FUNCTIONAL REMEDIES OR REMEDIES PROPERLY CALLED HOMOEOPATHIC
Let us now speak about functional remedies which are legion. They are numerous because the question of chronic rheumatism has not yet been properly solved. Often we have failures. Gradually as we arrive at a good knowledge about a question and get good results, we make a selection of remedies (as for example we have simplified the treatment of diphtheria in 50 years). It is impossible to keep in mind all the remedies used in the treatment of chronic rheumatism. Each among us does not use more than 35 to 30 medicines while nearly 150 medicines are indicated in chronic rheumatism. It is often said that one does not cure a patient because one has not used the best remedy. However we must try to find out the good remedies.
Before enumerating the remedies and classifying them in groups, I must insist on a special point the localisation.
The young homoeopath who takes a repertory finds it ridiculous to learn that question when he finds that a remedy is given for the wrist, another for the second phalange of the index of the right arm, another for left knee etc. For a long time I also believed that it is stupid to classify the remedies according to the localisations. But such a reasoning is ridiculous because the remedies act according to the local tropism; there are some affinities in relation to the tissue which we cannot yet explain. It is always Dr. Nebel and his successors who have put the question. It may seem absurd to localise too much. It is the homoeopaths who should try in the future to understand well the importance of localisations. In any case we must remember that some remedies have local affinities. It is a very interesting and important question, unfortunately very difficult to answer. Here is how we have classified the functional and organic remedies of chronic rheumatism.
Let us take up Calcarea carbonica with its troubles of metabolism of calcium. By its side we may places Calcarea phosphorica and Calcarea fluorica. The latter acts well in the 3x when you have cartilaginous as well as bone and muscular pains in persons whose articulations are deformed, whose ligaments become ossified. He begins for example with a rheumatism of the spinal chord which becomes later on hypertrophysing osteitis. You will often find syphilis in the heredity. You will often find syphilis in the heredity. Calcarea carbonica may be given to big, fat, soft, chilly, hesitating and indolent persons who think that they will never be cured.
Sulphur has digestive and hepatic troubles when he has rheumatism The very moments he begins to have rheumatism he will require other remedies.
This subject for example has periodic diarrhoeas alternating with rheumatism. You can give him Dulcamara. He may have enterocolitis with swelling of the abdomen, false membranes in the stools aggravation by sweets. He may have arterial hypertension, buzzing in the ears, congestive troubles. He is often a great eater who is never satisfied. He feels weak when he is hungry, feels better after eating . He may have cutaneous troubles in the relation with his digestive troubles. Antimonium crudum is related to Sulphur. He is rheumatic, having always a white-coated tongue with distended intestine, who feels better after a laxative or if a good intestinal drainage is effected.
Nux vomica may also be used as a complementary to Sulphur. By the side of these satellite remedies of sulphur in chronic rheumatism we have another group that acts on acute articular rheumatism. The best remedies are Ferrum phosphoricum Bryonia, Rhus tox, Apis, Pulsatilla. These remedies will be useful in persons who suffer from rheumatism with occasional and periodic acute or sub-acute inflammation. Suddenly the joints are attacked. It is a form of gouty rheumatism.
Ferrum phosphoricum and Aconite have intense pain dry heat, joints painful to touch, with possible fever but not yet any swelling. Aconite has aggravation in dry cold. The subject then passes to the stage of Bryonia; amelioration by rest, aggravated by movement, pricking pains, painful joints, clear intra- articular rheumatism, often fixed. From Bryonia the evolution is towards Rhus tox and Apis. Both are complementary to Bryonia but incompatible. These are two horses of the same harness but they go different directions. Rhus tox has the modalities inverse to those of Bryonia and we then enter into the group of hydrogenoid remedies which we will soon see. From Bryonia the patient goes to Apis.
The subject will have then all the symptoms of Apis: pale, rosy swellings, pains redness but the swelling is predominant.
After Apis, or even without passing through the stage of Apis, the patient may come to the field of Mercurius solubilis. Often the rheumatism is aggravated at night. The patient has frequent sweats, oily, bad smelling sweat. The mouth is moist but no thirst.
After Mercurius you have the stage of Pulsatilla and of Silicea. If the patient has suppurations he enters into the stage of Hepar sulphur. Pulsatilla and Silicea often indicate venous congestion, amelioration and finally cure. At this time you can use Sulphur to check periodical relapse.
The chronic rheumatic patient may follow two paths. That of the digestive and hepatic troubles and that of periodic attack of acute or subacute rheumatism.
The other groups are related to Lycopodium, Natrum sulphuricum and Thuja.
Lycopodium has a kind of acid diathesis which is related to dehydration of albuminoids. Thus it has as complementaries the salts of Lithium: the carbonate, the benzoate, Benzoic acid and also Ammonium benzoicum, a group of four remedies which may act as complementaries of Thuja, but they are at that stage complementaries of Lycopodium. If you use these remedies empirically and not in Lycopodium subjects you will get only inconstant results.
They act better in lower dilutions and in ponderable doses. The high dilutions are generally inefficacious. Sarsaparilla and Kali carbonicum may be placed in this group.
The hydrogenoid group is more homogeneous, and most easy to manipulate. The most important are Rhus tox and Dulcamara which are drainers of Natrum sulphuricum and Thuja. The subject has the need of being drained by Rhus tox (which acts better when applied in the morning), by Rhus radicans or any other Rhus. Rhododendron is aggravated by cold and in humid weather. Rhus tox is one of the most unfaithful remedies, it often fails. When it fails Rhododendron may be used. Perhaps we do not know well the application of the dilutions of Rhus tox or its preparation is not from fresh plant. It is always difficult to have an active Rhus.
Dulcamara is aggravated by humidity or in summer after having suddenly taken cold or having seated on a humid place. Ranunculus bulbosus has, like Rhus tox, some cutaneous affections, eczema or neuralgia or rheumatic pains of the intercostal spaces. Aranea diadema is a typical drainer of all hydrogenoids specially of Natrum sulphuricum: you may use it in 3x in Natrum sulphuricum subjects with Rhus tox 30.
We must not forget that there are other drainers of hydrogenoid state. I cannot indicate all of them here. As for example Nux vomica and Ipecac are often very good drainers in these cases. Ammonium causticum may be related to Aranea diadema. The patient is weak, and down out.
Let us now pass to the compounds of Iodide. It is certain that in allopathy Iodium gives good results in some forms of rheumatism. I think that when we use Plumbum iodatum, Natrum iodatum, Kali iodatum in lower dilutions we somewhat behave like the allopaths without knowing it. Similarly the allopaths sometimes do homoeopathy without knowing it. The most important of these remedies is Kali iodatum which is a remedy for syphilitic condition.
There is another group of remedies which goes out of our field. They are remedies for neuralgia. These remedies are to be given to persons having hybrid pains, neuralgic as well rheumatic pains. It is the group headed by Kalmia, Guaiacum, etc.
Kalmia is used in the rheumatism of upper limbs. Ledum palustre is used in the rheumatism of the lower limbs. Kalmia is very erratic, it has fulgurating pains. In Ledum palustre the pains go from above downwards.
Guaiacum is related to Thuja and to all remedies that act on the rheumatic pains and at the same time on kidneys. When Rhus tox or Dulcamara do not act you may use this remedy specially when the neuralgia alternates with numbness.
Derris pinata was indicated to me by Dr. Cartier who insists on three remedies which are less known.
Radium bromide is used in homoeopathy in the same manner as it is used in allopathy as radium pomades, which act well in rheumatic patients. It is a good remedy but sometimes aggravates. It must be given in high dilutions. Magnesia phos is to be used in patients suffering from neuralgia who has some very acute pains. The patient cannot bear the pains like that of Chamomilla; he is hypersensitive. These patients have pains at the roots of hairs. Oxalic acid is interesting in chronic rheumatism. The patients have atrocious pains with neuralgia, neuritis and some phenomena that may lead us to think of myelitis.
In relation to Silicea we must think of all the remedies acting on rheumatism of bones. Ruta acts specially on cartilages and has the sensation as if the pains are from a bruise. In all affections of bones you will find syphilis as a cause. I insist on the value of Phytolacca. It is to be given repeatedly in 3x. I only mention here the other remedies: Mezereum, Kali bichromicum, Kali iodatum, Stillingia, Mercurius, Aurum. I often use Silicea 200 followed by Ruta 30, Arnica 30, Phytolacca
With Pulsatilla we have the remedies of venous and capillary congestion and circulatory troubles. It is a very important remedy. The group of remedies having erratic pains is related to it and Stellaria is related to circulatory troubles. Kali bichromicum, Lac caninum, Kali sulphuricum are complementaries of Pulsatilla and have like it erratic pains . Colchicum, Ferrum metallicum and Sanguinaria are not erratic.
I have indicated them here because they have circulatory troubles. Colchicum is a remedy for gout, the pericardium is affected by this remedy. Ferrum metallicum is a remedy for anemia and rheumatism of the left shoulder whereas Sanguinaria is a remedy for the rheumatism of the right shoulder.
Finally you have in Cimicifuga a remedy for muscular rheumatism. The first remedy of this group is Arnica, which has contusions and muscular pains. Lac caninum was a patient of Lachesis who has passed into the field of Cimicifuga. Lac caninum is an excellent remedy for rheumatism with neuralgia and pains coming during menopause. Caulophyllum is a good remedy to open a recalcitrant col uteri. It is marvellous for the muscles of the sphincters. Actea spicata is a very important remedy for rheumatism of small joints.
Colocynthis has cramps coming out of cold, better by bending double. Agaricus has spasms, cramps and muscular jerkings. Ranunculus bulbosus, Bryonia and Lachnanthes act on torticollis vertebral rheumatism.
Ground remedies of secondary importance are Nux vomica in relation to Sulphur; Graphites is related to Calcarea carbonica; Arsenicum album is related to Lycopodium; Iodium is related to Cimicifuga, but these remedies are less important.
There are great many more remedies that we could have indicated, but to be more practical we have limited ourselves only to the principal remedies.
SYMPTOMATOLOGY OF THE REMEDIES FOR RHEUMATISM
Phosphorus :- This remedy has particular affinity for the tissues. For this reason its field in rheumatism is very wide. Its pathogenesis is not yet well known but its homoeopathic application must be very wide. It is Dr. F-Bernoville who says that this remedy is to be tried in old sclerous rheumatic patients, having tendency to ankylosis.
Its symptoms are: The patient is generally old having tendency to sclerosis: he is of syphilitic type. Feet are cold; hands hot or burning. Pulse often rapid. Head is easily congested; tendency to vertigo. Desire for cold drinks. Great sensitiveness to change of weather, specially to stormy weather.
The 200th potency is used at an interval of 20 to 30 days according to the reappearance of the symptoms.
Its marked effects on pains as well as on the general condition of the patient have led us to think that in the treatment of chronic rheumatism, this remedy will be necessary to one time or another.
Sulphur:- We are going to give here only some characteristics of this remedy which are seen in chronic rheumatism. (a) Chilly patient, eats less, has itching of the skin with or without eruption. Feet are cold, head is hot. The articulations are stiff and crackling. Drawing and burning pains in the evening or at night, during change of weather. Hyperthyroidism patient. In this case Sulphur is used in decimals, frequently repeated with Thyroid which is given in ponderable doses.
(b) The patient is always very hot, with the feet burning. Congestion of the face, lips and ears are red. Hunger and thirst, goneness feeling in the stomach at 11 A.M. morning diarrhoea. Itching at night in the heat of the bed.
The rheumatic affections are not so much stubborn as in the first type. Use Sulphur 200. A few doses will soon give good results.
Thuja:- It is an antisycotic remedy. It is very often indicated when there is the history of gonorrhoea. Here it is complementary to Medorrhinum. But for its use one should depend on its totality of symptoms even when there is no history of gonorrhoea.
Its characteristics are:
Aggr. cold damp weather. It can be compared with Natrum sulphuricum, Rhus tox and Dulcamara
A left sided remedy. Aggr. 3 to 4 a.m.
Articular pains worse during rest. The patient must move when he is in bed. If he is not sycotic says Kent, Rhus tox will cure him, but when sycosis is intricated in the case thuja or Medorrhinum will be necessary to complete the cure specially when the symptoms appear after the suppression of gonorrhoea. Dark persons with black hair, corpulent, having a big belly, thick skin, greasy, with accentuated features. Varicose veins of the nose; localised sweats of the uncovered parts. Particularly the soles of the feet are sensitive (Medorrhinum).
Tendency to growths (cauliflower growths, condylomes, naeve), Action of Thuja should be completed by Medorrhinum or T.R. Afterwards the symptoms of Sulphur will appear.
Lycopodium:- Lycopodium is an auto-intoxicated, sedentary type, whose liver does not work well. Uricaemic, later on uremic persons.
It has calcium and uric acid deposit on joints.
Persons with emaciated thorax limbs have weak muscles, with the face like that of an old man, having transverse frontal wrinkles; yellow spots on the temples; slow digestion of farinaceous foods; somnolence after meals with distention of the stomach; vertigo, loss of memory.
Aggr. of all symptoms between 4 and 8 p.m.
Drawing, tearing pains aggravated by hot applications amel by slow movements. Desire for constant movement of an arm or of a leg. On foot cold the other hot. Specially the elbows and the small joints are affected (compare Medorrhinum, Natrum phos, Ruta)
Red sand deposit in the urine. The general condition becomes good after this deposit.
At the beginning of the treatment lower dilutions are necessary because a high dilution may block the liver and may cause congestion. The drainer of Lycopodium are Chelidonium, Carduus marianus and Taraxacum (in decimals).
The articular drainers are Bryonia, Rhus tox, Argentum nitricum, etc.
Bryonia :- It is an important remedy for synovitis (Apis. Cantharis). It will be frequently indicated.
Its characteristics are very clear. Stinging pains in joints, very sensitive to pressure (by tips of finger, but better by wide pressure by palms). This characteristics is marked in acute cases when there is strong effusion. However, it is used in chronic cases.
Articular serous inflammation explains the characteristic of the remedy. Aggravation by the least movement. Aggravation by continuous movement. The patient tries to remain completely immobile. The pains are generally fixed and is slightly ameliorated by local heat.
It is the opposite of Rhus tox which is a remedy for the periarticular tissue.
Teste speaks of a Bryonia type with firm flesh, accustomed to rich food. Kent speaks of a gouty type having renal troubles. Others describe Bryonia as a lean, dark, subject with bilious colour of the skin. Clarke says that because of its very wide action we should not look for a definite type.
The chronic type of Bryonia seems to be an auto-intoxicated whose liver and kidneys do not function well. He cannot bear prolonged physical fatigue and excess of dishes. Generally it is a remedy for the serous membranes. It is related to lycopodium, Oxalic acid, Rhus tox.
Rhus toxicodendron :- It is a remedy for the fibrous tissues (Ruta, phytolacca, Rhododendron). The modalities are important: Aggr. by rest and by the first movement. Amel. by continued movement. It is complementary of Bryonia. There is alternation of symptoms in these two remedies. Amel. by heat and aggr. by cold and damp weather.
Compare with Kali iodatum which has aggr. by movement. But Rhus tox is chilly and wants heat and is easily fatigued. Kali iod wants cold, and bears exercises without marked fatigue.
Causticum:- According to Nash Sulphur, Rhus tox, and Causticum are frequently indicated in chronic rheumatism.
Its symptoms ar almost similar to those of Rhus tox. They are to be distinguished. Rhus tox is continually in movement, while Causticum is restless only at night, movement does not ameliorate his pains.
Rhus tox has aggravation in cold and humid weather while Causticum is aggravated in dry weather and particularly in dry cold weather. It is a remedy for tendons which have a tendency to become retracted. The joints are stiff, painful, movement with the sensation of being scorched. Causticum has often a great weakness with a tendency to paresis and trembling. 12th and 30th dilutions are generally suitable.
Argentum nitricum :- We have often seen the rapidity of action of this remedy on pains we well as on functional troubles. In our observations it is applicable to the following symptoms:
Stinging pains as if from splinters, but we have also seen that even when this symptom does not exist there is often very rapid amelioration.
Frequent modalities are: Aggr. by first movement even continued; amel. by heat, by wide pressure.
Associated but not constant symptoms: Desire for sugar; tired look often seems older than his age. The symptoms are associated with those of Lycopodium and Arsenicum album.
This remedy generally acts on lumbo-sacral pains and on pains of small joints and big joints. It seems that this remedy has affinity for synovial as well as peri-articular tissues. The rapidity and persistent action of this remedy used in different cases have led us to think that though this remedy has not well characterised modalities yet it should be one of the important remedies for chronic rheumatism.
Other remedies :
Actaea racemosa (Cimicifuga)- Muscular rheumatism. Aggravation of all symptoms during menses (inverse-Lachesis). Often used in pains of menopause.
Apis :- Chronic rheumatism with or without exudation. Aggr. by heat; amel. by cold application. Sharp stinging pains.
Local hypersensitiveness. Absence of thirst (Apis 200).
Compare: Cantharis and the serpent poisons.
Benzoic acid – Rheumatism related to the infection of urinary tract: colibacillosis or other. Strong, repulsive odour of the urine. Very great pain in the renal region. Articular pains aggr. by movement. Pains of tendoachillis (Ruta)
Berberis vulgaris – Erratic gouty rheumatism. Charged urine. Cutting and beating pains in the renal region (left) radiating to the thigh. Hepatic troubles.
Calcarea fluorica :- Complementary of Rhus tox by its affinity for fibrous peri-articular tissue; aggravation by rest, by cold and by humid weather, amelioration by heat and movement. Hereditary malfunction of the pituitary.
Calcarea phos :- Rheumatism of small joints. Rapidly changes place. Amel. of pains by closing hands concomitant uterine troubles.
Colchicum :- Gouty rheumatism; erratic pains extremely painful; aggr. at night and by movement. Affinity for toes. Hypersensitiveness with great weakness. Intolerance of smells. Distended abdomen.
Dulcamara:- Articular pains, aggr. by change of weather (humid weather). The modalities are similar to those of Rhus tox. It is often an acute of Natrum Sulph.
Elaps carolinus :- Patient suffers from obesity, congestion, hypertension. Somnolence. Gouty modalities. Large elimination of uric acid with the urine. Diabetes.
General symptoms are similar to those of Lachesis (gushes of heat, desire for fresh air, aggr. after sleep). Generally 30th potency is used.
Formica rufa:- Rheumatic troubles related to a renal infection (colibacillosis). Bad smell of the urine, pyuria. Burning erratic pain, aggr. by movement, cold application, before snowfall. Amel by heat, by rubbing, after midnight. Profuse sweat that does not ameliorate.
Kali bichromicum:- Acute pains, rapidly shifting from one joint to the other (lac caninum, Kali sulph, Manganum, Pulsatilla, Stellaria media) Pains appear and disappear rapidly (phytolacca).
Rheumatic and digestive troubles alter. Affinity for small joints (Caulophyllum, Ledum, Lycopodium, Medorrhinum, Ruta) Sensitiveness of bones (particularly of tibia). Heels are sensitive. Aggr. at night and by cold.
Kali iodatum:- A remedy having affinity for fibrous tissue and periosteum. Pasty swelling of articulations (particularly of the knee). Bone pains. Tibia sensitive to touch. Rheumatism with pains worse at night and by immobility. Gouty old persons, must move ceaselessly, want open air, and have great heat. Fatigue when remains immobile and suffers much: he can walk for a long time in the open air without fatigue, specially when the weather is cold.
Kalmia :- Rheumatic spasms from above down-wards (inverse Ledum). Fleeting, lightning-like pains; erratic pains. Heart troubles of the gouty, with acute pains in the heart. Slow pulse. Lac caninum :- Great shifting of pains from left to right or right to left.
Ledum:- Ascending rheumatism. Localised on feet, soles are sensitive (Antimonium crudum, Medorrhinum, Thuja, Natrum, Sulph). The patient is particularly chilly but his rheumatic pains are ameliorated while bathing in cold water and the heat of the bed aggravates the pains.
Natrum muriaticum:- It gives good results in rheumatism of persons living at sea-side and when other remedies have failed. It is used in 6x or 12x.
Natrum Sulphuricum :- Auto intoxicated persons suffering from insufficient function of the liver and retention of water, having tendency to obesity, having periodic morning diarrhoea. Insufficient function of glands. Aggr. by humidity (by all sorts of humid atmospheres). Amel. in hot and dry atmosphere. Periodic asthma and skin troubles. Different articular pains; aggr. by rest; in humid weather. Soles of feet are very sensitive, sometimes with burning sensation.
Complementary: Aranea, Arsenic alb., Dulcamara, Rhus tox, Thuja
Petroleum:- Stiff and painful articulations; crackling. Sensation of localised coldness. Burning of hands and feet so that the patient puts them out of the bed. Aggr. in winter, by change of weather in cold air. Amel in summer. Dry, rough skin, easily cracks, specially in the winter season. Itching Gastric troubles. Petroleum is often indicated in chronic gonorrhoeal catarrh and it is used in arthritis of gonorrhoeal origin.
Phytolacca:- Affinity for fibrous tissue and periosteum. Erratic pains coming and going suddenly like electric shocks (Kalmia, Kali bichromicum). The patient is very much run-down, tries to find amelioration by movement. Aggr. at night and in humid weather. Osteocopic pains; pains of the heels (talalgia) Sciatic pains. Syphilitic ground.
Pulsatilla :- The pain moves rapidly from one place to another. Aggr. in the evening, by rest, by heat. Amel. by movement. in open air. Absence of thirst. Rhododendron:- Aggr. in windy or stormy weather is the most important characteristic. Amel. by movement. Rheumatic gout.
Ruta:- Affinity for bone tissues, cartilages and fibrous tissues Aggr. by rest, humidity, at night. Rheumatism of small articulations. Pains of the tendoachillis.
Silicea :- Advanced stage of sclerosis in very chilly old persons. Nails are yellow, breaking, deformed. Sensitiveness of the soles.
Medorrhinum:- Chronic, obstinate, gouty rheumatic affection. Rheumatism, neuralgia, myelitis. It is used when other remedies do not act. Aggr. during the day (from sunrise to sunset) by movement, when the patient thinks about his ailment (Oxalic acid, Helonias, Ignatia), by heat and during storm. Amel by humid weather (Causticum, Nux vomica). Affinity for small articulations. Erratic pains coming and going suddenly. Movements of the feet at night (Zinc). Hands and feet burn at night (Sulphur, Petroleum). Hasty patients (Argentum nit) loss of memory.
Complementaries: Natrum sulph, Thuja, T.R., Rhus tox.
T.R. (residual tuberculin of Koch)
Chronic cases with tuberculous heredity, Aggr. by rest, by first movement, in cold and humid weather. Amel. by local heat, by continued movement. In a word the symptoms of Rhus tox, which Rhus tox cannot alone cure.
Frequent complementary: Sulphur, Thuja, Rhus tox, Luesinum (Syphilinum).
Luesinum: – Aggr. at night Luesinum (from sunset to sunrise), by humid weather. Amel during the day, on mountains. Aggravation and amelioration are always progressive. Pains of bones. Headache. Alopecia. Profuse salivation.
Acute articular rheumatism:
Considered as a specific and autonomous disease, although the pathogenic agent is still unknown. Acute articular rheumatism requires a deep study from the homoeopathic point of view. The conception about acute articular rheumatism is sensibly different from the idea which has led to give the name of this disease: Bouillaud’s disease.
According to the modern authors the joints are hardly attacked or less attacked and that the articular rheumatism is not a disease of the articulations but a general disease which can be defined as chronic cardiopathy complicated with fluxional inflammation of the articular serous membranes. The infection seems to affect specially persons of oxygenoid tuberculinic type of Natrum sulphuricum, Sulphur iodatum, Calcarea or Kali carbonicum. Its periodicity seems to be annual which is -Predominantly Phosphorus and those that come in July or August are predominantly Sulphur.
Finally let me say that there is a possible relation between chorea and acute articular rheumatism, but let me also say that the nature of chorea is still obscure as that of the acute articular rheumatism. The relation between the two affections are very much controversial.
The possibility of co-existence of the alternate choreic movement and rheumatic arthralgia is undeniable. Charcot says that chorea and rheumatism are two distinct diseases and rheumatism would only play the part of determining agent like all other infectious diseases, for the apparition of chorea.
On the contrary, in pediatrics chorea is essentially a real rheumatism and in infants it is similar to the cerebral rheumatism of adult. Fraenkel has besides shown the existence of Aschoff’s nodules in chronic myocardia. Clinic shows frequent articular attacks in course of a choreic attack or their alternance.
Finally let us study the homoeopathic treatment of acute articular rheumatism.
(A) Beginning. Angina- Ordinary red inflammation exists in one third of the cases with some mild functional symptoms and therefore rarely treated except in cases where it coincides with arthritis.
Aconite:- Dry skin, agitation, anxiety, thirst. Attack after exposure to dry cold. Used in lower dilutions (1x to 3x and even M.T.) Ferrum phosphoricum (3x to 6x) Less intense fever than that of Aconite. Sweat. Soft pulse. It is a link to Belladonna: throbbing, sweat, mydriasis.
Mercurius solubilis :- Attack comes after cold at night. Night sweat without relief. Humid tongue, gray coating, imprint of teeth. Salivation, breath and sweat have foul smell. Then comes the stage when the disease is established. In this stage the medicines already described are useful and the disease may be checked.
(B) The disease is established. Bryonia (1x to 6x) A remedy for serous membranes in opposition to Rhus tox which attacks the peri-articular tissue. It has action on temporomaxillary joint.
Bryonia:- It is characterised by its stinging, acute pain. The patient remains immobile. Great thirst with dry mouth. Pains ameliorated by cold application and by wide pressure (with the palm.)
Rhus toxicodendron:- The modalities are inverse of Bryonia. Restlessness aggr. at night. Red triangle on the tip of the tongue. Bryonia and Rhus tox succeed each other mother often than they oppose. Rhus tox will be specially indicated in a dynamic state.
Apis (3x to 6) – Erratic pains, not so severe. Absence of thirst. Stinging and burning pains, worse by cold application, amel. by cold. When there is renal lesions this remedy is to be thought of.
Pulsatilla (3x to 6) -: Erratic pains, not so severe. Absence of thirst. Chilliness.
Lac caninum:- It is not so important but it is to be used with Pulsatilla. Pains alternating from one side to the other.
Chamomilla (3x to 6) :- Used in acute articular rheumatism of children. Very great pains, patient cannot bear it. Irritability. One cheek more red than the other.
Kali bichromicum :- Erratic pains in some fixed places which may be covered by the finger tip.
Benzoic acid(3x to 6) Urine with strong smell of ammonia.
Colchicum:- Sub-acute stage. Symptoms of Bryonia but the general condition is more serious. Sensitiveness to outward impressions, to noise and to light.
Cantharis:- It will be indicated only when there is pleural localisation.
Sodium salicylate:- It may be used in small doses 1/1000 every two hours. In the pathogenesis of Salicylic acid Boericke writes: Articular attack with stinging pains, aggr. by touch, movement. Profuse sweat does not ameliorate (Merc sol).
Burning of the stomach, vertigo.
Dose: 3x, repeated every three hours.
Veratrum album:- Grave adynamic form. Delirium.
End: At this stage we often find the indications of Sulphur 30 (in oxygenoid type it is preferable to give Sulphur iodatum). Heat on the top of the head with cold feet. Jerkings of the arms while sleeping.
Natrum muriaticum (200)- Weeping look. Marked anaemia. Pale mucous membranes. Goneness feeling in the stomach towards 10 A.M.
Natrum muriaticum is indicated when there is trouble of metabolism of salt and troubles caused by abuse of Salicylate. Natrum muriaticum is complementary of Ferrum metallicum, Pulsatilla and China.
Marmoreck 30, Spengler or Aviare in tuberculinics, always observing the rules for the use of tuberculins.
These remedies for convalescence: Natrum muriaticum, Sulphur iod. and the tuberculins are to be well drained by china 6 kali phos 6, Silicea 30 and Avena sativa 1x.
From the beginning when symptoms of Ferrum phos are seen on must think of cardiac localisation. The very rapidly the following remedies are to be added to the treatment of cardiac localisation. Spigelia 6 Dyspnoea with anxiety (myocardia is affected). Constricting, sensation (Cactus) Aggr. after sleep (Lachesis)
If the condition aggravates:
Arsenicum album(6)- Great anxiety. Fear of death. Dyspnoea aggravates at night from midnight to 3 A.M. Tongue as if roasted. Thirst for small quantities of water repeatedly.
Pyrogenium :- It should be given before the clinical indications. Echinacea M.T. may be used even intravenously.
Streptococcin may be used
Some other remedies are those that we have already studied.
Apis- Stinging pain in the region of heart. Partial oedema. No thirst. Aggr. by heat.
Bryonia:- Dry cough, painful. Cardiac pains. Better when the patient lies on the left side (pericarditis). Dry mouth. Great thirst.
Rhus toxicodendron:- Complementary to Bryonia Restlessness. Pain all over the body.
Kalmia (3x to 6x) lightning-like pains, rapidly change places, and extend below (inverse of Ledum). Slow pulse. Alternance of cardiac symptoms and rheumatic symptoms.
Aurum metallicum :- Very tumultuous beating of the heart. Dyspnoea while sitting down or bending forward.
The development of articular rheumatism in tuberculinic and oxygenoid subjects explains the relative frequency of pleuropulmonary complications, either congestion of the lungs or rheumatic pleurisy.
Classical rheumatic pleurisy of Lasigne type, sometimes bilateral, will require Bryonia and Cantharis.
In order to avoid sequelae of acute articular rheumatism: Natrum muriaticum, sulphur iodatum and Tuberculins in high dilutions. Sometimes Thuja 200, Baryta muriaticum 200 and Rheumatoxin, a nosode obtained from a drop of blood of a rheumatic patient and diluted, which is given alternately with ground remedies and Tuberculins.
Thus we will be able to check the terrible Osler’s disease and the evolution of cardiac rheumatism.