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Aurum metallicum and the aurum salts
Aurum metallicum and the Aurum salts K.
G. PRIESTMAN,
M.n.c.S.,
L.R.C.P.,
M.F. r I O ~ .
I was really rather fascinated while preparing this lecture on Aurum metallicum, because Kent talks about Aurum metallicum and Aurum muriaticum. There is a much less well-known book of his, called New Remedies where he goes into quite considerable detail of Aururn ars., Aurum iod., and Aurum suIph., and it made me wish that I had paid much more attention long ago, because I feel that their Mentals are so alike one tends to be lectured on Aurum metallicum and left with that. But the mentals of these others are so alike that you might easily find that you are missing the right remedy. You think you have got the right remedy and if you just give Aurum metallicum and it does not work, or does not work as well as you think it should, you go off to another remedy, whereas probably it is one of the other Aurums. So if you really check, and check at the very beginning, you will get the right one and get a remarkably good result. These patients are the manic depressives. Now, I know it comes mainly as a depressive, but they are all alternating. They all have these alternating states and though depression perhaps is the most outstanding, they do have excessive irritability, hysterical symptoms and a great m a n y contrasting symptoms, so that it is a swing of mood. Their general symptoms also are similar and need a very careful comparison. Sometimes I found that Kent gave a great many almost opposite symptoms, particularly in Aurum ars., without even differentiating in type between one and another. I know that does make it very difficult, but at the same time it does make it worth while studying most carefully. So we will think of the general mental symptoms first, as a group, and then go into detail. The main characteristic is suicidal depression with want of self confidence, alternating with hysteria and a kind of hysterical excitement and anger. Now here is another contradiction: they are restless and hurried mentally, but they are aggravated from hurrying physically. They can none of them walk fast, or if they do it aggravates themselves and their symptoms. They are frightfully irritable and the thing that makes them most angry is to be contradicted. They are full of self-condemnation but extremely critical of others. The mental condition--of hysteria or depression--may be brought on by anxiety, fear, or contradiction. I t is interesting, too, that they all desire open air except Aurum sulph., and I would have expected Aurum sulph, to be the one that most craved open air, being a sulph. Most of them are better for cold and cool applications. A Tuesday lecture given at the Royal London Homoeopathie Hospital in 1974
250
THE
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JOURI~AL
Another seeming contradiction: there is a great desire to lie down and rest, they want to lie down and rest and yet most symptoms are worse for the warmth of bed and worse at night. They all have vivid, horrifying, terrifying dreams. (The Aurum sulph, can, occasionally, have pleasant dreams--it is the only one. Sulphur often has pleasant dreams.) Most of them are worse when they wake up in the morning. They are all sensitive to pain and the pains are described as deep, boring, tearing pains with rheumatic conditions of the joints, induration of glands everywhere, including the ovaries and the testicles. There is a tendency to deep ulceration of the skin and malignant disease, particularly epitheliomas of the face and lips. All the Gold salts are valuable remedies in serious heart disease and chronic nephritis. I think every single one of the records spoke of a lot of albumen in the urine and sometimes purulent, blood-stained urine as well. So that it is a deep-acting remedy suitable for serious diseases, not only mental diseases but diseases where serious pathology is present. Again, I myself have found that it is easiest perhaps to list them in colunms. I shall do Aurum met., Aur~tm tour., and Aurum ars. first and then Aurum iod. and Aurum sulph. I have not done them in alphabetical order because two were in one book, and two were in Kent's other book. M]S~TALS. Aurum ~netallieum is the one we hear about most and we are told so much about the dreadful depression and self-criticism. He feels that he has let himself down; he feels he has let his friends down; he gets absorbed in himself and broods, longs to die and is actually suicidal and can commit suicide. At the same time there is this dreadful sense of mental hurry and worry, and contradiction rouses him to fury. I t is a really dreadful mental state. He feels that everything he has done, he has done wrong, and it is possible to meet people with this kind of mental state. They are in such distress that it is great to be able to help them. Under A u r u m 7nuriaticum we get very similar symptoms: that he hates his life, and he hates his work which drives him to suicidal depression. There is a great feeling of indolence; he can't rouse himself to do anything; this condition alternates with extreme irritability and in both you can get the complaints brought on by fright, anger and mortification. Mortification--it's a horrid word really, it means you feel you've been insulted. It's a feeling of injured pride, that is a more modern word. I found the Aurum ars. was a remedy of tremendous contrasts: anxiety with anger; I think the Arsenicum radical comes out here because this is by far the most critical and fault finding, of others as well as of himself. He is much more critical and fault-finding with other people. Over conscientious, a perfectionist and sometimes real confusion and alternating states of mind. You get hysteria with restless excitement and then this same depression and desire for death. And they complain of being absent-minded. That is a real worry to them. They are very forgetful. Aurum iodide: the same thing; axiety and hurry; cheerfulness alternating with depression. I think there is more cheerfulness in the Aurum iod. than in the others. I f they have to do any mental work they are apt to get excited; it is a sort of exaggerated cheerfulness, this hysterical excitement. They dread work; they don't want to use their minds; they become very fretful and impatient and irresolute. You get almost exactly the same repetition in A u r u m sulph., the
Aldl~UM METALLIGUM
AND
THE
AUI~IY~ SALTS
251
anxiety with fear; the excitement alternating with depression, which is aggravated from mental exertion; a loathing of life; a desire for death; but here there is rather a distinguishing feature: they are much more afraid of people; there is a fear of people and they definitely get full of fear at night. Now the GE~m~Av, S to do with the heat and cold reaction. I n Autumn metallicum: a great desire for open air; wants the doors and windows open; wants to throw the clothes off; better for cold and cold washing; the "worse at night" is described as worse from sunset to sunrise. The A u r u m rnur. is better for cold, wet weather. Very few remedies are better for cold, wet weather, so it is worth remembering the ones that are. A u r u m tour. is one. These patients hate warm air, w a r m t h of bed; warmth in general. They hate walking fast, in fact they find it impossible. And here is your contrast: slow walking in the open-air ameliorates, rather like Pulsatilla, but I don't think you could mistake the mentals of a Pulsatilla and an A u r u m tour. patient. I t is very interesting because under the heart symptoms every one of them has palpitation from fast walking and palpitation from going upstairs. I n a sense, if you have got heart trouble those are two normal reactions, but it is stressed so much that I think it must be an exaggerated reaction, so t h a t it is worth remembering this inability to walk fast. _durum arsenieum: desires the open air but movement in general aggravates and though walking, and walking fast, aggravates, yet the patient is excessively restless, t h a t is a typical mental restlessness like you get in A r s e n i c u m patients. They hate windy weather and they are worse in cold, wet weather. The A u r u m iodide: again your strong desire for open air; better in the open air; better cool; worse in warm air and warmth in general and here is this: under A u r u m sulph., a desire for open air in Kent, yet worse from cold, worse becoming cold, and sensitive to draught. As a matter of fact, in spite of the Sulphurs' discomfort in heat, a Sulphur patient is sensitive to draft and they do feel cold at ~he bottom of their back. Always remember that; sulphur patients can feel cold and chilly in the lumbar region, especially in their acute conditions. They hate to feel cold, and they do feel unusually cold in the lumbar region. A u r u m patients are all full of catarrhs of all kinds. Catarrh is one of the outstanding symptoms, and catarrhs with destruction of tissue. I n fact, when the eyes, nose, and ears are affected you will get ulcerations of the cornea, inflammation of the iris, really serious eye conditions; inflammation of the eyelids; ulceration of the nose, destruction of the nasal bones. You get this in all of them. They have really offensive discharges of all kinds from the ears, from the nose, the eyes. Another recurring thing that I noticed was that it said, under "Ears": hearing appeared to be more acute to begin with and impaired later on; I suppose that was in the provers (it can't have been in patients with severe catarrhal conditions). So if you get patients who eomplain t h a t they have had very acute hearing but since they have had this bad catarrh it has become impaired, think of the A u r u m salts. They all complain of noises in the ears. Two of them, A u r u m metallicum and A u r u m iodatum, have been used for exophthalmos and exophthalmic goitre. Now we will go a little bit more on to particulars of the nose: in A u r u m metallicum the patient complains that everything smells too strong, and that he has this putrid smell from his own nose. There is very often ulceration of the
252
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JOURNAL
nasal bones. The tip of the nose is red, swollen and bulbous and Kent makes a lovely little remark, " I t m a y be due to his whiskey and it m a y be due to his heart." Most of them crave alcohol and feel better for alcohol and you m a y sometimes get a very good result in an alcoholic patient, from Aurum metallicum, and in others of these remedies, too. I n A u r u m muriaticum, apart from the same symptoms, you also get the nasal bones extremely sensitive to pressure, and deep cracks in the wings of the nose. They all have this swollen, red, bulbous tip to the nose. And they all can be helpful in epitheliomata of the nose and lips and the edges of the ears. They all have a most annoying metallic taste and in A u r u m ars. and Aurum sulph, it is specially mentioned that the teeth are sensitive, feel loose, and feet too long. You get patients who say they camlot clean their teeth as they are too sensitive to the toothbrush, and their teeth feel too long. Very often there is an ulcerative and inflammatory condition of the gums. All except Aurum metallicum, where thirst is not mentioned at all, have a tremendous thirst, burning thirst. A u r u m metallicum has very few digestive symptoms, but they all are useful for conditions where the liver is affected. And in Aurum metallicum you can get hardening and enlargement of the liver, congestion of the portal system, which " m a y be due to his alcohol or his heart". A lot of them desire coffee and sometimes milk. They all desire alcohol. A u r u m muriaticum has a very slow digestion and though it desires coffee and wine it is aggravated by both. A u r u m muriaticum tends to have a lot of putrid eructations and enlarged, hard liver, and a feeling of tightness in the region of the liver. Aurum arsenicum has a ravenous appetite with aversion to food; desires the alcoholic stimulants and coffee; m a y have a lot of nausea with headache and vomiting; much more headache than either Aurum met. or Aurum tour., and Aurum ars. is particularly mentioned for atrophy of the liver but not enlargement of the liver. A u r u m iod., as perhaps you might expect, has a ravenous appetite and again the desire for alcohol, and the liver m a y be enlarged or atrophied. A u r u m sulph, has a ravenous appetite also and the desire for stimulants and coffee, and as a contrast to its other things, it does want cold drinks though it was worse for cold generally, but it does want cold drinks. Very few other digestive symptoms for Aurum metallicum. For Aurum muriaticum, the patients can have diarrhoea, haemorrhoids, and anal warts. A u r u m ars. has constipation alternating with diarrhoea, dreadfully offensive flatus, and haemorrhoids. A u r u m iod. has alternating constipation and diarrhoea, and so does Aurum sulph. They all have offensive flatus, and a tendency to haemorrhoids. They all have a great tendency to induration of the abdominal glands. Very few of them have much of inflammation of the lungs as such, they m a y have hoarseness and catarrh, but their chest symptoms are nearly always related to their hearts, so t h a t they will get congestion of the lungs but this is due to heart failure. They will get asthma, but it is cardiac asthma. A u r u m metallicum has a description: agonizing oppression under the sternum; tumultuous beating of the heart with a feeling of suffocation as if blood would boil in the chest and burst out. Under A u r u m tour., similar heart symptoms: distressing pain under the
AURUM
METALLICUM
AND
THE
AUI~UM SALTS
253
sternum; sensation as if the heart would burst on fast walking, and suffocation in a warm room or from tight clothing. Both can have this cardiac asthma and anginal pain. A u r u m arsenicum has rather more cough, but it is a short, dry cough at night, mostly due to the asthmatic condition which again is related to the heart. I t can have a little expectoration which is usually yellow, offensive and difficult to bring up. To finish the A u r u m tour. heart symptoms: it can be very useful in rheumatic endocarditis, and it will have palpitation worse from mental exertion as well as from physical exertion with a very violent, irregular action. A u r u m ars. again is very useful in heart conditions, with constricting pain, anginal pains in the chest, palpitation, oppression in the chest which is worse from rapid motion and lying down. A u r u m iod. great anxiety in the region of the heart. I t is almost a contradiction of terms but the patient has a feeling of uncertainty in the chest, and constriction in the chest and it produces a great sense of anxiety. Again, inflammation of the heart with endocarditis, palpitation worse at night, and worse for the slightest exertion; and this description: tumultuous action of the heart on walking. Aurum sulph, has hoarseness and a short, hard, dry cough in cold air and they also complain of pain in the chest on coughing and on inspiration. They complain of a trembling sensation in the heart, or a fluttering sensation in the heart; a great feeling of congestion in the chest which produces anxiety. Gold salts have been used in allopathic medicine for rheumatoid arthritis for m a n y years and we do get rheumatic symptoms coming up in these A u r u m salts. They often have a history of rheumatic pains, tearing joint pains, and possibly you do not see the patient until the heart has become affected. They tend to have acute rheumatic fevers which go on to heart symptoms. K e n t did not give any very specific modalities for the rheumatic symptoms in A u r u m metallicu~r4 but he does say under Auru~n muriaticum that the tearing pains are worse from the warmth of bed, worse from rest, and he particularly also mentions acute sensitiveness of the tibia, tenderness of the tibia. All of them have icy cold hands and feet and A~trum muriaticum and A u r u m iodatum both have burning redness and swelling of the toes like chilblains. So does Aurum arsenicum. The Aurum ars. patients often complain of numbness, particularly at night, with gnawing, aching, stretching pains and tremendous restlessness of the limbs. Aur~tm sulph, has a great deal of cracking of the skin of the hands as well. That is perhaps an indication for the sulphur component. Generally, most of them do have ulcerative skin conditions, with burning of the skin, quite often blueness of the skin. There m a y be dusky blueness of the lips, blueness of the fingers, it all goes with the tendency to heart conditions and heart failures and congestion.
G. PRIESTMAN,
M.n.c.S.,
L.R.C.P.,
M.F. r I O ~ .
I was really rather fascinated while preparing this lecture on Aurum metallicum, because Kent talks about Aurum metallicum and Aurum muriaticum. There is a much less well-known book of his, called New Remedies where he goes into quite considerable detail of Aururn ars., Aurum iod., and Aurum suIph., and it made me wish that I had paid much more attention long ago, because I feel that their Mentals are so alike one tends to be lectured on Aurum metallicum and left with that. But the mentals of these others are so alike that you might easily find that you are missing the right remedy. You think you have got the right remedy and if you just give Aurum metallicum and it does not work, or does not work as well as you think it should, you go off to another remedy, whereas probably it is one of the other Aurums. So if you really check, and check at the very beginning, you will get the right one and get a remarkably good result. These patients are the manic depressives. Now, I know it comes mainly as a depressive, but they are all alternating. They all have these alternating states and though depression perhaps is the most outstanding, they do have excessive irritability, hysterical symptoms and a great m a n y contrasting symptoms, so that it is a swing of mood. Their general symptoms also are similar and need a very careful comparison. Sometimes I found that Kent gave a great many almost opposite symptoms, particularly in Aurum ars., without even differentiating in type between one and another. I know that does make it very difficult, but at the same time it does make it worth while studying most carefully. So we will think of the general mental symptoms first, as a group, and then go into detail. The main characteristic is suicidal depression with want of self confidence, alternating with hysteria and a kind of hysterical excitement and anger. Now here is another contradiction: they are restless and hurried mentally, but they are aggravated from hurrying physically. They can none of them walk fast, or if they do it aggravates themselves and their symptoms. They are frightfully irritable and the thing that makes them most angry is to be contradicted. They are full of self-condemnation but extremely critical of others. The mental condition--of hysteria or depression--may be brought on by anxiety, fear, or contradiction. I t is interesting, too, that they all desire open air except Aurum sulph., and I would have expected Aurum sulph, to be the one that most craved open air, being a sulph. Most of them are better for cold and cool applications. A Tuesday lecture given at the Royal London Homoeopathie Hospital in 1974
250
THE
BRITISH
IIOM(EOPATHIC
JOURI~AL
Another seeming contradiction: there is a great desire to lie down and rest, they want to lie down and rest and yet most symptoms are worse for the warmth of bed and worse at night. They all have vivid, horrifying, terrifying dreams. (The Aurum sulph, can, occasionally, have pleasant dreams--it is the only one. Sulphur often has pleasant dreams.) Most of them are worse when they wake up in the morning. They are all sensitive to pain and the pains are described as deep, boring, tearing pains with rheumatic conditions of the joints, induration of glands everywhere, including the ovaries and the testicles. There is a tendency to deep ulceration of the skin and malignant disease, particularly epitheliomas of the face and lips. All the Gold salts are valuable remedies in serious heart disease and chronic nephritis. I think every single one of the records spoke of a lot of albumen in the urine and sometimes purulent, blood-stained urine as well. So that it is a deep-acting remedy suitable for serious diseases, not only mental diseases but diseases where serious pathology is present. Again, I myself have found that it is easiest perhaps to list them in colunms. I shall do Aurum met., Aur~tm tour., and Aurum ars. first and then Aurum iod. and Aurum sulph. I have not done them in alphabetical order because two were in one book, and two were in Kent's other book. M]S~TALS. Aurum ~netallieum is the one we hear about most and we are told so much about the dreadful depression and self-criticism. He feels that he has let himself down; he feels he has let his friends down; he gets absorbed in himself and broods, longs to die and is actually suicidal and can commit suicide. At the same time there is this dreadful sense of mental hurry and worry, and contradiction rouses him to fury. I t is a really dreadful mental state. He feels that everything he has done, he has done wrong, and it is possible to meet people with this kind of mental state. They are in such distress that it is great to be able to help them. Under A u r u m 7nuriaticum we get very similar symptoms: that he hates his life, and he hates his work which drives him to suicidal depression. There is a great feeling of indolence; he can't rouse himself to do anything; this condition alternates with extreme irritability and in both you can get the complaints brought on by fright, anger and mortification. Mortification--it's a horrid word really, it means you feel you've been insulted. It's a feeling of injured pride, that is a more modern word. I found the Aurum ars. was a remedy of tremendous contrasts: anxiety with anger; I think the Arsenicum radical comes out here because this is by far the most critical and fault finding, of others as well as of himself. He is much more critical and fault-finding with other people. Over conscientious, a perfectionist and sometimes real confusion and alternating states of mind. You get hysteria with restless excitement and then this same depression and desire for death. And they complain of being absent-minded. That is a real worry to them. They are very forgetful. Aurum iodide: the same thing; axiety and hurry; cheerfulness alternating with depression. I think there is more cheerfulness in the Aurum iod. than in the others. I f they have to do any mental work they are apt to get excited; it is a sort of exaggerated cheerfulness, this hysterical excitement. They dread work; they don't want to use their minds; they become very fretful and impatient and irresolute. You get almost exactly the same repetition in A u r u m sulph., the
Aldl~UM METALLIGUM
AND
THE
AUI~IY~ SALTS
251
anxiety with fear; the excitement alternating with depression, which is aggravated from mental exertion; a loathing of life; a desire for death; but here there is rather a distinguishing feature: they are much more afraid of people; there is a fear of people and they definitely get full of fear at night. Now the GE~m~Av, S to do with the heat and cold reaction. I n Autumn metallicum: a great desire for open air; wants the doors and windows open; wants to throw the clothes off; better for cold and cold washing; the "worse at night" is described as worse from sunset to sunrise. The A u r u m rnur. is better for cold, wet weather. Very few remedies are better for cold, wet weather, so it is worth remembering the ones that are. A u r u m tour. is one. These patients hate warm air, w a r m t h of bed; warmth in general. They hate walking fast, in fact they find it impossible. And here is your contrast: slow walking in the open-air ameliorates, rather like Pulsatilla, but I don't think you could mistake the mentals of a Pulsatilla and an A u r u m tour. patient. I t is very interesting because under the heart symptoms every one of them has palpitation from fast walking and palpitation from going upstairs. I n a sense, if you have got heart trouble those are two normal reactions, but it is stressed so much that I think it must be an exaggerated reaction, so t h a t it is worth remembering this inability to walk fast. _durum arsenieum: desires the open air but movement in general aggravates and though walking, and walking fast, aggravates, yet the patient is excessively restless, t h a t is a typical mental restlessness like you get in A r s e n i c u m patients. They hate windy weather and they are worse in cold, wet weather. The A u r u m iodide: again your strong desire for open air; better in the open air; better cool; worse in warm air and warmth in general and here is this: under A u r u m sulph., a desire for open air in Kent, yet worse from cold, worse becoming cold, and sensitive to draught. As a matter of fact, in spite of the Sulphurs' discomfort in heat, a Sulphur patient is sensitive to draft and they do feel cold at ~he bottom of their back. Always remember that; sulphur patients can feel cold and chilly in the lumbar region, especially in their acute conditions. They hate to feel cold, and they do feel unusually cold in the lumbar region. A u r u m patients are all full of catarrhs of all kinds. Catarrh is one of the outstanding symptoms, and catarrhs with destruction of tissue. I n fact, when the eyes, nose, and ears are affected you will get ulcerations of the cornea, inflammation of the iris, really serious eye conditions; inflammation of the eyelids; ulceration of the nose, destruction of the nasal bones. You get this in all of them. They have really offensive discharges of all kinds from the ears, from the nose, the eyes. Another recurring thing that I noticed was that it said, under "Ears": hearing appeared to be more acute to begin with and impaired later on; I suppose that was in the provers (it can't have been in patients with severe catarrhal conditions). So if you get patients who eomplain t h a t they have had very acute hearing but since they have had this bad catarrh it has become impaired, think of the A u r u m salts. They all complain of noises in the ears. Two of them, A u r u m metallicum and A u r u m iodatum, have been used for exophthalmos and exophthalmic goitre. Now we will go a little bit more on to particulars of the nose: in A u r u m metallicum the patient complains that everything smells too strong, and that he has this putrid smell from his own nose. There is very often ulceration of the
252
T~E
BRITISI{
HOlY[(EOPATHIC
JOURNAL
nasal bones. The tip of the nose is red, swollen and bulbous and Kent makes a lovely little remark, " I t m a y be due to his whiskey and it m a y be due to his heart." Most of them crave alcohol and feel better for alcohol and you m a y sometimes get a very good result in an alcoholic patient, from Aurum metallicum, and in others of these remedies, too. I n A u r u m muriaticum, apart from the same symptoms, you also get the nasal bones extremely sensitive to pressure, and deep cracks in the wings of the nose. They all have this swollen, red, bulbous tip to the nose. And they all can be helpful in epitheliomata of the nose and lips and the edges of the ears. They all have a most annoying metallic taste and in A u r u m ars. and Aurum sulph, it is specially mentioned that the teeth are sensitive, feel loose, and feet too long. You get patients who say they camlot clean their teeth as they are too sensitive to the toothbrush, and their teeth feel too long. Very often there is an ulcerative and inflammatory condition of the gums. All except Aurum metallicum, where thirst is not mentioned at all, have a tremendous thirst, burning thirst. A u r u m metallicum has very few digestive symptoms, but they all are useful for conditions where the liver is affected. And in Aurum metallicum you can get hardening and enlargement of the liver, congestion of the portal system, which " m a y be due to his alcohol or his heart". A lot of them desire coffee and sometimes milk. They all desire alcohol. A u r u m muriaticum has a very slow digestion and though it desires coffee and wine it is aggravated by both. A u r u m muriaticum tends to have a lot of putrid eructations and enlarged, hard liver, and a feeling of tightness in the region of the liver. Aurum arsenicum has a ravenous appetite with aversion to food; desires the alcoholic stimulants and coffee; m a y have a lot of nausea with headache and vomiting; much more headache than either Aurum met. or Aurum tour., and Aurum ars. is particularly mentioned for atrophy of the liver but not enlargement of the liver. A u r u m iod., as perhaps you might expect, has a ravenous appetite and again the desire for alcohol, and the liver m a y be enlarged or atrophied. A u r u m sulph, has a ravenous appetite also and the desire for stimulants and coffee, and as a contrast to its other things, it does want cold drinks though it was worse for cold generally, but it does want cold drinks. Very few other digestive symptoms for Aurum metallicum. For Aurum muriaticum, the patients can have diarrhoea, haemorrhoids, and anal warts. A u r u m ars. has constipation alternating with diarrhoea, dreadfully offensive flatus, and haemorrhoids. A u r u m iod. has alternating constipation and diarrhoea, and so does Aurum sulph. They all have offensive flatus, and a tendency to haemorrhoids. They all have a great tendency to induration of the abdominal glands. Very few of them have much of inflammation of the lungs as such, they m a y have hoarseness and catarrh, but their chest symptoms are nearly always related to their hearts, so t h a t they will get congestion of the lungs but this is due to heart failure. They will get asthma, but it is cardiac asthma. A u r u m metallicum has a description: agonizing oppression under the sternum; tumultuous beating of the heart with a feeling of suffocation as if blood would boil in the chest and burst out. Under A u r u m tour., similar heart symptoms: distressing pain under the
AURUM
METALLICUM
AND
THE
AUI~UM SALTS
253
sternum; sensation as if the heart would burst on fast walking, and suffocation in a warm room or from tight clothing. Both can have this cardiac asthma and anginal pain. A u r u m arsenicum has rather more cough, but it is a short, dry cough at night, mostly due to the asthmatic condition which again is related to the heart. I t can have a little expectoration which is usually yellow, offensive and difficult to bring up. To finish the A u r u m tour. heart symptoms: it can be very useful in rheumatic endocarditis, and it will have palpitation worse from mental exertion as well as from physical exertion with a very violent, irregular action. A u r u m ars. again is very useful in heart conditions, with constricting pain, anginal pains in the chest, palpitation, oppression in the chest which is worse from rapid motion and lying down. A u r u m iod. great anxiety in the region of the heart. I t is almost a contradiction of terms but the patient has a feeling of uncertainty in the chest, and constriction in the chest and it produces a great sense of anxiety. Again, inflammation of the heart with endocarditis, palpitation worse at night, and worse for the slightest exertion; and this description: tumultuous action of the heart on walking. Aurum sulph, has hoarseness and a short, hard, dry cough in cold air and they also complain of pain in the chest on coughing and on inspiration. They complain of a trembling sensation in the heart, or a fluttering sensation in the heart; a great feeling of congestion in the chest which produces anxiety. Gold salts have been used in allopathic medicine for rheumatoid arthritis for m a n y years and we do get rheumatic symptoms coming up in these A u r u m salts. They often have a history of rheumatic pains, tearing joint pains, and possibly you do not see the patient until the heart has become affected. They tend to have acute rheumatic fevers which go on to heart symptoms. K e n t did not give any very specific modalities for the rheumatic symptoms in A u r u m metallicu~r4 but he does say under Auru~n muriaticum that the tearing pains are worse from the warmth of bed, worse from rest, and he particularly also mentions acute sensitiveness of the tibia, tenderness of the tibia. All of them have icy cold hands and feet and A~trum muriaticum and A u r u m iodatum both have burning redness and swelling of the toes like chilblains. So does Aurum arsenicum. The Aurum ars. patients often complain of numbness, particularly at night, with gnawing, aching, stretching pains and tremendous restlessness of the limbs. Aur~tm sulph, has a great deal of cracking of the skin of the hands as well. That is perhaps an indication for the sulphur component. Generally, most of them do have ulcerative skin conditions, with burning of the skin, quite often blueness of the skin. There m a y be dusky blueness of the lips, blueness of the fingers, it all goes with the tendency to heart conditions and heart failures and congestion.