After the suffocative attacks quantities of ropy mucus may be brought up.
Generalities.-The intolerance of constriction, or pressure of clothing mentioned above, is found in other regions-round the waist, round the limbs, &c. It is in part a physical feeling, as in the neck, where it indicates respiratory embarrassment, and partly nervous, ex. gr. in limbs.
There is general weakness, physical and mental, felt most in the morning. Associated with weakness there may be trembling and jerking of the whole body; or alternatively, bodily restlessness and tossing about in acute cases; or in chronic cases this may be replaced by a busy, hurried feeling-the patient must do everything as quickly as possible and talks all the time.
A general desire for open air, as adding to the sense of well-being, or as an expression of air hunger in a mild degree, is found in lachesis cases. In the latter sense anything which may be supposed to interfere with free access of air is irksome- the proximity of objects or of people. This may be the interpretation of the symptom “wants to be fanned at a distance.”
Lachesis appears to affect predominantly the left side; ailments may be limited to the left, or begin on the left and pass across to the right.
Sensitiveness to extremes of cold and heat is a lachesis feature, with a preponderance in the direction of aversion and aggravation from heat, especially from exposure to the direct rays of the sun.
The lachesis patient is not a good sleeper; he is specially wide awake in the evening; sleep, when it comes, is apt to be restless and disturbed by dreams. They may be of an amorous nature or may be a repetition of any worries on the patient’s mind, which are accentuated during the dream and wake him in a fright. Most of the symptoms are aggravated on first waking. Instead of the patient being strengthened and refreshed by sleep, his maladies all seem worse. Patients wake confused and unable to recognize their surroundings, wonder where they are, &c.
Urinary System.-Frequent micturition is caused by lachesis, and the urine may have a strong odour; straining is sometimes induced. The haemolytic effect of snake poisons is shown in this region by the presence of dark or blackish urine, which froths when first passed; examination shows that it contains albumin and decomposing blood.
Generative System.-Similarly the menstrual blood is dark and unusually offensive, the flow is usually scanty, and is accompanied by labour-like (uterine intermittent) pain or by sharp, cutting pains in the abdomen, chiefly in the left ovarian region, passing over to the right side. The abdomen is sensitive nose. The fauces partake of the purplish colour noticed elsewhere, and the cervical glands swell. The neck and throat are sensitive to touch, to the pressure (or even the presence) of clothing.
So pressure, or to the weight of the bed-clothes. The onset of flow relieves these pains.
Skin.-The cutaneous lesions of lachesis appear to be due to or secondary to the haemic disorganization.
Petechiae, ecchymoses and their attendant discolorations, and erythema and oedema are fairly definite. During the septic stages, after a viper bite, old scars may break down. When recovery is taking place, in milder cases, a general icteric tint, apparently of haematic origin, is commonly present.
Digestive System.-Mouth.-Toothache and neuralgia, left-sided from jaw to ear are present, and the tongue is dry and black.
Throat.-The throat feels swollen inside; it is described as if a lump or a crumb were there, requiring to be swallowed; or as if two lumps were blocking up the fauces, but there is little real swelling. The discomfort or pain on deglutition is more on swallowing liquids than solids, and most on empty swallowing; fluids, especially if warm, are liable to cause choking, and to return through the nose. The fauces partake of the purplish colour noticed elsewhere, and the cervical glands swell. The neck and throat are sensitive to touch, to the pressure (or even the presence) of clothing.
Stomach.-The appetite may be increased, but not necessarily; thirst may be insatiable in febrile conditions, with dry tongue and skin. An ordinary meal may be followed by a sense of repletion, but when the stomach is becoming empty a gnawing sensation may come on, relieved by eating. A craving for oysters is said to accompany some Lachesis cases, and is not due to a liking for the acid dressings of these mollusks, for there is aversion from sour things. There may be abdominal distention and severe cutting pains on the right side. Symptoms indicative of peritonitis are found in some cases of poisoning- pain, sensitiveness to touch and all pressure, nausea, vomiting, distention amounting to tympanites, with attendant lessened abdominal respiratory movements.
The state of the bowels varies; there may be a watery offensive diarrhoea, containing altered blood and, in severe and septic cases, loss of control of sphincters; in less severe illnesses, offensive, soft, yellow stools occur. In chronic cases a form of constipation is likely to be present-loss of expulsive desire and power, and voluntary straining may be necessary. Throbbing in the anus and prolapsus rickety after stool occur; also pain from anal spasm grasping the prolapsed mucosa.
Limbs.-Weakness of limbs and pain in left arm and leg are occasionally felt.
The Face.-The complexion varies with the stage of the illness; it may be flushed, swollen and purplish or pale and grey during collapse.
THERAPEUTICS.
The foregoing description of the powers of viperine poisons would suffice to indicate their usefulness in the treatment of a large number of diseased conditions. As remedies they are, however, so important that a review of their curative powers, though involving a certain amount of repetition, is worth while. This is especially the case because clinical experience has shown that they are very valuable therapeutic agents in certain conditions which are but dimly foreshadowed in the pathogenesis.
The great blood-disintegrating (haemolytic) powers of lachesis and crotalus are utilized in a number of febrile, septic, toxic and typhus-like conditions, present in many named diseases, and in some forms called “malignant” exanthems, where the body resistance has more or less completely broken down. When this point is attained the distinguishing or diagnostic features of the particular diseases have largely disappeared. As Professor Teale, in a lecture before the British Homoeopathic Society, explained: “Widely different bacteria may produce very similar clinical features… When profound poisoning occurs, instead of the poisoning becoming more it becomes less characteristic and clinically is seen to be in the typhoid state.”
T.F. Allen’s “Handbook of Materia Medica and Homoeopathic Therapeutics” gives under Crot. (p. 433) so good a general description of these conditions that it is worth quoting with one or two slight alternations. The description is clinical, and is dated 1889, and refers primarily to the U.S.A. “Crot. is, “he says, “extremely valuable in fevers of a malignant type, especially malignant scarlet fever, and in all fevers which, present a haemorrhagic or putrescent (septic) character.” There are present “great weakness, tremulousness, torpor, unconsciousness, efforts to vomit anything taken into the stomach; when vomiting, blood oozes from the gangrenous fauces; the respiration is sighing and intermittent; epistaxis and extreme prostration are present, and the tonsils and fauces are dark red and tumid.” Similarly it is valuable in measles, with a dark confluent eruption, oedema of face, stupor, &c. Malignant subtertian malaria cases, “bilious” remittent fevers and low types of fevers generally call for crotalus: “the tongue is dry, cracked, brown in the centre and deep red at the edges, the stools are pasty and black” (and offensive), ” the urine is dark and scanty,” drowsiness, lapsing into unconsciousness, prostration, yellow colour of face and skin, gnawing aching pain in liver and sometimes hepatization of base of right lung are present.
An American doctor called to a case of snake bite while attending yellow fever cases was struck by the clinical resemblance of those cases to that due to the bite of the viper (see page 578). Crot. is “the most homoeopathic remedy for yellow fever, with symptoms of blood-poisoning,” vertigo, “as if falling over a precipice”; pain all over the body and tenderness of the liver, or with swollen parotids, nose-bleed, dusky face, hands nearly black; yellow skin; dark, involuntary and bloody offensive stools; black, scanty or suppressed urine (haematuria) and haematemesis. (Modified quotation end here.)
The present writer, recently reading some cases of infectious jaundice (spirochaetosis ictero-haemorrhagica) in the British Medical Journal, was struck with their great resemblance to the provings of viper poisons. Crot. has indeed been recommended for that disease, and for the similar spirochaetal “seven-day fever”-with what results we cannot say. It is, however, known that crotalus and lachesis stand very high as therapeutic agents in the treatment of some of these fevers-notably yellow fever, plague, bad subtertian fevers, and black-water fever before anuria has set in. In many cases it is impossible for want of time, lack of apparatus or skill, to diagnose the parasitic cause, but where the clinical symptom-complex of drug and disease corresponds, the indication is clear and sure even without the microscope.
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,