Natrum Muriaticum nat-m.

For the anæmic and cachectic; whether from loss of vital fluids—profuse menses, seminal losses—or mental affections. Great emaciation; losing flesh even while living well (Abrot., Iod.); throat and neck of children emaciate rapidly during summer complaint (Sanic.).

Great liability to take cold (Cal., Kali c.).

Irritability: child cross when spoken to; crying from slightest cause; gets into a passion about trifles, especially when consoled with.

Awkward, hasty, drops things from nervous weakness (Apis, Bov.).

Marked disposition to weep; sad weeping mood, without cause (Puls.), but consolation from others < her troubles.

Headache: of school-girls (Cal. p.); from sunrise to sunset; beginning with blindness (Iris, Kali bi.); from eye strain; with left-sided clavus; as if bursting; with red face, nausea and vomiting before, during, and after catamenia; as if beaten with little hammers in the brain; during fever, better after sweat begins.

Hay fever: squirming sensation of the nostril, as of a small worm; brought on by exposure to hot sun or intense summer heat.

Sensation as of a hair on the tongue (Sil.).

Tongue: mapped, with red insular patches; like ringworm on sides (Ars., Lach., Mer., Nit. ac., Tarax.); heavy, difficult speech, children slow in learning to walk.

Fever blisters, like pearls about the lips; lips dry, sore and cracked, ulcerated (Nit. ac.).

Lachrymation; tears stream down the face whenever he coughs.

Constipation: sensation as of contraction of anus, torn, bleeding, smarting afterwards; stool hard, difficult, crumbling; stitches in rectum (see Nit. ac.); involuntary, knows not whether flatus or fæces escape (Aloe, Mur. ac., Iod., Olean., Pod.).

Urine: involuntary, when walking, coughing, laughing; has to wait a long time if others are present; cutting after (Sars.).

Pressing, pushing torward genitals, every morning, must sit down to prevent prolapsus (Lil., Mur., Sep.).

The hair falls out when touched, in nursing women (Sep.—after fevers, Lyc.); face oily, shiny (Plb. Thuja).

For the bad effects: of anger (caused by offence); acid food; bread; quinine; cauterizations of all kinds with silver nitrate; too much salt.

Hangnails: skin around the nails dry and cracked (Petr.); herpes about the anus, in border of hair (in bend of knees, Graph., Hep.).

Dreams of robbers in the house, and on waking will not believe to the contrary till search is made (of robbers, danger, Psor.); of burning thirst.

The heart's pulsations shake the body (Spig.).

Eczema: raw, red, inflamed, especially in edges of hair; < from eating too much salt, at sea-shore, from ocean voyage.

Warts on palms of hands (sore to touch, Nat. c.).

"Cannot often be repeated, in chronic cases, without an intercurrent."—DUNHAM.

Should not be given during paroxysm.

If vertigo and headache be very persistent or prostration prolonged, Nux vomica will relieve.

Complementary to Apis: acts well both before and after it.

Natrum mur. is the chronic of Ignatia, which is its vegetable analogue. Is followed by Sepia and Thuja.

At 10 or 11 A. M.; heat of sun or stove; in summer; at sea shore or from sea air; mental exertion; talking, writing, reading; lying down.

In open air (Puls.); cold washing; sitting up; fasting.

Every type of fever belongs to Natrum muriaticum: vernal, midsummer, autumnal, midwinter; quotidian; tertian; quartan. Simple type. Anticipating tertian. Malarial.

3, 4, 5, 6, 7, 8, 9 A. M.—10 to 11 A. M. Like Nux vom. the characteristic paroxysm is in the morning or forenoon; the lesser paroxysm occurs in afternoon or evening. 4 to 7 P. M.; 6 to 7 P. M.; 5:30 to 7:30 P. M. Chilly all day, with fever all night.

Fever without chill, 10 to 11 A. M.

Exposure to emanations from salt or fresh water; living on, or in the vicinity of water, margins of streams, or ponds; in damp regions or near recently turned up soil, especially freshly plowed fields of virgin soil. When Quinine has perverted and temporarily suppressed the original or regular paroxysm.

Patient dreads the chill. Languor, headache, thirst; knows the paroxysm is coming because of headache and thirst; nausea and vomiting sometimes present; if vomiting, it is water recently drunk; tearing pains in hands, feet, and kidneys.

With thirst. Paroxysm at 8 A. M.; violent chill till noon; then heat till evening; without perspiration or thirst during the chill or heat; unconscious, with violent headache; sensation as if the head would fly into fragments, is stupefied, knows not where he is. Great chilliness every morning between 3 and 4 o'clock, with languor, headache, great dyspnœa, followed by great heat and thirst, and terminated by profuse perspiration. Long and severe chill from 10 to 11 A. M., beginning in the feet, fingers, and toes, or small of the back (Gels.), with blue lips and nails (Nux). Thirst, drinking often and much at a time (drinking often and large quantities, but it produces vomiting, Eup.—drinks little and often, Ars.). Bursting headache; nausea and vomiting; and sometimes complete unconsciousness. Frequent creeping chills about 5:30 P. M., followed by heat and perspiration that lasted till 7:30. Violent chill, especially in a warm room, from 4:30 to 7 P. M.; relieved in the open air. Chilliness over the whole body between 6 and 7 P. M., with great sleepiness; was able to keep awake only by a great effort. Chill over the whole body in a warm room, between 4 and 7 P. M., with frequent yawning, though warm to the touch, except in the face.

Internal shivering from 4 to 7 P. M.; she is generally chilly; each night suffers excessively from rigors, followed by heat and profuse perspiration; as rigors come on, and during continuance, excessive languor, with headache and dyspnœa "almost indescribable." Chill predominates mostly internal; hands and feet icy cold; could not be warmed. Chilliness, great thirst, tearing in the bones, blue nails, chattering of the teeth, at 10 A. M. Chilliness, with increasing headache in the forehead every day from 9 A. M. till noon; afterwards heat with thirst, and gradual appearance of sweat; the headache decreasing gradually as the sweat increases until 5 o'clock in the evening. Chill of right side (Bry.—left, Caust., Carbo v.).

"Icy coldness about the heart (Arn., Camph., Helod., Kali c., Olean., Petr.), continuing after the paroxysm; blindness and unconsciousness during the chill, with great prostration, worse after chill; slight fever (Ars.)."—LIPPE.

"Chill predominates; chilliness internally, as from want of natural heat, with icy coldness of hands and feet. Continuous chilliness from morning till noon."—LIPPE.

With increased thirst; intolerable hammering headache (as if beaten with a thousand hammers), with stupefaction and unconsciousness (Bell., Cac., Op.), or obscuration of sight and fainting.

Long severe heat, with excessive weakness, which compels him to lie down (weakness and prostration during chill, Lyc.—great prostration after paroxysm, Ars.) Great thirst for large quantities of water; drinks much and often, which refreshes (Bry.—drinks little and often, but it produces vomiting, Ars.). Nausea and vomiting (Ipec.).

"Fever blisters cover the lips like pearls."—RAUE.

Hydroa, especially on upper lip (Rhus—see Ign., Nux).

"Continuous heat in the afternoon, with violent headache and unconsciousness; they are gradually relieved during the perspiration which follows."—LIPPE.

With thirst; profuse, gradually relieving all pains, except headache, which may continue during and after sweating stage (Samb.—headache is increased, Eup.). Profuse sweat breaks out easily during motion, although he is very chilly (Bry., Psor.); over whole body at night and in the morning (over whole body, except legs, Lyc.); sour-smelling sweat.

Thin, yellowish-white coating on dry tongue; blisters on the mapped tongue or looks like ringworm (herpes) on the sides (Lach., Tarax.). Taste: water tastes putrid (water tastes bitter, Ars.); bitter, salt, sour; food has no taste at all. Longing for salt or bitter things. Aversion to bread.

Irregular intermission when lying on left side; at one time rapid and weak; at another full and slow; every third beat intermits (Mur. ac.). The heart's pulsations shake the body.

Never clear; emaciation, languor, debility; livid, sallow complexion; stitches about the liver and spleen; urine muddy, with red, sandy sediment (Lyc.); loss of appetite, loss of taste; aversion to bread (aversion to meat, Arn.); hiccup, after suppression by Quinine; hydroa, like beads on the lips (Ign.,

Nux, Rhus); ulceration of labial commissures; sensation of fulness of the stomach after eating ever so little (Bry., Lyc.); sexual desire diminished, or entirely lost, in men.

"Hard chill about 11 A. M., with great thirst, which continues through all stages; the heat is characterized by the most violent headache, relieved by perspiration."—RAUE.

Arsenicum. Natrum mur.

Advancing type. Receding type.

Worse afternoon and night. Worse forenoon and daytime.

Headache beginning with fever, Headache begins in chill, increased and continuing long after sweat. in fever, partially relieved by pro- fuse sweat.

Vomiting of bile with the chill; of Vomiting of bile between chill and water after drinking, in every stage. fever (Eup., Lyc.), or during heat.

Thirst, drinks little and often dur- Thirst in all stages; drinks large ing chill and heat; large quantities quantities and often, which refresh during perspiration. him.

Hungry. Loss of appetite.

Had been at seashore or summer Had been near freshly plowed or watering-resorts during hot weather newly turned grounds, swamps,

(Gels.). canals, or standing water.

Lips pale, dry and cracked. Lips covered with hydroa, like strings of pearls.

"It is taught by every writer, that the chill must come on about 11 A. M., for Natrum muriaticum to be curative. This is all bosh and nonsense. I have cured many, many cases of chronic and acute intermittents where the chill has come on late in the afternoon. If the rest of the symptoms indicate this remedy, it makes no difference when the chill commences. And let me say here, that Natrum will cure more cases of intermittent fever, both acute and chronic, especially the latter, than any known remedy.

With the thirtieth potency, I have cured several hundred cases with this drug alone. It is the best friend a physician has in a malarious district."—BURT.

While it is true that time is but one element in a case, for one symptom, however prominent, never overides the totality, and that we must always obtain the totality or majority of symptoms, it is also true that the morning paroxysm predominates, especially at 11 A. M.

"During my travels in Hungary, in the malarious plains of the

Theiss and Maros, as well as during a prolonged residence among the Guarosi Indians, of South America, I used a cheap remedy which radically cures every case of ague in twenty-four hours by taking one or, at the utmost, two doses of it. I order a good handful of fine, clean kitchen salt to be thoroughly roasted—if possible, in a new pan, or at least, in one thoroughly cleansed— over a slow fire, till it takes on a brown color, similar to that of lightly roasted coffee. From this roasted salt, a grown up man takes a full tablespoonful, rather more than less, dissolved in a glass of hot water, at once, on the morning following the paroxysm, on an empty stomach, and in quotidian fevers a few hours after the paroxysm is over. As the remedy is only sure of its action on an empty stomach, neither food nor drink must be taken. Though great thirst follow, the patient must only sip a little water through straws; and, when the patient becomes hungry, forty-eight hours after taking the salt, he might take a little chicken broth, or a little beef tea. Strict diet and great care not to catch cold are of the utmost importance. I have used this remedy for the last eighteen years, and it has never failed in a single case when rightly applied. Hundreds of cases in Hun- gary were cured by it; and, during my voyage to Buenos Ayres, the mate of the steamer Ibis was cured by a single dose in twenty- four hours from an ague which had troubled him periodically for years, and the cure remained permanent. In the tropics of

America every European immigrant, as soon as he goes inland, is attacked by intermittent fever, which, if neglected, is too fre- quently fatal. Thus, four hundred English people succumbed to it in the most paludal forests of Stape, in spite of the immense doses of Quinine and brandy taken; whereas the equally suffering

German colony in the adjacent department of Haqua and Para- guay took their roasted salt, and no death occurred among them."

Dr. Brooke, in N. A. J., 1878.

There is, probably, no remedy in our Materia Medica (Arsenic alone excepted) so often indicated in severe cases—acute or chronic, even those maltreated by Arsenic and Quinine—as Natrum muri- aticum. It will cure promptly when indicated; and much quicker and more permanently in the attenuations above than below the thirtieth. Like Lyc., Cal., Sep., Sul., and some of the metals, it is comparatively inert in the crude form. Hydroa on the lips is a guiding symptom, although Ign., Nux and Rhus all have it. If hydroa be present in first onset of the fever, although after fre- quent suppression by Quinine it may not be present in old cases,

Natrum muriaticum should be thought of. In nursing children, hydroa on the lips, and later the ulcers which succeed them with forenoon attack, are guiding.

The patient dreads the chill.

Chill; 10-11 A. M.; with thirst; long, severe; beginning in fingers, feet, toes, small of back, with blue lips and nails; head- ache, often unconscious; nausea and vomiting; bone pains.

Heat; more thirst; long, severe; headache, with stupefaction and unconsciousness.

Sweat; with thirst, profuse, sour, gradually > all pains except headache; thirst, drinking refreshes.

Hydroa on the lips.

Pulsations shake the body.