Generalities: From the time of Hahnemann to the present day Arsenicum has been one of the most frequently indicated medicines, and one of the most extensively used. In the Old School it is most extensively abused, in the form of Fowler’s solution.
Arsenic affects every part of man; it seems to exaggerate or depress almost all his faculties, to excite or disturb all his functions. When all our medicines have been as well proved we will effect wonderful cures. It is a substance easily proved because of its active nature, and from its very abuse we have learned much of its general nature.
While Arsenic impresses the whole economy and disturbs all the functions and tissues of man, there are certain prevailing and striking features in it.
Striking features: Anxiety, restlessness, prostration, burning and cadaveric odors are prominent characteristics.
The surface of the body is pale, cold, clammy, and sweating, and the aspect is cadaveric. In chronic sickness with great debility, anaemia, from long exposure to malarial influence, in the poorly fed and from syphilis this remedy is of great service.
The anxiety that is found in Arsenicum is intermingled with fear, with impulses, with suicidal inclinations, with sudden freaks and with mania.
It has delusions and various kinds of insanity; in the more active form, delirium and excitement. Sadness prevails to a great extreme. So sad that he is weary of life; he loathes life, and wants to die, and the Arsenic patient does commit suicide. It is a remedy full of suicidal tendencies.
The anxiety takes form also in the restlessness, in which he constantly moves. If he is able to get up lie goes from chair to. chair; the child goes front nurse to mother, and from one person to another. When in bed, unable to sit up, the patient tosses and turns from side to side; if he is able, he climbs out of bed and sits in the chair, keeps moving from one place to another, and when thoroughly exhausted, he gets back into bed again.
The restlessness seems to be mostly in the mind; it is an anxious restlessness, or an anguish, with the idea that anguish is a deathly anxiety. That is an effort to express it in the extreme. It seems that he cannot live, and it is not pain that drives him to anguish, but it is an anxiety intermingled with restlessness and sadness.
This state prevails in all diseases intermingled with prostration. An uneasiness comes in the early stage of disease, and lasts but until the prostration becomes marked. While lying in bed, at first he moves his whole body, moves himself in bed and out of bed; but the prostration becomes so marked that he is able to move only his limbs until at last he becomes so weak that he is no longer able to move and he lies in perfect quiet in extreme prostration.
It seems that prostration takes the place of anxiety and restlessness, and he appears like a cadaver. So remember that these states of anxiety and restlessness go towards the cadaveric aspect, towards death. This is seen, for instance, in the typhoid, where Arsenicum is indicated. At first there is that anxious restlessness with fear, but the increasing weakness tends towards prostration.
Running all through the remedy there is the burning mentioned as one of its most marked generals. There is burning in the brain, which makes him want to wash his head in cold water. This sensation of heat in the inner head with pulsation is ameliorated by the cold bathing, but when there is a rheumatic state that affects the scalp and outward nerves, and there is burning, the burning then is ameliorated by heat.
When the headache is of a congestive character, with the sensation of heat and burning inside the head, and there is a feeling as if the head, would burst, and the face is flushed and hot, that headache is better from cold applications and in the cool open air.
So marked is this that I have seen the patient sitting in the room with clothing piled on to keep the body warm and with the window open to relieve the congestion of the head.
Therefore, we say a striking feature belonging to this medicine is relief of all the complaints of the body from wrapping up and from warmth in general, and relief of the complaints of the head by cold, except the external complaints of the head, which are better from heat and from wrapping up. The neuralgias of the face and eyes, and above the eyes, are better from heat.
The burning is felt in the stomach; there is burning in the bladder, in the vagina, in the lungs. It feels as if coals of fire were in the, lungs at times, when gangrenous inflammation is threatened, and in certain stages of pneumonia.
There is burning in the throat and burning in all the mucous membranes. The skin burns with itching, and he scratches until the skin is raw, and then it burns, but the itching ceases; as soon as the smarting lets up a trifle the itching commences again. All night the itching and burning alternate, burning for a minute, when be scratches it until it is raw, but soon the itching begins again and it seems that he has no rest.
The secretions and excretions of Arsenic are acrid; they excoriate the parts, causing burning. The discharge from the nose and eyes causes redness around the parts, and this is true of all the fluids from the various orifices.
In ulcers there is burning, and the thin, bloody fluid discharged excoriates the parts round about. The odor of the discharge is putrid. If you have ever discovered the odor of gangrene, of mortified flesh, you know the odor of the Arsenicum discharges.
The stool is putrid, like decomposed flesh, putrid blood. The discharges from the uterus, the menstrual flow, the leucorrhoea, the faeces, the urine, the expectoration, all the discharges are putrid. The ulcer is so putrid that it smells like decomposing flesh.
Arsenic produces a tendency to bleeding. The patient bleeds easily and may bleed from any place. There is vomiting of blood; bleeding from the lungs and throat. Bloody discharge from the mucous membrane, at times, when inflammation is running high; haemorrhage from the bowels, kidneys, bladder and uterus; anywhere that mucous membrane exists, there may be haemorrhage. Haemorrhage of black blood and discharges that are offensive.
Gangrene and sudden inflammatory conditions like gangrenous and erysipelatous inflammations are common in Arsenic. Parts suddenly take on erysipelas, or parts that are injured suddenly take on gangrene.
Gangrene in internal organs, malignant inflammations, erysipelatous inflammation. No matter how you look upon the condition, no matter what it is called, if it is a sudden inflammation that tends to produce malignancy in the part it belongs to Arsenicum. Inflammation will go on in the bowels for a few days attended with a horribly offensive discharge, vomiting of clots of blood, great burning in the bowels with tympanitic condition.
You may almost look upon this as a gangrenous inflammation, so violent, sudden and malignant is it, and it has the anxiety, prostration, fear of death, and chilliness, the patient wanting to be covered warmly.
When with this inflammation of the bowels the patient is relieved by heat, it means Arsenic.
You should remember that Secale has a similar state; it has all the tympanitic condition, all the ulceration and prostration, all the offensive odor and expulsion of offensive clots, and all the burning, but the Secale patient wants to be uncovered, wants things cold, wants the windows open.
The only distinguishing feature between these two remedies in a case may be that Secale wants cold and Arsenicum wants heat, but this is the way we individualize in our homoeopathic prescribing.
When there is gangrenous inflammation in the lungs, we find the patient has been taken with a chill, there has been restlessness, prostration, anxiety and fear; as we enter the room we detect a horrible odor, and on looking into the pan we see the patient has been spitting up by the mouthful, black, foul expectoration.
Look and see if the patient wants to be covered warmly; if he is easily chilled, and heat feels good; then it is a hard thing to cover that case outside of Arsenicum. The prostration, the vomiting, the anxiety, the restlessness the cadaveric aspect are present, and where will you find a remedy with that totality outside of Arsenic.
I have many times gone a long distance to detect, from the very aspect of things, these symptoms that could be gotten while walking from the door to the bedside. Every symptom is Arsenic; he looks like in acts like it and smells like it. You may go to a patient with high grade inflammation of the bladder, with frequent urging to urinate, straining to urinate, and there is bloody urine intermingled with clots.
It has been found by the attending physician when he introduces the catheter to draw off the urine that clots dam up the catheter, a little is drawn off and then it stops. We have a history of restlessness, anxiety, fear of death, amelioration from heat, great prostration.
You must give Arsenic, not because there is inflammation of the bladder, but because it is a rapidly progressing inflammation, and because it is gangrenous in character. The whole bladder will be involved in a short time, but Arsenic will stop that.
So it is with all the internal organs, the liver, lungs, etc.; any of them may take on violent and rapid inflammation. We are not now speaking of the particulars, but only illustrating the general state of Arsenic, in order to bring out what runs through the whole nature of it.
We shall find when we take up the remedy and go through it in a more particular way these features will stand out everywhere.
Mind: The mental symptoms show in the beginning anxious restlessness, and from this a continuation towards delirium and even insanity with all that it involves; disturbance of the intellect and will.
“He thinks he must die.”
I went to the bedside of a typhoid patient once with all the general aspect I have described; he was able to talk, and he looked up at me and said:
“There is no use of your coming, I am going to die; you might as well go home; my whole insides are mortifying.”
His friend was seated on one side of the bed, giving him a few drops of water, and just about as often as he could get there with it he wanted it again.
That was all he wanted; his mouth was black, parched and dry. He got Arsenic. One of the characteristic features of Arsenic is thirst for small quantities often, just enough to wet the mouth. It is commonly used as a distinguishing feature between Bryonia and Arsenic for the purpose of memorizing the Bryonia has thirst for large quantities far apart, but Arsenicum little and often, or violent unquenchable thirst.
“Thoughts of death and of the incurability of his complaints.”
“Thoughts crowd upon him; he is too weak to keep them off or to hold on to one idea.”
That is, he lies in bed tormented day and night by depressing ideas and distressing thoughts. This is one form of his anxiety; when tormented with thoughts, he is anxious. In the delirium he sees all kinds of vermin on his bed.
“Picks the bedclothes.”
“Delirium during sleep, unconscious mania.”
“Whimpering and gnashing teeth.”
“Loud moaning, groaning and weeping.”
“Lamentations, despair of life.”
“Screaming with pains.”
“Fear drives him out of bed, he hides in a closet.”
These are instances of insanity that take on first a state of anxiety, restlessness, and fear. Religious insanity, with the delusion that she has sinned away her day of grace, the biblical promise of salvation do not apply to her, there is no hope for her, she is doomed to punishment.
She has been thinking on religious matters until she is insane. Finally she enters into a more complete insane state, a state of tranquility; silent, and with aversion to talk. So we see one stage enters into another; we have to take the whole case together; we have to note the course that the case has run in order to see it clearly and note that in one stage there were certain symptoms and, in another stage, other symptoms.
For instance, we know that in the acute conditions of Arsenicum there is either thirst for ice cold water, and for only enough to moisten the mouth, or there is thirst for water in large quantities and yet it does not quench the thirst; but this thirsty stage goes on to another in which there is aversion to water, and hence we see that in chronic diseases.
Arsenicum is thirstless. So it is in a case of mania; in the chronic state he is tranquil, but in the earlier stages, in order to be an Arsenicum case, he must have gone through the Arsenicum restlessness, anxiety and fear.
Fear is a strong element in the mental state, fear to be alone; fears something is going to injure him when he is alone; full of horror; he dreads solitude and wants company, because in company he can talk and put off the fear; but as this insanity increases he fails to appreciate company and the fear comes in spite of it. He has a violent increase of his fear and horror in the dark and many complaints come on in the evening as darkness is coming on.
Many of the mental troubles, as well as the physical troubles, come on and are increased at certain times. While some complaints, pains and aches are worse in the morning, most of the sufferings of Arsenicum are worse from 1-2 P.M. and from 1-2 A.M. After midnight, very soon after midnight sometimes, his sufferings begin, and from 1-2 o’clock they are intensified. Extreme anxiety in the evening in bed.
“Averse to meeting acquaintances, because he imagines he has formerly offended them.”
Great mental depression, great sadness, melancholy, despair, despair of recovery. He has dread of death when alone, or on going to bed with anxiety and restlessness. He thinks he is going to die and wants somebody with him.
The attacks of anxiety at night drive him out of bed. This is an anxiety that affects the heart, and so the mental anxiety and cardiac anxiety almost seem to coincide. A sudden anxious fear comes over him at night; he jumps out of bed with fear that he is going to die, or that he is going to suffocate.
It is full of dyspnoea, cardiac dyspnoea, and varying forms of asthma. The spells come on in the evening in bed or after midnight; from 1-2 o’clock he is attacked with mental anxiety, dyspnoea, fear of death, coldness, and is covered with, cold sweat.
“Anxiety like one who has committed murder.”
This is one form of his anxiety; he finally works up to the idea that the officers are coming after him, and watches to see if they are coming in to arrest him. Some unusual evil is going to happen to him; always looking for something terrible to happen.
“Irritable, discouraged, restless.”
“Restlessness, cannot rest anywhere.”
“As a consequence of fright, inclination to, commit suicide.”
The Arsenicum patient with this mental state is always freezing, hovers around the fire, cannot get clothing enough to keep warm, a great sufferer from the cold.
Chronic Arsenicum invalids cannot get warm; they are always chilly, pale and waxy, and in such invalids, after they have bad several unusual weak spells, dropsical conditions come on.
Arsenicum is full of puffiness and dropsy; oedematous condition of the extremities; dropsy of the shut sacs or of the cavities; swelling about the eyes; swelling of the face, so that it pits upon pressure. Arsenicum in these swellings is especially related to the lower eyelid rather than the upper, while in Kali carb. the swelling is more in the upper eyelid than the lower, between the lid and the brow.
There are times when Kali carb. looks very similar to Arsenic, and little features like that will be distinguishing points. If they run together in generals, then we must observe their particular peculiarities.
Periodicity: In the headaches we have a striking general feature of Arsenicum, brought out in their periodicity. Running all through this remedy there is periodicity, and for this reason it has been extensively useful in malarial affections which have, as a characteristic of their nature, periodicity.
The periodical complaints of Arsenic come on every other day, or every fourth day, or every seven days, or every two weeks. The headaches come on these cycles, every other, or third, or fourth, seventh or fourteenth day.
The more chronic the complaint is, the longer is its cycle, so that we will find the more acute and sharp troubles in which Arsenic is suitable will have every other day aggravations and every fourth day aggravations: but, as the trouble becomes chronic and deep-seated, it takes on the seventh day aggravation, and in the psoric manifestations of a long, lingering and deep-seated kind there is a fourteenth day aggravation.
This appearing in cycles is common to a good many remedies, but is especially marked in China and Arsenic. These two remedies are similar to each other in many respects, and they are quite similar in their general nature to the manifestations that often occur in malaria. It is true, however, that Arsenic is more frequently indicated than China. In every epidemic of malarial fever that I have gone through I have found Arsenicum symptoms more common than those of China.
These headaches bring out the interesting point that we mentioned above. Arsenicum has in its nature an alternation of states, and this carries with it certain generals. Arsenicum in all of its bodily complaints is a cold remedy; the patient sits over the fire and shivers, wants plenty of clothing, and wants to be in a warm room.
So long as the complaints are in the body this is so; but when the complaints are in the head, while he wants the body warm he wants the head washed in cold water, or wants the cold air upon it.
The complaints of the head must conform to the generals that apply to the head, and the complaints of the body must be associated with the generals that apply to the body. It is a difficult thing to say which one of these two circumstances is most general, and it is sometimes difficult to say which one is the general of the patient himself, because he confuses you by saying:
“I am worse in the cold,” but when his headache is on he says:
“I am better in the cold, I want to be in the cold.”
It is really only the head, and you have to single these out and study them by the parts affected. When things are so striking you must examine into it to see what it is that brings about modality.
You will see a similar state running through Phosphorus; the complaints of the stomach and head are better from cold, i. e., he wants cold applications upon the head with head sufferings, and wants cold things in the stomach with stomach complaints, but in all the complaints of the body be is ameliorated from heat.
If he steps out into the cool air, he will commence to cough, if he have a chest trouble. So we see that the modalities that belong to the part affected must always be taken into account. For instance, you have a patient suffering from neuralgia or rheumatic affections and these same pains, extend, to the head, then he wants the head wrapped up because they are ameliorated from heat.
But when it comes to cases of congestive conditions of the head, he then is better with his head very cold. Now, as I have said, there is an alternation of these states in Arsenicum.
I will illustrate by mentioning a case.
Once a patient had been dragging along with periodical sick headaches. The sick headaches were better from cold water, cold applications to the head, could hardly get them cold enough, and the colder the better. These headaches came every two weeks, and so long as they were present he desired cold to the head.
Then these periodical headaches would be better, for long periods; but when they were away he was suffering from rheumatism of the joints, which was also periodical, and also more or less tenacious, and when this rheumatism of the joints and extremities, with more or less swelling and oedema, was present he could not get warm enough; he was at the fire and wrapped up; he was relieved by heat, and wanted warm air and a warm room.
This would last for a period and then subside, and back would come his sick headaches and last for a while. That is what I meant by the alternation of states. Arsenicum cured that man, and he never had any of them afterwards.
The alternation of states sometimes means that there are two diseases in the body, and sometimes the remedy covers the whole feature in alternation of states.
I remember another case, which will illustrate this peculiar nature of alternation of complaints, which is shared by other remedies besides Arsenic.