tissues. Lime salts form a very large much smaller extent in the soft tissues In some not very obvious way they are necessary to the healthy activity, if not to the life, of animal tissues.
It is doubtful if any other single element plays a more varied role in out bodies than does calcium. Any deficiency or excess can affect bones, muscles, blood and nerves. it is present to a greater or less extent in all foods mainly as salts of oxalic, phosphoric and carbonic acid, but some of it in complex organic compounds. Oatmeal, cabbage and milk are particularly rich in assimilable calcium. When such food has been digested the calcium circulates in the blood and there are normally 10 mg. of every 100 c.c. of normal blood-serum. Deficiency of calcium in the blood leads to insufficiency of that substance in growing bones causing rickets, to insufficiency in the walls of the small blood vessels causing them to break down under excessive changes of temperature, with the formation of chilblains, to an inability of the blood to clot on exposure to air as in haemophilia, and to other derangements in the physiology of the body, such, for example, as tetany, laryngo-spasm, carpo-pedal spasms, eclamptic spasms and similar nervous and convulsive affections. Cardiac and nervous tissues are extremely sensitive to the calcium-potassium-sodium balance of the body.
Deficiency of calcium salts in the blood is due to an inability of the blood-stream to absorb them from the intestines; though present n the food they pass out unused. Experiments have proved that the power of the gut to absorb calcium is diminished as the intestinal contents become more alkaline and increased as they become more acid (or less alkaline), so that the administration of sodium carbonate or lime water, though containing calcium, by increasing the alkalinity of the intestinal contents lessens the absorption of calcium into the blood, thereby causing a deficiency and therefore predisposes to rickets. It has been shown that vitamin D and ultra-violet light also, in some way not understood, make the intestinal contents more acid, and to this their beneficial effects in rickets is probably due. The parathyroid glands are the controllers of calcium metabolism and when they are too active or when the hormone is administered calcium is extracted from the tissues and the bones and is found in excess in the blood, the calcium is mobilized, and hence the value of parathyroid in haemorrhages, as calcium lessens the coagulation time of the blood and so favours the formation of clot.
Muscular tissue paralysed by washing it out with sodium chloride (” normal saline solution”) regains its contractile power if a trace of calcium salt be added to the solution, and ciliated epithelium reacts in a similar manner.
The pathogenesy of calcarea (the carbonate only is referred to here, reference will be made to the phosphate later) is made up of the effects of lime starvation, of the genuine results experienced by provers, and of the symptoms noted as being cured by or developed during the administration of calcarea as a homoeopathic remedy, In spite of this mixed origin the results of a properly chosen prescription are amongst the most certain and successful of drug therapeutics. The chief general effect is weakness felt in a variety of spheres, e.g., the walking powers, especially when mounting stairs or ascending hills (due probably to shortness of breath); general muscular weakness; fatigue felt from exertion, excitement or excesses. In spite of the weakness the face remains plump.
Reduced general body-resistance induces liability to take cold and special sensitiveness to damp cold, readiness to perspire, tendency to develop faulty metabolic states, leading to tuberculosis, or chronic disease with emaciation. The emaciation often begins with the neck which becomes thin and “scraggy” and extends to the limbs and trunk with the exception of the abdomen, which is prominent and distended.
Mind.-The mental condition, too, is one of lowered resistance, shown by apprehension, fears, depression, weeping, inability for sustained mental exertion. Precocious young children are melancholy and say they want to die. A calcarea patient may be very nervous, especially in twilight, may be afraid he is losing his reason, or that some misfortune is about to happen to himself or his friends. He is liable to be in a state of nervous tension and feels he must scream to relieve his feelings. Children’s intellectual development is retarded and they are irritable and obstinate.
Head.-calcarea produces frontal weight and pressure, worse from using eyes and mind together; general headache from mental and physical exertion; an icy cold sensation on the right side of the head, or heat with flushes, throbbing and palpitation. The head (scalp) may be hot to the touch but feel cold to the patient.
Vertigo comes in sudden attacks, possibly induced by the effort of ascending stairs or some other exertion, or on first rising in the morning. It may arise as a result of mental effort or strain or from shock.
The Scalp Sweats Profusely.-The fontanelles are late in closing, the hair falls out and the skin is scurfy and itchy.
Eyes.-Lachrymation may be a physical as well as a mental symptom of calc;. the eyelids itch and stick together the eyes burn and shoot, worse in the evening and in artificial light. Photophobia and dimness (like a mist before the eyes) are due partly to corneal hyperaesthesia, partly to mucus and partly to weakness of the ciliary muscle (accommodation).
The nose becomes sore and the nasal mucous membrane swollen and ulcerated, causing offensive discharge and, subjectively, unpleasant feeling of swelling in the nostrils.
Face.-The face is usually puffy, fat, yellowish or pale and chalky-looking, with dark rings under the eyes.
Mouth and Throat.- Pains in the mouth and teeth come on and are worse from cold air, water or food. The tongue tends to b dry, the gums spongy, and the taste in the mouth sour.
There are nervous, choky feelings, as if the food would not go down, cracking noises on swallowing, and the submaxillary glands are large, tender and painful, worse from movement of the jaw and from touch.
Digestive Organs.- There may be excessive hunger or anorexia, but always thirst, and this is often worse at night.
Vomiting of sour food or water (worse at night) and a sore, swollen feeling and tumefaction of the epigastrium are very prominent calcarea symptoms. Eructations, tasteless or sour or tasting of the food, go with nausea and vomiting.
The provers experience aversion from meat, milk and tobacco. They may desire eggs (which agree), sweets and party, or their tastes may be perverted, craving chalk or egg shells (children), coal, &c. The abdomen feels distended, and the epigastrium swells, and in children has been described as “like an inverted saucer”; even light clothing is not well borne and colic is frequent.
Haemorrhoids or prolapsus recti, with a crawling feeling like worms moving in the anus, and burning in the rectum during stools, are produced. The stools are chiefly loose, pale and partly undigested, and often of sour odour.
Sexual Organs.-In men increased desire with lessened sexual power is noticed, progressing to impotency.
In women menstruation is early, profuse, bright in colour and is easily brought back after a period is over by excitement or emotions, good or bad news, &c. Prostration after intercourse is a common feature. Perverted sexual may develop.
Respiratory System.-Hoarseness, worse in the morning, and a violent, dry cough occur, the latter worse at night and from deep breathing. Tickling in the throat and a feeling of a plug there may seem to cause the cough. Deep breathing causes stitches in the side and hypochondria. The cough may be accompanied by profuse yellow or purulent, offensive expectoration.
Heart, &c.- Palpitation often accompanies the cough, especially at night. Eating and effort easily induce it.
Neck and Back.-The neck is stiff and cracks on movement, the back aches, the cervical glands are often enlarged. Extremities.- The limbs are weak and weary, with trembling, especially the legs. Varicose veins may be present. Rheumatic shooting pains are felt and the parts are sore to the touch. There is cramp in the calves and soles.
A cold, damp condition of the feet extending up to the knees is a very striking calcarea symptom, but there may be burning along the course of varicose veins.
Skin.-The skin itches, worse in cold air; nettle rash, ulceration, warts and condylomata are caused.
Sleep.-The prover goes to sleep late, kept awake by nervous excitement, and the sleep is disturbed by alarming dreams. Subsequently heavy sleep and snoring come on.
Fever.-Chill and heat alternate. The head may be hot and the feet cold, especially at night during an attack of fever. Sweat comes on towards morning, worse from any effort., The hands and feet are damp, but the head is very wet, soaking the pillow.
CALCAREA is one of the few medicines which correspond sufficiently closely with a type of patient for the correspondence to be an important guide towards its choice. As is the case with silica the type of patient requiring calcarea is not limited by the pathological designation of the case. It is not necessarily co-extensive with or limited to rickets, tubercle, osteomalacia, anaemia or mental deficiency.
The most striking results are obtained in children, and especially in those of a fat, flabby, pale appearance. Many such have large heads with open fontanelles and are late in acquiring strength of limb for walking. There is typical drenching, sour- smelling perspiration of the head, chiefly at night, when the child`s pillow becomes widely wet with it. In a less degree the neck, axilla, hands and feet sweat, in rickets, tuberculosis or non-specific debility, or from lime starvation (or excess?). Enlarged, indurated glands in the neck further indicate calcarea; they tend to break down, but may become cretaceous.
Another type of countenance is of chalky whiteness, or is yellowish, and though the face is fat and flabby and the abdomen large, the neck and the rest of the body are thin almost to emaciation.
One of the most striking characteristics of a calcarea patient is extreme sensitiveness to cold-cold air, cold water; all draughts are liable to cause discomfort or some attack of disease; the patient`s skin is cold and in places damp, and he even feels the effects of a coming storm. The head, however, may be an exception to the cold feeling, though not to the sensitiveness to cold, open air. Few drugs have a modality so imperious as to be exclusive, but calcarea, in its extreme sensitiveness to cold in almost every sphere, is one of those which have, i.e., a patient who suffers from hot weather, the heat of a fire, &c., would seldom (if fever) require calcarea.
Mind.-The calcarea patient`s mental state may vary with his physical ailment, but it is almost invariably characterized by lowered tone or resistance (see p. 278). Consequently, trying circumstances like worry, vexation, disputations, or fatigue from business pressure (which normally would be borne without serious consequences) result in some ailment-sleeplessness, dyspepsia, inability and unwillingness to apply the mind to the duties of life (in a normally diligent and industrious person). A state of indecision arises, the patient cannot make up his mind -cannot even marshal the facts which should enable him to form a judgment. He consequently loses confidence in himself and fancies that others will notice this and will mistrust him as he mistrust himself. He dwells on one set of ideas which cannot put aside, and every trifle increases his depression. He is easily started by noises, and fears to be left alone because he sees ghosts or alarming objects or visions on shutting his eyes-even if awake.
It is an easy step from such a state of lack of confidence in himself to fearing and believing that his mind will give way– that he will become insane.
Such a patient`s disposition changes towards his friends or employees.
If the difficult environment lasts and he cannot obtain mental rest and suitable treatment, the mental state he fears may actually develop-a cerebral atrophy, so-called softening, may take place.
If this state can be recognized in time calcarea will do a great deal to restore tone and strength.
Sleep.-This remedy will help to give good sleep to calcarea patients who are very likely to be restless-the mind being over- busy until well after midnight, so that the sufferer who needs more sleep gets much less than his normal. His sleep, when it does come, is disturbed by horrible dreams and grinding of the teeth-“night terrors” in children.
Circulation.-Palpitation may further disturb his rest; it is easily induced by exertion or excitement.
Head.-Chronic unilateral headaches, chiefly left-sided, migraine, meningitis, acute and chronic (including the tuberculous variety), and epilepsy, are all conditions for which calcarea may be required., Impetigo of the scalp occurring in rickety or tuberculous children has also benefited by it. The drug has no specific effects on these diseased conditions, and to treat them by routine with this remedy can only lead to a proportion of disappointments.
The head symptoms indicating it are such as it produces (p. 279), irrespective of the name of the malady or diathesis. They may be recapitulated here, even at the risk repetition.
First of all there is the extreme sensitiveness to cold draughts, the patient feels as if a blast of cold air were blowing on or through the head. The head itself feels cold and may be cold to the touch, the patient instinctively wrapping it up (as with silica). Mixed with this general coldness there may be burning in a small spots or spots, ex.gr., on the vertex. Next, there is profuse, sour perspiration, which is a guide. The pains in the head are throbbing and constrictive, and they are not seldom periodic recurring every seven or fourteen days. THe area is frontal, extending down the nose; or unilateral. Aggravation is caused by bright light, movement, talking, noise and cold; amelioration by heat, such as very hot bathing, by lying down and by darkness.
The headache are caused by draughts, arrest of perspiration or of nasal discharge, and by overfatigue or mental exertion, and they are likely to begin in the morning and get worse as day advances, often ending with vomiting.
Eyes.-Calcarea has been extensively prescribed (with good results) for ophthalmia, keratitis and corneal ulcers and even opacities and cataract, all occurring in ill-nourished subjects, “strumous,” rickety, syphilitic, or ill-and under fed. Redness of the conjunctiva and sticking of lids in the morning with definite depressed and creeping ulceration of the cornea may be present. The objective signs are accompanied by photophobia, even to ordinary daylight, and very great pain in bright sun or artificial light. All the signs and symptoms are worse in cold, damp weather and from reading, writing and fixing the gaze on any object. The muscles of accommodation are weak, causing dimness, and the extrinsic muscles are unbalanced of images from the perpendicular.
Opacities will only be affected if the general health has notably improved-apparently sometimes as an after-thought.
Ears.-The aural conditions curable by calcarea acknowledge causation similar to those of the eye. Pain (“earache”) may be due to arrest of discharge from exposure or astringent applications. Polypi from otorrhoea are amenable to this remedy.
Nose and Throat.-The same is true of these areas. In the nose there may be a thick, yellow discharge, mixed with thick, black crust from oozing of blood; nasal polypi also may be cured by it. The throat is patchy red, or it may have small ulcers on the fauces, associated with a dry, choky feeling.
Digestive System.-Calcarea helps much in difficult and delayed dentition, especially if associated with other symptoms of rickets. Acid dyspepsia (hyperchlorhydria) in adults and children, if pronounced, frequently requires calcarea. In the former it is often associated with constipated, hard, white motions, and in the latter with diarrhoea; the stools contain undigested, sour coagula of milk, and excoriate the skin round the anus.
Milk and meat are disliked and disagree; eggs are liked and are well digested.
The abdomen is liable to be distended and the epigastrium bulged out, probably from gaseous distension of the stomach. If the patient (especially a child) is thin enough, hard lumps (calcareous mesenteric glands) may be felt. For tuberculous peritonitis of the “dry ” variety calcarea is a prime remedy : but the phosphate may be more beneficial than the carbonate in some emaciated subjects. Worms of any temperate zone kind may flourish in the unhealthy intestines of calcarea patients, and they may frequently be as it were starved out by restoring a healthy state of the mucosa and so rendering the environment unsuitable for these parasites.
Though there seems to little indication in the pathogenesy of calcarea for its use to relieve pain in biliary and renal calculi, its efficacy is so thoroughly vouched for by some of the early practitioners of homoeopathy that it must again be placed on record.
Hughes (loc. cit.) praised it from experience in his own person-a strong plea in its favour; he even says its use may dispense with “hot baths and chloroform.”
Sexual System.-Weakness in both sexes is notable with exhaustion and perspiration post-coitum, and sleeplessness in women and heavy sleep in men. Orchitis, especially tuberculous, may benefit by calcarea. In women menstruation recurs early, is profuse, bright, too long-lasting, and may easily be brought back (after the period has stopped) by excitement (good or bad news); emotions (fear) or exertion.
The menorrhagia may be associated with metritis and subinvolution after a septic confinement, with prolapsus, “erosion” of cervix or polypi (mucous). The accompanying leucorrhoea is thick and yellow and causes soreness and itching.
The iodide of lime has been used in fibroids with some lessening of haemorrhage.
Respiratory system.-Subacute or chronic laryngitis, with painless hoarseness or aphonia, may precede or accompany cough. Dyspnoea on exertion, especially ascending or facing a strong wind, may bring on a cough.
The expectoration may contain pus or blood, and many presage or form a feature in a tuberculous condition requiring calcarea. The choice of this remedy (as else where) must depend on the presence of the “calcarea constitution .” This medicine is no specific for this or any malady.
Limbs.- Rheumatic and gouty conditions having the usual causative features should bring calcarea to mind. Stiffness on first moving (rhus), worse at night, worse on rising from sitting, pains in any joints, aggravated by becoming cold, by cold winds and by every change from warm to damp, cold weather. These conditions all indicate calcarea.
Extremes sometimes occur, such as the alternation of burning hat of the feet with the cold, damp feet so characteristic of the drug.
(1) Extreme sensitiveness to cod, local and general, i.e., cold is disagreeable or distressing and is liable to cause ailments. Patients take cold readily.
(2) Coldness of surface, especially damp, cold feet; perspiration of feet; coldness and sweat of single parts-clammy hands.
(3) Craving for acids, pickles, chalk or coal, sweets, raw potatoes (chiefly in children). Aversion: adults dislike milk, coffee or meat, and smokers dislike tobacco.
(4) Sourness of excreta-breath, eructations, vomited matter, stools, perspiration and body-smell.
(5) Excessive sweat of head, especially at night (sil)-and of other parts less markedly; he [perspiration is sour. sweating when cold.
(6) The calcarea subjects are blondes, with blue eyes and fair skin, fat, pale, flabby, easily fatigued and timid; fontanelles late in closing; dentition delayed.
(7) Weakness of limbs-children late in walking; bones bend.
(8) Women with chest weakness, who have grown rapidly and are flabby, plethoric, anaemic or breathless.
(9) Women who menstruate too early, too long and too profusely, and especially if the period recurs from emotions, excitement or exertion.
(10) Mental state is one of lowered resistance-ailments from worry, controversy, and mental strain, leading to indecision, loss of self-confidence, fear of losing reason; easily startled by noises and fears being alone: easily fatigued in mind and body; nervous, overstrained, and hysterical, and in children lethargy and dulness and slowness.
(11) The patient feels better when constipated.
After midnight, cold air (e.g., in tooth-ache), and wet weather, letting limbs hang down; morning (hoarseness), afternoon (diarrhoea).
In dry, warm weather, and by lying on affected part; by heat and by lying down in the dark (head), when constipated.