Stages of enteric and typhus also require lachesis or crotalus. Diphtheria, too, sometimes requires lachesis, especially when it begins on the left side, associated with the spasmodic (constructive) symptoms of faucial and laryngeal origin, with the sensitiveness of throat and larynx to touch or pressure of hand or clothing. Prostration and heavy bluish-red flush on face (indicating commencing carbon-dioxide poisoning, whether from respiratory on obstruction or destruction of red blood-cells), with aggravation during sleep and on waking, are essential indications. For post-diphtherial laryngeal paralysis, palatal paralysis, laryngitis, spasmodic cough, pertussis with toxic symptoms waking patient from sleep, some low forms bronchitis and pneumonia, and for cough of reflex origin (of pelvic or abdominal source), lachesis will require study, and if the lachesis diagnostic symptoms be present in the patient it will not cause disappointment unless his responsive reaction be already exhausted.
Mental States.-The mind symptoms of the drug are chiefly valuable in guiding to its selection in chronic and neurotic cases, but they may point to its used in a few cases of actual alienation where the symptoms are not part of a name disease. Delusions of being away from home, of robbers being in the house from which the patient feels he must escape: mental disturbance with great loquacity or muttering delirium during fevers, religions melancholy, and extreme unfounded jealousy, frequently point to lachesis. The religious aberration may take the form of self-accusation of misdeeds of which the sufferer is innocent; of a desire to confess imaginary crimes amounting to mental torture if the opportunity does not present itself; of the feeling of being unpardonably wicked, Suspicion of being poisoned or of plots to murder him or her may possess the mind. Delusions of being somebody else or of being under the control of superhuman powers may be present; these powers seem to be commanding the patient to kill or steal, Fears of insanity coming on, of natural or eternal death, that God’s promises do not apply to him or her, may add to the patient’s misery, and may result in feelings of revenge or acts cruelty.
Other indications are furnished in the section on pathogenesis.
Headaches.-The only symptoms connected with the site of pain in lachesis cases which are of much value in selecting the remedy are the unilateral left-sided situation, and the radiating pains mentioned on p. 578. For the rest, the sites are so many that they are of little help. Waves of pain, not synchronous with heart-beats somewhat resembling the waves of heat or flushes in the face and elsewhere, spread from the neck up over the head. They come on suddenly, possibly after some movement or exertion, and settle into a quiet ache or disappear gradually. The headaches may be associated with momentary confusion or vanishing of thought or consciousness, somewhat resembling petit mal.
The pains are various in character.-bursting and throbbing in head or all over simultaneously, and weight or pressure are common varieties.
Head and heart symptoms in lachesis cases often go together, weak, quick pulse, throbbings and palpitations. In neuroses (ex. gr. menopausic), flushes and perspiration and flushed face are added to the head pain. In cardiac cases the face may be purple or mottled, and the body and limbs cold. In antagonizes chloral in its action on the heart (Linn Boyd).
The scalp may be sensitive to a light touch, but hard pressure relieves. Noise, conversation, motion, vibration but firm pressure relieves.
Eyes.-Lachesis is not much used for external ocular troubles (conjunctivitis, &c). For dimness of sight from muscular fatigue, with black flickerings before the eyes, worse in the evenings; for aching in the eyes, relieved by open air; for blue or fiery rings round artificial lights, and photophobia especially in direct sunlight, lachesis may be required. It has also found a plus place in the treatment of optic neuritis and retinal haemorrhage, with or without albuminuria. The eyeball is painful and “feels as if squeezed”-possibly indicating increased intra-ocular tension. The possibility of glaucoma requiring surgical aid must not be overlooked. If that is unobtainable, or for any reason undesirable, lachesis should be thought of and its general indications studied in connection with the case. The ocular pains and dread of light are worse after sleep or from touch; touching the throat may cause pain in the eyes. The eyelids may be puffy.
Special Senses.-Sight, hearing and smell are painfully acute, and the external parts-globe, meatus auditorius, nose, all sensitive to touch. Eustachian catarrh and thickening come on, and nasal catarrh and headache may accompany other symptoms. The nasal orifices and bones are sore, and ozaena with foetor and discharge of thin, dark blood would suggest the use of lachesis in nasal syphilis or tuberculous conditions.
The facial aspect will vary with the nature of the case- bluish from venous stasis in cardiac conditions, jaundiced or sallow in liver cases, dusky and besotted in septic cases, mottled in the same and in alcoholic cases, pale and cold in collapse. Lachesis may correspond with any of these conditions.
Mouth.-As a part of a septic condition the mouth may be slimy, the gums bleeding easily, the breath foetid; or the tongue may he dry and dark or black, with red edges, hard and leather- like, or dry, red and shiny, as if varnished. Enunciation may be thick and indistinct from these states or from mental dulling; the patient may be unable to control the tongue-it trembles or jerks or catches against the teeth during efforts to put it out- which attempts are liable to be painful.
Thick, stringy saliva is excreted in excess, efforts to spit it out are ineffectual and it runs away.
Throat.-In diphtheria, lachesis has proved of great service, and there are experienced practitioners of homoeopathy who believe that with this drug and cyanide of mercury, a large proportion of diphtheria cases may be cured without antitoxin. It is probable that the drugs and the antitoxin are not incompatible. The drugs stimulate the formation of a natural antitoxin by the patient’s own tissues, and that is supplemented by mass introduction into the circulation of a similar antitoxin produced by the horse’s tissues.
Clinically, the site of the diphtheria-infected tissue is not of much value as an indication for lachesis; membrane may be visible or not; also any degree of severity may be present in a lachesis case. The indications are: a decided tendency to bleeding (noticed after a choking cough), the blood being dark; decided foetor; origin of the attack left-sided, warm drinks aggravate and tend to induce choking, cold drinks less so, solids are swallowed more easily than fluids, aggravation in a warm room (cough, choking), sensitiveness to touch, aversion from clothing round neck, clutching at throat due to a feeling of obstruction to breathing or constricted feeling, a bluish colour of the mucosa, especially around patches of membrane or ulceration.
Less often lachesis is useful in tonsillitis; such of the above symptoms and modalities as are relevant must be present to justify its use. For the follicular form, however (especially of the left side), when the orifices of the follicle are seen to be plugged with white mucus, which may be mistaken for membrane, and may lead to an erroneous diagnosis of diphtheria, lachesis has been found to be a useful and reliable remedy (merc, biniod.).
Female Sexual Organs.-Lachesis is one of the most used and most useful remedies for menopausic discomforts. Its routine use, regardless of its modalities, tends to bring it into disrepute. The general aggravation from heat, in the evening and after sleeping, should be among the patient’s symptoms. The waves of pain and of heat, i.e., “flushes,” are chiefly felt in the upper part of the body-neck and chest to head, sometimes with perspirations. Headaches, burning and weight on the vertex, and throbbing are frequent accompaniments, as also in nausea. Sometimes the daytime flushes are replaced at night by chills.
The menstrual pains are intermittent, they may extend from the pelvis up to the chest, or a definite sharp, the navel. If the pain is unilateral it is usually on the left side, and may pass over to the right. This would be an indication in ovaritis or ovarian pain. Pain just above the left groin attributed to subacute salpingitis has often yielded to lachesis. The flow is also liable to intermit, and if it stops, headache, &c., comes on, being relieved by the return of the flow. The patient feels better during menstruation than at other times. Suspension or delay of this or other discharge may mean distant symptoms, which disappear when the discharge is re-established. Diarrhoea before menstruation is another lachesis indication.
Abdomen.-Peritonitis with influenza, or from coli or gonococcal infection may require lachesis. The extreme sensitiveness to superficial skin touch, to touch of clothing or bands round from a warm, close room, after sleep or in the evening, would be guiding symptoms. If the peritoneal covering of the uterus were involved, labour-like pains might be present.
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,