The tissue most affected is fibrous tissue-joints, tendons, aponeuroses and muscular sheaths.
The sites are the neck, back (especially loins), arms, elbows, wrists, hands, fingers, legs, ankles. Cramps and paretic feelings are more common in the lower than the upper extremities.
An apparent exception to the relief from movement is stitches in the back, worse when walking or stooping; and an apparent exception also to the warmth (relief) modality is a “tingling” pain in the shafts of the tibiae. or at night when the feet are covered.
Rhus radicans appears to cause a pain definitely following the course of the ulnar nerve (compare kalmia).
Skin.-The skin lesions have been sufficiently described. It should be stated, however, that the itching and burning, which are common feature, may be accompanied by the sensation of being “pierced with hot needles.” The itching is most in the hairy parts. In rare cases, a measles-like, reddish, mottled rash may be present. Desquamation follows the dermatitis. A certain periodicity may characterize the skin eruptions in patients-they are liable to recur in the late spring.
“The more acid and irritating the eczematous exudation the less marked are the rheumatic symptoms, ” is a useful indication for the rhus venenata.
Sleep.-Sleeplessness is the natural result of the itching and the rheumatic pains, which often drive the patient out of bed. Anxious dreams of the day`s business wake him from his first sleep; he cannot lie on his back. Incessant yawning, with pain and cracking in the mandibular articulation, disturbs rest in the evening.
Fever.-The febrile modalities have been brought out by clinical experience, and will be further alluded to in the therapeutics section.
THERAPEUTICS.
Rhus as a poison and a remedy, furnishes an apt illustrations of four facts: (1) That the information obtained by the gross poisonous effects is limited, and for therapeutic purposes correspondingly limited in value; (2) that tested on the healthy, a wider and more detailed pathogenesis is elicited; (3) that on the homoeopathic principle, all the pathological effects can be utilized for therapeutic purpose; (4) that when a drug is introduced to the profession as something like a specific (ex. gr., as in the case of rhus for :rheumatism”) it has quickly fallen into disrepute because prescribed indiscriminately for cases bearing a certain name, rather than for an individual suffering from a diseased state, and with clearly defined indications and limitations.
Rhus has been seen to have a wide pathogenetic power, wide in the sense of affecting many areas or sites; but its remarkably consistent. The same is true of its therapeutic powers.
The curative spheres of rhus will be considered as follows: A list of the named diseases or diseased conditions for which it is useful will be given, on the clear understanding that to secure success it must only be prescribed for patients who have not only the named disease or disorder, but who likewise have clearly marked the modalities of the drug. These will be re- stated later.
(1) Rheumatic and rheumatoid affections, chiefly of a chronic or subacute nature, but if the following modalities should chance to be present in acute rheumatic cases, or as part of a toxic or septic :complex,” rhus will still be the right remedy.
(2) Traumatism. -The results of sprains and strains are helped by rhus, taking the former to mean sudden external violence and the later over-exertion, such as too violent exercise in sports, or other forms of taxing the strength of a tissue or organ beyond a legitimate point, as in running, and rowing races, or even too long a walk. Traumatism in the sense of direct bruising is not intended; ligaments and tendons are chiefly involved.
(3) Neuralgia due to implication of the fibrous sheath of nerves, causing numbness, stiffness and cramps.
(4) Neuritis involving the same tissues.
(5) Paresis or muscular weakness is conspicuous, often described as “paralytic.” In some cases it may merit this description, being the due to diminished efferent nerve impulses. More often it is probably due to some “rheumatic” condition having a metabolic origin, and it may be associated with venous stasis, chronic ore subacute fibrositis or myositis. In any case, pain and stiffness “a lame feeling” – are present clinically.
In any of these the pains may be brought on or aggravated by one or more of the following causes; Exposure to wet, cold weather; getting wet; damp seats or beds; north-east winds, especially when the patient is over-heated; living in damps houses, or working in water.
(6) Dermatitis.-The main feature in rhus eruptions-in addition to erythema-is vesiculation; thus is seen in vesicular eczema, with oozing, eczema impetiginodes, herpes, especially herpes zoster, pemphigus, erysipelas. Itching is of a burning and stinging nature, worse on hairy parts. The areas affected are any exposed part (scalp, face, hands, &c.), and genitals (especially scrotum) and trunk.
Acne urticaria, pruritus vulvae, prurigo senilis, are other skin lesions for which rhus is useful.
(7) Boils and carbuncles with dark red margins.
(8) Cellulitis, both before and after suppuration, with dark red cutaneous covering; abscesses.
(9) Glandular enlargements, either lymphatic or salivary (parotitis, &c.) may go on even to suppuration; mammary abscesses.
(10) Fevers of a “low” adynamic type often require rhus, but they are not of the most severe kinds, requiring crotalus, arsenic, &c. It is the condition, not the name of the disease, which influences the choice, but amongst the following named disease rhus cases will from time to time to be found: Scarlet fever, measles and other exanthemata with dark and irregular appearance of rash; typhus fever and typhus-like (“typhoid”) conditions, and diphtheria; typhlitis and perityphlitis, peritonitis, enteritis; puerperal and other sepsis; dysentery. Dengue is especially well simulated by rhus.
Mild delirium, stupefaction, extreme restlessness (in early stages, epistaxis sordes on lips and teeth, dry, red, cracked tongue and oedema of affected parts.
(11) Eyes.-Blepharitis, with sticking of lids, oedema of lids with Cellulitis, orbital Cellulitis; purulent ophthalmia, ophthalmia neonatorum with great photophobia; phlyctenular and “strumous” ophthalmia; iritis, especially rheumatic and gouty; (glaucoma?); ptosis and other ocular paresis brought on or made worse by cold, especially cold, damp winds; pains, &c., after cataract operations.
(12) Otalgia, with throbbing worse at night, otitis media and externa.
(13) Chronic nasal catarrh in rheumatic subjects.
(14) Sore throats, with darkish colour of mucous membrane; swelling.
(15) Dyspepsia, with flatulence and “a lump” in the epigastrium, “like a stone there”, dysentery, with crampy, griping pains, extending down the thighs.
(16) Piles and anal fissure.
(17) Post-operative paresis of bladder, retention of urine; cystitis; oxaluria.
(18) Membranous dysmenorrhoea: threatened abortion, especially from overlifting, straining, &c.; offensive lochia with (mild) puerperal sepsis: phlegmasia alba dolens. In all cases the modalities of rhus should correspond with those of the patient.
(19) The respiratory affection are chiefly those associated with febrile affections-laryngitis or diphtheria, bronchitis and pneumonia with septic symptoms. Haemoptysis may be present.
(20) Cardiac hypertrophy from over-exertion in gymnasts, where muscular failure has temporarily occurred; rheumatic, even organic, heart affections, where the muscular tissue is giving out, with weakness, pain and numbness in the left arm.
(21) Rhus was formerly used in the Southern States of North America as a substitute for “bark”. It may be required occasionally on homoeopathic principles in malaria, where there are rheumatic symptoms, tearing cough and profuse perspirations- chiefly in chronic cases.
(22) Sleep is disturbed by pains which necessitate constant change of position, even driving a patient (if not too ill) out of bd. Fears and suspicious keep him awake before a stage of stupor has been reached. Dreams of undergoing great fatigues are occasionally. Dreams of undergoing great fatigues are occasionally noticed.
LEADING INDICATIONS.
(1) Movement Modalities.-(a)Aggravation of pains from rest and on first movement; (b) as a corollary relief from continued gentle movement, short of fatigue-fatigue brings back the pain; (c) a very marked degree of restlessness, necessitating constant change of position, or even getting out of bed and walking about.
(2) Temperature and Weather Modalities.-Next in importance (if not co-equal) are (a) aggravation from damp, cold weather or rooms, from damp beds, cold winds; and (b) corresponding relief from warmth-warm air and warm applications; (c) aggravation in the air (cough, &c.).
(3) Site.-Most of the pains and lesions (in patients) are: (a) right-sided (exceptions are left-sided sciatica and pain in the left arm in morbus cordis cases); (b) hairy parts (itching).
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,