Skin: Croton oil, when applied to the skin, produces both vesicles and pustules upon an inflamed base, and the part becomes very red and sore.
The inflammation often increases until it resembles erysipelas, but more commonly the eruption produced resembles a vesicular eczema. This eruption will come on for a few days and will then desiccate, and in a few days longer it will desquamate.
When one has been overdosed, as is done in a too prolonged proving, or by the crude drug, or when the prover has been markedly sensitive, we get an alternation of states, the internal alternating with the external.
After the eruption is out the internal manifestations are not present, as is seen in the rheumatic state, the cough and the bowel symptoms. If we study these groups separately we will find they are all interesting.
Cough: First, its cough. It has an asthmatic cough, coming on in the middle of the night, often arousing the patient from a sound sleep. Attacks of violent coughing, with dyspnoea and choking, worse at night and worse on lying down, compelling him to sit up, to be bolstered up in bed, or to sit up in a reclining chair.
His friends wonder if he is not going into consumption. If it is a child they wonder whether it is not whooping cough. There is extreme irritation of the air passages, so that the inhalation of air brings on the cough. Sensitive to deep breathing. Now, this will go on for a while and finally he will break out with an eruption somewhere upon the body, vesicles and pustules, in clusters and patches, that become inflamed and red and finally dry up and desquamate and disappear, and then back comes his cough. This may go on as a chronic state, and when such is the case it will be very well to know this remedy.
Bowels: The next most important symptoms are the bowel symptoms, and perhaps they are the best known of any of its symptoms outside of the eruption. It is suitable in both acute and chronic diarrhoea. It is suitable in cholera infantum.
The marked feature is the extreme, suddenness with which the stool is ejected. It seems to come out in one gush of yellow, watery or pappy stool; soft, thin fÃ¦ces, coming, out with one gush, so marked is this that it is not an uncommon thing for a rural patient to describe it as “like that of a goose.”
It all gushes out in one squirt.
The mother says of the little patient:
“You would be astonished, doctor, at the violent rush, for it all comes out with one squirt.”
That is descriptive. Many remedies have a holding on and a prolonged effort at stool, until it takes quite a long time. Many of the diarrheas are prolonged with numerous little gushes of thin fÃ¦ces or water, but this particular feature is striking.
It may not always be so, but this violent gush of thin, yellow faeces or yellow water is a striking feature of the remedy.
With this the abdomen is very sensitive, and is greatly distended; there is much gurgling in the bowel, and when the physician puts his hand upon it the patient will say he feels the gurgling, as if he were full of water, and it probably is so, for the expulsion of the stool would not occur in one strong gush were it not for the fact that the colon and rectum were full of fluid.
Another peculiar thing commonly attending Croton tig. diarrheas is that pressure over the abdomen or pressure about the umbilicus causes a pain in the rectum and urging to stool, and a feeling, with the expulsion of the stool, as if the rectum would protrude. Clinically it has been described as if the pain followed the intestines all the way down to the anus.
The taking of a little water, or of a little milk, what would ordinarily be suitable food for such a diarrhea, will at times cause an instant urging to stool; he must go to stool immediately after eating.