In and around the throat we find many conditions of interest. Outside and inside there is great sensitiveness. They cannot bear to have anything touch the neck (166) and are constantly pulling at the collar to loosen it, no matter how much room there may be. Dr. Hering, “who could never tolerate tight clothing about his neck, noticed during the proving of Lachesis that this symptom annoyed him more than usual and he made a note of it, although he did not place much value on it. Since then the symptom has been confirmed many times in practice, and has been found true, not only as a local symptom of the neck, but as a symptom of the body generally” (Farrington), for the whole surface is sensitive and they cannot bear anything, not even the clothing, to touch them.
In the throat we have elongation of the uvula, a sensation as if a crumb stuck in the throat, with hawking (44) and constant efforts to get rid of the irritation.
We often have a feeling of a lump in the throat, which will waken one out of a sleep, This sensation of a lump, or as if they throat were swollen and he would suffocate, is noticed on empty swallowing or when swallowing liquids, more than when swallowing food (183). In certain conditions when the attempt is made to swallow liquids they regurgitate through the nose (183), but in all diseases of the throat there is extreme sensitiveness to external touch or pressure, which causes a feeling of suffocation.
The disease starts on, or is confined to the left side, the throat is swollen and of dark red or purple color (191); there is soreness or sharp pains that extend from the throat to the ear on swallowing (191) and the odor from the throat to the ear on swallowing (191) and the odor from the throat is very offensive (62). With those symptoms Lachesis is indicated in all forms of throat troubles, from follicular tonsillitis and pharyngitis to ulceration (including syphilitic), gangrene and the severest forms of diphtheria (62). With the throat lesions the submaxillary and salivary glands are apt to be swollen.
In the stomach Lachesis is valuable for the gastritis of drunkards (176) and for weakened digestion after mercury (139).
It may be needed in the vomiting of pregnancy (153) and it must not be forgotten in yellow fever in the stage of black vomit (209), but the important thing to remember in all stomach and abdominal conditions is the soreness and sensitiveness to touch and the intolerance of the pressure of the clothes (12). A couple of pathogenetic symptoms, of different degrees of severity, read : “Obliged to wear the clothes very loose, especially about the stomach; even in bed is obliged to loosen and raise the night dress, in order to avoid pressure; she dares not even lay the arm across the abdomen on account of the pressure” (Allen’s Encyclop.).
We can make a note here that, as Allen points out, “the right side of the abdomen presents numerous symptoms of Lachesis, while in the throat most of the symptoms are on the left side.”
It is a remedy that has been found useful in appendicitis and in a late stage of peritonitis, and in a great variety of debilitating diseases of the abdominal and pelvic viscera, always with the aggravation from sleep, as well as the intolerance of clothing over the affected part.
It has been used in gall-stone colic (82), with jaundice (82), the liver swollen and very painful, and in inflammation of the liver, with threatening abscess (127). It is to be thought of in ascites (11) of drunkards and for “threatened gangrene in strangulated hernia” (Hering).
Lach, is useful in haemorrhoids (86), especially when strangulated, with great constriction of the anus (158) and a feeling of a plug there (160), with stitches running upward and severe throbbing. It is of value in fissures of the anus (159), with throbbing and beating as of many little hammers.
The stools of Lachesis are very offensive and putrid (59). “Of the odor of putrefying snakes”, as one symptom reads; but as few of us have had the opportunity of verifying the odor, the words putrid or cadaverous-smelling must satisfy our demands for exactness. The stools are sometimes involuntary, especially in low types of disease.
In low types of disease we have haemorrhages from the bowels of black decomposed blood, with as several authors, other than in the Handbook, say, “black particles of blood on the bottom of the vessel looking like charred straw.”
It is useful in diarrhoea worse in warm weather (57), for the diarrhoea of women at the climacteric, and for that of drunkards.
The urine under Lachesis is scanty and offensive, dark or blackish (193), with a sediment of decomposed blood (94) looking like coffee-grounds. It is to be thought of in general dropsy (63) after diphtheria and scarlet fever, with this black, albuminous urine of decomposed blood, and dark purple or bluish skin.
It is useful for chancroidal ulcers and buboes, with a general bluish look (26) and with a tendency to become gangrenous.
In reference to the female sexual organs, Allen says, “the most frequent indications for Lachesis in all diseases of the uterus and ovaries are the intolerance of the weight of the clothing, the tendency to the disease to extend from left to right” and the aggravation during sleep; with these symptoms “it has cured almost every pathological condition to the female organs, tumors, inflammations, displacements, indurations, neuralgic, etc.”
In addition Lachesis is useful in “menstrual colic beginning in the left ovary” (Hering), in dysmenorrhoea and in membranous dysmenorrhoea (138), worse alcoholic stimulants (5), with pain in left ovary (147) darting upward.
It is valuable for inflammation of the ovaries, worse left (148), especially if the menses are offensive (137), with general relief on the free appearance of the flow (134); also of value in puerperal metritis, with offensive lochia (153), and in phlebitis following pregnancy.
Lachesis is very valuable for many troubles occurring during the climacteric, some of which we have already spoken of.
One of the most important uses for the remedy at this time is for the flushes of heat to the head and face, the “hot flushes” that are so annoying (32). With this we have as prominent symptoms, the desire to loosen the clothes about the waist and especially around the neck, for they feel as if they would suffocate if the collar touched them.
It is valuable for metrorrhagia at the climacteric (136), with hot flushes, fainting turns, pain in the ovary and aggravation from sleep. Hering gives as an additional indication for the remedy, “women who have not recovered from change of life, `have never felt well since that time.”
On the respiratory organs under Lachesis we find the same prominent symptoms that we have now given so often that you begin to look bored at the mere mention of them; but for all that, I am going to repeat them and venture to predict that in spite of your familiarity with them at the present moment, there will come a time when they are presented to you in practice that you will overlook them, and instead of giving Lachesis at once, you will hunt all around for the remedy to fit the case, very like the woman who always looks under the bed for the man instead of between the sheets, where she might expect to find him.
There is the sensitiveness of the larynx to external touch or pressure (191), the feeling of suffocation and the cough from external pressure (44).
It is to be thought of in nervous cough (46) at the climacteric (42), or cough of reflex origin (42), without symptoms of local inflammation. We have asthmatic attacks (19) coming on during sleep and making the patient afraid to go sleep for fear she will die, so difficult is it to get her breath when she wakens. It is useful in emphysema (66), with the dyspnoea so great that the patient cannot lie down on account of the suffocative fulness of the chest, and with necessity to have the clothes around the neck and chest very loose.
It is useful in cough and whooping cough, the attacks waking one out of sleep, and in both false and true croup, “the child may be fairly well while awake but as soon as it gets to sleep the croup symptoms appear in great violence, the child almost suffocates, and the mother or nurse in consequence fear to let the child go to sleep” (Guernsey). In diphtheria and croup there is great fetor (62) under this remedy, with blue face and extreme prostration. Hering says in reference to diphtheria, “constitutional symptoms out of all proportion to local manifestations, prostration considerable even before any local evidences of disease could be detected.”
We can think of Lachesis in mastitis (22), with suppuration, bluish appearance of the breast and extreme sensitiveness of the nipple.
In the heart Lachesis is indicated in all inflammatory diseases, with palpitation (111), suffocation, intolerance of pressure about the heart (107) and pain going down the left arm (110). It is extremely useful in atheromatous arteries, in chronic aortitis, in angina pectoris (107) and hypertrophy of the heart (110) with the terrible dyspnoea.
