Rediscovery of Materia Medica

Jana S N
1
, Rath P
2
Acetic Acid
Abstract
In continuation with the previous paper on Abrotanum in this same newsletter another
medicine in our Materia medica Acetic Acid comes in the queue. Hence the medicine has been
discussed here from the same viewpoint of looking into the genesis of symptoms. This is only an
effort to correlate the symptoms of clinical materia medica with that of the genius of internal
medicine. This is at best a hypothesis and in no way confirms that the explanations of the
symptoms are anything from full and final, this is only a sincere effort to bridge the gap
between Materia Medica and Practice of Medicine.

The explanations may be as follows -
Adapted to pale, lean persons with lax, flabby muscles; face pale,waxy.
Paleness or pallor due to decreased redness is a feature of anemia, and in decreased blood flow as
found in fainting or arterial insufficiency which is a feature of peripheral vascular disease. Since here no
mention of limbs and any specific part is there it appears to be due to anemia. However this finding in
Acetic Acid goes well with anemia due to hemorrhages from diseases of various organs, hemorrhagic
disorders which is very much prevalent in Acetic Acid, wasting diseases like Malignancies, Anemia of
Pregnancy, Anemia of Chronic disease which is there in Acetic Acid like Tuberculosis etc. Paleness is also
a feature of Hypopituitarism, Hypothyroidism ,Hypogonadism when associated with other relevant
features or Pituitary tumour when found with Bitemporal hemianopia.
To make out what is leanness we have to understand the meaning of Lean body mass which means
body mass composed predominantly of muscles and visceral organs. Here we have to recognize the
importance of the fact that the lean body mass may get reduced in course of different illnesses.
Leanness is a state of absence of excess adipose tissue. We must recognize here that lean but very
muscular individuals may be overweight by numerical standards without having increased adiposity.
Lower motor neuron disease and myopathies present with lax muscles, loss of motor neurons do not
cause weakness but decreases tension on the muscle spindles, which decreases muscle tone and
attenuates the stretch reflexes elicited on examination. Decreased tone is most commonly due to lower
motor neuron or peripheral nerve disorders. The first sign of muscle atrophy is that muscles become
weak and flabby. One may notice that the muscles in the body are not sitting in the same position as
they were earlier, as also the muscles are sagging and making the skin stretch from the weight of the
sagging muscle. Gradually the routine physical works become difficult to perform e.g, sitting for longer
time etc. Loss of Gamma-motor neurons does not cause weakness but decreases muscle tone and
attenuates the stretch reflexes elicited on examination.
As about the paleness of the face this we have already discussed as a feature of anemia, and various
endocrine organ hypofunction.
Waxy pale face is a feature of anemia, at times also found in anemic patients suffering from Ac.
Glomerulonephritis. Frostbite also may feature pale, waxy face.
Hemorrhages : from all mucous membranes nose, throat, lungs, stomach, bowels, uterus; metrorrhagia;
vicarious; traumatic epistaxis.
Hemorrhages are disorders of homeostasis. One should focus on pattern of bleeding. Vascular and
Platelet disorders lead to prolonged bleeding from cuts, bleeding into skin and from mucous
membranes. Coagulation disorders cause delayed bleeding into joints and muscle. A very important
observation is easy bruising and menorrhagia are common complaints in patients with and without
bleeding disorders.
Metrorrhagia is heavy, irregular and frequent uterine bleeding. In clinical practice more important is
character of the blood loss and daily variation in bleeding is more useful than labeling a patient as
metrorrhagia. However causes range from endocrine, neoplasia, inflammatory, trauma, endometrial,
bleeding disorders, pregnancy and others.
Vicarious menstruation : Its rare, but can happen as a boost in blood estrogen levels cause the delicate
vessels of the noses mucous membranes to fill up and burst. The symptoms of vicarious menstruation
nose-bleed are found in women who use IUDs, occur at the start of menstrual cycle, happen in the left
nostril, the blood is dark and symptoms decrease as normal menstruation increases.
Traumatic epistaxis can happen from any kind of trauma to nose as well as fracture of skull.
Marasmus and other wasting diseases of children. Marasmus and cachexia are a little different.
Marasmus is loss of fat, whereas cachexia is loss of lean body mass; however the diagnosis is based on
fat and muscle wastage from prolonged calorie deficiency and/or inflammation. Diminished skinfold
thickness,a feature of marasmus found in loss of fat reserves whereas reduced arm muscle
circumference, a finding in cachexia with temporal and interosseous muscle wasting reflects catabolism
of protein throughout the body, including vital organs such as the heart, liver and kidneys.
Great prostration : after injuries; after surgical shock; after anesthetics. : As for great prostration after
injuries, this may be a case of fatigue i.e. weariness or tiredness following mental or physical exertion
often resulting in a reduced capacity for work and limited efficiency to respond to stimuli. Fatigue is one
of the most pervasive symptoms following traumatic brain injuries and it can actually be out of
proportion to exertion may even occur without any exertion ; is multidimensional and can affect
physical, cognitive and subjective aspects.
Shock is a state of peripheral circulatory failure that is failing to meet the metabolic needs of the tissues.
Prostration after surgical shock is a feature which goes in consonance with the hemorrhages that is so
much evident in Acetic Acid and this is an acute feature that goes away with recovery of shock.
As regards prostration from anesthetics is concerned the following is an observation : Long-term post-
operative cognitive dysfunction is a subtle deterioration in cognitive function, that can last for weeks,
months or longer. Most commonly relatives of the person report a lack of attention, memory, and loss
of interest in activities previously dear to the person. In a similar way people in the workforce may
report an inability to complete tasks at the same speed they could previously. There is good evidence
that post-operative cognitive dysfunction occurs after cardiac surgery and the major reason for its
occurrence is the formation of microemboli.
As regards the prostration another possibility is a co-exiting illness which was not previously apparent
but times itself post-traumatic in presentation, or a patient who may suffer from Chronic Fatigue
Syndrome or Fibromyalgia may come with features like prostration after injuries/surgical
shock/anesthesia.
Thirst intense, burning, insatiable even for large quantities in dropsy, diabetes, chronic diarrhea; thirst
intense is a common symptom of Diabetes Mellitus due to a combination of Diabetic Ketoacidosis and
Diabetic Hyperosmolar State, as also a common symptom of and Diabetes Insipidus due to increased
plasma osmolarity and hypernatremia; chronic diarrhea is commonly due to Giardia, but additional
causative organisms need to be considered are C. Difficile, E Histolytica, Cryptosporidium,
Campylobacter and some others and thirst in chronic diarrhea is due to the dehydration. So as to no
thirst in fever is concerned, thirst is never an established symptom of fever until there is some
dehydration from profuse sweating. However polydipsia and hypodipsia are associated with damage to
central osmoreceptors located in preoptic nuclei.
Sour belching and vomiting of pregnancy, burning waterbrash and profuse salivation day and night; this
is a finding in upto 90% of pregnant women. A more severe form is called Hyperemesis Gravidarum.
Diarrhea copious, exhausting, great thirst; in dropsy,typhus,phthisis; with night sewats.
Diarrhea is a common symptom of intestinal tuberculosis which may at times be present with
pulmonary tuberculosis i.e. phthisis in which night-sweats are common; may be associated with dropsy
in peritoneal tuberculosis; as to typhus : epidemic typhus may present with gastro-intestinal symptoms,
murine typhus can present with night fever in upto 50% of cases where the child remain well during the
day time and even be able to play during daytime.
True croup, hissing respiration; cough with the inhalation; last stages. Croup is an infection involving
both upper and lower respiratory tract hence hissing respiration may be a common feature, also as the
respiratory tract is irritated; cough during inspiration is also a common symptom. As of last stages, dying
from respiratory infection is more common in extremes of age group and in immunocompromised
patients or patients suffering from other ailments that may be pre-existing in a patient.
Inhalation of vapor of cider vinegar has been successfully used in croup and malignant diphtheria. This
has been used as a treatment hence does not come under the purview of our objective.
Cannot sleep lying on the back; this is a position known to be face up position which results in partial
extension of the spine and cause pain in individuals with facet joint syndrome, also the same may be
the case in spinal stenosis.
Hectic fever, skin dry and hot; red spot on left cheek and drenching night sweeats : Hectic fever is
defined as a daily recurring fever with profound sweating, chills and flushed appearance, not much
mention is found in modern texts, but is something which is such a febrile illness that rapidly damages
involved structure and terminates in death if not adequately treated. Drenching night sweats is a feature
of Tuberculosis. Red cheeks with fever may be a feature of Lyme disease.
1. Jana S N ; Lecturer, Practice of Medicine, Dr B R Sur Homoeopathic Medical College, New Delhi
2. Rath P ; Research Officer(Hom.), Central Research Institute(Hom.) under Central Council for
Research in Homoeopathy, A1/1, Sector-24, Noida
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