Rhus toxicodendron (“poison oak, ” called also “poison ivy”) and Rhus venenata (“poison sumach,” called also `poison elder” and swamp dogwood”). N.O. Anacardiaceae. Tincture from the fresh leaves.
INTRODUCTION
THE effects of these two plants are well known, and bear a close resemblance one to the other. They are due to an extremely acrid volatile oil or emanation, and in sensitive subjects the proximity of the plant, without its being handled, is enough to cause at least the cutaneous effects. Some individuals, on the other hand, appear to be immune.1.
PATHOGENESIS.
An acute dermatitis having features resembling both eczema and erysipelas is constantly produced. The erythema is accompanied with a certain amount of cutaneous oedema, with vesiculation and intense itching. The vesicles are usually small, but may be bullae of
It is only right to add that these statements, supported by a former lecturer on materia medica at the School of Medicine at Westminster Hospital, and by very widespread experience, are regarded by no less an authority than Cushny as popular errors. Toxicodendron is, he states, not volatile. He explains the popular errors by pointing out that the effects are often delayed in their appearance and may (it is presumably argued) be due to contact with the virus on a previous unknown occasion. He throws doubt, without advancing evidence, on the supposed immunity of some persons;as regards toxicodendron as a local irritant this may be true. The suggestions may be made that some of the effects, not due to known contact, may be due to some not yet isolated volatile juices or principle. Considerable size. These effects may be due to handling the plant, to being near it and to consuming the tincture. Exposed portions of skin are not the only parts involved. After testing the tincture by the mouth, the skin becomes dry and even cracked, itching is intense, worse in the evening and in warm room, and after scratching, which is irresistible; redness and fine vesicles appear on the extremities, neck and scrotum. Where the cellular tissue is loose, ex. gr., lower eyelid, puffy swelling appears. Serous oozing takes place from the inflamed surfaces. Boils may develop on the face and arms. Aching of wrists, ankles and feet causes restlessness and loss of sleep, especially after midnight. Mucous and synovial surfaces may be affected, ex.gr., throat, ankle- joint, &c. Fever is not always present, but when it exists may be attended with delirium of a low typhus-like character; or the fever may be intermittent and accompanied by profuse sweating.
Headache, aggravated by walking and stooping, comes on, with lachrymation, aching of eyeballs, &c., Cutting pain about the umbilicus is produced, and though it is relieved by an action of the bowels, it is not cured. The stool is loose and blackish. These are the main symptoms of acute poisoning.
PROVINGS.
MInd.-The mental state is chiefly one of depression; sadness, tearfulness, desire for solitude, weariness of life are the predominant features. The patient feels worse in the house, and is relieved by walking in the open air. Other symptoms on the minus side are mental confusion, difficulty of understanding, forgetfulness of even quite recent event, and desire to die. These is disinclination for mental effort. On the side of irritation is fretfulness, ill-humour and impatience. Restlessness is a very marked feature and is compounded of an anxious mental state, and the results of the pain and irritation of kin, disturbing sleep and forcing the patient or prover to rise from bed and walk about-the itching predominating.
If delirium comes on it is low, mild type. The patient may have delusions and imagine he is going to be poisoned.
Head.-With the confused feeling is headache–a fulness, heat and heaviness in the forehead, pressing downwards. There may be a feeling as if something inside the head (“the brain”) were loose and striking against the skull; it is worse when stepping or shaking the head.
Occipital headache is sometimes present, and is relieved by bending the head backwards.
Giddiness is felt when rising from bed, as if intoxicated.” The scalp is sensitive; an eczema-like eruption, which oozes a sticky fluid, drying into crusts, is very irritable and causes the hair to fall out.
Eyes.-Swelling of the loose cellular tissues of eyelids and orbits occurs, and may go on to suppuration. In patients this condition may result from exposure to cold and damp; the lids feel paralysed. The eyeballs feel sore, and the edges of the lids stick together at night, and styes form on them; more pain on pressure or moving the lids and globes.
Ears.-Dermatitis, like erysipelas, of external ears, especially the left, may occur. Hearing is interfered with by a whistling noise, and by a sensation of wind blowing into ear.
Nose.-A free discharge of mucus in the morning is accompanied by violent sneezing; sometimes there is bleeding with it, brought on by stooping. There may instead be ulceration of the nostrils, with offensive discharge of pus.
Face.-In addition to the vesicular eruption due to the fumes (or emanations) of the plant, there may be stiffness and pain in the maxillary articulation, worse when yawning, and pain and swelling of the parotid glands.
Apart from these acute manifestation the complexion is pale and sickly, and the eyes sunken, with blue rings round them; the corners of the mouth may be ulcerated and sore.
Mouth and Tongue.-The typical buccal condition is associated with a febrile state. Blisters form on the tongue, which is dry and cracked, and covered with a dark brown coating. Saliva runs from the mouth during sleep, and the breath is offensive. Taste is perverted; food, especially bread, may taste bitter, or even putrid.
In the less severe cases the tongue may feel sore: its tip show a red triangle, and its sides be indented, and it may have a yellowish-white coating at the back. In the evening shooting toothache may come on, lasting into the night: the lower incisors feel long and loose; warm fluids in the mouth, and warm external applications, give relief.
Throat.-As part of the irritation of the poison the throat may be swollen and swallowing be impeded thereby. Or difficulty in swallowing may be due to a weak, paralysed feeling-a feeling, if not an actual fact, experienced in many other muscular groups. The submaxillary glands may, like the parotids, be hard and swollen.
Stomach, &c.-With loss of appetite there is special aversion from bread and meat, owing, apparently, to the bitter and putrid taste in the mouth. With dryness of the mouth and throat goes unquenchable thirst for cold water, worse at night. Nausea, eructations, and weight in the epigastrium after a meal (“like a stone”) are present. Alternatively there may be an empty feeling.
Abdomen.-Various pains are present, especially soreness in the belly, worse in the hypochondria and whole right side, worse on the side lain on, and worse on the side lain on, and worse from turning over or on beginning to move. Walking about brings relief, even though at first the patient is obliged to walk “bent double.” The cutting, griping pains and tympanites are worse after eating, and better from an action of the bowels, lying on the left side, and from lying on the back. Watery diarrhoea with distinct dysenteric features is induced by the rhus poison; the particular features of it are that it is worse at night, with colic, that some of its pains extend down the thighs, and that it may be involuntary. Or the stool may be merely yellow and frothy. Diarrhoea and constipation may alternate.
Urinary System.-Pyknuria with some urging, both day and night, recurs. The urine may be dark and hot, and soon deposits a whitish sediment on cooling (? urates). Incontinence may occur when the patient is at rest.
Sexual Organs.- There are no sexual symptoms as such. Dermatitis, with swelling or with blisters on prepuce, scrotum and vulva are part of the general cutaneous affection. It is strange that unexposed portions of the body should be affected if there are no volatile properties in the juices of the plants. Minute quantities may be absorbed, perhaps through the respiratory mucosae.
Respiratory Organs.-Tickling in the upper respiratory tract (behind the sternum), with rawness and scraping sensation, causes dry cough and oppressed, hurried breathing. The cough causes pains in the chest and stomach, and a shattering headache. Wet weather and rest aggravate the cough and pains. Sneezing and deep breathing, however, make the shooting pains in the chest worse. They are worse lying down, and in the evening before midnight.
Putting the hands out of bed is said to start a cough. Circulation.-Palpitation while at rest is a marked rhus manifestation, appearing to shake the body, but the pulse is rapid, small and soft. There is a trembling feeling in the chest.
Muscular System.-The back and limbs may be considered together. An aching or bruised feeling in any part is a constant feature, stiffness and a weak, paralysed feeling are also present. The modalities are much the same everywhere, namely: (a) Outstanding relief from continued movement (short of fatigue); (b) temporary aggravation and pain on first moving (as from rising from a seat); (c) lying on something hard seem also to relieve; (d) rest (therefore) generally aggravates, and the pains necessitate constant change of position; (e) aggravation from wet and cold north-east winds is pronounced.
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,