Speaking of Vipera torva (the remedy was referred to in a letter in the August Recorder), the remedy has a slow pace as well as a very rapid one. This slow condition appears in the clinical verifications listed in Clarkes Dictionary of Materia Medica and in occasional reports in periodical literature; but the acute infections are apt to be very rapid. The same distinguishing characteristics appear to run through both types. Some of these, at least, will be observed to run through the case reports submitted herewith.
CASE 1. Young man; cut front of right lower leg with an axe just proximal to the ankle joint producing a deep incised wound into the tibia. The surgeon washed, mercurochromed and closed the wound with clips about a gauze drain. The next day there was severe pain to contend with, throbbing, bursting, relieved with cold applications, temperature 100.6. As the dressing had been too tight he was given Bellis perennis 200. Next day the situation was alarming for the infection had spread rapidly through the night although the boy said the remedy had given relief the first two hours after taking it.
The pain was now much worse (and of course swelling and redness); he could not let the leg hang down the least bit without severe aggravation for it felt” as if the blood were swelling it up so that it might pop open”. The pain was better while the leg was exposed to cold air, intense, burning, sore, extending to the knee and the soreness into the abdomen which was tender on the affected side. Extreme sensitiveness to touch. Black blood had oozed when the drain had been removed.
The mind was dull, the patient in general heavy, sluggish, though restless; severe headache, bad, “exhausting” dreams, great thirst, frequent urination, general aching; night aggravation. The temperature at one time in the night had been 104. Vipera torva 8c. J.,d.u., was given in the early morning. At evening there was no relief except drop in temperature. Copious sweating throughout the night. The remedy was repeated at evening. The action of this second prescription was prompt and nothing more was needed until a month later Silica 200 was used for tenderness of the cut bone and two fistulae which had formed which that remedy cleared up.
CASE II. Miss E., 19, had stuck a splinter in the sole of the right foot four months previously but had had no trouble until recently when a piece of wood was discharged. No physician had been consulted. Infection started immediately, the inflammation extending up to the ankle with hammering, throbbing pain aggravated by letting the foot down, at night, by any pressure or touch; relieved by coolness. Vipera torva 1000 (Ehrhart). The young lady slept all that night and was all right soon afterward.
CASE III. During my absence Dr. Woodbury prescribed Vipera torva 1000 for an infection superseding a chronic phlebitis of the right leg, with bursting pain, < when leg was in perpendicular position, puffy swelling and redness. Temperature 100.4. Trace of albumen in urine. If the doctor should read this he will be pleased to know that when the patient came in five days later the leg was greatly improved. Even the old condition had improved. I elicited also the symptom “blood congests in the head when stooping with dizziness on rising,” which also seems suggestive.
CASE IV. G.B., 48. Infection following a hernia operation in 1933 which under local treatments extended to the testicles, the left one excised meanwhile, followed by abscesses in the right knee, the left calf in front of left elbow, chased up with surgical incisions over a period of several years. Gonorrhoea was contracted on the way. A month previous to the use of Vipera torva an iron was dropped on the right great toe causing a periostitis with the usual swelling, redness, throbbing pain > by cool applications, < by the foot being let down, < at night, waking him often but worst at sundown. Character of pain congestive, pressive. Vipera torva DMM. (Swan) d. tr., 12 hours apart. Report received several weeks later. “The foot healed in two weeks time and he was up and going”.
CASE V. A lady of 50 had rheumatic localizations of obscure origin in the neck, sciatic region and complicated with a diarrhoea contracted at the seashore. She has lymphatic swellings of the forearms and backs of thighs apparently of a myxoedermatoid nature. A sister has a condition resembling elephantiasis. The rheumatic condition had been shifting slowly for several weeks. Rhus radicans prescribed by Dr. Woodbury had helped temporarily. But a more severe condition appeared in the foot which became swollen, slightly red, very sensitive to touch. She was compelled to change position frequently but without relief.
The sciatica also became worse. Pulsatilla was given without relief. The patient then spent most of her time weeping, upsetting and discouraging her family. It was now evident that the condition was worse nights, especially the first part, the pain extending to the toes and shooting upward, < by heat of the bed, to even a suggestion of touch, unable to let the foot down at all. Vipera torva 1000 Ehr. was given. Next day showed little if any improvement with the weeping going on almost constantly. The prescription was repeated, clearing up the arthritis effectively. Moreover, the general improvement (three weeks later) is striking.
The symptoms aggravated by heat and relieved by cold runs through all these reports and is a valuable modality because it substantiates the choice of Vipera torva from other remedies having similar local manifestations.