From Journal of the American Institute of Homoeopathy, February, 1932.
THE remedies, in general, which come to ones mind when first thinking of suppuration are not many. Nevertheless, any remedy in the materia medica may be used if the symptoms demand it. For suppurating conditions, whatever the nomenclature, we prescribe, just as we prescribe for a person with any other ailment, upon the “Totality of Symptoms” whether or not the digression from health be a simple boil, or an abscess of the lung, spleen or liver. We must shun the idea of prescribing for this or that, and must cultivate the attribute of prescribing for the individual.
Belladonna is one of the first remedies that comes to ones mind when inflammation is encountered – inflammation with its redness, swelling, pain, throbbing and burning-when suppuration, maybe, is commencing. The affection comes on suddenly and with great violence. There are painful, hot, shining, erysipelatous swellings, intensely inflamed about their bases.
The part swells rapidly, becomes bright red, throbs and pus develops speedily; the swelling increases, the redness radiates – red streaks radiate from the part. Here it is in close relation with Hepar and Mercurius, but comes in earlier than either. It corresponds most closely to the active, sthenic variety of abscess be fore pus is matured. Aconite or Arnica may be needed at the beginning, or they may be alternated if symptoms are mixed or are not clear.
Belladonna will be of use if the symptoms agree for alveolar abscesses, acute glandular abscesses-glands swollen, tender, red- cervical, inguinal, salivary, mammary; for beginning otitis media, membrane tympani bulging and injected, pain causes delirium, child cries out in sleep; for beginning suppuration in any part.
The wonderful thing about Belladonna is that cases requiring it rarely go on to suppuration. Remember the modalities; worse, touch, jar, draft, noise, lying down. Better, semi-erect.
Hepar sulphuris is likely the most often thought of remedy in connection with suppuration. It comes not use after pus formation is inevitable, and especially, when heat furnishes the only comfort. It suits best the lymphatic or phlegmatic type, the dull, sluggish, apathetic patient. The parts affected are exceedingly sensitive, which is the leading indication.
It has chilliness, throbbing, sharp sticking pains, is worse at night and from cold draughts. (Mercurius is worse from warmth.) Its suppurating glands are very sensitive and sore. A Hepar patients skin is very unhealthy-every little injury suppurates. (Sul., Graph., Sil.).
Hepar sulphuris will limit the extent of suppuration, greatly reduce the pain or sensitiveness, or will help open the part with little or no pain. It ill suppurate foreign bodies out from under the skins. (Sil.) – (Calc. carb. incases them in a fibrous deposit).
Calcarea sulphurica. Similar to Hepar, is though of in suppurative processes after pus has forced a vent, but continues indefinitely as in fistulous abscesses about the anus, gum, boils, etc., Hepar and Calcarea sulphurica, given in low potencies, favour suppuration; given in high potencies, might abort. You may expect to the use of this remedy for suppuration in any part of the body-about the eyes, ears, throat, nose, glands. In quinsy, retropharyngeal abscess, any suppurative condition of the throat, it is often indicated. The sensation of a fish bone in the throat is a good characteristic.
Remember that the Hepar patient is “Chilly, oversensitive (like Belladonna), quarrelsome, hard to get along with; nothing pleases; everybody disturbs; oversensitiveness to persons and place.” The general symptoms will guide to the remedy and will cure. Hepar follows well after Mercury; Silicea, after Hepar. As Silicea does not do useful work when Mercury is still acting or has been acting, Hepar thus becomes a useful intercurrent in the series.
Silicea is the remedy generally required in scrofulous and tuberculous patients. As it is a slow-acting remedy, it is suited to complaints that develop slowly. It is full of suppurative abscesses, and it will ripen them, if the symptoms agree. Every little injury suppurates. It has felons, boils, old, long-lasting fistulous ulcers. Especially is it famous for its old, sluggish, indolent, fistulous burrowings.
The skin is delicate, pale, waxy. It has abscesses with much cellular infiltration where suppuration continues and the wound refuses to heal. Its pus is generally thin, watery, offensive. Tuberculous swollen and suppurating glands are within its field of action.
A Silicea patient eats well, but is not well-nourished. Under Silicea, if the symptoms agree, the suppurating process becomes healthy, the pus benign, and granulations appear. You may then need another remedy, such as Fluoric acid, which antidotes the over-use of Silicea. Silicea is better from warmth; Fluoric acid is better from cold. Silicea as well as sulphur is a dangerous remedy to use in tuberculous patients. They will break down well-encysted tubercles and abscesses quickly and kill, especially if given too low and too frequent.
Silicea, by its power to kill, has strengthened my faith in the power of the potentised remedy, more emphatically than any other observation I have ever been able to make. I have seen it cure quickly, fistulous conditions of years standing, and Ive seen it kill one patient and almost another, it failing to bring euthanasia to the latter because he didnt have initiative to take a second dose-of the 6x. So before you prescribe Silicea in a tuberculous case, be sure to have your patient under close observation. Study Kent or some other authority on the subject and be cautious.
Always keep Silicea in mind when dealing with patients who have the scrofulous diathesis-patients with malnourished constitutions due to impaired assimilation. These are oversensitive to noise, are despondent, have a disgust for life, have unbearable dread of undertaking anything, which dread is imaginary. (Lycopodium has the same dread, but it is due to stupidity and from a general knowledge of inability.) Silicea has styes and other pustular affections about the eyes.
It has abscesses about the roots of the teeth and dental fistulas. It may be useful in suppurative ear troubles accompanied by caries of the mastoid cells; in suppurative conditions about the tonsils when the abscess is broken, but gland will not heal. It is often the remedy for suppurating affections of the breasts, cervical, inguinal and salivary glands; other suppurating surfaces which refuse to heal, such as abscesses of the hip, hip-joint disease, Potts disease, felons, boils and carbuncles; abscesses of the lungs, liver, or any other organs; suppurative skin diseases. Remember its relief from heat and warmth and its aggravation from the cold air.
Mercurius (vivus or solubilis) is another important remedy to help form and evacuate pus, but unlike the rapid, violent, sthenic action as is that of Belladonna and Hepar sulphur, it corresponds more closely to the condition when the life force is so low that there is no tendency to repair. It has slow and long-continued pus formation, no irritability in the part, no tendency to granulate. Such an abscess opens, keeps on discharging, seems dead. There is suppuration without heat, profuse perspiration which does not ameliorate, great nocturnal aggravation, sensitiveness to cold air, yet aggravated by heat, hot poultices, etc. Marked loss of flesh, trembling and weakness, are other characteristics.
When Mercurius is needed you will find other guiding symptoms, such as fetid breath, flabby tongue which shows imprints of teeth, offensiveness of sweat and of all other discharges. From the ears, nose and affected parts comes horribly stinking, green, thick, acrid pus-stinking, purulent, offensive otorrhoea. With inflammation and suppuration of any part, there are generally found associated swollen and indurated adjoining glands; salivary and cervical glands, with inflammation of ears, nose and throat.
Glands anywhere in the body may inflame, swell, indurated, and then suppurate. Abscesses become dark red from asthenic, venous engorgement (Lachesis, purple), take on an intense shining appearance, have throbbing, burning and stinging pains. Pus will form in inflamed joints or pleural cavity, and may be thick, greenish, yellow, putrid, or may be thin and fluid, streaked with blood.
Mercurius may be indicated where pus is flowing from a fistulous opening, but Silicea and Fluoric acid are most often indicated. A thick, greenish-yellow gonorrhoea discharge, with stinging and burning in the urethra, calls for Mercurius. Mercury is scarcely ever indicated after Silicea and does not follow Silicea well. In high potencies, if indicated, it may arrest the process of suppuration. Lets remember the picture of Mercurius, and prescribe for the patient.
Lachesis is another important remedy often called for in the treatment of suppuration. It has many symptoms like Mercurius, having abscesses aggravated by hot poultices, hot-water applications; has the same sadness, despondency, hypersensitiveness, weakness and trembling; is worse from touch or light pressure, from constriction about the affected parts (hard pressure may be agreeable), from exposure to the sun, from heat and sleep.
Great physical and mental exhaustion, loquacity, and its choice for the left side (Bell., Lyco., and Merc., the right), are others of the Lachesis generals. The abscesses of Lachesis are dark, dusky, purplish; the tissues surrounding have a purple, mottled appearance. Its pus is thin, dark, ichorous and very offensive. There is hot perspiration. I doubt if it should be prescribed under the twelfth potency.
Crotalus horridus, another snake poison, may be of use in certain suppurating conditions, but when it is called for the picture is indeed a horrible one. With a typical Crotalus patient, you will feel that death is very near. And with these patients, death generally does come so quickly – the entire system is so terrifically affected – that no part has had time to suppurate or resist.
In boils, abscesses carbuncles, the broken- down material which is being discharged is thick, black blood that will not coagulate, instead of pus. In fact the pus, if it may be called such, is not from bacterial cause, as we generally think of it, but from toxins.
Boils, carbuncles and eruptions are surrounded by a purplish condition of the skin, a mottled, blue, splotched or marbled state. It produces boils, abscesses and a condition resembling a carbuncle, with burning and violent pains, but the characteristic feature is the doughy centre. Around the boil or carbuncle for many inches there is edema, with pitting upon pressure; and the boil, or carbuncle for many inches there is edema, with pitting upon pressure; and the boil, or abscess, or carbuncle, will bleed a thick, black blood that will not coagulate.
Carbuncles that come upon the neck and back begin with a pustule, and then several come and they are surrounded by little pustules and papules and there is pitting upon pressure. For these carbuncles you will need to study particularly Arsenicum, Anthracinum, Lachesis, Secale, and Crotalus. They are the medicines that have in their nature malignant manifestations.
Tarentula cubensis may be mentioned here with the snake poisons. It will be indicated at times in septic conditions, and in various forms of malignant suppuration, where the parts take on a purplish hue, and have burning, stinging pains. Its chief characteristic is extreme restlessness. The patient must be in constant motion, though motion aggravates-rolling from side to side to ease the distress.
Tarentula has boils, abscesses and carbuncles, especially on the back of the neck and between the shoulder blades, characterised by a blue, mottled appearance, having intense knife-cutting and burning pains and a thin, excoriating discharge. Another indication is an early-marked black core centre. It produces a perfect picture of sloughing carbuncle with great prostration and atrocious pains. If a part is mottled, bluish, growing dark, and patient is chilly, nauseated, vomiting, and has great weakness, is probably delirious, worse from cold air, and from becoming cold, think of Tarentula as the remedy, and of the condition as an impending pyemia.
Rhus toxicodendron is a plant poison and might appropriately be mentioned at this time. When it is needed you will recognise it by its one grand prevailing characteristic-aggravation from rest and relief from motion. It gets its other leading indications- dark red, angry, edematous, erysipelatous swellings and eruptions, its great prostration, heat and burning, from its malignant septic and toxic states.
Besides it vascular eruptions -its dermatitis venenata, and erysipelas-it has abscesses and carbuncles which are exceedingly hot and painful, and discharges a serous, bloody pus. It has a predisposition to attack the cervical, salivary and axillary glands, which inflame, become hot and painful and suppurate. It has pustules upon the cornea, purulent conjunctivitis-the lids becoming agglutinated with copious, purulent, mucous discharge. Chronic, suppurating eruptions of the face may at times call for this remedy.
Arsenicum album, a mineral poison, is regarded by many as the chief remedy for carbuncle. It is almost synonymous with gangrene, yet has suppuration.
It will be of use many times, in the treatment of malignant, septic, suppurating disturbances, and you will know it when it is needed, by its pronounced characteristics-great weakness and prostration, burning everywhere-as if live coals were on the affected part, pains worse at rest and increased by cold, restlessness and anguish (here restlessness is not to relieve pain, as with Rhus, but from anxiety), midnight aggravation, unquenchable thirst for small quantities of water very often, and great irritability of mind and body.
It is of use in the treatment of carbuncles, bed- sores, dissecting wounds and abscesses, when you have the lancinating and burning pains, and other characteristic indications. The discharges are thin, fluid, bloody, putrid, cadaveric-similar to those of Mercurius, but thinner. It has perspiration which gives relief, while that of Merc. does not relieve.
Arnica montana has the characteristic bruised soreness as has no other remedy. This soreness is general or merely of parts affected, and is relieved by slight motion. Its suppurating processes, instead of maturing, retrogress, shrivel up, and a new crop follows. If definitely indicated, Arnica will often prevent the injured tissues from suppurating, hinder the absorption of pus, prevent pyemia or septicemia, even if given only on general principles.
It has many small boils, painful, one after another, extremely sore. It prevents suppuration and septicemia and promotes absorption. Arnica, although an old remedy is not so often used as it should be in general practice, obstetrics and surgery.
Echinacea, the corrector of blood dyscrasia, although a fairly new remedy, is a valuable one. It is of value in acute auto- infections, septic conditions with lymphatic involvement, for abscesses and carbuncles associated with great loss of strength, and for obstinate scrofulous and syphilitic diseases, for which it may be used both locally and internally. It may be indicated in conditions that come from crushing injuries, where the tissues have lost their resistance. It promotes localisation and pus formation.
At times it will have to be differentiated from ARnica, Arsenicum, Rhus toxicodendron and others. The leading characteristics are: aggravation after meals, in the evening and from motion, great prostration. Furthermore it has swollen glands, the skin over which is irritated and smarting, frequent pustules and furuncles, especially on the neck. It is an excellent remedy with which to break up the “boil habit”.
Sulphur – many of you may wonder why this great psoric remedy has not been taken up sooner in the study of homoeopathic remedies for suppuration. The answer is, that sulphur is a chronic remedy, and is not called for nearly so often as some of the remedies previously mentioned. It stimulates more the chronic ailments-maybe suppurative-and is called upon to stimulate the reactionary powers of the system and render it susceptible to the effect of other remedies in cases where it is not of itself capable of effecting a cure.
It does produce a tendency to boils and is applicable to scrofulous persons. Glands become inflamed and suppurate. It establishes all sorts of suppurating cavities, has numerous abscesses-beneath the skin, in the deeper tissues and in internal organs. Sulphur has all sorts of eruptions-vesicular, pustular, scaly, all attended with intense itching. It has an unhealthy condition of the skin aside from its eruption.
Small wounds will not heal but will continue to suppurate. Abscesses formed under the skin become little discharging cavities with fistulous openings which leak and discharge for a long time. The discharges are acrid, offensive, filthy, excoriating. Burning and itching, aggravated by bathing, are always present, whatever the complaint.
The Sulphur suppurating patient emaciates, has hectic fever- steaming heat-itching, burning, stinging, and is worse from warmth and washing. He is always thirsty, maybe hungry, but loathes food. Keep a picture in your minds of the Sulphur patient, and you will recognise him the moment he presents himself-the quick, wiry, nervous, dirty, unhealthy complexioned, selfish, happy-go-lucky. Sulphur follows well many acute remedies.
It is not best to give it before Lycopodium-Sul., Calc., then Lyco. It is not out of place to call your attention here to the value of Sulphur in puerperal and surgical fevers, when there are flashes of heat and steaming sweat.
Sulphur iodide, a very profound, long-acting remedy, has been spoken of highly by Professor Bier, for the treatment of boils. However, it is with this remedy as it is with all others, it must be the absolute similimum of the case before it can cure. It has many eruptions, pustules, boils, blood boils, accompanied with itching, burning and stinging. It has ulcers-bleeding, cancerous, indolent, sensitive, spongy, suppurating; the discharges being copious, bloody, corrosive, thin, watery, yellow.
Among its general symptoms and modalities, it has a feeling throughout the body of general physical anxiety, has great body heat, swelling of glands-mesenteric, of the groins- suppurating buboes, is inclined to be right-sided, and is aggravated from warmth. It also has emaciation with increased appetite-ravenous appetite-and diarrhoea.
Pulsatilla, although primarily a catarrhal remedy, does have suppurative conditions in the eyes, ears, and nose. When needed you will be dealing with Pulsatilla type of patient-gentle, yielding, weeping, blue-eyed, blonde, fat, plump, red-faced, thirstless. Its discharges are thick, profuse, greenish-yellow and bland, except the vaginal discharge which may be very excoriating at times. All symptoms are aggravated in the evening, from warmth and rest; better in the open air.
It always has styes. Its eyes are inflamed, with thick, greenish pus- purulent conjunctivitis-applications of water, warmth, tepid or even cold, furnish comfort. (Sulphur is aggravated by bathing.) The ears have the same catarrhal or suppurative conditions, there being discharged the same profuse, thick, purulent, bland, offensive, fetid pus; otitis media following eruptive diseases, with sharp, tearing, pulsating pains, worse at night. worse at night. Pulsatilla is a good antidote for over-action of Sulphur. Silicea is its chronic. Its inflamed parts are bluish, mottled with venous engorgement, like Lachesis, Tarentula, etc.
Kali Sulphuricum one of the tissue remedies-the mineral Pulsatilla-is very similar to Pulsatilla, or, more accurately, is Pulsatilla intensified; unless the patient becomes chilly, and is better from rest, in which case, Silicea will be found to be more indicated and will finish the work. Unlike Pulsatilla, the Kali sulphuricum patient is more easily angered, is very obstinate and irritable, yet is very timid.
It has otitis media, the discharge being thin, yellow, bright yellow or greenish, bloody, offensive, purulent, with accompanying itching and all sorts of noises. It has smarting, suppurating tuberculous. It has Pulsatillas evening aggravation, and improvement from the cool, open air. Cyclamen is very similar to Pulsatilla and Kali sulph., but is worse from the open air, and better from warmth.
Kali bichromicum, unlike Pulsatilla, has tough, thick, ropy, tenacious discharge. It has ulcerations which tend to perforate- look as if punched out, with deep, regular edges (luetic); chronic suppurations of middle ear, with stitching, pulsating pains, and yellow, viscid discharges which may be bloody- pustules, boils, suppurating tubercles; many other skin manifestations. Pains in small parts, which appear and disappear suddenly are characteristic. Its pains fly from place to place like Pulsatilla, Kali sulph., Lac caninum, Manganum, Aceticum, Kali bich. works best in fat, light-haired people.
Phytolacca decandra might be called the vegetable Mercury (although Kali hydriodicum is most similar), and is Mercurys antidote. It is said by some to be a specific for boils. It does have a disposition toward boils, carbuncles and glandular swellings, but much of its action centers about the mammary glands.
From every excitement, fear of impending accident, tribulation, these glands are affected; lumps form and grow, there is heat, tumefaction, often resulting in violent inflammation and suppuration, associated with which there is aching in the back, and in the bones, fever and shivering all characteristics of Phytolacca.
This remedy may remove the predisposition to malignancy after breast abscesses and inflammations. In very hard, greatly swollen, hot and painful-the nursing child causes pain to radiate all over the body or all over the back. if there is high fever, congestion to the head, throbbing carotids, much redness radiating from nipple, Belladonna is the remedy; or Mercury when the general symptoms agree; Hepar and Silicea general after pus is inevitable and the only comfort is gained from heat.
Phytolacca should be in use before suppuration sets in (Aconite, Belladonna or some other remedy may be needed in the initial stage) and may prevent suppuration, but even after the case has gone on to pus-formation, and there are large, fistulous, gaping, angry-looking ulcers, discharging watery, fetid pus, Phytolacca may still be the remedy; or the choice may be made among other remedies such as : Croton tiglium, Phellandrium, Silicea, etc. Bryonia complements Phytolacca.
Lycopodium, another one of Hahnemanns anti-psorics (Sul. and calc.), because of its scope of action, and its general characteristics, may well be mentioned in connection with suppuration. Surface wounds suppurate as though they had contained splinters; burrow along under the skin. Its ulcers bleed easily and form great quantities of thick, greenish-yellow, offensive pus.