Kalium Carbonicum (kali-c.)
As mentioned by Kent, Kali carb. is a remedy which is difficult to perceive in its essence both in the patient and in the Materia Medicas. The primary image of the patient is not readily available from provings, so it is known mostly by experienced homoeopaths possessing the skill of careful, systematic observation. It is very important to understand, however, because Kali carb. is a profoundly deep and long lasting remedy when prescribed early enough to prevent progression to an incurable stage of pathology. The Kali carb. patient has a distinctive personality; committed dogmatically to strong sense of duty to an inflexible, rigid degree. It is an uptight state in which the mind maintains iron control over experience, behavior, and emotions. Such a person is compelled to see the world in terms of black and white, right and wrong, proper and improper. In his appearance and behavior he is correct, uptight, proper. He, or she, will be stoic, uncomplaining, dogmatic, by the book. In the field of psychology, the Kali carb personality would be the epitome of the “anal-retentive” type To such a person, life seems to be solid, clear, immutable, functional. Such people often become police officers, prosecuting attorneys, translators, bookkeepers – occupations in which routine, properness and the sense of duty are valued.

It this sense, the Kali carb. patient is overly metalized. It is not metallization in the sense of philosophizing or mental creativity or analysis, but rather an over-use of the mind as a mechanism for control over emotional expression as well as physical functioning. The Kali carb. mind is systematic, proper and routine-oriented. It thrives on clear-cut, black and white, dogmatic situations and functions.

Such a patient may appear to others to be devoid of emotions because emotion is expressed in a metalized way, but this is far from the case. Internally, Kali carb. can be quite sensitive emotionally, but will never show it. If you tall a Kali carb. patient about your troubles, you will assume from his response that he couldn’t care less, but you may be surprised to find a few days later that he has silently been dwelling on your situation and has come up with a solution. Such a patient, although suffering internally and silently, ma be admired by others for dignity and integrity in the face of difficulties; the Kali carb. wife for example, may tolerate silently her husband’s adulterous behavior. On the other hand a Kali carb. man can be frustrating to live within a marriage, unless the wife is understanding enough to appreciate the indirect way in which such a person shows his feelings. he may appear to be devoid of emotions because of his controlled expression of them, but he may well feel things quite strongly (unlike, for example Phosphoric acid or Aurum met. which are internally truly dead and “still” in the emotional sphere).

It is for these reasons that the Kali carb. patient is difficult for the homeopath to treat. Such a patient will stoically tend to ignore problems until they may have reached a serious stage. When he does come to the homeopath, he answers question with a matterof-fact shrug of the shoulders. This is the patient who gives you no symptoms at all. You may ask if he has a fear of the dark, and the patient may shrug his shoulders in assent conveying to you a mild degree of intensity, whereas indeed the truth is that he is extremely afraid of the dark. The very symptoms which mean the most to the homoeopath, the emotional and mental symptoms, are the ones the Kali carb. patient downplays the most. This is a situation in which the homoeopath’s skilled insistence of real life images and concrete examples, rather than mere recording of data can be crucial because the Kali carb. patient, left to his own devices, will allow his condition to reach an incurable stage before revealing the emotional intensity of his state. The toll that such mental control can take on the physical level can be illustrated by a sample case. A Kali carb. wife was admitted by all her friends for never displaying self-pity or frustration while her husband slid into a troublesome senility over a period of many years before eventually dying; later, after suffering a financial loss, she developed a renal colic treated allopathically by an injection, and then rapidly collapsed into congestive heart failure and died.

Such iron-clad mental control prevents the final force from utilizing its most important channels of expressions of symptoms on the mental and emotional levels. Therefore the symptoms become channeled with devastating force on the physical level, especially affecting the internal vital organs, and the lower regions of the body. The mental suppression is so extreme, as a matter of fact that it seems to have a deforming effect on the structures of the body; it would almost seem that the extreme mental control distorts the structure of even the cells themselves. There are deformities of the bones, of the spine, and of the joints. (Kali carb. is almost a specific for deformative arthritis).

The exaggerated mental control drives the symptoms expression most characteristically into the solar plexus. If he acknowledges emotion at all, he will describe it as being in the stomach – anxiety, fear, even shocks from the environment. Kent has a graphic description of this state. “A peculiar condition in Kali carb. is a state of anxiety felt in the stomach, as though it were a fear”. One of the first patient I ever had expressed it in a better way than it is expressed in the books; she said “Doctor, somehow or other I don’t have a fear like other people do. I feel it right here”, (epigastric region). Well, that is striking, that is peculiar. It was not long before I developed another feature of Kali carb. By a little awkwardness on my part, my knee happened to hit the patient’s foot as it projected a little over the edge of the bed, and the patient said. “Oh!” Sure enough, that was Kali carb. again, for you will find in Kali carb. a patient that is afraid and everything goes to the stomach, and when touched upon the skin there is an anxiety or fear of apprehensions felt in the region of the stomach”. One patient I recall described a sensation of being struck in the solar plexus every time she would lie down for sleep; it was so severe that she was forced to get up and walk around in order to relive the sensation. Another remedy having, a striking similar sensation is Mezereum; it also feels a powerful anxiety in the stomach, but in Mezereum the anxiety arises from the stomach then overwhelms the whole organism, causing the person to feel as if he is dying.

So we see that the Kali carb. patient is quite sensitive to emotions and to environmental changes, but maintains tight control over expressing this sensitivity. For this reason, we can also see the extreme sleeplessness present in Kali carb. Sleep is a time in which mental controls are naturally relaxed, something which is difficult for the Kali carb. patient. Such a person may go many weeks without sleeping, yet you cannot find any particular reason for the sleeplessness; the patient denies anxiety, overactivity of the mind or sensitivity to noise. It is merely an unwillingness to let go. It may even seem that the patient, living such a highly routinized, systematic, proper life, seemingly devoid of stress, is in fact conserving his energy so effectively that sleep seems as if it would become unnecessary. However, the patent does suffer from the lack of sleep. Because he seldom gets enough sleep. Kali carb. is one of the remedies most strongly manifesting the symptoms. Unrefreshed sleep (along with, but for different reasons, Nux vomica, Lycopodium, Sulphur, Phosphorus, Nitric acid. the Magnesias, and Lachesis).

Characteristically, the symptoms of Kali carb, are aggravated between 2 a.m. and 4 or 5 a.m. The sleeplessness, the cough, the cardiac dysphonea, are all worse at this time of morning. This is a time when the mental control mechanisms have their least force. As the control is relaxed, the symptomatic expressions become intensified – hence he wakes up with the characteristic 2 to 5 a.m. aggravations.

As the mental pathology progresses, the Kali carb. patient becomes very irritable. This again is an irritability arising out of the sense of correctness, the sense of duty, the dogmatism. The Kali carb. patient has a definite idea of what is “right”, or the “right” way to do something, and will not tolerate deviation from that. It is an inflexible state of mind. In this way, he refuses to accept his illness; the symptoms seem to annoy him and then make him peevish and extremely irritable. The wife who is internally bothered by her husband’s adulterous behavior, will not attack him for that but will instead become angry with him over trifling things – something wrong in his way of going about his job, or his household functions. If a Kali carb. prosecuting attorney decides that the defendant is innocent, he will take the case to his superiors and will tolerate no excuses, of, say, political influences or the necessity to set a legal example; the Kali carb. patient would rather risk his career than compromise his sense of duty, even if this means carrying his inflexible stance to an irrational degree. (He would rather “fight than switch”, as the cigarette commercial says).

As the pathology progresses even further, we see the emergence to prominence of many fears and anxieties which previously played a minor, or unrecognized role in the patient’s life. The nature of the fears is representative of the Kali carb. inability to cope with uncertainty or potential loss of control. There may well be a fear of loss of control in certain social settings in which his social role is unfamiliar to him. There is a strong fear of the dark, a fear of the future, and a fear of impending disease. This is not a hypochondriacal anxiety about health so much as a fear of the uncertainties involved with a disease; disease is something which he cannot control himself. There is a fear of ghosts, of course, because they represent a non-solid realm, the existence of which he has previously strongly denied.

Unlike many other remedies, the stages of mental pathology in Kali carb. rarely progress all the way to insanity. Mental control in Kali carb. is not lost easily to such a degree. Instead the patient is liable to succumb from a deep illness of one of the vital organs. It is as if the mind has forced the pathology into the physical body with such intensity that the vital organs succumb before the mind degenerates to the point of insanity.

It is interesting that two of the main organs which suffer from the Kali carb. pathology are the primary organs of excretion of wastes – the kindneys and the lungs. It is as if the rigidity and inflexibility, the exaggerated sense of properness, has caused a distortion of the bronchial and glomerular membranes in an attempt to contain the toxins whose existence are not acceptable to the Kali carb. patient. Inhibition of kidney function, of course, results in the well known dropsies of Kali carb. There are swellings around the eyes, of both the upper and lower eyelids. Most specifically, there are swellings, appearing like small bags, of the inner portion of the upper eyelids. In the lungs we see a wide range of pathologies, form bronchitis to pneumonia and even tuberculosis. The cough is very violent, racking the whole body, incessant, with gagging and vomiting and most aggravated 2-5 a.m. and by drafts.

Kali carb. can also affect the liver and heart in most extreme degrees of the failure, again most likely because the pathology has been allowed to progress too far before being properly acknowledged. This unrecognized progression into vital organs is described in Kent; “I can look back upon quite a number of case of fatty degeneration of the heart in which I could have prevented all the trouble with Kali carb. if I had known the case better in the beginning. These cases are insidious, and indications calling for Kali carb. must be seen early or the patient will advance to an incurable condition. There is a breakdown and organic changes and you look back over these cases and say, if I had only seen in the beginning of this case what I see now it seems as if the patient ought to have been cured. We learn the beginnings of remedies as we learn the beginnings of sickness. It is a prudent thing for a homoeopathic physician to glance back over a case that he has failed on, or someone else has failed on, to study its beginnings and see what the manifestations were. This kind of study to the homoeopathic physician is as delightful as post mortems are to the old school”. There are quite severe and varied symptoms in the gastro-intestinal tract. There is great flatulence and alternating constipation and diarrhoea, but most striking are the severely painful haemorrhoids. The Kali carb. patient is exquisitely sensitive to even the slightest of drafts. The patient is so sensitive to a draft, or even the normal movement of air through the house, that he may go from room to room trying to find the source of a barely perceptible draft of no consequence to others.

When confronted with a patient of such extreme properness and mental control that symptoms are difficult to come by, we may be led to the remedy by the very presence of this essence, requiring only corroboration by one of the other key symptoms known in Kali carb. the 2 to 5 a.m. aggravation, the extreme sensitivity to drafts, the swellings of the inner upper eyelids, the anxiety felt in the stomach, the pathological states of the vital organs, and also the strong desire for sweets.

The essential qualities of Kali carb. can be reminiscent of other remedies to which it is related. Of course, one cannot study Kali carb. without recalling Nux vomica. Kali carb. however, is different from Nux vomica in its essence. Nux is highly ambitious and impulsive, whereas Kali carb. is quite content to remain in his routine, only then becoming irritable because of his sense of correctness and not because of frustrated ambition as in Nux vomica. It is nevertheless common to see a patient, after responding nicely to Kali carb. progress into a Nux Vomica state. Another remedy that may follow Kali carb. is Phosphorus, particularly once the Kali carb. solidity has loosened up enough to enable the more etheric Phosphorus sensitivities and fears to manifest.