Tartar emetic.
Introduction
HERING says of this drug, “An invention of the alchemists, very popular with them, forbidden by the French Academy, finally introduced and much used and much abused by the Old School.”
Old School, Farrington says, does not make much play in these days with Tartar emetic: and he is borne out by its present day teachings, for we are told (Hale White) that “many years ago an ointment, of Tartar emetic was applied as a counter irritant: but it causes too much pain and is now seldom used”. That Tartar emetic “cannot be recommended as an emetic, its action is slow and its general depression great. It should never be given to produce purgation”. It is also pronounced “an undesirable expectorant”. But this is qualified.” The only cases in which it is permissible are those in which an emetic is required for laryngitis, bronchitis, or some other acute inflammatory condition of the respiratory tract for then its depressant action on the circulation may perhaps be beneficial, but usually Ipecacuanha is preferable.
For its uses in the nervous and muscular systems, “it has now been abandoned”: and “it is much less used in medicine than formerly”.
Thus Old School, with its crude methods and crude dosage, fails to realize the precious life-savers at its command, and leaves practical and curative medicine to the disciples of Hahnemann.
“Ant. tart.” was proved by Hahnemann and some of his students: but his provings were only published in Stapf’s Archives:–in our Hospital Library: but one does not joyfully grub in the old German books, when one can get the desired matter in other, later, English works. His proving of course appears in Allen, Hering, etc.
Hering (Guiding Symptoms) “makes use” also “of the masterly monograph of Dr. R. Hencke (1874) who collected all poisonings, provings and cures”.
In the hands of homoeopaths Antimonium tartaricum is a very precious and indispensable remedy and has saved innumerable lives: the lives of infants and small children especially, dying of bronchitis and broncho-pneumonia, cyanosed and almost moribund; and, at the other end of life, of old people, with chest full of rattles and wheezes, with lungs filling up, and no power to raise the phlegm. One of our early recollections was of a baby brother gasping, with blue lips and nails: a mother’s distress; how she took the matter out of the doctor’s hands, and slipped into the baby’s mouth a few of the little sweet things– so powerless, seemingly!–and yet so powerful where they fill the picture: and then the allopathic doctor’s surprise at his next visit! after which he only looked on, while she prescribed.
Knowing the Law of Healing, one could do quite good curative work, if put to it, with an allopathic materia medica: going, however, by the rule of contraries when it comes to its deductions and teachings, and leaving its suggestions and warnings severely alone. They do not apply!
Old School calls Tartar emetic a powerful irritant of the skin. We use that action, and give the drug internally for just such powerful irritations of the skin as it can excite. One has seen over and over again, for instance, how a dose or two of Ant. tart. cm has cured impetigo contagiosa in a few days, without any external application whatever, except a little plain starch powder to “slop it up”. One remembers a grown-up brother and two little sisters who appeared at “out-patients” with extensive patches of the infection, even extending, in one case, to the neck. Ant. tart. cm, as usual, sufficed. Pustular eruptions– here, of course, it is one of our most useful remedies in small- pox. Among our great remedies in pustular eruptions are Ant. tart., Cicuta, Rhus, Thuja, and especially Variolinum–Burnett’s great remedy in herpes, by the way!–but, each and all, only according as the rest of the symptoms agree. We shall see, again and again emphasized, how Ant. tart. comes in for gastric and intestinal conditions, and its magnificent use in chest troubles, and most especially in the broncho-pneumonias and pneumonias of little children. Here, with us, the large mortality of the old school is almost obliterated.
HUGHES says, *”Pharmacodynamics.” “The best known action of Tartar emetic–that to which it owes it name–is its power of producing nausea and vomiting. The nausea which it causes is very intense and long lasting”: and he reproduces a useful little drug-picture:
“The face is pale, the skin cool, moist and relaxed, the pulse feeble, frequent and often irregular, the saliva flows copiously, and feelings are usually experienced of gastric uneasiness, languor, and unusual weakness, which are, sometimes, in the highest degree distressing; so much so as, if long continued, to render the patient utterly prostrate in body and mind, and indifferent to all things around him, even to life itself.’ To these should be added universal muscular relaxation.”
Hughes quotes (in dogs poisoned by Ant. tart.)” the lungs were always more or less affected: orange-red or violet throughout: destitute of crepitation, gorged with blood, and in some parts hepatized. Lepelletier independently confirmed these observations and naively remarked, `One would imagine that, admitting its action in man to be similar, far from being useful, its administration would be particularly pernicious in pneumonia; but it is not so, for, instead of favouring engorgement of the lung, it promotes its resolution.'”
FARRINGTON points the characteristics, and gives valuable tips in regard to this drug.
“Head confused: warmth of forehead and confused feeling, as if the patient ought to sleep (in passive congestion of brain). If the patient is a child we notice an unwillingness to be looked at or touched. If you persist in your unwelcome attention, it will have a convulsion.
“On awaking from sleep the child seems stupid, and is so excessively irritable that he howls if one simply looks at him.
“Suppressed eruptions with these head symptoms and great difficulty in breathing. Face bluish or purple, the child becomes more drowsy and twitches. There is rattling breathing. These symptoms that I have mentioned accompany two grand sets of phenomena for which Ant. tart. may be useful, namely pulmonary and gastro-enteric affections.
“For children, invaluable in diseases of the chest, when the cough is provoked whenever the child gets angry, which is very often. Eating brings on the cough, which culminates in vomiting of mucus and food.
“A nursing infant suddenly lets go of the nipple and cries as if out of breath, and seems better when held upright and carried about. Now, this is the beginning of capillary bronchitis. There are fine crepitant rales all through the chest. Ant. tart. here nips the whole disease in the bud and saves the child much suffering. Another form of cough marked wheezing when child breathes. The cough sounds loose, and yet the child grows drowsy. Its head is hot and bathed in sweat. The cough grows less and less frequent. The pulse is weak. Symptoms of cyanosis appear. The quicker, in these cases, you give Ant. tart., the better for your patient.
“Ant. tart. is also indicated in the affection of old people and particularly in orthopnoea, or threatening paralysis of the lungs in the aged. You hear loud rattling of phlegm in the chest yet the patient cannot get up the phlegm. (Here Baryta carb. is complementary, and may suffice when the other only partly relieves.)
“In this threatening paralysis of the lungs you must compare Antimonium tartaricum with several other drugs: with Lachesis, which has aggravation when arousing from sleep; with Kali hydriodicum, especially where there is oedema pulmonum and a great deal of rattling of mucus in the chest. What little sputum is raised is frothy and greenish, and looks like soapsuds.
“Carbo veg. also suits these cases, but here the rattling is accompanied by cold breath and by coldness of the lower extremities from the feet to the knees.
“Moschus in paralysis of the lungs, when there is loud rattling of mucus and the patient is restless. Especially after typhoid fever. The pulse grows less and less strong and finally the patient goes into a syncope. (Ant. carb.)
“Ant. tart. produces a perfect picture of pleuro-pneumonia. Portions of the lungs are paralysed. Fine Rales are heard, even over the hepatized portions. Great oppression of breathing, especially towards morning. The patient must sit up in order to breathe.
“Pustules very nearly identical with those of small-pox.
“Diseases of intestinal tract. Very like Veratrum: only here Veratrum has more cold sweat on forehead, Ant. tart. more drowsiness.”
NASH, as usual, sums up the action of Ant. tart. in a few words of vital import.
“Great accumulation of mucus in air passages, with coarse rattling and inability to expectorate; impending paralysis of lungs.
“Face very pale or cyanotic from unoxidized blood.
“Great coma or sleepiness in most complaints.
“Vomiting; intense nausea, with prostration; general coldness, cold sweats and sleepiness.
