Materia Medica

Phosphorus – Farrington

Phosphorus
phos

This hour I wish to say a few words about Phosphorus. It has two complements, ARSENICUM and ALLIUM CEPA. I have placed Nux vomica and Terebinthina as the antidotes. The use of Terebinthina comes to us from the old school. It seems to antidote Phosphorus by chemical action in rendering it inert. It also has antidotal effects when used in potency. NUX VOMICA is good when. Phosphorus as a remedy has produced over-effects, or when it has been incorrectly given.

In the study of Phosphorus we have to remember first of all as most important and as a quality that permeates every part of the Phosphorus proving, its action on the nervous system. Its symptoms in no instance point to increase of power or vitality, or to any genuine stimulation of function, but rather to that condition which we found under Arsenic, irritable weakness. The patient is exceedingly susceptible to external impressions. He can bear neither light, sounds nor odors. He is very sensitive to the touch. Electric changes such as occur in sudden changes of weather, but particularly in a thunderstorm, make him anxious and fearful, and aggravate all existing symptoms. His mind, too, is excitable and impressionable. He is easily angered and becomes vehement. This is not a simple peevishness. He actually gets beside himself with anger, and just like the Nux patient he suffers physically in consequence. At other times he is anxious and restless, especially in the dark or about twilight. He has all sorts of fanciful or imaginary notions. He sees faces grinning at him from every corner of the room. His thoughts may be increased so that they fairly rush through his mind; but this effect is only transient, and is followed either by inability to think and remember, or by aggravation of all his symptoms on mental exertion. He cannot stand mental tax. Here again it impinges on Nux vomica. As further evidence of the irritable weakness of Phosphorus, we have the delirium of that remedy. Now this delirium may be associated with typhoid fever, with jaundice, or with sexual erethism. It may be quite violent. It is characterized by a condition of ecstasy. The patient has a notion that his body is all in fragments, and he wonders how he is going to get the pieces together. He imagines that he is a great person surrounded by grand accoutrements, the mania of grandeur it is sometimes termed. At other times the mania takes the form of sexual excitement. He uncovers his person without any shame and seeks to gratify his sexual appetite, no matter who may be the victim. These delirious attacks pass into a state of coma, or into a stupid condition of mind or state of apathy, during which he answers questions not at all or very reluctantly. Phosphorus is here very similar to HYOSCYAMUS, and often follows that remedy in erotic mania. It also bears points of resemblance to STRAMONIUM, BAPTISIA, RHUS TOX., and MURIATIC ACID.

The same quality of the drug is shown in the symptoms throughout the body. Headache, for instance, is attended with increased sensitiveness to odors; the sense of smell is very acute, so that the patient faints away from the smell of flowers. There may be pulsating, throbbing headache, worse from music. The hearing for the human voice is impaired; associated with this is roaring in the ears, as from rush of blood. Sounds reverberate unpleasantly in the ears. There is also sexual excitement with frequent erections, lascivious thoughts perfectly beyond the control of the patient, and frequent seminal emissions during sleep.

Symptoms of spinal irritation are very characteristic of Phosphorus. These are associated with palpitation of the heart, worse from any emotion, whether it be grief, anger or pleasure. The spine, as in all these cases of spinal irritation, is exceedingly sensitive to touch. With all this there is weakness of the spine. The back feels weak, as if it would soon give out. There is weakness of the limbs, with trembling, on beginning to walk. The patient stumbles a great deal, catching his toes in every little projection of the floor or pavement. He totters, and there seems to be imperfect coordination. He is sleepless from excessive heat. When asleep, his dreams are of a horribly exciting character. These are illustrations of the erethism of Phosphorus and also of diminished resistance to external stimulants. Such persons may degenerate into various diseased conditions. The loss of animal fluids, as blood, semen, or milk, or too frequent child-bearing or too rapid growth in the young, is sufficient to precipitate nervous diseases such as paralysis, chorea, and spinal disease, or tuberculosis.

You will find Phosphorus indicated in locomotor ataxia, when there is a great deal of burning along the spine. There is also great tingling and formication along the spine and in the affected extremities. In the beginning the patients have extreme sexual excitement. That is a sort of SINE QUA NON, either that they are excessively excitable or else have been so.

You seldom find Phosphorus indicated in impotence, unless it has resulted or has been preceded by over-excitation of the sexual organs. This is a valuable hint. I find it especially indicated in young men who are trying to restrain their natural passion, and yet there is locally this erethism. This Phosphorus helps most wonderfully to control. If by reason of celibacy or of over-indulgence in sexual pleasures, the sexual organs lose their power and the patient becomes impotent, Phosphorus is the remedy when this has been preceded by over-excitation. It is different from CONIUM, in which the patient may have been naturally excitable, but has gone on to this weakness.

Phosphorus is also indicated in locomotor ataxia, when it can be traced to excessive loss of animal fluids, as semen.

Softening of the brain is another form of atrophy of the nervous tissue in which Phosphorus has won many laurels. The patient has a dull pain in. the head, a wearied, tired feeling all the time, and slight difficulty in walking. It is particularly indicated after the use of NUX VOMICA. The question is sometimes asked, and quite properly too, how can you put Nux vomica down as the antidote of Phosphorus, and then speak of it as a remedy that can precede or follow it ? First, the antidote may follow the drug and may be needed not to antidote it, but because symptoms which come up have an opposite polarity and consequently require an opposite remedy; and, secondly, a remedy may be antidotal in some of its symptoms and concordant in others.

Phosphorus may be used very successfully in chorea when it occurs in children who are growing too fast. The patient is very weak and walks as if paralyzed.

Continuing the nervous symptoms of Phosphorus still further, we find it indicated in low types of nervous fever and in typhoid types of fever. I am induced to use this expression typhoid types of fever in order to show that you can consider Phosphorus not only in typhoid or typhus fever, but in any form of fever which assumes a typhoid form when these symptoms appear. It is indicated when there is great cerebro-spinal exhaustion. It is particularly the brain and spine which seem to have suffered from the typhoid poison. The face is apt to be of an ashy or waxen hue or appearance. The tongue is covered with a viscid, thready sort of slime, which is expectorated with great difficulty. It seems to collect on the teeth and around the gums and on the tongue. It is tenacious and the patient is weak ; and these two incompatibles make it difficult for him to cleanse the mouth. The body is hot,—and by the body I mean the trunk,—the head being rather cool and the limbs decidedly cold. There is congestion of both chest and abdomen. The breath is hot, and there is almost always either bronchial catarrh or pneumonia. I refer now more particularly to the pneumonic infiltration which belongs to typhoid fever, in which case Phosphorus is often indicated. The patient has burning thirst, which is relieved by drinking cold water. This thirst is worse from three to six o’clock in the afternoon. The patient is better from cold water until the water becomes warm in the stomach, when it is violently ejected. Phosphorus does not often do any good in vomiting except in the chronic vomiting of dyspeptics, unless there is this condition present.

This is different from Arsenic. It is also very different from BISMUTH; this last-named remedy has vomiting immediately after taking food, with burning, cardialgic pains.

It is different from KREOSOTE, which has vomiting of undigested food hours after eating.

Let us return to Phosphorus in typhoid types of fever. The bowels are always affected. You will find that the liver is sore to the touch and usually enlarged. This is also true of the spleen. The patient has diarrhoea as soon as he eats. Here it is identical with Arsenic. Now the stools in the Phosphorus case are flaky, dark, and often bloody, and there is external weakness after stool, that being a decided cerebro-spinal symptom. You find it in the cerebro-spinal remedies, in CONIUM, in NUX. VOMICA, and especially in Phosphorus. When there is constipation you may have what has been called characteristically “dog stool,” I. E., long, slender stool, which is evacuated with considerable effort. During this fever, which I say is mostly congestive and affects the chest and abdomen, the patient continually throws off the bedclothes. He puts the arms out of bed to cool off. There is profuse sweat which does not relieve. Now I would like to caution you here that Mercury is not indicated in typhoid fever unless there be clearly defined icteroid symptoms, consequently you will not often have occasion to give it in this fever, and never should you give it for this symptom, ” profuse sweat without relief,” unless it is so well defined by the icteroid and bowel symptoms that you are certain that you have the properly indicated remedy. Other remedies than Mercury have this symptom, notably PHOSPHORUS and also RHUS TOX. and CHAMOMILLA, the latter particularly in children. Phosphorus is indicated even in extreme cases of typhoid fever when there is threatening paralysis of the lungs. The patient lies in a sort of coma, with hot breath and rattling breathing. It seems as if there was a large quantity of phlegm rattling in the lungs. The limbs are cold and are covered with a cold sweat. The pulse is scarcely perceptible.

I would here remind you of CARBO VEG. as also being suitable in collapse. It follows Phosphorus very well. It is distinguished, theoretically, at least, from the latter remedy by this: Phosphorus acts more upon the cerebro-spinal nervous system and Carbo veg. more upon the sympathetic nerves, particularly on the solar plexus.

Next I wish to speak to you of a property of Phosphorus which does not depend upon the action of the drug on the nervous system, and that is the power of the drug to produce fatty degeneration. Phosphorus seems to affect the blood, how is not exactly known. It decomposes the blood, rendering it more fluid, rendering it difficult to coagulate. At the same time it produces hypersemia of one part or another. Thus you will find tendency to congestion of the head or chest or of any of the viscera of the body. This hypersemia is not an active arterial congestion, but rather a stasis of blood. The affected part becomes engorged with blood, and as this is of an impoverished quality, it does not nourish properly and we have setting-in fatty degeneration of the part. This may be in the brain or spine (of this I have already spoken), it may be in the heart or lungs, but it is especially apt to occur in the liver and kidneys. The muscles even may undergo fatty degeneration. On the liver, Phosphorus acts very prominently. The symptoms here are directly connected with fatty degeneration. When Phosphorus is taken for a long time you will find at first this hypersemia of the

liver. That organ is consequently enlarged with the attendant symptoms, well-marked soreness and jaundice. The stools are apt to be grayish-white, showing the absence of the secretion of bile. The abdomen becomes decidedly tympanitic. By and by, the jaundice increases to an alarming extent, the pulse becomes weak and thread-like. These symptoms are traceable to two causes: First, the inevitable alterations in the blood which Phosphorus produces; and secondly, the poisoning of the blood by the retention within it of the elements which go to make bile. These have a depressing effect on the heart, making the pulse slow or else weak and thread-like. If you examine the liver at this stage, you find that it is beginning to atrophy, this atrophy depend ing upon destruction of the hepatic cells proper and increase of the stroma of the liver. The connective tissue framework of the liver has undergone inflammatory increase. The pressure which this exerts on the hepatic cells causes their destruction. Thus we have what has been termed cirrhosis of the liver. Then comes ascites, and you find varicose veins coursing all over the abdomen. The icteroid symptoms increase, and finally death ensues. The blood becomes so poisoned that the patient goes into the delirium which I have already described. The urine may be highly albuminous in these cases.

Phosphorus is useful in acute yellow atrophy of the liver, a condition which it also produces.

Again, it may be useful in fatty degeneration of the liver as a sequel of heart disease. It may also be indicated in waxy liver dependent upon long-lasting bone disease, as caries of the vertebra or of the hip-joint.

Phosphorus is also indicated in hepatitis when suppuration ensues with hectic fever, night sweats, enlargement in the right hypochondrium, and marked soreness over the liver.

The jaundice of Phosphorus is not functional in origin, but is indicative of organic disease; it is associated with anaemia, with brain disease, with pregnancy or with malignant diseases of the liver.

Phosphorus has a marked action on the alimentary tract. The tongue is coated white, and this, as under BRYONIA, is more along the middle of the organ. With bilious affections the tongue is coated yellow ; in typhoid affections it is brownish or blackish and very dry. Here it is very much like RHUS. The throat may be inflamed, particularly the uvula. White, transparent mucus collects in the throat. The patient is very hungry, particularly at night. This symptom may almost amount to bulimy. (That is a symptom which indicates Phosphorus in chills and fever.) He wakes up hungry and lies awake until he gets something to eat. There is longing for cold things, ice-cream, ice-water, etc. Cold food seems to relieve until it gets warm in the stomach, when there appears the characteristic vomiting of the remedy. Phosphorus may cure vomiting in chronic dyspepsia when there seems to be simple exhaustion of the stomach. Perhaps the inner surface of the viscus is coated with mucus, thus preventing the action of the gastric juice on the food.

We also find Phosphorus useful in spasmodic stricture of the oesophagus, especially at its cardiac end. Food seems to go down a certain distance and then is violently ejected.

Coming to the stomach itself, we find Phosphorus indicated in that very dangerous disease, perforating ulcer of the stomach. We find it there indicated by the pain, by the vomiting of food as soon as swallowed, and by the vomited matters containing a dark, grumous, semisolid substance looking like coffee-grounds.

We also find Phosphorus indicated by these same symptoms in cancer of the stomach, particularly when it is about to pass into the stage of ulceration.

Phosphorus is one of the few remedies that act on the pancreas. It is especially useful if there be fatty degeneration of that organ. The symptoms indicating it here are the gastric symptoms just enumerated, and oily stool. Sometimes the stool looks like frogs’ spawn, or, to speak more accurately, like cooked sago. It may also be remembered in diabetes mellitus and Blight’s disease when these have been preceded or are accompanied by disease of the pancreas.

The intestinal tract is attacked by Phosphorus almost as violently as it is by Arsenicum. It produces constipation, the character of which I have already explained to you. It also produces diarrhoea. The stools may be profuse and watery and worse in the morning. Here it runs against SULPHUR and PODOPHYLLUM. It also produces green mucous stools, worse in the morning. The stools are apt to contain undigested food and are very debilitating to the patient. We find Phosphorus indicated in cholerine, or diarrhoea occurring in time of cholera epidemics. Paralysis of the bowels is also produced and cured by Phosphorus, particularly when the lower portions of the bowels, the colon and rectum are affected. The anus seems to stand wide open and exudes moisture.

In diseases of the urinary organs Phosphorus is a first-class remedy. It is to he thought of in the diseases classed under the general term, Bright’s diseases. It is useful in fatty or in amyloid degeneration of the kidneys, especially if associated with a similar pathological condition of the liver and of the right or venous heart, with the consequent symptoms of venous stagnation and venous hyperaemia in different organs, with oedema of the lungs and all the symptoms of pulmonary engorgement which indicate pneumonia. The urine contains epithelial, fatty or waxy casts.

Phosphorus may cure haemorrhages from any part of the body, particularly from the lungs and stomach when associated with Bright’s disease.

Phosphorus is a decided irritant to the sexual organs in either sex, producing nymphomania in the female and satyriasis or uncontrollable sexual desire in the male.

It does not affect the female organs very prominently. The menstrual discharges seem to be altered. They are often more profuse and long-lasting. There is always a weeping, sad mood at that time. The menstrual blood is pale. It is, however, more when the menses are checked that we find Phosphorus indicated; amenorrhoea when menstruation becomes vicarious; that is, when blood-spitting, epistaxis or haematuria ensues.

In diseases of the mammary gland Phosphorus is especially useful when abscesses have formed. The inflamed gland has an erysipelatous appearance. Red streaks start from the opening in the abscess. The pus discharged is not laudable, but is of a thin, watery, ichorous character. Here it is complementary to SILICEA.

Next we take up the action of Phosphorus on the respiratory passages. In nasal catarrh we do not find it often indicated except it be chronic catarrh or ozsena. Then it is indicated by the color of the discharge, which is green mucus and blood-streaked. Green mucus NOT blood-streaked does not often require Phosphorus.

Nasal polypus, when it bleeds much, calls for Phosphorus. It may also be used in polypi of the ears or uterus. Other remedies to be thought of here are TEUCRIUM, CALCAREA and SANGUINARIA.

On the larynx it acts more prominently than any other remedy we have. It produces inflammation of the larynx. The symptoms indicating it here are hoarseness, which is usually worse in the evening, at which time it may amount to aphonia, and extreme sensitiveness of the larynx. The patient is worse from talking or coughing. It hurts the larynx for him to cough or talk, so sensitive is it to the vibrations thus produced.

It also causes catarrhal or membranous croup. It is not usually indicated here in the beginning. But it acts as a sort of prophylactic to prevent the return of the disease. It is useful also in advanced cases of croup when the cerebro-spinal system is giving out, just as we found in typhoid states. Thus there are aphonia, rapid sinking of strength, cold clammy sweat, rattling breathing, sunken, pale face and dropping of the lower jaw. The pulse in such cases is weak, thready and intermittent. In this group of symptoms Phosphorus is very similar to Lycopodium.

You find Phosphorus indicated in tracheitis and bronchitis, especially in tall, slender persons of rather tuberculous habit or tendency, rather inclined to stoop and to be hollow-chested. The cough is particularly worse on going from the warm room into the cold air, or in changes from warm to cold. It has dry, tickling cough caused by irritation in the larynx and beneath the sternum. In extreme cases it is associated with tremor of the whole body, so nervously weak is the patient. It is frequently accompanied by almost intolerable pain in the larynx from laryngeal catarrh, by splitting pain in the head just as you found under BRYONIA, and by burning rawness down the larynx and trachea. There is tightness across the upper third of the lungs. Now, a word of caution respecting this tightness. It is not a feeling as from a band around the chest, but as though the lungs themselves were constricted.

The relation between the fauces, larynx and trachea, as a starting point for cough, has been aptly mapped out by Dr. Dunham and carefully distributed among three remedies. For instance, BELLADONNA acts upon the fauces. It causes dry, tickling, teasing cough. The throat is bright red and the tonsils enlarged.

Going further down, you find tickling in the suprasternal fossa. Every change in the breathing causes cough. This condition calls for RUMEX.

When the irritation extends down still further, into the bronchi, then Phosphorus becomes the remedy.

We find Phosphorus indicated in a great variety of coughs. Thus it is useful in stomach or hepatic cough coming on after the patient eats, and starting from tickling at the pit of the stomach. It is also indicated in cough made worse by the entrance of a stranger into the room ; this being purely a reflex nervous symptom. It is also called for in cough provoked by strong odors. In fact, perfumes or anything that will disturb the balance of the nervous system will bring on cough under Phosphorus.

Phosphorus is indicated in bronchitis or bronchial catarrh, whether the disease involves the bronchial tubes high up or whether it extends down into the bronchioles. The symptoms are as follows : Cough with tearing pain under the sternum as if something were being torn loose; suffocative pressure in the upper part of the chest, with constriction of the larynx. You will also find the lungs to be engorged with blood, mucous rales through the lungs, panting and labored respiration and even emphysema. The sputa are of various kind. Thus we may have bloody and mucous sputum. Very characteristic is sputum consisting of yellowish mucus, with streaks of blood running through it. It may be rust-colored as in pneumonia; or it may be purulent and have a sweetish or salty taste.

In pneumonia, Phosphorus is indicated when the bronchial symptoms are prominent. Then it is almost certain to be the remedy. It does not cause hepatization of the lungs, so that it would not be indicated when the lung or lungs are in a complete state of hepatization. But it may be indicated for typhoid symptoms in the course of pneumonia (these symptoms I have already given to you), especially in the latter part of the period of deposit and in the early part of absorption, that is just when hepatization is coming on and just when it is going off. There is great dryness of the air-passages, with burning, excoriating, raw feeling in the upper part of the chest.

In tuberculosis you find Phosphorus particularly indicated in youths, and by this expression I mean both young men and women who have grown too rapidly, who have delicate skin ; long, silky eyelashes and who are of easy, graceful manners. The mental development is excellent, yet they have not the physique to support this keenness of mind. Particularly is it indicated if they have an hereditary tendency to consumption or have had bone diseases in early childhood. The early symptoms you will notice are these: The patient catches cold easily ; he suffers from rush of blood to the chest; he has the above-mentioned constriction across the chest with every little cold; pains through the apex of the left lung; patient cannot lie on the left side; aphonia; dry cough; hectic flush of the cheeks, particularly towards evening; oppression of the chest at night, forcing him to sit up; empty feeling at the pit of the stomach, particularly in the forenoon at ten or eleven o’clock; he awakens hungry at night, feeling that he must eat and that he would faint if he did not. Finally, the hectic fever grows more prominent. There is rapid formation of vomicae or cavities in the lungs. These are the indications for Phosphorus in pneumonia and I must supplement them with a warning. Unless you give the drug cautiously, you precipitate what you would prevent. Be certain that it is the remedy, and do not give it too often or you will hasten the process you are anxious to avoid. I would not advise you to give Phosphorus in well-marked tuberculous patients. If tubercles have been deposited in the lungs, you should hesitate before giving it, unless the “picture” calling for it is so strong that you cannot possibly make a mistake.

I may say that the same is true also of Sulphur. SULPHUR is adapted to the onset of the disease. Then, a dose or two allowed to act will frequently head these symptoms off. But after tubercles have been deposited, you must be careful how you use the drug.

I would next say a few words about the action of Phosphorus on the heart. It is particularly indicated in affections of this organ when the right side of the heart is involved more than the left. Its symptoms point more to the bad results that follow disease of the right heart than disease of the left; in a word, venous stagnation. It is suited to all forms of palpitation ; palpitation from emotion, as from the sudden entrance into the room of an unexpected visitor, welcome or unwelcome ; from motion ; and also from rush of blood to the chest. Particularly does this latter occur in the rapidly growing young.

Phosphorus must also be remembered in endocarditis, in which disease it is often forgotten. Particularly is it indicated when endocarditis or myocarditis occurs during the course of acute inflammatory rheumatism or during pneumonia.

Phosphorus is also useful for fatty degeneration of the heart. You distinguish it from ARSENICUM by the involvement of the right heart, by venous stagnation and puffiness of the face, particularly under the eyelids. Arsenicum has more symptoms of the left heart, more oppression of the chest in breathing, more orthopnoea, and more anasarca or general dropsy.

Phosphorus acts upon the bones. We find this illustrated in the necrosis of the lower jaw, formerly so common among matchmakers. The fumes of the Phosphorus cause necrosis of the lower and sometimes of the upper jaw. You may ask is this not a local effect produced by inhalation of the fumes. If it is a local effect, why does it affect by preference the lower jaw? Why not the upper? Then, too, when persons have been poisoned by eating Phosphorus, if necrosis resuits, it is the lower jaw that is affected, thus showing you that the drug has a special affinity for this bone. It is to be remembered in caries or necrosis of the lower jaw. This you sometimes meet with from teething or from an inflamed or suppurating gland. Phosphorus affects other bones as well as the lower jaw, however. We find it not infrequently indicated in caries of the vertebra in scrofulous children. The concomitant symptoms have to decide the remedy for you. For instance, the child is of the characteristic Phosphorus build. There is diarrhoea, worse in the morning, much like that of SULPHUR, the stool containing undigested food. There is tendency to involvement of the lungs. For instance, the patient catches cold easily, with marked tendency to bronchitis. Still further, we may be called upon to use Phosphorus in caries of the vertebra when the inflammation has extended inwards and involved the spinal cord itself. This you notice to be expressed first by burning in certain portions of the spine. The patient cannot tolerate any heat near the back. A hot sponge on the back causes him to wince. There will be a feeling as of a band around the body. The difficulty in walking increases until finally the child cannot walk at all. There is often partial loss of control over the sphincters.

Phosphorus also affects the joints, the hip- and knee-joints in particular. Hence, it may be indicated in morbus coxarius or in white swelling, both common, as you know, in scrofulous children. Here, too, you have to separate it from the other antipsorics by the general symptoms. I would say, for your guidance, that Phosphorus belongs with Silicea and seems to complement it. It is useful when Silicea has been partially successful in these joint-diseases.

Fistulae in the glands and about the joints are apt to form with Phosphorus. These fistulous ulcers have high edges from exuberant granulations, the purulent discharge being rather thin and ichorous. Around the ulcer, Phosphorus has, probably more than Silicea, an erysipelatous blush often radiating as in BELLADONNA. There will frequently be burning, stinging pains, well-marked hectic fever with night sweat, diarrhoea, and anxiety towards evening.

These same symptoms apply to inflammation of the mammary glands when there are fistulous ulcers, as in Silicea, but distinguished from that remedy by the erysipelatous blush.

Burning and stinging pains also suggest APIS but Apis does not cause deep-seated suppuration, such as that in the parenchyma of an organ.

Next, I wish to say a word about the action of Phosphorus on the eyes. While it may not be the best remedy for affections of the external parts of the eye, it certainly does lead the list for diseases involving the deeper structures of that organ, as the retina, choroid and vitreous humor. It is particularly in nervous affections of the eye, that we find Phosphorus indicated, and by “nervous” I mean belonging to the nerves of the eye. Thus it is suited to hypersemia of the choroid and retina, which may even result in retinitis or choroiditis, and when it does so result, it is apt to be a serious trouble. Vision is greatly lessened. The patient sees all sorts of abnormal colors, black spots in the air and gray veils over things, it seems as if he was constantly looking through a mist or fog. Objects look red. Letters appear red when rending. That symptom, I believe, is under no other remedy than Phosphorus. Other remedies have red vision, but under Phosphorus alone is it that in reading, the letters look red.

This remedy is also indicated in retinitis accompanying kidney affections, retinitis albuminurica.

It may also be indicated in retinitis with suppression of menses or some other uterine or ovarian disorder. When you have an eye affection to deal with, do not forget that the eyes are not the whole body. Remember that lesion in the eye may have as a starting point disease in some other part of the body. Therefore in making your prescription do not forget to look for any constitutional symptoms that may be present.

We also find Phosphorus indicated in either amblyopia or asthenopia, particularly when associated with Bright’s disease or resulting from loss of fluids. When the patient attempts to read, letters blur and run together and the eyes smart and burn. It is useful in amblyopia occurring after typhoid fever, sexual excesses or loss of fluids. It is also suited to blindness after lightning-stroke. In these cases the patient almost always sees a green halo around the candle-light.

I would like to say that Phosphorus will retard the growth of cataract. Other remedies that may suggest themselves in this condition are SILICEA, CONIUM, SECALE and NATRUM MUR.

In addition to producing oversensitiveness to sound, as already mentioned, Phosphorus has the opposite effect, deafness or hardness of hearing particularly to the human voice. We have exactly the opposite symptom under IGNATIA. This deafness may be purely nervous as after typhoid fever. It may also indicate the drug in congested states when the hardness of hearing is associated with buzzing and roaring in the ears.

Phosphorus acts on the blood, destroying its coagulability. Thus it is that small wounds bleed much. I think that these are the words of the symptom as Hahnemann gave it to us. The way that he found that to be characteristic of Phosphorus was this : One prover noticed that when he pricked his finger, it did not stop bleeding readily. Hahnemann put this down as a possible symptom of Phosphorus. Later, a patient came to him, and described the totality of her symptoms. She had this bleeding. He gave her Phosphorus, which cured her. Since then, this drug has been used many times for this haemorrhagic diathesis. LACHESIS has a similar symptom, but has not been so thoroughly confirmed as has Phosphorus.

Phosphorus is also indicated in hsematemesis. This may be vicarious as from a suppressed menstrual flow, or it may result from simple congestion of the stomach, or even from organic disease of the stomach, particularly open cancer or round ulcer of the stomach. The vomited matters contain dark grumous substances, looking like coffee-grounds.

Phosphorus may also be used in haemoptysis, when indicated by the symptoms already given.