I prefer to speak of the constitution of our remedies instead of constitutional remedies. You will agree with me that Sulphur, Calcarea carbonica, Lycopodium, and Thuja should be mentioned first, if I am to speak of constitutional remedies, which I shall try to present in pictures.
Sulphur is the most important, the main remedy in Hahnemann’s psora treatment. It is the best agent where there is lack of reaction of the body. This lack of reaction is, of course, more or less dependent upon constitutional conditions. It is therefore indispensable also in acute conditions, and the chief remedy in diseases following suppressed skin troubles. Farrington thinks it is a racial remedy for negroes, because they are widely suffering from scrofulosis. The constitutional indication for Sulphur is found in those who have all kinds of skin affections, unpleasant skin odour, aversion to water and bathing; they drink much and eat little, have a stooping walk; all orifices are red, red ears especially in children; they are vexed easily and tend to melancholia. Intuitively I recognize a Sulphur patient when he enters the room; he looks dirty. There is disturbed circulation, irregularity of the blood distribution, tendency to congestion in any part of the body, sometimes with burning heat. Sulphur acts especially on the lymph channels and glands, hence it dominates the scrofulous constitution. Three cardinal indications are: burning on vertex, burning of feet evenings in bed, and feeling of hunger at 11 a.m.
Calcarea carbonica is just as important and indispensable. It is easily differentiated from Sulphur. In the exterior it differs from the lean, sinewy Sulphur patient in being fat, or at least in being inclined to be so. The children have pot bellies. The colour of the face is watery, pale. Temperamentally the patient is indolent, clumsy and slow in his motions, does not like to work, while the Sulphur patient is lively and changeable. Calcarea carbonica acts pre-eminently upon the bony structure, hence such patients have under-developed bones, disturbed growth, soft or bent bones. They dispose to glandular enlargement and swellings, polypi, etc., and to skin affections, which in contradistinction to Sulphur are more moist. While Sulphur has heat and burning, the Calcarea patient feels cold, and complains of cold head, and his feet are cold as “from wet socks”. Typical are partial perspirations, in children especially around the head, in men of the sexual organs with sexual weakness; women have too early and profuse menses with copious leucorrhoea. Peculiar is the Calcarea patient’s desire for eggs, while milk is not tolerated, often vomited.
Sulphur is well followed by Calcarea in constitutional treatment, and then Lycopodium or Silica are usually the sequence unless some other remedy is more indicated.
Lycopodium is a priceless remedy. Its patient is lean, dark complexioned and yellow, and appears to be older than he is. Dark circles around the eyes. His muscles are weak, and he is disposed to liver affections and uric acid diathesis. He is either irritable or sad, or dominating, thinks himself important, and often seems to be haughty. His memory is weak. He is inclined to varices and naevi. Constipation is always present, contrary to Sulphur and Calcarea. Older patients are impotent. Peculiarities are: the Lycopodium patient can never eat to satiety, suffer from flatulency, distension of lower abdomen (Carbo veg. of upper, china of entire abdomen), he craves open air, i.e. he wants open windows. One foot is cold, the other warm. It acts, especially on the right side, and has aggravation afternoon from 4 to 8 pm. I had a diphtheria epidemic which was prevalent in patients of Lycopodium constitution, in which this remedy quickly cured. During the cholera epidemic in Hamburg in 1894, Sulphur was always the curative remedy, when I found the Sulphur constitution at the beginning presented cholera-like symptoms. This shows how important it is to pay close attention to the constitution, even in acute diseases.
Silicea patients give the impression of weak people, physically and temperamentally, are easily depressed, indecisive and irritable. This general weakness shows also in the nervous system with inclination to paralysis. The children are lean because of poor assimilation; they eat enough, but continue getting weaker, and may finally die from marasmus. Characteristic is that inflammations in tissues and bones have a tendency to suppuration without healing reaction. Foetid perspiration of feet is frequent. It has cured cases of epilepsy which had decided aura from the solar plexus, and which appeared especially during new moon. Also whooping cough of severest degree was cured by it if the constitution corresponded.
From Silicea I come to Thuja of the conifer family, because it is complementary to Silicea. It is Hahnemann’s antisycoticum, also a great agent. Of course there are constitutions for which Thuja is suitable, even if contagion has not created that constitution. There are two poisons: the gonorrhoeal and vaccination; if they are implanted in the system, they will act so much more violently in a constitution present, and they even can create such a constitution. Formerly vaccination was done from arm to arm, and there I have many observations and cured many children with Thuja. How does the Thuja patient look? He is hasty, impatient and quarrelsome, often has fixed ideas, e.g. that he considers himself fragile like glass, and permits not one to come near him; he has many symptoms of a sick nervous system, His hair is thin, dry, and split at the ends. Warts appear all over the body, or condylomata, or cauliflower-like excrescences. There is a tendency to hardening of epithelium, hypertrophies with following softening. Often we find misshaped nails. Characteristic perspiration of uncovered parts; sweet smelling perspiration on genital organs. Women often have the sensation of something live in the abdomen.
I shall now mention a constitutional remedy which many do not consider capable of changing the body or soul. Natrum muriaticum, a remedy for nordic races. For many years in my practice not a day passed that was without Natrum muriaticum constitutions, or that I did not have to treat patients for ailments springing from this constitution. I have previously pointed out that chiefly climatic, geologic and nutritive conditions may be causative factors which a malaria cachexia develops. These “salt men” are tall, spare build, have thin necks, and often a very severe countenance, are serious, unapproachable, hypochondriacal, not tolerating contradiction, unforgiving; the nordic soul lives in them. If skin affections appear, they are most liable to show at the hair margins and flexor surfaces of joints. The entire digestive tract from mouth to anus can show diseased conditions. Lips and corners of mouth are cracked and dry. The products of the mucous membranes are watery and clear. The heart beats are felt all through the body, or there may be fluttering of the heart or intermittent pulse. Backache better from leaning against something hard. Needlework aggravates all symptoms. In women displacement of the uterus may cause these troubles. Characteristic is the great changeableness of the symptoms. Aggravations are between 11 and 12 a.m., when shivers occur as concomitants. The peculiar sensation of a hair on the tongue I have often observed. Many anaemics have been cured by Natrum muriaticum.
These are the most important constitutional remedies, which all should know well. Of course, a number of others can be indicated, depending upon constitution, location, clime, types and races, of which I wish briefly to characterize a few in their individual peculiar symptoms.
The Phosphorus constitution is of a neuropathic, haemorrhagic character; they are tall, pale, of a consumptive habitus, which have grown up too quickly; oversensitive to all external impressions, fear to be alone, and during thunder. They incline to clairvoyance and somnambulism, and get easily ecstatic. They are disposed to haemorrhage, even small wounds bleed profusely. Their pains they feel as burning. While they are inclined to emaciation, their organs are inclined to fatty degeneration. During or after loss of body fluids they get nerve troubles, especially diseases of the spinal spinal cord. Generally speaking, their nervous system and respiratory organs are puncta minoris resistentiae. It is characteristic that they cannot lie on the left side, and that their hands burn; they are sleepy in day time. They perspire during sleep, which stops when they awaken, but begins again when they go to sleep.
Kali carbonicum is complementary to phosphorus and follows advantageously. Such patients are anemic, of irritable, nervous temperament; their faces are often bloated with swollen upper eyelids. Like phosphorus it is suitable for individuals weakened by loss of body fluids or after a long siege of sickness. They are sensitive to cold and local congestion. Their pains are stitching and independent of motion. Circulation and metabolism are low, muscle degeneration and weakness extend even to the heart. Characteristic are the great weakness and pain in the small of the back and loins; all aggravations are between 2 and 3 a.m. If there is inclination to perspiration the sweat is not connected with sleep as in phosphorus.
Graphites was designated by Hahnemann as a deep acting anti- psorinum, with the characteristic especially on the skin, usually in the form of moist eruptions, predominating on and behind the ears and on the eyelids with honey-like, viscous secretions. The patients are usually fat, bloated, sad and depressed, with lack of body warmth and poor circulation. The nails of fingers and toes are thickened and deformed. The rectum and anus are points of minor resistance.
Iodum is another important constitutional remedy, much abused, but very valuable in torpid forms of scrofulosis and luetic conditions. These people are lean, brunette with dark hair and eyes; they have unclean skin. They dispose to diseases of glandular organs and hyperplasias of connective tissues. The ductless glands function poorly, or wrongly (Basedow). The mucous membranes show increased secretions, which are acrid and corroding. They are always hungry and feel better after eating. They dislike warmth or warm rooms, prefer cool air, and love to walk in the open.
Ferrum is almost as much abused as Iodum. It is indicated in young, slender people, healthy countenance in consequence of false erethism when excited, but in reality they have sallow, pale complexions, and pale mucous membranes. The gums are almost white. Local congestions are often found all over. Their system is not strong enough to assimilate the iron from the food. They have aversion to meat, but love bread and butter. The haemorrhages are bright red and coagulated. The time of aggravation is midnight or a little later, especially in asthmatic conditions.
Finally I wish to say a few words about Tuberculinum, which I consider a great constitutional remedy for all scrofulous or tubercular disposed patients. They incline to catarrh of all mucous membranes, and to colds more than the previously mentioned constitutional remedies. Tuberculinum patients have coryza constantly, periodic skin eruptions, which can be considered nature’s way of catabolism. Generally the symptom picture is changeable. If in chronic and constitutional diseases there is no real improvement, regardless of what form of pathology is present, a dose of Tuberculinum koch 100 or 200 will help. The action is biologic, like all remedies chosen according to the law of similia, by aiding the efforts of nature to ward off disease.
These named important constitutional remedies are to heal body and spirit from inside, and thoroughly. All should always be given in higher potency. I never dispense below the 30th centesimal potency, and often give the 200th. I teach myself and my patients to have patience in awaiting the action.