Kreosote. A product of distillation of wood tar. it is obtained from beech tar and consists chiefly of guaiacol (C7H8O2) and creosol (C8H10O2). One part of kreosote is dissolved in ninety- nine parts of alcohol to make the 2x dilution.
THE action of kreosote is similar to that of carbolic acid in many respects, but it has less tendency to produce nervous symptoms, and is less irritant and poisonous.
Labbee summarizes the action of kreosote as follows: “From a small dose there is noticed only a stimulant effect on the digestive tract. From a large dose there will; first arise gastro-enteritis, with pain, vomiting, diarrhoea, &c., then will follow vertigo, muscular feebleness and circulatory and respiratory difficulties, due to absorption of the poison rather than to sympathy with the gastric irritation. Next will ensue effects due apparently to elimination of the drug, viz., bronchial irritation, diuresis and dysuria, with black colour of urine. After a massive dose, in addition to the above, serious disturbance of the neuro-muscular apparatus arises, such as muscular weakness, profound disturbance of the sensorium and mind, general trembling, spasms, convulsions and coma. The circulation and respiration are profoundly affected, the heart’s action being slowed, dyspnoea and suffocation coming on, terminating in asphyxia from excessive bronchial secretion and arrest of the heart’s action.” (Vide C.D.P.)
General Effects.- The proving bring out the dynamic effects of the drug and show that it produces vomiting and exercises a depraving influence on the blood and secretions, causing them readily to decompose, with the resulting production of haemorrhages and foul, acrid discharges, especially from the mucous membrane of the female generative organs. There are general weakness and exhaustion of the body, sometimes with faintness, the limbs tremble and the legs feel as if about to give way at the knees, the patient feels chilly and yawns much.
Mind.- Memory is weak and the thoughts fly away. ” The patient wants everything and is satisfied with nothing.” He is emotional, weeps from small cause and is especially susceptible to sad music. His emotions bring on headache, he becomes cross and irritable and is irascible over every trifle.
Head.- A whirling vertigo is common, felt mostly in the vertex, where also there may be an out-pressing pain. A similar pain is felt in the temples and forehead, aggravated by stooping, which causes a sensation as if everything would be forced out there. A continual throbbing may be felt in mid-forehead, or a general heavy, confused feeling may be experienced, described by one prover as like the sensation caused by having drunk too much alcohol the day before. With the headache there is drowsiness and, independently of headache, sleepiness often accompanies the weak condition caused by kreosotum. The hair falls out much and the scalp is painful when it is combed.
The face is usually pale and bloated, with blue circles round the eyes, but not infrequently it is hot, with bright red cheeks, while the rest of the body is cold, especially the feet. The whole extent of the forehead may be covered with miliary papules accompanied by shooting pains. The eruption has a tendency to persist, but in this position it never becomes vesicular. Pustules occur on the cheeks and chin with the formation of honey-yellow scales.
Eyes.- A dull pressure is felt over the eyes, the lids quiver and twitch, lachrymation occurs, easily and the tears are as acrid as brine and cause redness and smarting of the eyelids and excoriate the skin of the cheeks over which they flow. The lids itch much, necessitating rubbing, which increases the inflammation.
Nose.- There is a pressive pain over the root of the nose, relieved by epistaxis, which may recur repeatedly. Sneezing is frequent, with or without accompanying coryza. Herpetic vesicles form under the nose and in the folds of the alae nasi. There is subjectively a foul odour in the nose.
Ears.- Pustules appear on the ears, with swelling and inflammation of the surrounding parts and pricking, shooting and itching. Humming and ringing noises occur. The hearing is dull before and during the menstrual period.
Digestion.- The lip dare dry, cracked and sore and there are tension and burning in the angles of the mouth, the tongue feels cold and is covered with a white fur. Aphthae form on the tongue and in the mouth, the odour from which is putrid, the gums become spongy, blue and purple, the teeth feel raised and too long, and dull, throbbing pains occur in them, especially if thy are carious. There is flow of acrid water into the mouth of bitter taste, and food, too, tastes bitter. The fauces are red, dry and feel stuck together, there are scraping and burning in the oesophagus, so that swallowing is difficult and painful. The appetite is voracious or there is complete anorexia. Empty eructations, nausea and inclination to vomit and vomiting of sweetish water occur. There are tight feelings over the stomach and scrobiculus, which make the patient desire the clothing to be loose, and fulness and distension in the abdomen. In the umbilical region there is a sensation of a painful, twisted lump or ball, various pinching and shooting pains are felt and a pressure in the hypogastrium resembling labour-pains. Pressure in the rectum causes urging but only ill-smelling flatus is discharged; with large doses diarrhoea of copious, soft, pappy stools may occur.
Urine.- There is frequent urging to urinate, and urine is passed in large quantities at night, in the daytime it is more often frequent and scanty. It may be colourless or of a chestnut- brown colour, it is ill-smelling, hot and causes burning in the vulva while urinating, and scalding between the labia afterwards.
Sexual.- The female generative organs are much affected by kreosotum. Menses come on too early, they are too protracted, very profuse and in clots, after a few days they may cease for a day or two and then return. They may flow only when lying down and cease on sitting or waking about (lil. tig., only when moving). They are succeeded by a bloody, ichorous leucorrhoea, which is acrid an causes itching and smarting of the genital. Stitches shoot from abdomen down the vagina like electric shocks, and labour-like pains occur followed by leucorrhoea, which is corrosive, yellow or white, of the odour of green “corn,” stains the linen yellow, and causes violent itching and burning between the labia and between the labia and thighs, so that the patient cannot refrain from scratching. There is also felt a voluptuous itching deep in the vagina, provoking desire for coitus, but if coitus takes place it is painful and is followed by bleeding some hours afterwards. The os uteri is patulous and the seat of sore pain. Leucorrhoea is accompanied by great weakness, especially in the legs, and is often preceded by pain in the sacrum or coccyx, After menstruation the abdomen becomes distended.
Respiration.-The patient has a sensation of fulness and tightness in the chest, and a feeling that he cannot expire properly on account of a sensation of weight in the lower part of the chest; he feels he must often breathe deeply but is unable to do so to his satisfaction. The dyspnoea is worse in a warm room and better in the open air. Phlegm in the larynx induces cough with expectoration of gelatinous mucus, or a cough may be caused by a feeling of mucus stuck in the middle of the chest. In various parts of the chest and between the ribs are recurring shooting pains, and bruised pains are felt in the sternum, especially on pressure or during inspiration.
Circulation.- The pulse is slow and feeble, and stitches occur in the cardiac region from any emotion, such as that caused by music; tightness is felt about the heart and the patient must weep. When at rest and under the influence of emotion pulsation can be felt by the prover in every part of the body.
Back and Limbs.- The sacrum is the centre of pain in the back, from it pain proceeds upwards to between the scapulae, the back feels as if it would break, and is worse from rest and better from motion. A labour-like pain may spread round from the sacrum, causing urging to urinate or an ineffectual desire for stool, or a spasmodic drawing may start from the sacrum forwards to the genitals and down the thighs. Pain, as if bruised, and a weariness are experienced in all the limbs. Gnawing pains in the shoulders and thighs, drawing pains in the ulnar muscles extending to the little finger and in the elbow-joint, as if the tendons were too short; dying away of the first phalanx of all the fingers, oedema of the legs, which are white, cold, heavy and numb; cold feet, or burning of the feet and a sensation in the soles as if treading on balls are the principal symptoms in the extremities caused by kreosotum. Pain in the left thumb, as if sprained and stiff, seems to be characteristic.
Sleep.-The patient is sleepy but cannot get to sleep till after midnight, as he is made restless by heat, itching and burning all over the body, or he may feel too tired to sleep. In a woman prover the dreams are anxious, of falling from a height, of being pursued by a man who wants to ravish her, of taking poison, of a small object which grows always larger, of fire; a man dreams of erections and urging to urinate.
Skin.-kreosotum causes all over the body an eruption of large pustules like small-pox, or wheals like nettle-rash or bug bites, or a vesicular eruption that itches violently, worse at 5 or 7 p.m. and at night. The itching induces scratching, which is followed by burning on the legs and arms, but not on the rest of the body.
Fever, &c.-Chilliness predominates, the patient is always chilly, especially in the back, and is more so during the menses. After a rigor comes thirst and then a dry fever heat without thirst, with cheeks brilliantly red, as if painted, and cold feet, to be followed by a warm sweat and this in turn by pain in the sacrum. There may be alternate chill and heat with much thirst.
In considering whether a case is suitable for treatment with kreosotum, one must bear in mind the characteristics of the drug, viz., tendency to haemorrhages and destruction of tissue, foul, acrid discharges, vomiting, itching burning pains, and great general weakness.
Digestive Tract.- Kreosote has been found very useful for sympathetic vomiting, such as that occurring in phthisis, in hepatic and uterine cancer, in chronic kidney disease and in the vomiting of pregnancy. It is also palliative to the pain and vomiting of cancer of the stomach. The vomited matters are sour, acrid and of undigested food or of sweetish water; the acridity is such that it sets the teeth on edge, and excoriates the buccal mucous membrane and lips; vomiting is worse from cold food and better from warm. Kreosotum is a valuable remedy in cholera infantum; in these cases the vomiting is incessant and the stools are cadaverous smelling. It is useful also in disorders of the stomach and bowels caused by eating smoked meats and fish, and in sea-sickness. In summer diarrhoea and the diarrhoea of dentition, kreosotum is of great service, also for foetid, bloody stools, sometimes clotted, which may come on with great perspiration during typhoid fever. It is a prime remedy for dentition troubles, and meets not only the pain but also the cachexia and the state of general irritation, and the constipation frequently present in children who are cutting their teeth with difficulty, and in whom the teeth with difficulty, and in whom the teeth decay almost as soon as they are erupted. For toothache caused by carious teeth there is no medicine so valuable; it is common practice to plug a carious tooth with cotton wool soaked in kreosote to allay the pain, but the administration of kreosotum in dilutions of 12, 30 or 200, internally, is much more efficacious. Scurvy, with spongy and bleeding gums and rapid decay of the teeth, yields to this remedy.
Urinary.- The heavy drowsiness and copious secretion of urine caused by kreosotum have led to its successful use n nocturnal enuresis in children whose sleep it too profound, so that they can only with difficulty be waked when taken up. The enuresis is usually during the first sleep. Kreosotum has caused sugar in the urine and has been used in diabetes.
Head.- It is a useful remedy for chronic headache, associated with great drowsiness and pressing-out pain, mainly in the forehead, as well as for falling off of the hair and of masses of indurated scales from the scalp.
Sexual.-Kreosotum has an important place in the treatment of diseases of the female generative organs : it is a remedy for ulcerations and erosions of the uterine cervix and vagina when characterized by offensive, excoriating discharge, and also for acrid, offensive leucorrhoea causing much itching and smarting of the external genitals. Offensive, putrid lochia call for it. It is a useful palliative in cancer of the uterus when the pain is burning and the discharge offensive and excoriating, causing great burning and itching between the pudenda and in the crural- labial folds, is usually yellow and stains the linen yellow; its odour has been compared to that of fresh Indian corn. It is accompanied by great weakness in the legs, and often follows menses that are too early, too copious, and that last too long, with frequently a day or two of intermittence in the flow.
Respiratory.- Kreosotum has been used by both schools of medicine chronic bronchitis, bronchiectasis, chronic pneumonia, phthisis, and the chronic winter cough of old people. The cough is paroxysmal, moist, is caused by crawling or tickling behind the sternum and there is burning in the chest.
Eyes.- It is indicated in chronic inflammation and swelling of the margins of the eyelids, which become agglutinated, and for moist eruptions about the ears with swelling of the cervical glands.
Epitheliomata occurring in the face, nose and lips, cancers of the stomach and uterus and gangrenous ulcerations, if accompanied by burning pains and very excoriating discharge, may all require kreosotum.
Skin.- it is indicated in urticaria when the itching is very violent towards evening, or when it occurs after menstruation.
(1) vomiting; sympathetic; from malignant disease of the stomach.
(2) Four, excoriating discharges and secretions.
(3) Small wounds inclined to bleed easily; scurvy.
(4) Pulsation all over the body, easily excited by emotion.
(5) Menses flow only when lying (lil. tig., only when moving).
(6) Extremely irritating and excoriating leucorrhoea.
(7) Difficult dentition, cachexia, caries of teeth, odontalgia.
(8) Leuocophlegmatic temperament; blondes; old looking children, old women.
From cold weather, cold water and bathing, becoming cold, after menstruation, from leucorrhoea, during coitus and afterwards, standing and waking (leucorrhoea), at rest, touch, fasting, the lying down position (incontinence and uterine haemorrhage).
From open air, pressure, warmth, moving about, sitting (leucorrhoea), sneezing (hoarseness).