CLINICAL NOTES FROM TIMOTHY FIELD ALLEN


Arsenic is not as often indicated in ulcerations of the throat as many other drugs, rarely in the early stages of diphtheria; it is valuable in the later stages with profound prostration, especially if the membrane of the throat becomes dry with burning thirst, irritable stomach, profound prostration, or with albuminuria and dropsy. Inflammation of the esophagus, with spasmodic stricture on swallowing food, burning.


Arsenicum album: It is adapted to a condition of profound prostration, rapid exhaustion, or even collapse. Paralysis, especially in lower extremities. Hysterically paralysis. Spinal paralysis from myelitis. General dropsy, with a weak heart. Dropsy from kidney disease. General anaemia. Pyemia with oedema, erysipelas, gangrenous ulcers, and purulent expectoration.

“Melancholy, with suicidal tendency, great restlessness, constant change of place, wringing of hands, aggravation during the last part of the night. Insanity with self mutilation. Excessive fear of death, yet despair of life. Nearly all of the mental disorders are characterized by extreme, anxiety, fear and restlessness.

“Neuralgia headache, with extreme prostration, burning in stomach, retching, thirst, etc. The pains are burning, shooting, like needles, with soreness in the painful part. Dandruff, head dry and scarcely, soreness, rarely eczema, and still more rarely pustular eruptions.

“Ophthalmia, which is extremely painful, with very great sensitiveness of the eyes to light, burning and swelling of the lids. In all of the external inflammation of the eyeball; it is characterized by extreme painfulness (burning), hot and excoriating lachrymation, swelling of the lids, great photophobia; with these symptoms, it has been found useful, not only in ophthalmias, but in inflammation of the cornea, with, or without ulceration, and also in internal inflammations, with accumulation of pus in the anterior chamber. In ciliary neuralgia, with fine burning pains. Disseminated choroiditis. Retinitis albuminuria.

“Otorrhoea with thin, excoriating discharge sometimes fetid. The skin within the ear becomes raw and burning, and the discharge becomes ichorous and very offensive. (Compare with mercury.).

“Fluent coryza, with watery, burning, acrid discharge, and sneezing. As a rule there is no ulceration, not stoppage, as in nux vomica, thought these may occasionally happen. The discharge is always burning, excoriating. Extreme sensitiveness of smell, can not bear even the smell of food.

“Face is apt to be pale and puffy, even in fever, especially with all gastro-enteric troubles; sometimes pinched and drawn, hippocratic, cold, or covered with cold sweat. Facial neuralgia, with burning tearing pains.

“Neuralgia of the teeth, burning, tearing; ameliorated by heart, aggravated after midnight, with great prostration; teeth feel long and very sore. Guns unhealthy, bleeding easily, with a general cachectic condition. Tongue ulcerated. Canker sores on tongue.

Epithelioma of tongue. Neuralgia of tongue with burning pain. In fevers the tongue may be dry and red, or it may be brown and black, smooth as if varnished, generally with very sore mouth, gangrenous sloughs of tongue (cancerous). Ulceration of mouth with great dryness and and burning heat. Gangrenous sore mouth of children (compare with chloride of potash.).

“Arsenic is not as often indicated in ulcerations of the throat as many other drugs, rarely in the early stages of diphtheria; it is valuable in the later stages with profound prostration, especially if the membrane of the throat becomes dry with burning thirst, irritable stomach, profound prostration, or with albuminuria and dropsy. Inflammation of the esophagus, with spasmodic stricture on swallowing food, burning.

“Most violent gastro-enteritis, even ulceration and various diseases of the stomach (cancerous, etc.) are cured by arsenic, always with a few characteristic indications — extreme irritability of the stomach which will retain but little, if anything; extreme soreness, with burning heat.

In less serious conditions, it is frequently useful for instance, in persistent deathly nausea of pregnancy, chronic catarrh of the stomach; the whole inner portion of the stomach seems raw; constrictive pain when the stomach is empty. Severe gastralgia brought on by the slightest food, or drink. The patient thinks that she will die; with profound prostration the pain is burning hot and extends up sides and over abdomen.

“Metro-peritonitis, nausea, vomiting, profound prostration, cold sweat, brown tongue, burning pain, etc. Catarrhal enteritis. Ulceration of the bowels. Enlarged spleen, with inflammation of the liver associated with inflammations of the kidneys. A great variety of inflammatory disorders of the abdominal viscera, characterized by extreme sensitiveness, tendency to collapse; and general arsenic symptoms. Dropsy of the abdomen.

“Haemorrhoids, with burning like fire, ameliorated by heat.

“Diarrhoea generally a dark, scanty, watery, or mucus sometimes bloody. Stools may be brown, or black, burning, putrid, brought on by eating, or drinking, or aggravated after midnight, preceded by most violent burning and cutting pains and followed by extreme exhaustion, general arsenic symptoms. Arsenic symptoms usually present. Constipation rare, abdomen painful.

“Acute and chronic inflammation of the kidneys, either idiopathic or associated with various diseases; the urine is scanty, hot, there are generally great oedema and dropsy, very irritable stomach and bowels, great thirst. Inflammation of the bladder, with extreme burning on urinating. The urine is generally very scanty with all diseases, suppressed (in Asiatic cholera or in dropsy) thick, sometimes fetid. Diabetes has been cured.

“Hydrocele in a child. It has been found valuable in inflammations of the pelvic viscera, pelvic cellulitis, uterine enlargement and tumors, ulcerations and cancer of the uterus, uterine haemorrhage; in all these diseases the indications are lancinating burning pains, etc. Burning pain in right ovary, amenorrhoea, instead of menses, profuse, excoriating leucorrhoea. Granulations on inner surface of uterus with pains as from red hot wires.

“Laryngeal catarrh, with dryness, burning, sensitiveness. Bronchitis cough in the night, with rawness behind the larynx. Paroxysmal cough, with suffocation, increased by cold air. Capillary bronchitis, extreme anxiety, puffiness of the face, etc. Emphysema, with excessive dyspnoea, suffocative cough, cold perspiration, etc. Asthmatic attacks coming on after midnight, suffocative, with cold sweat, burning in chest, extreme anguish. Asthma especially increased by cold changes of temperature, feeling of great constriction in air passages and gasping.

Dyspnoea from oedema of lungs in Brights disease, consumption; consolidation of the lungs, with extreme prostration, sweat, etc. Valuable for the cachexia which leads to chronic disease of the lungs. In all pulmonary troubles the cough is increased after midnight, and by lying on back, expectoration is very scanty, with general arsenic symptoms. Angina pectoris.

“Very valuable in weak heart, which is irritable, rapid action on slightest provocation. Tumultuous action of heart, palpitation. Irritable heart of smokers, or of tea drinkers. Occasionally indicated in inflammatory affections of the heart, endocarditis, hypertrophy, dropsy about the heart.

“Sciatica coming on at night, decreased heat, burning pains, anguish.

“Eruptions on face. The skin diseases requiring arsenic are, as a rule, dry, scaly with soreness, intense itching, and burning. In unhealthy states of the skin, and in low fevers we may have ulceration and even gangrenous sloughs.

“It is sometimes, but rarely, indicated in vesicular, and even in pustular eruptions, when the general symptoms of the patient correspond. It has cured a great number of indurations and tumors even after the ulcerative stage has been reached. In all of these diseases the general indications must be followed.

“Malarial fevers of various sorts, with profound prostration. A great variety of intermittent, with the general indication of inequality between the three stages; the febrile stage is generally greatly prolonged; either the cold or sweating stage, or both, may be suppressed with the general arsenic symptoms of great restlessness, prostration, thirst, irritability of stomach and bowels, etc.

In low types of typhoid fevers with the arsenic characteristics frequently enumerated. In typhus fever; in blood poisoning; hectic fever; yellow fever; in short in a great variety of low types of fever, with tendency to disorganization of the blood and other tissues. Eruptive fevers, sometimes in scarlet fever. In haemorrhagic measles.

“Arsenic is above all a tissue drug”.

Fred B. Morgan