By W. J. Hawkes, M.D., Los Angeles, Cal.
These three medicines have many points of resemblance, and as many of dissimilarity. There are probably no other two remedies in the Materia Medica which present so many points of similarity from the standpoint of pathology, and at the same time so many and marked points of dissimilarity in their therapeutic indications, as Bryonia and Rhus tox. There are probably no other two remedies so often alternated with so little excuse, especially in rheumatism. Thejr likes and unlikes furnish a pregnant object lesson on the question of symptomological or pathological basis for prescribing. In rheumatism, for instance, the Bryonia patient’s symptoms are intensely and immediately aggravated by even the slightest motion; while the Rhus tox. Patient’s symptoms are as promptly and markedly ameliorated by motion.
This characteristic accompanies these remedies through all conditions in which they are curative; and especially is this true in typhoid fever and pneumonia, as well as in rheumatic conditions.
In typhoid fever the Bryonia patient lies perfectly still, resisting, even in stupor, all movement; while the Rhus patient is constantly changing or trying to change his position. These characteristics accompany the remedies in all diseased conditions where they are indicated. And may be regarded as their most constant and valuable symptoms.
The resistance to motion on the part of the Bryonia patient is because motion of any kind, though never so slight, causes increase of pain or suffering of any character. The restlessness of the Rhus patient, on the other hand, is because motion always ameliorates his sufferings.
The Arnica patient also desires to change his position, but it is because the bed on which he lies feels hard to him, and this, is because of the sore, bruised sensations so peculiar to Arnica.
The brain and mental symptoms of these remedies in typhoid fever are marked and quite characteristic. The Arnica patient shows evidences of great passive congestion to the brain, He is stupid, with eye fixed and lower jaw dropped. The head and face is noticeably warmer than the body. His face is dark red, and faces and urine are passed involuntarily; he forgets the words he intended to speak. The stupor is very pronounced, breath putrid. He goes to sleep while answering; the skin will show purplish ecehymosed spots.
The Bryonia patient worries about his business and the affairs of the day. He worries about them while awake, dreams about them while asleep, and raves about them while in delirium. This is very peculiar and characteristic of the remedy, nor is it confined to patients ill with fever. I have seen the most terrible mental distress of delirium tremen promptly relieved by bryonia where this symptom was pronounced. The Bryonia patient also imagines himself away from home, and persistently begs to go home.
The Rhus patient’s delirium is of a muttering and undistinguishable nature. He dreams of roaming over fields. This corresponds with the general restlessness of all Rhus patients. The stupor and typhoid symptoms of Rhus are very profound. Until Baptisia was proved, and tested at the beside, Thus was recognized as the drug which better than any other fitted the typicala typhoid condition. Since Baptisia has been in use, however, thus has been relegated to second place. Baptisia at the present time, more than any other drug, fits the stupid, besotted appearance of the typical typhoid patient. Baptisia, Rhus tox., Arnica is the order in which these three remedies rank as to typhoid stupidity.
While on this subject I cannot resist the temptation to digress a little in order to emphasize the value of Baptisia in the treatment of typhoid patients, and at the same time give my unquali fied endorsement to the value the never-failing value of the remedy’s most characteristic mental symptom. In the books the symptom is expressed thus; “Imagines that the different members of his body are separated, and is distressed trying to bring them together.” “I am bound to tell you,” as dear old Professor Ludlam used to say, “that when that delusion bothers a typhoid (or any other) patient, Baptisia will greatly aid in warding off dangerous symptoms and hastening recovery.” I go further and say that I agree with Farrington that typhoid fever can be aborted by the timely administration of this or either of the other remedies, as the peculiar symptoms may indicate.
Nor is it always necessary for the patient to tell in so many words that his bodily members are scattered about the bed, and that he is very much distressed because he cannot get them to gather. He is often too “typhoid” to be able to tell you in words. But his actions will often suggest the idea to the carefully observant physician.
A case in point: A young girl in one of my old families, whom I had introduced to her mother about fourteen years before, and who is now a somewhat noted writer of fiction, was taken with a fever which had all the ear marks of typhoid. The attack had progressed to the point of mild delirium, but I had not been able to single out any particular remedy as the one surely indicated and it seemed as if we were booked for a run of typhoid fever. But as I sat watching the patient during a morning visit, I observed her continually pushing herself up against the head board. I asked her why she did that, and she replied that her neck felt too long, that her head was too from her body, and she was trying to push it back to place.
There was the characteristic symptom of Baptisia, but not expressed in the stereotyped words of the books. The action of that remedy initiated a change for the better which cut short all the typhoid symptoms, and would have convinced the most skeptical observer.
In rheumatic conditions Arnica corresponds to the gouty kind; there is extreme soreness of the parts affected. The parts are so sore and sensitive, the patient dreads even the approach of anyone toward his bed. Farrington says of Arnica: “Arnica develop as a true myalgia. The pain occurs in the muscles of any part of the body. They are of traumatic origin or they come from over-exertion and are accompanied by this sore, bruised feeling, which is so necessary to the choice of the drug”
In rheumatism you may employ Arnica, not for true inflammatory rheumatism, but for the local rheumatism which occurs in winter weather and which seems to be the combined effect often of exposure to dampness and cold and strain on the muscles from over-exertion. The affected parts feel sore and bruised. Any motion, of course, aggravates this sensation. There are sharp, shooting pains which run down from the elbow to the forearm, or which shoot up through the less and feet. The feet often swell and feel sore and bruised.
In the Bryonia rheumatic patient the joints are more likely to be affected inflammatory rheumatism where the slightest motion causes most excruciating pain. With Rhus the opposite obtains: the patient is restless, and gentle motion relieves, and the muscles and sheaths of nerves are the tissues selected. In sciatica, especially of the left side, Rhus is much more frequently called for, and, if it has an equal, has no superior in this affection; while in rheumatism of the joints and in inflammatory rheumatism Bryonia is more often indicated and is as valuable. But whatever the condition, the differentiating symptoms will guide to the choice of the remedy: Arnica, extreme sensitiveness and soreness, so that the soft bed seems hard, with tendency to ecchymosis. Bryonia, aggravation from least motion. Rhus tox., restless and relief from motion; and always worse before a storm with rain. The Rhus patient is a good weather forecaster, for he can predict the coming of a rain storm twenty-four or even forty-eight hours before it comes.
Both Arnica and Rhus have the sore, bruised feeling, but Arnica is worse from motion, and with Arnica the sore, bruised feeling is more marked.
Considering causes as factors, traumatism, whether from blows or violent straining of parts, belongs to Arnica, while getting wet while heated after violent exercise belongs to Rhus. With Bryonia a dryness of the membranes seems to be a chief cause; it is certainly a condition.
The same symptoms apply to pneumonia, with the addition that the more the tendency to a typhoid condition, the more we think of Rhus.
The skin symptoms of Bryonia are not very marked, while dryness of all the internal membranes, serous as well as mucous, is characteristic: dryness of mouth and lips, with great thirst for large quantities; constipation, with dry stools; dryness of synovial membranes in inflammatory rheumatism, in the treatment of which there is no remedy superior the Bryonia. Dryness of plural surfaces, causing pleuritic catching pains. Bryonia here has no superior. So in meningitis cerebro-spinalis. This dryness is probably thee cause of the bryonia patient’s distress from all motion, which is its most characteristic symptom.
The skin symptoms of Rhus are marked and peculiar; eruption under the skin, which may always be felt, but not often seen. All have seen and some have felt the eruption caused by Rhus poisoning. A similar eruption from another cause is characteristic of Rhus, as in hives or urticaria.
The skin symptoms of Arnica are as marked as those of Rhus: there is a tendency to ecchymosed spots on the skin, similar to results of contusions or bruises. Bedsores come with comparatively little cause. There is a tendency to small boils, which are extremely sensitive and appear in consecutive crops. They often do not “come to a head,” as the saying is, but become hard and dark and finally slowly disappear.
Another marked difference between Bryonia and Rhus is that the Bryonia patient always feels better while lying on the painful side. Pressure relieves in Bryonia and aggravates in Rhus. The Arnica patient is so sore and sensitive that he suffers and cries out even before he is touched; hence we understand that pressure aggravates his sore spots.
All of these three remedies are classed as acute, scarcely ever as remedies in chronic conditions. This, I am sure, leads to their being often overlooked and neglected when they are the curative remedies. Troubles which can be traced, no matter how far back to physical shocks or injuries are curable by Arnica, as surely as any other chronic trouble by any other remedy.
So ailments which may be traced back, no matter how long ago, to the patients getting wet while overheated and exhausted, can be cured by Rhus tox. When a remedy is indicated by the totality of the symptoms, give it, no matter what the books or prejudice may say as to its being an “acute” or “chronic” remedy. Aconite is regarded by nearly all as especially a remedy for acute conditions only. I have repeatedly demonstrated the contrary, to my own satisfaction. So also with the others; so that now the question never influences me in prescribing them, if they are otherwise indicated.
If there is a lesson to be learned from what I have said, it is that the only scientific and sure way to prescribe is on the totality of symptoms presented by the patient, one of these, and often an important one, being the pathological condition.
Since writing the above, I have read of two important and valuable discoveries by two old school physicians, which may not be out of place as addenda to a paper on Materia Medica.
The first is “a communication to the Paris Academy of Medicine by M. Albert Robin, to the effect that metals, when administered to the human subject in doses so minute as to be altogether inappreciable, exercise an influence that is almost magical, and quite inexplicable by any theories heretofore known to science.”
The second is a quotation from an article published in the Medical Brief for April, 1905, on “Thuja as a Remedy for Warts,” by Charles D. F. Phillips, M.D., LL. D. (Aberd.); LL. D. (Edin.); F.R.S. Ed.; F.R.C.S. Ed.; M.R.C.P. (Lond.); Honorary Fellow of the Medico-Chirurgical College of Philadelphia; late Examiner in the Universities of Edinburgh, Glasgow and Aberdeen, and Lecturer on Materia Medica at Westminster Hospital. London England. After the reading of That string of titles you are expected to listen with bated breath to what he has to say.
“For many year I have employed Thuja in the treatment of Warts. By the term Thuja I wish to indicate the fresh tops of Thuja occidental is, the white cedar growing in the northern United States of America. It contains pinicripin, a bitter, active principle, probably not an alkaloid, and thujin, a yellow coloring agent. Its most important constituent is a volatile oil allied in pharmacological action to savin, and known as thuetin. Thuja is useful in all papillomatous conditions, and a wart is a papilloma of the skin, whether it be single or multiple, simple or branched, acuminated or flattened. My own experience, lasting now over a considerable number of years, induces me to recommend it in the highest terms for the cure of worst with a narrow base and a pendulous body. They may occur upon any part, and have often a history which is hereditary. In addition to warts about the genitals, only some of which are gonorrhoeal in origin, crops of filiform warts sometimes appear on the scalp, about the skin of the neck, in the axilla, and even on the eyelids. In these cases a wash or lotion of Thuja is most useful, and often the warts fall off in two or three days after this application, leaving the base perfectly healed, although the strong tincture should be applied locally to such as are intractable. Condylomata about the arms or pudenda of either sex, whether of a syphilitic character or otherwise, are rapidly cured by the application of the same tincture. In addition to the local application, five drops of the tincture should be taken in a wineglass of water internally every night and morning. Although the great and most useful sphere of action of Thuja is in the treatment of warts and papillomatous growths, it is also valuable in rheumatic and arthritic pains and in ulcerated surfaces, especially about the corona glandulis.”
These two prominent physicians of the old school cannot escape one or other of the horns of a very ugly dilemma: either they must plead guilty to inexcusable ignorance of medical literature, current and a hundred years old, or they must stand convicted of the most glaring plagiarism; whichever horn they may choose, their position as pretentious and many-titled teachers of the healing art is not an enviable one.
At all events we, as adherents and conscientious practitioners of the “Science of Therapeutics,” may look on with the utmost complacency, realizing that it is a tribute to the truth of the homoeopathic law, and convincing though unwilling testimony to the genius and greatness of Samuel Hahnemann, whom they and their ild persecuted during his life and whose good name they have ghoulishly traduced in his honored grave – Hahnemann, our grand old man, the latchets of whose professional shoes they are not worthy to unloose.