THE onset of a Rhus tox. influenza is usually gradual and with out a very high temperature; it is a slowly progressing feverish attack, which is accompanied by very violent generalised aching.
The aching in Rhus tox. is vary typical indeed. The patients are extremely restless; their only relief lies in constant movement, constant change of position. If they lie still for any length of time, their muscles feel stiff and painful, and they turn and wriggle about in search of ease. This constant restlessness is the most noticeable thing about Rhus tox. patients on first sight.
They are very chilly, and very sensitive to cold. Any draught or cold air will aggravate all their conditions, and is enough to aggravate their coryza and start them sneezing; an arm outside the bedcovers becomes painful and begins to ache, and so
Understandably, Rhus tox. patients are extremely anxious; they get no peace at all, and are mentally worried, apprehensive and extremely depressed. The depression is not unlike that of Pulsatilla; the patients go to pieces and weep.
With all the restlessness and worry, they become very exhausted and, considering that their temperature is moderate, unduly tired-out, almost prostrated.
Rhus tox. patients invariably have extremely bad nights. It is very difficult for them to get to sleep because of their constant discomfort: when they do sleep, their sleep is very disturbed, full of all sorts of laborious dreams-either that they are back at work, or making immense physical effort to achieve something.
They sweat profusely. And the sweat has a peculiar sourish odour, the sort of odour one used to associate with a typical case of acute rheumatic fever.
They patients always have intensely dry mouths and lips, and very early in their disease they develop a herpetic eruption which starts on the lower lip-small crops of intensely sensitive vesicles that spread to the corners of their illness.
The typical Rhus tox. tongue is very. It has a bright red tip and a coated root, the coating varying from white to dark brown. Instead of the typical triangular red tip, some patients have a generalised dry, red tongue which tends to crack, is burning hot and very painful.
Associated with the sensitiveness of their lips and tongue, these influenza patients tend to very acute dental neuralgia; their teeth become very sensitive and are painful if touched.
They develop extremely sore throats-dry and burning. On examination, the throats- dry and burning. On examination, the throats appear to be oedematous. they are very sensitive on swallowing, particularly empty swallowing; and it is easier for them to take solids than fluids.
Rhus tox. patients have very violent attacks of sneezing. They describe them as usually more troublesome at night, and so violent as to make them as usually more troublesome at night, and so violent as to make them ache from head to foot. As a rule, the nasal discharge is somewhat greenish in colour.
They get very troublesome tickling irritation behind the upper part of the sternum. this produces a persistent and very racking cough, with which they develop a raw, burning sensation in the larynx, which very often progresses into definite hoarseness.
This hoarseness is very characteristic: the patients complain of a feeling as if their larynx were full of mucus. they feel that they cannot clear their voices until they have coughed the mucus out, and yet the effort of coughing feels as if it is almost tearing of scalding their larynx.
As a rule, there is a good deal of congestion of the eyes- generalised congestion, with very marked photophobia and a good deal of lachrymation.
They suffer from rather severe occipital headaches, with a sensation of stiffness down the back of the neck and, very often, marked giddiness on sitting up or moving. they often complain of a sensation of weight in the head, as if it were an effort to hold it up.
Rhus tox. patients often complain of a feeling of intense heat inside, and yet their skin surface feels the cold. they are sweating profusely and any draught seems to chill them- they feel the cold on the surface-but they feel burning inside.
In these influenzas, the patients are very apt to have violent attacks of nodular urticaria, scattered anywhere over the body and intensely irritable.
The patients are not usually markedly thirsty though they do like sips of water to moisten their very dry mouths and throats.
I have seen a Rhus tox. influenza go on to a definite enteritis with violent abdominal pain; pain down in the right side, down in the caecal region, with extreme restless, tenderness and very stinking diarrhoea.
But I have seen only the one case. It responded very well to Rhus tox. There was the typical tongue and general anxiety and restlessness, general aching pain, sweating and chilliness; and it was more on the general than on the local abdominal symptoms that I prescribed Rhus tox.