THERE are quite a number of conditions in which one finds indications for Rhus tox., and the majority of them are very acute.
You may get indications for Rhus tox. in acute inflammatory disturbances of the oesophagus, usually the result of taking some scalding fluid or something of that sort. The outstanding characteristic is the intense pain. There is almost complete inability to swallow and any attempt to do produces most violent, scalding pain all down the oesophagus.
This is associated with a very dry mouth and throat and the most violent thirst, with a desire for very cold drinks. Taking any cold fluid, however, produces a sensation of general chilliness.
Further indications for Rhus tox. may be found in a very acute gastritis with acute nausea and fairly violent vomit. There will be a history that the acute attack of gastritis has been brought on by taking very cold fluids, ice-cream or iced drinks in very hot weather-it is the result of a sudden chill.
Again there is the intense dryness of the mouth, with very violent thirst and the desire for cold drinks. Sometimes, there is desire for cold milk, which seems to comfort the stomach. On occasion in these attacks of acute gastritis, the Rhus tox. patients complain of a feeling of intense hunger, though they get sudden attacks of vomiting after taking any food.
There is another group of conditions in which one gets definite indications for Rhus tox. : acute inflammatory conditions in the abdomen. The commonest of these are acute appendicitis and acute generalised peritonitis. Acute dysentery is also common.
In the acute inflammatory abdominal condition, the abdomen is extremely sensitive to touch, the pains are pretty violent, and you will find the patients lying with the legs drawn up in order to relieve abdominal pressure. Most of the acute inflammatory conditions in the abdomen tend to be on the right side.
Not infrequently, you get indications for Rhus tox. in an appendicitis which is associated with a good deal of liver disturbance, either a cholecystitis or just a general congested liver with a degree of jaundice. In a typical Rhus tox. case of dysentery, there is the most violent tenesmus before and after stool, with acute abdominal colicky pains and the passage of bloody mucous stools.
You will occasionally see indications for Rhus tox. in typhoid. There are two stages at which this may occur. First, when the patients are having very violent, copious watery stools, associated with a degree of tenesmus. Second, where there is complete incontinence-here, you are even more likely to observe Rhus tox. indications.
In both cases, the stools are much more frequent at night much less frequent during the day. It is interesting to note that although one ordinarily associates Rhus tox. with bowel upsets which are accompanied by violent tenesmus and extreme straining at stool, in typhoid indications, for Rhus tox. are much more likely to show themselves accompanied by complete incontinence.
In order or clinch a Rhus tox. diagnosis, there must be the general Rhus tox. modalities. The patients are always extremely tired. They are very despondent, and may be actually weepy. There is always a fairly marked anxious mental restlessness, and the patients may feel that they really want to die.
They nearly always complain of a feeling of general chilliness, and their discomforts are relieved by external warmth. In all their conditions, they complain of a degree of general stiffness, particularly after they have been still for a little time.
In all these painful condition, they are restless, constantly on the move and find it impossible to keep still. This is one of the diagnostic points about the Rhus tox. appendicitis. Accompanying a somewhat distended right side of the abdomen, rigid muscles, acute tenderness to touch and relief from hot applications, the Rhus tox. patient is restless, constantly moving a little and appearing to get some relief from movement.
The thirst in Rhus tox. cases is as marked as it is any drug in the materia medica; and the desire is for cold drinks. The restlessness of Rhus tox. is the main feature which distinguishes it from Bryonia, the other acute appendicitis drug. The appearance of the tongue is also a distinguishing feature between them. In practically all the acute complaints of Rhus. tox., there is intense dryness of the tongue, and the appearance is always suggestive.
In typhoid dysentery, the tongue tends to be red and scalded looking all over. In acute appendicitis and acute gastritis, there is more likely to be a coating at the root of the tongue and a bright red, very sensitive, burning hot, dry tip.
In typhoid, the Rhus tox. patient tends to become very weak and develops a wandering, restless, very laborious type of delirium. In that state, the sleep is often very disturbed by nightmares of most violent physical exertion.
If the liver is involved and there is any jaundice, there is liable to be very intense skin irritation of the type one associates with the ordinary Rhus tox. eruptions.