Rheum officinale. Rhubarb. N.O. Polygonaceae. Tincture and trituration of the dried root.
Digestion.-Rhubarb contains an organic acid, chrysophanic acid, and a good deal of tannin.
The provings of rhubarb show that it acts mainly on the gastro-intestinal tract. It produces a sour or nauseous taste in the mouth and causes all food, even sweets, to taste bitter. The breath is offensive and there is nausea, which seems to be felt in the abdomen. The patient is hungry and desires food, but this changes to disgust on taking the first mouthful. The stomach feels full, as if overloaded, and there is throbbing at the epigastrium. The abdomen is distended and tense, wind seems to press up into chest and there is a sensation like a lump round the navel. Cutting pains occur about the umbilicus which compel the patient to bend double, are worse from standing, and come on soon after a meal. The colic may be followed by a stool. Hahnemann writes, “It is not an easy, liquid and copious stool, or a painless diarrhoea which is the primary action of rhubarb on the bowel, but rather a colicky and sometimes ineffectual urging to altered evacuations, which are nevertheless, always faecal.” Rhubarb stimulates the muscular fibres of the whole length of the intestine, but does not inflame the bowel or cause any increased watery or mucous secretion into it. It increases both the liquid and solid elements of the bile. The stools are pappy, brown, loose, fermented, turning green, and, characteristically, extremely sour-smelling. Before stool there is colic, and, may be, ineffectual urging to urinate. Evacuation of the bowel is accompanied and immediately followed by shivering and a feeling of tenesmus, with renewed urging in the rectum and pinching pain in the bowels, but no stool occurs till after a considerable interval. Urging to stool is increased by moving and walking.
Urine.-The urine is scanty and red in colour.
Back and Limbs.-Cutting pains are felt in the region of the lumbar vertebrae, which are increased by evacuation of the bowels, and there may also be cutting pains in the left loin, and in the left side of the hypogastrium, just above the os pubis. Bubbling sensations are described in the elbow-joints and from the bend of the knee to the heel. The limbs feel stiff and fatigued, especially the thighs.
Head.-There is a dull, stupefying headache, with heat and pulsation in head and dilated pupils. The scalp and forehead are covered with sweat after the slightest effort, and a cool sweat is present on the face, mostly round the nose and mouth.
Sleep.-The sleep is restless and the patient has vivid dreams, talks in sleep, tosses about and snores. Not only is breath and the odour of the stools sour, but the patient smells sour all over and washing does not alter it.
Skin.-Vesicular eruptions occur in the skin with discharge of yellow fluid from them.
Mind.-The patient is indolent, taciturn and morose, and, if a child, he demands all sorts of things impetuously and with crying.
Rheum has been used almost solely for the kind of diarrhoea it produces, and this is seen mainly in babies and children who are suffering from teething troubles. Besides being indicated by the colic and stools already described, it will be given with additional confidence if there are present the characteristics sour odour, the perspiration on the scalp and forehead, and the impatient, peevish temper of the child, who screams for things and then throws them away. He curls himself up in strange attitudes during them away. There is a tendency to frown.
Older people are suitable subjects for treatment with rheum if they have the characteristics diarrhoea. This sometimes results from eating unripe fruit, especially plums.
(1) Non-inflammatory diarrhoea of faecal stools.
(2) Evacuations accompanied by shivering and followed by renewed urging.
(3) Sourness of stools (mag. Carb.), secretions, and body generally.
(4) Perspiration on the scalp and face.
(5) Nausea felt in the abdomen.
(6) Sucklings, children during dentition.
From cold, uncovering (uncovering an arm or leg increases colic), standing, walking, summer, after eating, during teething at night.
From wrapping up, warmth, lying curled up.