THERAPEUTICS.
Traumatism.-It is surprising that a drug with such well authenticated powers should have been neglected outside homoeopathic circles. Before Hahnemann`s time it was known as a “vulnerary.” This is still perhaps its greatest sphere-certainly it is best known as such. The term is a wide one and in the case of arnica must be interpreted at its widest.
The drug is not only valuable for actual cuts or bruises to facilitate healing or remove pain or restlessness due thereto; strain of ligaments from overstretching of tissue (sprains of joints), overstretching or actual bruising of muscle tissue, and soreness, tenderness, pain, and even impaired function from over- use of muscles all come under its soothing and healing influence. Instances of such over-use are the effects of an unduly long walk, the strain of muscles involved in parturition, including actual bruises so induced, over-strain of the muscular tissue of the heart from hard running or boat-racing, and strain of the voice from speaking, especially out-of-doors, or from singing. In the last-named instances it is where the muscular vocal apparatus or the vocal cords themselves suffer that the drug is useful, rather than where catarrhal effects are prominent. Arnica is also of some value as a prophylactic to lessen the effects of traumatism or shock due to parturition or surgical procedures, and for such conditions as post operative retention of urine and the painful startings of a fractured limb. It will also aid in checking venous oozing from lacerations, operations, &c. Indeed, it appears to have some haemolytic power favouring ecchymosis or other haemorrhages. Consequently, such conditions would confirm the choice of arnica as a remedy whether they were due to traumatism, sepsis or a typhoid state.
With respect to this drug for traumatism Kent says that high potencies are better than low, and that external applications of the drug are not necessary.
For sprains involving ligaments and tendons, if arnica leaves any stiffness or weakness and if there is sensitiveness to damp, or the chief pain is on first moving, rhus tox. may be required, and later calcarea carb. If the bone and periosteum are the chief sufferers ruta comes first.
Another point of interest and importance is that arnica (especially if given in a high dilution) will often benefit conditions due to an injury inflicted long before.
Chronic pain, stiffness, “neuralgia,” tenderness due to old injury may require the drug.
The inquirer into homoeopathy should not suppose that it is claimed that arnica produces actual cuts, bruises, or lacerations, though equally unreasonable beliefs have been attributed to homoeopaths. How far the drug goes in altering the physical or chemical condition say of a muscle is not known; it is known that it produces sore, bruised feeling in provers- effects closely resembling those due to injury or over-use of muscular tissue; and it is known that its exhibition will relieve such a condition, whether due to traumatism or to other causes, if the similarity between the drug effects and the patient`s condition is sufficiently close.
Dermatitis such as arnica has been shown to produce (p.188), when it is due to other causes should be treated by arnica. It may resemble acute eczema or erysipelas, with (or even without) bulbae. Crops of pustules or boils–especially if slow in maturing–may also call for it.
Mental Symptoms and States.-The mental symptoms induced in provers have been mentioned on p. 191; they are mild symptoms such as may be associated with any traumatic, rheumatic, intestinal or other conditions. THey may be found quite early, as in cases which develop into serious maladies.
Kent (loc. cit) gives a long and graphic description of the mental state indicating arnica in such conditions, and we would refer readers to that account for further details, and in meantime we give a statement more or less embodying his teaching.
It is possible to classify the different mental symptoms somewhat as follows:-
(1) When the Patient is quite Conscious.-(a) He objects to being approached lest he be hurt-he is very sensitive to pain; (b) he objects to being approached lest he should have the effort (he is weary) and the bother of talking. Thus (in the language of provers) “he wants to be alone” for a double reason; this makes him morose and irritable. Another mental state in this category is grave fear; of serious illness, as present or impending, e.g., of heart disease.
(2) When the patient is Semi-conscious or between Waking and Sleeping.-In this state there may be night terrors-waking up with a feeling of horror, apparently of cardiac origin. The patient is convinced he is about to die suddenly. This may be repeated during the same night or in successive nights. Such cases have happened soon after some shock, such as a railway accident, when the victim in imagination again goes through the real horrors he felt or saw (cf. opium).
(3) When the Condition of Stupor is Approaching.-The patient may be sufficiently conscious to wish to explain himself, but be unable to find words to express his meaning and giving up the effort lapses into somnolence. Or he may be able to speak and misjudges his state of illness, under-estimating its gravity instead of exaggerating it, and resents the presence of doctors or solicitous friends-another phase of “wants to be alone.”
As the malady advances more the patient begins to answer a question correctly, he lapses in the middle of a sentence into muttering delirium or unconsciousness (baptisia).
When a patient has arrived at this mental state he is well on in a typhus-like (typhoid) state, whether it be actual typhus, enteric, malignant malaria, yellow fever, or sepsis (surgical, puerperal or other). The usual concomitants in the shape of muttering delirium, fever, rapid, weak pulse, dusky skin, possibly with ecchymoses, or congestive patches, dry tongue, sordes, &c., some or all of these will now be present.
Several remedies besides the one under consideration produce a disease-picture closely resembling this typhoid state-baptisia, arsenic, ailanthus, crotalus or lachesis, bryonia, rhus tox., muriatic acid, and carbo veg. The malady out of which the typhus- like state has sprung may be some guide. In typhus fever probably baptisia or arsenic will be called for; for septic pneumonia or endocarditis arsenic or one of the serpent poisons. Nash (loc. cit.) regards loss of control of the sphincters and petechiae as specially indicating arnica, and lays stress also on the symptom “everything on which the patient lies seems too hard”-in other words the sensitive, bruised feeling is very marked. This symptom, however, is indicative of several other drugs also, and is only of value during the stage of illness when the patient is more or less conscious. Its value again would be lessened if he were really on a hard or lumpy bed! Another symptom, though not found exclusively in the arnica pathogenesis, is of diagnostic importance-“dark-red, hot face and head, while the rest of the body is cool or cold”; and the occurrence of crops of “blind” boils would be confirmatory, as would other cutaneous conditions such as are described on pp. 188-189.
A careful study of the materia medica is advised in a case showing typhus-like symptoms. Some well-marked extraneous symptoms may decide the choice of remedy.
It is of interest to know that arnica has actually been found useful in Western America for malignant malarial conditions, and kent regards it and lachesis as superior to quinine. He extends his recommendation of arnica to zymotic diseases, e.g., scarlet fever where the rash does not come out well and the spots are of a dusky hue-a condition we call malignant scarlet fever.
The pathogenesis also suggests a resemblance to some of the features of yellow fever, but we are unaware whether arnica has been so used. In most cases a more markedly haemolytic drug would be required.
Dreams.-Closely akin to mental symptoms are dreams, and some of those of arnica have been referred to already (pp.192 and 195). Other kinds of dreams indicating it are “recurrence of the same kind of dream,” and waking up suddenly, screaming with fright,” also “dreams of being reproached for immoral conduct.”
Digestive System.-The provings and poisonings have led to the use of arnica in dysentery, but there are other drugs which are more suited to the acute stage of either variety. When in advanced cases the patient has lost control of sphincters and is getting drowsy or delirious, arnica should come in for consideration. The arnica patient dislikes both meat and milk, and vomiting of dark uncoagulated blood may be present. The breath and stools are of a putrid offensive odour; tenderness, tympanites and distension will confirm the choice.
Atonic dyspepsia with eructations tasting of rotten eggs, voracious appetite, and undigested food in the stools, which are very foetid and dark, if found in a patient with the milder arnica mentality, would require this remedy.
Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,