Kali Carbonicum
by Ian Watson
At college I was
taught that there were certain types of person that would
most likely require the remedy Kali carbonicum. They were
rigid, closed individuals with a strong sense of duty and
an excessive control over their emotions. They would have
a great need for order and structure in their lives, and
would tend to understate their sufferings until they had
progressed into a pathological state. They were probably
to be found working in middle management, or as bank
managers or police officers. They would be unlikely to
come for homœopathic treatment, except perhaps as a last
resort, and even then it would be difficult to find the
remedy because of their closed, rigid nature...........
I expect that
this picture is familiar to many. The impression I
carried for quite some time was that Kali carb. would be
needed in practice on rare occasions, and that only those
types of person described above would require the remedy.
Fortunately, however, a patient came along to teach me
otherwise.
A forty-six year
old woman presented with pre-menstrual syndrome of many
years duration, which acupuncture and previous
homœopathic treatment had only palliated. Before each
period for at least one week she suffered with the
following: aching pains in the legs, worse on lying down;
insomnia, waking around 3am and unable to get back to
sleep; great exhaustion; emotional instability (‘like
being on a tightrope’) with frequent changes of mood. Her
periods came at intervals of three weeks.
She had a tendency to recurrent backache in the lumbar
region, since giving birth fifteen years previously.
History of post-natal depression lasting many months. She
had two children and had difficulties during both
pregnancies; the first birth was a forceps delivery. She
was generally chilly. She sweated easily, especially at
night in bed. Several times weekly she would have to rise
to urinate at 3 or 4am. A sore, bruised pain was felt
periodically in the region of the liver, with occasional
sharp stitches. She had great sleepiness after her
evening meal, suffered a lot from flatulence and her
stools tended to be very pale.
She was very well dressed and during the interview she
was extremely open, extroverted and quite loquacious. She
tended to worry about the family, about her children
being ill and about her own health. She said she was a
coward as she was frightened of pain.
When I had taken this case I was not sure what remedy she
needed. I could see aspects of Lycopodium, Arsenicum and
Phosphorus, but none of these seemed quite right. I could
also see a few ‘keynotes’ suggesting Kali carb., but her
openness and extroversion seemed to strongly contradict
my image of the ‘typical’ Kali carb. person. The
mental/emotional symptoms that I had elicited did not
seem that strong or problematic to her anyway, so I
decided to find a remedy that matched the physical
generals, which by contrast were clear and well marked.
I quickly
repertorised the case using Phatak’s Repertory,
taking the following rubrics:
Menses, Before Agg. (p. 229)
Menses, Early (p. 232)
Pregnancy, Childbed, affections of, or since Agg. (p 276)
Liver (& right hypochondria) (p. 217)
Time, 3am Agg. (p. 360)
Changing Moods (p. 46)
Because so many of her sufferings were worse before the
period, to save time I used the rubric ‘Menses, before
Agg.’ as an eliminator, that is to say I only considered
the remedies in that rubric. Whilst Cocculus and Calcarea
Carbonica featured strongly in the repertorisation, Kali
carb. was the only remedy to be found in every subsequent
rubric. Reading the materia medica it seemed to match her
overall state very well, so I prescribed a single dose of
Kali carb. 30 (the only potency I had in stock at the
time).
The result was an
aggravation of her symptoms lasting almost five weeks,
during which time she had a lot of pain in the liver
region and she felt quite depressed. A number of old
symptoms (some from fifteen years previously) returned
and subsequently disappeared. After this she suddenly
started to improve in every respect and her periods then
established a four-weekly cycle and she had none of the
pre-menstrual symptoms. All of the liver pains
disappeared and she felt better than for years. The
improvement lasted for three months, after which a return
of some of the cured symptoms called for a repetition.
Kali carb. 200 was given, which produced another lengthy
but less intense aggravation and she then remained well
for almost a year, when a further dose was needed. The
curative action of the remedy was very deep, and it was
obviously a remedy that she had needed for many years.
What this patient
taught (or rather, reminded) me was that the
psychological profiles of remedies can be terribly
limiting if we seek to fit all of our patients into the
‘familiar image’ we have of the polychrests. These images
provide wonderful confirmation when they are found, but I
have learnt from experience that there are many other
aspects of a person that a remedy may be ‘similar’ to,
and that there are many facets to a remedy other than
those that we were taught.
I would like to share some of the experience I have
gained with Kali carb. over the past two years,
emphasising the physical aspects of the remedy which I
have seen manifest in a wide spectrum of
personality-types. There are a number of key areas of
disturbance that have featured strongly in a majority of
my cases, which form the general headings given below.
Water balance
Kali
carb. is a major remedy for fluid retention - the materia
medicas state that it is suited to dropsical states, and
I have found this to be frequently the case. But the
water issue goes further than that. There is a
generalised sensation of dryness which runs through the
whole remedy picture and which crops up here and there in
a great many patients. Dry cough, dry stools, dry skin,
dry hair, dry eyes, dry throat , dry tongue and so on.
The urine flows too slowly, and the perspiration is
scanty or suppressed.
As with many of
our polychrests, there is a polarity within the picture
of Kali carb. so that symptoms of excess water are just
as pronounced. There is a strong tendency to weep in the
remedy picture - weepingwith headache, during chill, in
sleep, without knowing why, when telling symptoms etc.
The remedy also has continual gathering of water in the
mouth, excessive lachrymation, dimunition of sight after
working in water, regurgitation of water from the
stomach, and a tendency to profuse sweats and night
sweats. Even more strikingly, there is a sensation as if
the stomach is full of water, and even dreams of water
and dreams of weeping. Wherever there is an issue to do
with water or the lack of it, Kali carb. ought to be
considered along with Alumina, Bryonia, Natrum mur. and
Nux moschata.
I have verified
the water sensation in the stomach on several occasions -
the strangest was a man who described to me a feeling
that he had a U-shaped tube in his stomach partly filled
with water. Whichever way he turned, the water seemed to
slosh over to that side of the tube. In this case I took
the rubric in Phatak’s Repertory ‘Splashing, swashing, as
of water’ where Kali carb. is to be found, and the remedy
helped him a great deal. My wife Sally also prescribed
Kali carb. successfully for a woman who had a ‘sensation
as if the eyes were full of water’. I have not seen this
symptom listed under Kali carb., but it was cured in this
case along with her other symptoms which were
characteristic of the remedy.
Digestion
Kali carb. has a strong affinity with the digestive
tract, particularly the stomach and the liver. Emotions
are felt by the patient to affect the stomach area,
particularly anxiety, fear or sudden shocks like the
slamming of a door. There is nausea from emotions or
after vexation. Often there are palpitations, dyspnoea
and other respiratory or heart symptoms which are
secondary to digestive trouble. One of my patients had a
pain in the praecordial region extending down the left
arm. She naturally thought it was heart trouble, but
questioning revealed that it only came on after she ate
fatty foods, which confirmed my suspicion that it was a
referred symptom from the gall-bladder or the liver. Kali
carb. helped her generally and cured the chest pains. One
is constantly reminded of Burnett’s injunction to ‘get
behind the symptoms’ and find the seat of the disorder,
which often lies elsewhere even on a purely physical
level.
Kali carb. has
much in common with Lycopodium in the digestive area, and
they are a pair that I have often found myself
differentiating. Both have problems with eructations,
flatulence and distension. Both share a great desire for
sweet things, Kali carb. also having a specific desire
for sugar. Kali carb. has additionally a strong desire
for sour things, like Sepia, Hepar sulph. etc. Both
remedies have an aversion to bread and to meat. Both
remedies can be full after a small quantity of food
(although this I think is more pronounced in Lycopodium),
and both have a sensation of heaviness in the stomach
after eating. Both remedies have stomach ulcers within
their curative range. Both remedies can suffer from going
too long without eating, and both should be strongly
considered in patients with liver pains or gall-stones
when the characteristic symptoms are present. The typical
sharp, stitching pain in the right side often crops up in
patients needing Kali carb., either as part of the
presenting picture or at some time in the past history.
To differentiate,
Lycopodium may have aggravation from onions, shellfish
and ‘flatulent food’, whilst Kali carb. can be affected
adversely by bread, and also by warm food, which
Lycopodium tends to crave. Eructations can either
aggravate or ameliorate in Kali carb., whilst in
Lycopodium they virtually always ameliorate.
Physical Structure
The
ætiologies of Kali carb. have guided me to its use on
many occasions, and have helped me to understand certain
aspects of the remedy which I was previously unaware of.
The remedy should be strongly considered in patients who
have never been well since childbirth, abortion,
miscarriage, back or pelvic injury and overstraining the
back. The key theme which all of these ætiologies share
is that they are all capable of producing a degree of
physical misalignment. When childbirth or abortion leaves
a residual infection, Pyrogen would be the leading
remedy, and where the trauma is predominantly emotional,
Ignatia, Staphysagria and others would be most likely
indicated. With Kali carb., however, it seems to be more
of a mechanical
trauma affecting the uterus, pelvis
or the back, especially the lumbar region. Hence it is
often the case that Kali carb. is particularly indicated
after a prolonged or difficult childbirth, such as a
forceps delivery. One of my patients who responded to the
remedy said to me: ‘I feel that some of my problems have
to do with the rapidity with which I had children - my
body took a terrible bashing at that time’.
Another ætiology
I have been able to add to this list is never been well
since hysterectomy, which again is a pelvic trauma from
which the organism may not fully recover. I discovered
this indication after treating a woman in her early
fifties who was suffering from severe, right-sided
sciatica of several years duration. She had intense,
sharp pains travelling from the hip down to the knee and
was woken by them most nights between 3 and 4am. I
noticed that she walked and sat hunched over forwards and
to the right. The trouble had started almost immediately
following a hysterectomy, carried out to cure prolonged
menopausal flooding, which it apparently did.
I prescribed a
dose of Kali carb. 30, and the next day she telephoned to
say that she was haemorrhaging. I asked what it was like,
and she said that it was just like having a profuse
period, which she found rather alarming given that she no
longer had a uterus. The bleeding lasted for just one
day, and by the next day the sciatica had disappeared and
never returned. That was incredible enough, but I was
even more amazed when I saw her and found that her entire
posture had altered and she was now upright and relaxed -
she looked as though she had just completed a course of
the Alexander technique! I have since verified the
indication never well since hysterectomy in several other
cases and have found Kali carb. to be the leading remedy
where some mechanical problem has resulted.
One of the few
men I have treated successfully with Kali carb. also had
a right-sided sciatica, with the characteristic sharp
pain, travelling from the hip to the knee. He had a
feeling that the knee would give way on him and a history
of back injury. He also made a good recovery on Kali
carb. 30.
I have noticed
that several patients who have been helped by the remedy
for some mechanical problem such as back trouble or
sciatica have given the appearance when walking or
standing that they have one leg longer than the other,
and in some instances this was actually the case. I was
therefore fascinated recently to discover a rubric in
Kent’s repertory
‘Longer, leg’
(page 1033) with Kali carb. as the only italicised
remedy.
Female Organs
The only thing I can recall being taught about Kali carb.
in this regard is that it can ‘bring on the menses’ when
Natrum mur. fails, though apparently indicated. Having
freed myself of the stereotype image of a Kali carb.
person, I have found it to be very frequently indicated
for various types of women’s complaints, certainly as
often as Pulsatilla, Sepia and our other polychrest
female remedies. I have used Kali carb. successfully in
women’s problems more frequently than in any other single
category of complaint.
Pre-menstrual
syndrome, as in the case above, is an area where Kali
carb. is often useful, as the remedy has a general
aggravation of symptoms before the period. I have found
sleeplessness before the period to be a good indication,
particularly if it occurs between 2 and 5am, and also
ovarian soreness, backache or pains in the legs before
the period. Another indication is vaginal itching before
the period, and one which I have confirmed many times is
constipation before the period. The remedy should be
strongly considered where there are uterine pains before
or during the period which extend down the thighs. It is
also the leading remedy to think of during labour where
the labour pains extend into the thighs
(Viburnum).
The menses are most commonly early, profuse and
protracted, but they may also be late, scanty or
suppressed. Menses which are offensive, acrid and
excoriating also indicate Kali carb. very strongly. The
remedy has proved curative in uterine displacement,
fibroids and cysts, and I have obtained curative results
indysmenorrhoea, metrorrhagia, endometriosis, pelvic
inflammatory disease and menopausal complaints where the
characteristic symptoms were present. It should also be
strongly considered in cases of haemorrhage or other
disturbance following mechanical removal of afterbirth or
retained placenta, or after a D. and C. for any other
reason.
General Characteristics
I
would like to conclude by listing some of the other
general features of the remedy which I have frequently
come across in practice and which are reliable
indications.
Sensation as if the back, hips, knees or legs would give
way. This symptom often crops up in patients with back or
joint problems, and is a very strong indication for Kali
carb.
Aggravation
between 2 and 5am. There are different opinions as to the
exact aggravation time of Kali carb., some sources state
the time as being 3-4am, others state from 3-5am. I have
seen 3 or 4am to be the commonest aggravation time in
patients who have responded well to the remedy, but
sometimes the aggravation starts an hour or so earlier
and sometimes it may continue as late as 5am. Often there
is sleeplessness for a few hours during this period. It
is also the leading remedy where asthmatic attacks occur
between these hours, particularly when the patient has to
sit leaning forward with the hands on the knees. I have
treated patients who simply had to rise to urinate around
3 or 4am and, whilst this is a common symptom, it can
provide useful confirmation if other symptoms of the
remedy are present.
Pain in the back
relieved by lying on a hard surface, particularly on the
floor. Here the remedy must be differentiated with Natrum
mur., Rhus tox., and Sepia. The back pains tend to be
aggravated by walking, standing and sitting upright.
There may be amelioration from sitting bent forward or
from having the back supported, typically with a firm
cushion pushed between the back and a chair. Kali carb.
should be the first remedy to think of during labour when
the labour pains seem to centre in the back.
There is a
general over-sensitivity to noise, touch, drafts and to
pain. Hypersensitivity of the soles of the feet is
present in many patients for whom Kali carb. is
indicated. I once asked a woman with menstrual problems
how she would respond if I was to tickle her feet. She
looked me straight in the eye and said: “I would kill
you!” I was sure that she meant it, so I took it as
confirmation of the remedy and assured her I would never
do such a thing.
Sharp, stitching
pains. The combination of dryness plus stitching pains in
a patient bring Bryonia and Kali carb. equally to mind.
In the latter I have found stitching pains most often in
the liver region, the chest and in the joints,
particularly the hip joint and especially the right hip.
Other types of pain found under Kali carb. are stinging,
needle-like, shooting, jerking, cutting, drawing and
tearing. It also has pains which go to the side lain on,
like Pulsatilla, Bryonia and others.
Puffy, bag-like
swelling above the upper eyelids is given great emphasis
in the texts, but I must confess to only ever having seen
it once in a patient for whom I prescribed Kali carb. The
literature suggests that this symptom would be found more
commonly in patients with respiratory disease such as
hydrothorax and pericarditis, in which I have had
relatively little experience.
The mental picture
Whilst the majority of my
successful prescriptions of Kali carb. have been based
upon physical characteristics exclusively, I have found,
often in retrospect, that there were certain mental
symptoms of the remedy present in a fair number of these
patients.
An emotional
instability is often present, and Kali carb. should be
thought of particularly when this instability becomes
intensified in the week or so before the period. This has
been described to me by different (women) patients as
‘terrible mood swings’; ‘feels as though I am on a
tightrope’; ‘feels as if I am on a knife edge’; I have to
walk the middle road all the time’; ‘it’s like being on
an emotional see-saw’. In the repertory we find Kali
carb. listed under ‘Mood, alternating’ and ‘Mood,
changeable’, as well as ‘Contrary’ and ‘Capricious’.
Many of my
patients have used the word control
when describing
their emotional state, as the following quotations will
illustrate: ‘I’m afraid that I might lose control’; ‘my
husband says I should stop worrying about things that are
outside my control’; ‘I like to be in control of the
situation’; ‘we have an on-going battle about who is in
control’.
Irritability or
touchiness seems to be almost always present to some
degree. This tends to be worse on waking; in the
evenings; before or during the menstrual period. One
patient told me if she felt a cold draft it
annoyed
her immensely.
There is often a quarrelsome tendency, particularly with
one’s own family.
An element of
fear is usually present, and the fears will often suggest
remedies such as Arsenicum or Phosphorus. Fear of being
alone; anxiety about health; fear of impending disease;
fear of death, especially when alone. I have also found
fears regarding one’s children to be very strong in
patients who have responded well to Kali carb. One
patient presented with a crystal- clear physical picture
of the remedy, and mentioned a fear that she experienced
whenever she had to rise to urinate at night, and which I
asked her to describe in detail. She said: “It’s to do
with the emptiness in the house; fear of a presence, of
something unknown; that someone will come and touch you;
it (the fear) seemed to be pressing on my back”. I was
amazed to discover later how well she had described a
number of Kali carb. fears in that sentence - in the
repertory we find ‘fear of evil’, ‘fear of ghosts’, ‘fear
of touch’ and ‘fear of being alone in the evening’. Also
listed is ‘fear at 3am’, which was the time at which she
invariably had to rise.
On the emotional
level Kali carb. seems to overlap closely with Phosphorus
in many areas - the over-sensitivity, fearfulness, desire
for company etc. Often with Kali carb. however there is
additionally a hard edge to the personality that is not
seen with Phosphorus, which manifests as a kind of
obstinacy, dogmatism or rigidity in a certain area of
their life.
I have read that
patients needing Kali carb. will withhold or play down
their symptoms - in my experience they will often
withhold or de-emphasise emotional
symptoms, but I
have never had difficulty in eliciting physical generals
and particulars.
Related remedies
The
remedies I have found to be most closely related are
Lycopodium (especially in the digestive sphere); Natrum
mur. (problems with water/dryness, backache, menstrual
problems); Sepia (female pelvic, pregnancy and
childbirth, menopausal and lower back problems) and
Phosphorus (emotionally and respiratory problems). The
commonest acute satellites of Kali carb. seem to be
Bryonia, Colocynth, Nux vomica and Carbo veg. Patients
needing Kali carb. who have a pronounced weakness in the
liver and/or gall bladder will very often benefit from a
course of Chelidonium in tincture or low potency at some
stage during the treatment.
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This
article first appeared in The Homeopath, Journal of the
Society of Homeopaths a very long time ago!