In the effects of this drug are combined the action of potassium with those of the acid radical of chromic acid. The former are manifested by depression of the central nervous system, and of all kinds of muscle, including the heart muscle which becomes weakened; fall of blood pressure and slowing of the pulse.

The effect of the acid radical is to cause diarrhea, vomiting, hematuria, congestion of the intestinal tract, nephritis and ulceration. Chronic poisoning by Kali bichromi-cum is evidenced by ulcerations in the nose and skin. The cartilaginous septum becomes involved, leading to perforation. This condition is usually painless. Perforating ulcers appear upon the skin, especially if any abrasions of this tissue precede exposure to the poison. Ulcerations also apear in the stomach; these have occurred in man and may be experimentally produced in laboratory animals. A chronic inflammation of the larynx and pharynx is a prominent symptom. The patient develops a cough and the expectorated material becomes stringy in character, and, owing to the local paralysis of the muscles, is raised with difficulty. No rise in temperature is produced by this drug; its general action corresponds to those diseases which are essentially chronic in character and in which ulcerative conditions of mucous membranes are prominent symptoms. Such diseases as diphtheria, subacute bronchitis, chronic nasal and gastric catarrh, especially if associated with ulceration and the chronic gastritis produced by alcohol, are duplicated by the effects of Kali bichromicum. There is a close resemblance between the effects of the drug and certain forms of chronic syphilis.

Therapeutics

Kali bichromicum, the bichromate of potassium, when experimentally given to rabbits, is capable of producing, as has been shown by Hinsdale, ulceration of a destructive character of mucous membranes, particularly those of the gastrointestinal tract. Gastric and duodenal ulcers have actually been caused by the drug, when administered in appreciable doses.

Therapeutically, therefore, the presence of such ulcers in the stomach or in the intestine, as well as in other parts of the body, is at least strongly suggestive of the possible need for this medicine in infinitesimal doses. These ulcers have a very characteristic appearance in that they are clean-cut, deep, as though punched out. Another marked and guiding indication for this remedy lies in the nature of its secretions or discharges, which are very tenacious, gelatinous, stringy or ropy in character, and commonly yellow in color. This is particularly so in the nasal, bronchial and other catarrhs, for which the remedy is valuable.

Thus in chronic nasal catarrh, we find the formation of plugs or clinkers of hardened nasal mucus, with bleeding from the ulcerated nasal mucous membrane, if these scabby formations are forcibly removed, as well as masses of thick, stringy, tough, yellowish mucus. Pain over the eye, along the course of the supraorbital nerve is common; likewise pain at the root of the nose, over the frontal sinus. Ulceration and perforation of the nasal septum is also another condition often met with.

Tonsilitis will at times demand Kali bichromicum when there is a thickly coated yellowish tongue with rawness and soreness in the throat and swollen tonsils, whose crypts are filled with yellowish exudate.

In true membranous croup the remedy is of value when there is much hoarse, wheezing and choking cough, with the presence of the characteristic tenacious, yellow discharges. Subacute bronchitis often needs the remedy when the cough is worse in the early morning hours, about 2 or 3 o'clock, and when the sputa are coughed out in long, ropy, yellow masses.

A yellow coated or dry, red and cracked tongue, will often direct attention to Kali bichromicum.

Asthma, whether bronchial or cardiac in character, will be benefited by Kali bichromicum when the attacks are worse in the early morning, often waking the patient from sleep at two or three o'clock and when with the violent choking cough, there are long tenacious strings of yellowish mucus brought up.

In children the remedy is of great value in attacks of simple bronchitis or of whooping cough, especially in fat, chubby, blue-eyed urchins with short necks.

Kali bichromicum suits the gastric complaints of beer drinkers particularly, who complain of a heavy sensation in the stomach and distress, immediately after eating. In this respect the remedy differs from both Nux vomica and Pulsatilla, in which remedies the gastric symptoms are worse an hour or more after the meal has been eaten.

Ropy yellowish leucorrheas with ulceration of the os uteri, may be much helped by this medicine, when other additional symptoms of the drug in general, are present.

Characteristic Symptoms Of Kali Bichromicum

1. Discharges from nose, mouth, vagina, or from any other mucous membrane, of a tough, stringy mucus, which sticks to the parts and may be drawn out in long strings.

2. Sensation as if the nose were swollen and stiff, and as if a heavy weight were hanging from it.

3. Membranous and diphtheritic croup; invading larynx, trachea and bronchi. Croup worse 2 to 3 A. M.

4. Cough worse when undressing; better after getting warm in bed; worse in the morning on waking; wheezing and panting, then violent cough, with retching and expectoration of stringy viscid mucus.

5. Especially useful in fat, light-haired persons; fat, chubby children.

6. Ulceration deep, as if cut out with a punch, edges regular.