In the consideration of specific indications, we are apt to be too narrow, and to lay down as exact rules, suggestions that in some cases would be misleading. A writer in the National Transactions says that in determining the indications for drugs, the physician must not stop at mere surface indications, he must be a profound student of physiology and pathology. All red tongues do not indicate acids, a bright red, narrow, pointed tongue points to an irritation of the alimentary tract, which would be increased by the use of an acid. The red, pointed tongue, covered with a grayish white coat, points to an accompanying inflammation, the treatment of which would promptly change the tongue appearances. The broad, deep red, smooth tongue, in low grades of fever, suggests sepsis and will be benefited by acids, especially those of an antiseptic character.
All white tongues, on the contrary, do not indicate alkalies. A white tongue due to anemia is white because it is pale, and there may be present at the same time a necessity for iron or nux vomica, or other bitter tonics with the best of nutrition. A broad, pale, heavily coated tongue in acute disease is the result of fermentation in the stomach or bowels; this is corrected by the sulphite or phosphate of sodium. If the coating is very white and moist, and covers the tongue uniformly, there is usually present extreme acidity, and until this is corrected other remedies are of but little avail. Sometimes a single dose of thirty grains of sodium or magnesium bicarbonate will change the whole condition by neutralizing the excess of acidity.
Aconite is indicated when the pulse is small, hard and rapid, but the rapid, small, feeble pulse present in protracted fevers, or after a shock, must not be treated with aconite. An active, circulatory stimulant must be used and persisted in. Aconite given under these circumstances will increase the conditions present and would be decidedly unsafe. These statements will illustrate the necessity of considering all specific indication with reference to any possible indications which might resemble them, but which would appear under different conditions, in order that the exact indication be met only with its correctly indicated remedy.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.