Dr. Pope ameliorated a distinctly pemphigoid eruption with cantharis 3x. Later in the case-one of disseminated sclerosis- the eruption reappeared, and passed away without rupture under Phosphorus given on general indications for that drug.
The indications for the principal internal homoeopathic remedies are as follows.
Ammon mur.-Blisters the size of peas on the right shoulder with itching; burning at small spots on the chest; chilliness, especially when walking; fat body but thin legs.
Arsen. alb.-Black blisters, burning and very painful; great restlessness and typhoid symptoms; pemphigus foliaceus or when gangrene sets in.
Belladon.-Painful, watery vesicles on the palm of the hand sensitive to the touch; chill in the evening, mostly on the arms, with heat in the head.
Cantharis.-Pemphigus presents a very exact image of the lesions produced by the external application of cantharides; active inflammation, with blisters containing serum, burning more than itching; more on right side.
Causticum.-Large painful blisters on the left side of the chest and neck, which become flattened; with the eruption, there is difficulty of breathing, fever heat and sweat; very sensitive too cold; corpulent children, with tendency to enlargement of glands; involuntary urination when sneezing or blowing the nose.
Chamomilla.-Extreme irritability of the nervous system and great sensitiveness to pain, or to wind or currents of air; darting and lancinating pains.
China.-Great nervous irritability; the contents of the vesicles becomes ichorous with a putrid smell; where there is a tendency to gangrene.
Clematis.-Burning throbbing pains, yellow corrosive ichor; great emaciation.
Dulcamara-Burning pains, restlessness, thirst and emaciation; the bullae break forming corroding ulcers.
Gummi gutti.-May be used when other remedies fail.
Kali carb.-Burning, itching and stitch pains; blisters with tendency to spread; pemphigus foliaceus.
Iodine.-Gangrenous tendency, after mercury.
Lachesis.-Gangrenous tendency, bullae and blisters; tossing and moaning during sleep, and aggravation of symptoms on awaking.
Mercurius.-The bullae have a tendency to spread, with discharge of burning ichor, worse at night, particularly from warmth of the bed; profuse sweat which does not relieve.
Natrum carb-Blisters with oozing of purulent fluid; the whole skin becomes dry, rough and chapped.
Natrum mur-Fluid from blisters and blebs like water.
Natrum sulph.-Watery vesicles or blebs all over the body.
Phosphoric acid-Deep hard bullae on the ball of the thumb; blisters on the balls of the toes; great drowsiness and apathy; in debilitated individuals; after sexual excesses.
Phosphorus.-The blisters are full to bursting, painful and hard, but not itching; tall fair children with tendency to tuberculosis; languor and nervous itching; chilliness every evening with shivering; arms and hands become numb;regurgitation of food; small wounds bleed much.
Ranunculus bulb.-Blisters on the fingers the size of a hazelnut, followed after healing by small deep transparent dark- blue elevated blisters the size of ordinary pin-heads; this remedy has cured pemphigus in new-born children.
Ranunculus scel.-Vesicles, which emit a thin acrid, yellowish ichor and form obstinate ulcers; itching, boring, gnawing and biting pains; sleeplessness, with debility and anxiety.
Raphanus-Blisters full of water on the breast, with out inflammation, redness or pain.
Rhus tox. -Acute form, with much itching and burning; confluent blisters with milky or watery fluid and peeling of the skin.
Sepia.-Pemphigus on the arms and hands; heaviness of the limbs; sensitive to cold air; arthritic pains in the joints.
Tartar emet.-Vesicles filled with bloody serum, collapsing and bursting, turning blackish and changing to malignant broad deep ulcers; gastro-intestinal irritation.
Thuja.-Pemphigus foliaceus, with offensive odor, and formation of scales.
Anomalous Forms of Bullous Eruption. Hydroa.
Under the head of neurotic diseases, and in connection with herpes, attention may be directed to certain vesicular or bullous forms of eruption, which have been described by Bazin under the term of arthritic hydroa. He distinguishes three varieties of hydroa: 1.Hydroa vesiculeux. 2. Hydroa vacciniforme, confounded with aphthae chronique. 3. Hydroa bulleux.
Hydroa vesiculeux is generally confounded by authors with erythema papulatum. First, as regards Seat, “It is developed on the cutaneous and mucous surfaces. On the skin it exists ordinarily on the uncovered parts back of the hands and wrists and on the front of the knees, etc. In most cases the buccal mucous membrane is affected, and then the eruption occupies by preference the lower lip and the inside of the cheeks, and appears after its development on the skin. However, in one of our cases, the base of the uvula was surrounded by a circle of vesicles. The conjunctiva may also be the seat of this eruption.”
Symptoms- It is sometimes preceded by malaise, anorexia, and a slight febrile attack, but these prodromic symptoms are often wanting, or are so little marked that the attention of the patient is first attracted by the development of the vesicles.
Whatever be the seat of the eruption, it presents the following characters:-
There is seen at first spots of a deep red color, small, rounded, a little raised, and with their edges clearly defined. These spots vary in size from that of a lentil to that of a twenty-five cent piece; they are sometimes surrounded by a rose- colored areola: they show soon in their centre a small vesicle filled with transparent yellowish liquid. This vesicle appears the day following that of the red spot. It dries rapidly from the centre, which is occupied by a small blackish scab, whilst the liquid is absorbed from the circumference. The phenomena takes place towards the second or third day of the eruption.
The subsequent phenomena are as follows:- The liquid in the circumstance of the vesicle is reabsorbed, whilst that which occupies the centre becomes a blackish scab. At last it may happen, especially during cold weather, that the fluid exuded in the vesicle is absorbed rapidly. It will then have only a small whitish or yellowish macula, placed in the centre of a red disc, and formed by loosened epidermis. In this case it is that the affections has been confounded with erythema papulatum. On the mucous surfaces the vesicles are whitish and surrounded by a violet-colored areola-the scabs are detached sooner. The red discs and vesicles are more or less numerous. They are generally separated by intervals of sound skin; sometimes they are disposed in groups of two or three, touching at their circumstances. They do not all appear at once, but by successive crops during many days. The affected parts have scarcely any itching. The febrile symptoms which exist rarely at the commencement cease when the eruption is developed.
The duration of hydroa vesiculeux is from two to four weeks; each element in the eruption taken by itself runs through its course in four or five days. The affection is prolonged for many weeks only by the eruption of fresh crops of vesicles. A relapse may take place.
The disease is seen in both sexes, but more frequently in the male. It appears among adults from twenty to thirty years of age. It is more frequent in spring and autumn; cold and variation of temperature have a marked influence on its appearance and course. Finally it is always seen amongst people who have had still symptoms of gout.”
“Hydroa vesiculeux,” says Bazin, in continuing his description, which we have given above almost at length, ” is essentially arthritic-at least we have always found it among arthritic subjects, and it has steadily presented clear relation to gouty manifestations.”
Prognosis-“This affection is not grave; it disappears of itself in four or five weeks. It is subject to recur.”
Hydroa vacciforme is the same, only that the vesicles are varioliform.
Hydroa bulleux (pemphigus with little bullae) is an arthritic affection which is generally little known.
The eruption shows itself by bullae, which present one important character- the inequality of their size. Some are as large as a lentil; the largest do not go beyond the size of a pea. These bullae are rounded, arranged in an irregular manner, in groups of three or four; they are filled with transparent fluid, which grows thick quickly and takes a yellowish color; finally they are placed on a red surface, which extends from their base in the form of an areola. Whilst new bullae are developing, the old ones dry up and are replaced by a yellowish scab; and if one of these is rubbed off by scratching there appears a violet-colored, slightly excoriated, surface. In the interval of the crops of bullae there is no morbid phenomenon observed except the ordinary well-marked itching. The patient preserves his appetite, and the nutrition is not at all altered. Bazin states that the course is chronic, that the disease appears in successive crops, and lasts generally from five to six moths; that it is more frequent in men than in women, and appears in adults from twenty to forty years; that the seasons and variations of temperature have a marked influence on its development; that it is most common in the spring, and is excited by gout.
