From the time of Hahnemann to the present day Arsenicum has been one of the most frequently indicated medicines, and one of the most extensively used. In the Old School it is most extensively abused, in the form of Fowler's solution.
The
anxiety that is found in Arsenic, is intermingled with fear, with impulses,
with suicidal inclinations, with sudden freaks and with mania. It has delusions
and various kinds of insanity; in the more active form, delirium and
excitement. Sadness prevails to a great extreme. So sad that he is weary of
life; he loathes life, and wants to die, and the Arsenic patient does commit
suicide. It is a remedy full of suicidal tendencies. The anxiety takes form
also in the restlessness, in which he constantly moves. If he is able to get up
he goes from chair to chair; the child goes from nurse to mother, and from one
person to another. When-in bed, unable to sit up, the patient tosses and turns
from side to side; if he is able, he climbs out of bed and sits in the chair,
keeps moving from one place to another, and, when thoroughly exhausted, he gets
back into bed again. The restlessness seems to be mostly in the mind; it is an
anxious restlessness, or an anguish, with the idea that anguish is a deathly anxiety.
That is an effort to express it in the extreme. It seems that he cannot live,
and it is not pain that drives him to anguish, but it is an anxiety
intermingled with restlessness and sadness. This state prevails in all diseases
inter- mingled with prostration. An uneasiness comes in the early stage of
disease, and lasts but until the prostration becomes marked. While lying in
bed, at first he moves his whole body, moves himself in bed and out of bed; but
the prostration becomes so marked that he is able to move only his limbs until
at last he becomes so weak that he is no longer able to move and he lies in
perfect quiet in extreme prostration. It seems that prostration takes the place
of anxiety and restlessness, and he appears like a cadaver. So remember that
these states of anxiety and restlessness go towards the cadaveric aspect, towards
death. This is seen, for instance, in the typhoid, where Arsenicum is indicated.
At first there is that anxious restlessness with fear, but the increasing
weakness tends towards prostration. Running all through the remedy there is the
burning mentioned as one of its most marked generals. There is burning in the
brain, which makes him want to wash his head in cold water. This sensation of
heat in the inner head with pulsation is ameliorated by the cold bathing, but
when there is a rheumatic state that affects the scalp and outward nerves, and
there is burning, the burning then is ameliorated by heat. When the headache is
of a congestive character, with the sensation of heat and burning inside the
head, and there is a feeling as if the head would burst, and the face is
flushed and hot, that headache is better from cold applications and in the cool
open air. So marked is this that I have seen the patient sitting in the room
with clothing piled on to keep the body warm and with the window open to
relieve the congestion of the head. Therefore, we say a striking feature
belonging to this medicine is relief of all the complaints of the body from
wrap- ping up and from warmth in general, and relief of the complaints of the
head by cold, except the external complaints of the head, which are better from
heat and from wrapping up. The neuralgias of the face and eyes, and above the
eyes, are better from heat.
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The
secretions and excretions of Arsenic are acrid; they excoriate the parts,
causing burning. The discharge from the nose and eyes causes redness around the
parts, and this is true of all the fluids from the various orifices. In ulcers
there is burning, and the thin, bloody fluid discharged excoriates the parts
round about. The odor of the discharge is putrid. If you have ever discovered
the odor of gangrene, of mortified flesh, you know the odor of the Arsenicum
discharges. The stool is putrid, like decomposed flesh, putrid blood. The
discharges from the uterus, the menstrual flow, the leucorrhoea, the faces, the
urine, the expectoration, all the discharges are putrid. The ulcer is so putrid
that it smells like decomposing flesh.
Arsenic
produces a tendency to bleeding. The patient bleeds easily and may bleed from
any place. There is vomiting of blood; bleeding from the lungs and throat.
Bloody discharge from the mucous membrane, at times, when inflammation is
running high; hemorrhage from the bowels, kidneys, bladder and uterus; anywhere
that mucous membrane exists, there may be hemorrhage. Hemorrhage of black blood
and discharges that are offensive.
Gangrene
and sudden inflammatory conditions like gangrenous and erysipelatous
inflammations are common in Arsenic. Parts suddenly take on erysipelas, or
parts that are injured suddenly take on gangrene. Gangrene in internal organs,
malignant inflammations, erysipelatous inflammation. No matter how you look
upon the condition, no matter what it is called, if it is a sudden inflammation
that tends to produce malignancy in the part it belongs to Arsenicum.
Inflammation will go on in the bowels for a few days attended with a horribly
offensive discharge, vomiting of clots of blood, great burning in the bowels
with tympani-tic condition. You may almost look upon this as a gangrenous
inflammation, so violent, sudden and malignant is it, and it has the anxiety,
prostration, fear of death, and chilliness, the patient wanting to be covered
warmly. When with this inflammation of the bowels the patient is relieved by
heat, it means Arsenic. You should remember that Secale has a similar state; it
has all the tympanitic condition, all the ulceration and prostration, all the
offensive odor and expulsion of offensive clots, and all the burning, but the
Secale patient wants to be uncovered, wants things cold, wants the windows
open. The only distinguishing feature between these two remedies in a case may
be that Secale wants cold and Arsenicum wants heat, but this is the way we
individualize in our homeopathic prescribing. When there is gangrenous
inflammation in the lungs, we find the patient has been taken with a chill,
there has been restlessness, prostration, anxiety and fear; as we enter the
room we detect a horrible odor, and on looking into the pan we see the patient
has been spitting up by the mouthful, black, foul expectoration. Look and see
if the patient wants to be covered warmly; if he is easily chilled, and heat
feels good; then it is a hard thing to cover that case outside of Arsenicum.
The prostration, the vomiting, the anxiety, the restlessness, the cadaveric
aspect are present, and where will you find a remedy with that totality outside
of Arsenic? I have many times gone a long distance to detect, from the very
aspect of things, these symptoms that could be gotten while walking from the
door to the bedside. Every symptom is Arsenic; he looks like it, acts like it
and smells like it. You may go to a patient with high grade inflammation of the
bladder, with frequent urging to urinate, straining to urinate, and there is
bloody urine intermingled with clots. It has been found by the attending
physician when he introduces the catheter to draw off the urine that clots dam
up the catheter, a little is drawn off and then it stops. We have a history of
restlessness, anxiety, fear of death, amelioration from heat, great
prostration. You must give Arsenic, not because there is inflammation of the
bladder, but because it is a rapidly progressing inflammation, and because it
is gangrenous in character. The whole bladder will be involved in a short time,
but Arsenic will stop that. So it is with all the internal organs, the liver,
lungs, etc.; any of them may take on violent and rapid inflammation. We are not
now speaking of the particulars, but only illustrating the general state of
Arsenic, in order to bring out what runs through the whole nature of it. We
shall find when we take up the remedy and go through it in a more particular
way these features will stand out everywhere.
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"Thoughts
of death and of the incurability of his complaints." "Thoughts crowd
upon him; he is too weak to keep them off or to hold on to one idea." That
is, he lies in bed tormented day and night by depressing ideas and distressing
thoughts. This is one form of his anxiety; when tormented with thoughts, he is
anxious. In the delirium he sees all kinds of vermin on his bed. "Picks
the bed- clothes." "Delirium during sleep, unconscious mania."
"Whimpering and gnashing teeth." "Loud moaning, groaning and
weeping." "Lamentations, despair of life." "Screaming, with
pains." "Fear drives him out of bed, he hides in a closet."
These are instances of insanity that take on first a state of anxiety,
restlessness, and fear. Religious insanity, with the delusion that she has
sinned away her day of grace, the biblical promises of salvation do not apply
to her, there is no hope for her, she is doomed to punishment. She has been
thinking on religious matters until she is insane. Finally she enters into a
more complete insane state, a state of tranquility; silent, and with aversion
to talk. So we see one stage enters into another; we have to take the whole
case together; we have to note the course that the case has run in order to see
it clearly and note that in one stage there were certain symptoms and, in
another stage, other symptoms. For instance, we know that in the acute
conditions of Arsenicum there is either thirst for ice cold water, and for only
enough to moisten the mouth, or there in thirst for water in large quantities
and yet it does not quench the thirst; but this thirsty stage goes on to another
in which there is aversion to water, and hence we see that in chronic diseases
Arsenicum is thirst less. So it is in a case of mania; in the chronic state he
is tranquil, but in the earlier stages, in order to be an Arsenicum case, he
must have gone through the Arsenicum restlessness, anxiety and fear.
Pear
is a strong element in the mental state, fear to be alone; fears something is
going to injure him when he is alone; full of horror; he dreads solitude and
wants company, because in company he can talk and put off the fear; but as this
insanity increases he fails to appreciate company and the fear comes in spite
of it. He has a violent increase of his fear and horror in the dark and many
complaints come on in the evening as darkness is coming on. Many of the mental
troubles, as well as the physical troubles, come on and are increased at
certain times. While some complaints, pains and aches are worse in the morning,
most of the sufferings of Arsenicum are worse from 1-2 P. M. and from 1-2 A. M.
After midnight, very soon after midnight sometimes, his sufferings begin, and
from 1-2 o'clock they are intensified. Extreme anxiety in the evening in bed.
"Averse
to meeting acquaintances, because he imagines he has formerly offended
them." Great mental depression, great sadness, melancholy, despair,
despair of recovery. He has dread of death when alone, or on going to bed, with
anxiety and restlessness. He thinks he is going to die and wants somebody with
him. The attacks of anxiety at night drive him out of bed. This is an anxiety
that affects the heart, and so the mental anxiety and cardiac anxiety almost
seem to coincide. A sudden anxious fear comes over him at night; he jumps out
of bed with fear that he is going to die, or that he is going to suffocate. It
is full of dyspnoea, cardiac dyspnoea, and varying forms of asthma. The spells
come on in the evening in bed or after mid- night; from 1-2 o'clock he is
attacked with mental anxiety, dyspnoea, fear of death, coldness, and is covered
with cold sweat. "Anxiety like one who has committed murder." This is
one form of his anxiety; he finally works up to the idea that the officers are
coming after him, and watches to see if they are coming in to arrest him. Some
un- usual evil is going to happen to him; always looking for something terrible
to happen. "Irritable, discouraged, restless." "Restlessness,
cannot rest anywhere." "As a consequence of fright, inclination to
commit suicide."
The
Arsenicum patient with this mental is always freezing, hovers around the fire,
cannot get clothing enough to keep warm, a great sufferer from the cold.
Chronic Arsenicum invalids cannot get warm; they are always chilly, pale and
waxy, and in such invalids, after they have had several unusual weak spells,
dropsical conditions come on. Arsenicum is full of puffiness and dropsy; edematous
condition of the extremities; dropsy of the shut sacs or of the cavities;
swelling about the eyes; swelling of the face, so that it pits upon pressure.
Arsenicum in these swellings is especially related to the lower eyelid rather
than the upper, while in Kali carb the swelling is more in the upper eyelid
than the lower, between the lid and the brow. There are times when Kali carb
looks very similar to Arsenic, and little features like that will be distinguishing
points. If they run together in generals, then we must observe their particular
peculiarities.
In
the headaches we have a striking general feature of Arsenicum, brought out in
their periodicity. Running all through this remedy there is periodicity, and
for this reason it has been extensively useful. in malarial affections which
have, as a characteristic of their nature, periodicity. The periodical
complaints of Arsenic come on every other day, or every fourth day, or every
seven days, or every two weeks. The headaches come on these cycles, every
other, or third, or fourth. seventh or fourteenth day. The more chronic the
complaint is, the longer is its cycle, so that we will find the more acute and
sharp troubles in which Arsenic is suitable will have every other day
aggravations and every fourth day aggravations: but, as the trouble becomes
chronic and deep-seated, it takes on the seventh day aggravation, and in the
psoric manifestations of a long, lingering and deep-seated kind there is a
fourteenth day aggravation. This appearing in cycles is common to a good many
remedies, but is especially marked in China and Arsenic. These two remedies are
similar to each other in many respects, and they are quite similar in their
general nature to the manifestations that often occur in malaria. It is true,
however, that Arsenic is more frequently indicated than China. In every
epidemic of malarial fever that I have gone through I have found Arsenicum
symptoms more common than those of China.
These
headaches bring out the interesting point that we mentioned above. Arsenicum
has in its nature an alternation of states, and this carries with it certain
generals. Arsenicum in all of its bodily com- plaints is a cold remedy; the
patient sits over the fire and shivers, wants plenty of clothing, and wants to
be in a warm room. So long as the complaints are in the body this is so; but
when the complaints are in the head, while he wants the body warm he wants the
head washed in cold water, or wants the cold air upon it. The complaints of the
head must conform to the generals that apply to the head, and the complaints of
the body must be associated with the generals that. apply to the body. It is a
difficult thing to say which one of these two circumstances is most general,
and it is sometimes difficult to say which one is the general of the patient
himself, because he confuses you by saying: "I am worse in the cold,"
but when his headache is on he says: "I am better in the cold, I want to
be in the cold." It is really only the head, and you have to single these
out and study them by the parts affected. When things are so striking you must
examine into it to see what it is that brings about the modality. You will see
a similar state running through Phosphorus; the complaints of the stomach and
head are better from cold, i. e., he wants cold applications upon the head with
head sufferings, and wants cold things in the stomach with stomach complaints,
but in all the complaints of the body he is ameliorated from heat. If he steps
out into the cool air, he will commence to cough, if he have a chest trouble.
So we see that the modalities that belong to the part affected must always be
taken into account. For instance, you have a patient suffering from neuralgia
or rheumatic affections and these same pains extend to the head, then he wants
the head wrapped up because they are ameliorated from heat. But when it comes
to cases of congestive conditions of the head, he then is better with his head
very cold. Now, as I have said, there is an alternation of these states in
Arsenicum. I will illustrate by mentioning a case. Once a patient had been
dragging along with periodical sick headaches. The sick headaches were better
from cold water, cold applications to the head, could hardly get them cold
enough, and the colder better. These headaches came every two weeks, and so
long as they were present he desired cold to the head. Then these period- ical
headaches would be better, for long periods; but when they were away he was suffering
from rheumatism of the joints, which was also periodical, and also more or less
tenacious, and when this rheumatism of the joints and extremities, with more or
less swelling and edema, was present he could not get warm enough; he was at
the fire and wrapped up; he was relieved by heat, and wanted warm air and a
warm room. This would last for a period and then subside, and back I would come
his sick headaches and last for a while. That is what I meant by the
alternation of states. Arsenicum cured that man, and he never had any of them
afterwards. The alternation of states some- times means that there are two
diseases in the body, and sometimes the remedy covers the whole feature in
alternation of states. I remember another case, which will illustrate this
peculiar nature of alternation of complaints, which is shared by other remedies
besides Arsenic. A patient suffered from a pressure in the top of the head,
such as 1 recently described to you under Alumen. She would suffer for weeks
from that pressure on the top of the head, and the only relief she could get
was from hard pressure; she tired herself out with hard pressure and would
contrive all kinds of weights to put upon the head. That would go away in the
night and she would wake up the next morning with constant urging to urinate.
The irritable bladder alternated with pain on top of the head. Alumen cured. In
many of these antipsoric remedies we have an alternation of states. This illustrates
the necessity for getting the symptoms of all the states that present
themselves for cure, otherwise you will many times prescribe in a chronic case
of psoric character and temporarily relieve it, when back comes another aspect
of it. You have only hastened the disease a little faster than it would go if
let alone. But that is not homeopathic prescribing. Be sure, when a remedy
presents one state, that it is as clearly indicated in the other state,
otherwise that remedy is not the simillimum. You must hunt until you find the
remedy that has both states, or you will be disappointed. We sometimes do not
discover this alternation of states until we have brought it back two or three
times by incorrect prescribing. Some people are so reticent and so difficult to
get symptoms from that we do not always get these symptoms. But you examine
your record and you find where you have made a foolish prescription, that you
drove a new condition away and came the first trouble, and you kept on with
this see-saw business. Now remember in doing this your patient is not
improving, and that you must re-study the whole case, taking the alternating
states into account. In Arsenic, the head symptoms alternate with physical symptoms.
You will find running through certain remedies, as a part of their nature, that
mental symptoms alternate with physical symptoms; when the physical symptoms
are present, then mental symptoms are not trates the necessity for getting the
symptoms of all the states that is determined it is a good point, but sometimes
you do not find a remedy, because many of our remedies are not well recorded;
they have not yet been observed in their alternations and marked as such. We
find in Podophyllum the peculiar feature that the headaches alternate with diarrhea;
he is subject to sick headaches and to diarrhea, and one or other will be
present. In Arnica the mental symptoms alternate with uterine symptoms. The
uterine symptoms, when ob- served, look like Arnica, but these go away in the
night and mental symptoms come on, the mind being heavy, gloomy and cloudy.
When we have remedies that have these manifestations it requires a greater
depth of vision to see the alternation of states, because these things are not
always brought out in the proving, for the reason that one prover had one group
of symptoms, and another, another. Yet a remedy that is capable of bringing out
the two groups of symptoms is sufficient to cure this alternation of states.
The
periodical headaches of Arsenic are found in all parts of the head. They are
the congestive headaches with throbbing and burning, with anxiety and
restlessness; hot head and relief from cold. There are headaches in the
forehead, which are throbbing, worse from light, intensified from motion, often
attended with great restlessness, forcing him to move, with great anxiety. Most
of the headaches are attended with nausea and vomiting. The sick headaches are
of the worst sort, especially those that come every two weeks. In some of these
old, broken-down constitutions you will find he is cold, pallid, sickly; he is
always chilly and freezing except when the headache is on, and it is better
from cold; the face much wrinkled, great anxiety and no desire for water.
Remember that it was said in the acute state of Arsenic there is thirst, thirst
for little and often, dry mouth and desire for water enough to moisten the
lips, but in the chronic states of Arsenic he is generally thirst less. There
are headaches on one side of the head involving the scalp, one-half of the
head, worse from motion, better from cold washing, better from walking in the cold
air, though very often the jar or stepping starts up a feeling as of a wave of
pain, shaking, vibration or looseness in the brain; such are the sensations and
these are conditions of pulsation. Then there are dreadful occipital headaches,
so severe that the patient feels stunned or dazed. They come on after midnight,
from excitement, from exertion; they come on from becoming heated in walking,
which produces determination of blood to the head. Natrum mur is a medicine
analogous to this in its periodicity and in many of its complaints. It has
congestive headaches from walking and becoming heated; especially from walking
in the sun. The Arsenicum headaches are generally worse from light and noise,
better from lying down in a dark room, lying with the head on two pillows. Many
of the headaches commence in the afternoon from 1 to 3 o'clock, after the noon
meal, grow worse into the afternoon, lasting all night. They are often attended
with great pallor, nausea, prostration, deathly weakness. The pain is paroxysmal;
violent head pain during the chill of an intermittent fever; headache as if the
skull would burst during an intermittent fever. Arsenicum has this head pain of
a congestive character in intermittent fever, as if the head would burst. A
peculiar feature of the thirst is that there is no thirst during the chill
except for hot drinks; during the heat there is thirst little and often for
water enough to moisten the mouth, which is almost no thirst, and during the
sweat there is thirst for large drinks. Thirst begins with the beginning of the
heat and increases as the dryness of the mouth in- creases; he desires only to
moisten the mouth until he breaks out in a sweat, and then the thirst becomes a
desire for large quantities very often, and the more he sweats the more desire
he has for water. The headache is during the chill; it increases, so that it
becomes a congestive, throbbing headache during the chill and heat; this grows
better towards the end of the heat as the sweat breaks out, it is ameliorated by
the sweat.
In
chronic headaches, congestive headaches and malarial complaints, a tendency to
shrivel is observed upon the skin; a prematurely old, wrinkled appearance of
the skin comes on. The mucous membrane of the lips and mouth often shrivels and
becomes wrinkled. This is also found in the diphtheritic membrane of the throat
as a peculiar feature of Arsenic, and belongs, as far as I know, to no other
remedy. The exudation in the throat is leathery looking and shriveled. A shriveled
membrane is not a sure indication for Arsenic, but when Arsenic is indicated
you would be likely to find this kind of membrane; such cases as are very
malignant in character, very offensive, putrid, those with a gangrenous odor.
At
times the head is in constant motion when there are complaints in the body,
because parts of the body are too sore to be moved; then the motion of the head
comes on because of restlessness and uneasiness, and he keeps it in motion even
though it does not ameliorate. The face and head are subject to edema; dropsy
of the scalp and erysipelatous inflammation of the face and head. The scalp
pits upon pressure and there is a little crepitation under it from pressure.
The scalp is subject to eruptions and is very sensitive. So sensitive is the
scalp that the hair cannot be combed; it seems as if the touch of the comb or
brush when rubbing over the scalp went into the brain.
Sensitiveness
is a feature of Arsenic; sensitiveness to smell and touch; over sensitiveness
of all the senses. A peculiar feature that perhaps I have not brought out is
the over sensitiveness to the circum- stances and surroundings of the room. The
Arsenicum patient is an extremely fastidious patient. Herring once described
him as "the gold- headed cane patient." If this is carried out in a
woman who is sick in bed she is in great distress if every picture on the wall
does not hang perfectly straight. Those who are sensitive to disorder and con-
fusion and are disturbed and made worse until everything is placed in order
have a morbid fastidiousness which has its simillimum in Arsenic.
The
eye symptoms of this remedy are very prominent. In old cases of suppressed
malaria, in broken down constitutions, in pallid, sickly people who are subject
to general catarrhal conditions, and such catarrhal conditions as localize more
especially in the nose and eyes, the eye symptoms will be troublesome. There
are discharges from the eyes. It may be a conjunctivitis, in a general way
involving the lids and the globe, going on sometimes to ulceration with thin,
bloody discharge, increasing to thick, acrid discharge that excoriates the eye,
making the acanthi red and causing granulation with burning. The burning is
better from washing in cool water and also better from dry heat. Very often
ulcers appear on the globe of the eye, often upon the cornea. It has various
kinds of hypertrophy beginning in patches that will form scars, and in old
ulcerated patches little growth similar to a pterygium growing towards the
centre of the eye and threatening blindness. The inflammations are sometimes
attended with swelling, burning and excoriating discharge; this swelling is
bag-like in character, and so we find "baggy" lids and little bags
forming under the eyes. The face is waxy and pale, presenting the appearance of
a broken down constitution or a dropsical condition.
The
catarrhal state involves throat and nose, and it is sometimes difficult to
separate the nose symptoms from the throat symptoms. The Arsenicum patient is
always taking cold in the nose, always sneezing from every change in the weather.
He is always chilly and suffers from drafts, and is worse in cold, damp
weather; always freezing, chilled through. These pale, waxy, broken down
constitutions with catarrhal discharges from the nose on looking at a bright
light become blind. Sneezing and coryza with inflammatory conditions through
the whole nasal cavity, throat, larynx and chest. The cold begins in the nose
and goes down into the throat, very often causing hoarseness with dry,
tickling, hard, rasping cough. It is a difficult matter to find remedies for a
coryza that begins in the nose and extends into the chest with bronchial
troubles; very often you require a change of remedy, as the chest symptoms
often run to a different remedy. It is difficult to find a remedy that covers
the symptoms of both nose and chest.
Arsenicum
is the remedy for old, chronic catarrhal troubles of the nose where the nose
bleeds easily, and he is always sneezing and taking cold, always chilly and
pallid, tired, restless, full of anxiety in the night and has troublesome
dreams. The mucous membrane is easily inflamed, producing patches of red and
ulcers that bleed easily. Great crusts form in the back of the nose. There is a
striking tendency to ulcerate in Arsenicum. If it is a sore throat it
ulcerates; if colds settle in the eyes, they may end in ulceration; catarrhal
troubles in the nose end in ulceration; and this ulceration tendency, no matter
where the trouble locates, is a very strong feature of Arsenicum. It is the
remedy for catarrhal complaints of the nose and other places in broken down
constitutions from syphilis or malaria, or a constitution that has gone through
blood of some kind, either poisoning from a dissecting wound, or from erysipelas
or typhoid fever or other zymotic states improperly treated, or poisoning with
quinine and like substances that break down the blood and establish a state of anemia.
If an ulcer comes upon the leg, if a leucorrhoea comes on, if any discharge is
established the patient is relieved thereby. Now let some of these discharges
slack up and you have a chronic state apparently from retained secretions, but
it is a form of blood poisoning. So it is with suppressed ear discharges,
suppressed throat discharges, sup- pressed leucorrhoea and ulcerations. Arsenicum
is one of the medicines that will conform to the anemic state that follows each
suppression. At the present day it is fashionable to use the cautery, to make
local applications to stop leucorrhoea and other discharges and to heal up
ulcers. Now, when these external troubles go there is an anemic state
established in the economy, the patient becomes waxy and pallid, sickly
looking, and these catarrhal discharges come on as a means of relief because of
the suppression of some other condition. For in- stance, since the suppression
of a leucorrhoea the woman has had thick, bloody or watery discharge from the
nose. It is frequently suitable to the constitution when an ulcer has been
dried up by salves, or an old ear discharge has been stopped by the outward
application of powders. The doctor thinks he has done a clever thing in
stopping such discharges, but he has only succeeded in damming up the
secretions which are really a relief to the patient. Such medicines as Sulphur,
Calcarea and Arsenicum are suitable for the catarrhal discharges that come from
these suppressions, in broken down constitutions. Arsenic is also like unto the
condition that has been brought about from the absorption of animal poisons. It
goes to the very root of the evil, as it is similar to the symptoms brought on
from a dissecting wound. Arsenic and Lachesis are medicines that will go to the
cause at once and antidote the poison, establishing harmony and turning things
into order.
The
nose symptoms, then, of Arsenic are very troublesome and furnish an extensive
part of the symptom image of an Arsenicum patient. They always take cold
easily, are always sensitive to cold and the catarrh is always roused up on the
slightest provocation. When an Arsenicum patient is at his best he has discharge
more or less of a thick character, but when he takes a little cold it becomes
thin; the thick discharge that is necessary to his comfort slacks up, and then
he gets headache and on comes thirst, restlessness, anxiety and distress. This
goes on to a catarrhal fever of two or three days' duration, and then the thick
discharge starts up again and he feels better; all his pains and aches
disappear. It has been of great service in epithelioma of nose and lips
Inflammation
of the throat and tonsils with burning, increased by cold and better by warm
drinks. There is redness and a shriveled condition of the mucous membrane. When
there is blood poisoning going on, as in diphtheria, an exudate appears upon
the mucous membrane and it becomes gray and shriveled, ashy colored, and this
some- times covers the whole of the soft palate and the arches. It looks
withered. He is prostrated, anxious, sinking, weak, not a great deal of fever,
but much dryness of the mouth.
The
catarrhal state goes down into the larynx with hoarseness, and into the trachea
with burning, worse from coughing, and then comes constriction of the chest,
asthmatic dyspnoea and dry, hacking cough with no expectoration. This teasing
cough is attended with anxiety. prostration, restlessness, exhaustion and
sweat, and the cough does not seem to do any good. The cough is the early part
of it and keeps on as a dry, rasping, harsh cough for several days without
doing any good; and then asthmatic symptoms come on, when he expectorates great
quantities of thin, watery sputum. There is constriction about the chest, a
great sense of tightness and wheezing, and he feels he will suffocate. Bloody
mucus is expectorated at times, but the symptoms are more generally of a
catarrhal character. Symptoms of pneumonia sometimes appear with the rusty
expectoration. The expectoration is excoriating. There is in the chest a sense
of burning, as if coals of fire were in the chest, and it goes on to bleeding
and liver-colored expectoration.
Arsenicum
is a bleeding medicine, one that predisposes to hemorrhage, and bleeding takes
place from all mucous membranes; commonly of bright red blood, but in this
region the parts take on a gangrenous state and the hemorrhages become black
and there are little clots like portions of liver. The same are found in the
vomited matter and in the stools. The expectoration is horribly offensive, so
much so that you soon get the idea that there is a state of gangrene. The
patient is at this time going into a state that perhaps cannot be any better
described than a gangrenous inflammation; there will be signs to indicate the
inflammatory condition, and there will be the smell of the expectoration which
you will detect as soon as you open the door. The expectoration is a thin,
watery fluid intermingled with clots. In the pan you will find this watery
looking like prune juice, and in the midst of it will be clots of blood; the
offensiveness is horrible. He has gone through the period of restlessness and
is now prostrated, sinking, pallid, and likely enough covered with a cold
sweat.
When
we come to the stomach we find everything that may be called a gastritis,
vomiting of everything taken, even a teaspoonful of water, extreme irritation
of the stomach, great prostration, horrible anxiety; dry mouth; a very little
hot water will sometimes comfort him for a minute, but soon it must come up;
cold fluids are vomited immediately. The whole esophagus is in a state of
inflammation; everything burns that comes up or goes down. Vomiting of bile and
blood. Extreme sensitiveness of the stomach is present; he does not want to be
touched. Heat applied externally relieves, and there is a temporary relief from
warm drinks; the heat is grateful. In the bowels we have much trouble; this
remedy has all the symptoms of peritonitis; distension of the abdomen, a tympani
tic state; cannot be handled or touched, yet he will keep moving because he is
so restless, he cannot keep still, but finally he becomes so weak that exhaustion
takes the place of restlessness. Dysentery is likely to come on, with
involuntary passages of urine and faces, one or both, with hemorrhage from the
bowels and bloody urine. As the bowels move, we get the cadaveric odor to the
stool, a smell like putrid flesh. The stool is bloody, watery, brown like prune
juice, or black and horribly offensive. Sometimes dysenteric in character with
dreadful straining and burning of the anus; every stool burns as though there
were coals of fire in the rectum; burning in the bowels, burning all the way
through. The pain in the abdomen is better from the application of hot things.
The tympani tic condition is extreme. Sometimes there is a gastro-enteritis
that takes on a gangrenous character that in olden times used to be talked
about as gangrene of the bowel, a mortification that always ended in death. A
thick, bloody discharge is passed with a horrible odor, all substances are vomited,
the patient desires to be in a very warm room, wants to be well covered, wants
hot applications and warm drinks, looks cadaveric and smells cadaveric, with a
dry, pungent odor that penetrates everything, but if he wants the covers off,
wants a cool room and windows open, wants to be sponged with cold water, and
wants ice cold drinks then he must have Secale.
I
want to warn you against the too promiscuous use of Arsenic in the summer
complaints of young babies, for dysentery and cholera infantum. It has so many
little symptoms that are so common to these complaints that if you do not look
out and are not warned you will be likely to give your patient Arsenic,
suppress some of the symptoms changing the aspect of the case so that you
cannot find a remedy for it and yet not cure the case with Arsenic. There is a
strong tendency to be routine and give Arsenic without a sufficient number of
generals being present; e, if you give it on particulars and not on the
generals of the case.
This medicine is full of diarrhea and dysenteric symptoms; in these conditions there will be the pallor, the anxiety, the cadaveric aspect and the cadaveric odors. In the dysentery there is most distreming and frequent urging to stool, scanty, slimy, black, fluid, inky stools with cadaveric smell, great prostration, restlessness and pallor. In the bowel troubles, in low forms of disease, the stool becomes involuntary. This is a condition of the rectum, a relaxation of the rectum, great prostration. Involuntary stool generally indicates either local or general exhaustion, and in this remedy there is terrible exhaustion, so that there is involuntary diarrhea in typhoid and in low forms of zymotic disease; involuntary urine.
Purging
is sometimes present in Arsenic, but generally he does not have much purging,
such as we find in Podophyllum, Phosphorus ac. Use- ally there will be little,
frequent gushes, little spurts with flatus and the great exhaustion that occurs
in cholera, little spurts with mucus, slimy, whitish stools. Arsenic is not so
commonly indicated in cholera, i. e., during the gushing period, but sometimes
after the gushing is over and the vomiting and purging have passed, leaving a
state of extreme exhaustion, we have a state that appears like coma, the
patient looks almost as if dead, except that he breathes. We find, then, that
Arsenicum will establish reaction. Cholera infantum with great prostration,
sinking and cadaveric appearance, great coldness, covered with cold sweat, cold
extremities, cold as death; cadaveric, sickly, foul, pungent, penetrating odor
in the room from the faces and urine and even of what is vomited. The passages
from the bowels are acrid, excoriating, causing redness and burning. Very often
the burning extends into the bowels. The rectum and anus burn, smarting all
about the anus. It has tenesmus, painful, unbearable urging, great distress in
the lower bowel, in rectum and anus, terrible state of anxiety of the patient
and the pain is so violent and the suffering so in- tense, the anguish so intense,
that he can think of nothing but death; the fearfulness and frightful feelings
are such as he has never experienced in his life, and he feels confident these
mean he is going to die. This, like all other complaints, is attended with
restlessness, and when not at stool he is walking the floor, going from bed to
chair and from chair to bed. He will get on the stool and then back to bed;
then he is hurried to stool again, sometimes he loses it Sometimes there is a
chronic hemorrhoidal state with burning, and the hemorrhoids protrude when at
stool; he is much exhausted after getting back into bed after a stool, with
these protruding lumps which are like grapes and feel like coals of fire They
are hot, dry and bleeding. Fissures of the rectum that bleed at every stool,
with burning Itching
and
eczematous eruptions about the anus with burning. This kind of pain may be felt
anywhere in the body; burning is characteristic of Arsenic, stitching is
characteristic of Arsenic. Now, put these together and the patient often
describes it as being stuck with red hot needles all over him. This red hot
sensation, which is a common feature all over, is felt at the anus, and
especially when there are hemorrhoids, burning and sticking like hot needles in
the hemorrhoids.
At
times when a patient is coming down with the early stage of a violent attack he
will have all the rigor and chill that it is possible to find in the Materia
Medica and that can be found in disease. Rigors and chills of violent
character, and at such times he describes a feel- ing as if the blood flowing
through the vessels were ice water. He feels a rushing through the body of ice
cold waves. When the fever comes on and he is intensely hot from head to foot,
before the sweat has appeared, he feels that boiling water is going through the
blood vessels. Then comes on the sweat and dyspnoea and all complaints in which
he is prostrated and becomes cold. While the sweat some- times relieves the
fever and pains, yet it is prolonged and attended with great exhaustion and
does not relieve his exhaustion. Many of his complaints are increased with the
sweat; for instance, thirst is increased, the drinking is copious and does not
relieve, it seems he cannot get enough and patients will say: "I can drink
the well dry," or "Give me a bucket of water" Such things are
indicative of the state of thirst. During the fever he wants little and often;
during the chill he wants hot drinks.
Arsenicum
is a very useful medicine in the eruptions of the genitals with burning In
little ulcers that burn, even when they are syphilitic; herpetic vesicles that
appear upon the foreskin and upon the labia; chancre or chancroid with burning,
smarting and stinging, but especially in those that are weak, that offer no
willingness to heal, but that do the very opposite, that spread, those that we
call phagedenic, those that eat from their outer margins, become larger and
larger, Arsenic and Merc corr are the two principal medicines for spreading
ulcerations such as eat in every direction, very offensive. Such ulcerations as
follow the opening of a bubo in the inguinal region where there is no tendency
to heal. A little, watery, offensive discharge keeps coming and extending,
ulceration keeps spreading round about the opening, no tendency to heal. Or the
patient has been in the hands of a surgeon who has passed his knife down the
threatening suppurating bubo and it has been followed by red, angry,
erysipelatous appearance and shows no tendency to heal. The edges have been
removed by ulceration, and now the surface has cleared off, leaving a surface
the size of a dollar; sometimes becoming serpiginous. These ulcers are
sensitive to touch and burn like fire.
In the male and female sexual organs there are many symptoms of importance. In the male organs a dropsical condition, dropsy of the penis, edematous appearance, so that the penis is enormously swollen and looks like a water bag; the scrotum, especially the skin of the scrotum, greatly swollen and humid round about the parts. In the female the labia are enormously swollen with burning, stinging pains, hard and swollen. Erysipelatous inflammation of these organs, ulcerations of a syphilitic character; these when such symptoms as burning, smarting and stinging are present. In the female, violent, burning pains in the genitals with or without swelling, burning that extends up into the vagina, with great dryness and itching of the vagina. The leucorrhoeal discharge excoriates the parts, causing itching and burning with great suffering. Whitish, watery, thin discharges that excoriate; so copious sometimes that it will run down the thighs. The Arsenicum menstrual flow is very often excoriating in character. Co- pious leucorrhoeal flow intermixed with menstrual flow, very profuse and very acrid. Suppressed menstruation going on for months; amenorrhea in prostrated, nervous patients, wrinkled, careworn, haggard faces. Of course, Arsenic has a wonderful reputation in the old school for anemia, and it is said to be as good as Ferrum for anemia; Ferrum and Arsenic are the strong drugs for anemia, so that it is not to be wondered at that these pallid mortals find benefit from Arsenic. "During menstruation, stitches in the rectum." "Leucorrhoea acrid, corroding, thick and yellow," etc. After parturition the woman does not pass the urine; no urine in the bladder; suppression, or the bladder is full and it does not pass. In connection with this subject you will find Causticum the most frequently indicated remedy when you go back, and the woman has not passed the urine and it is time that she should; you will frequently find it indicated when you have no other symptoms to go on. Aconite will be more frequently indicated than any other remedy if the infant has not passed the urine. This is keynote practice and is to be condemned when there are other symptoms to indicate a remedy. If there are no other symptoms study Aconite and Causticum and see if there is any reason why they should not be given. Another feature in connection with the woman, Arsenic is a wonderful palliative in cancerous affections, such as occur in the uterus and mammary glands. Burning, stinging pains have entirely disappeared, in incurable cases, of course palliatives. It becomes one of the. Arsenic has loss of voice, laryngitis, with dry teasing cough; a cough that does not seem to do any good; hacking constantly, dry, hacking cough. Study its relation to asthma and difficult breathing, dyspnoea. Arsenic has cured some long-standing cases of asthma of a nervous character; asthma that comes on after midnight, in patients who suffer from the cold, those who are very pallid, dry wheezing cough, must sit up in bed and hold the chest, anxious restlessness with prostration. The heart symptoms are troublesome to manage when they get to be like Arsenic; the symptoms correspond to a state of great weakness. great palpitation, palpitation from the least exertion or excitement, great anxiety, anguish, weakness; he cannot walk, he cannot go up- stairs, he can hardly move without increasing the palpitation; every excitement brings on palpitation. "Severe paroxysms of palpitation or attacks of syncope during endocarditis." Arsenicum corresponds to most serious complaints of the heart, corresponds to many of the incurable complaints of the heart; i. e, when you see Arsenic corresponding in all of the symptoms with these marked cardiac affections, dropsy of the pericardium, etc., you have a class of cases that are very serious, "Angina pectoris," etc. "Rheumatism affecting the heart," etc. "Hydro pericardium with great irritability," etc. "Pulse frequent, small, trembling." "Pulsation through whole body," etc., etc. Again this goes on to another state when the heart becomes weak, pulse thread-like, patient pale and cold, covered with sweat, pulse very feeble. When this is not a state of the heart itself then Arsenic becomes a wonderful remedy; that is, it is capable of cure.
I
want to say a few things concerning a few essentials, some few things most
general to the Arsenicum type of intermittent. You can read the general state
of intermittent fever and fevers generally and apply what has been said.
Arsenic has all the violence of the chill that you can find in any remedy, with
excitement, headache, prostration, dry mouth, desire for hot drinks and to be
covered up warmly, with all the anxious restlessness and prostration that you
can find in any medicine; but the time of the Arsenic case is an important
thing. A striking feature of the Arsenic time of chill is its irregularity,
coming not twice alike, coming at any time. It has afternoon chill and after
midnight chill, sometimes in the morning, sometimes at 3 or 4 r. M., sometimes
at 1 P. M. It has a striking periodicity in its nature. Hence it has an
intermittent nature. It has a striking feature of thirst. During the chill,
while there is sometimes great thirst, he has aversion to cold things, hence
can take only hot drinks, hot teas, etc. During the fever the thirst increases
because he has dry mouth, and he drinks little and often, just a teaspoonful to
wet his dry mouth. Water does not quench his thirst, for he wants but a
tablespoonful, little and often. This runs on into the sweat with prostration,
increased coldness, desire for copious drinks, unquenchable thirst for cold
drinks. The chill is attended with great aching in the bones, likely to
commence in the extremities, and during the chill there is a great head
congestion with purple fingers and toes. Put these things together and the
prostration that occurs with the awful anxiety, and you can most always in a
general way pick out the Arsenic case. But it has so many details in its chill,
fever and sweat that if you take the details of symptoms and leave these
general features out you will be likely to be able to cover almost any case of
chills, i. e., you may think you will, but unless some of these general states
are present that stamp it as Arsenic you will fail. It is one thing to stamp
the whole case as Arsenic and another thing to say that these are Arsenicum
symptoms. So it is with China and Quinine; they have numerous particular
symptoms, and yet to make the case a China or Quinine case the striking general
features must be present.
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