If there ever was a drug which one might consider suitable for demonstrating the truth of the fundamental laws of homoeopathy, then surely Arsenicum album is that drug. It is known to the medical world for its uses and misuses, to the criminologist for its illegal uses in murder, than which there is no more popular poison, and to the laity for the publicity which crime has given it. There are indeed few today who do not known that weed killer and fly-paper are the most common sources of this deadly but easily recognized poison.
And yet how rarely, comparatively speaking, is Arsenicum used in orthodox medicine except in the so-called specifics against syphilis and in the “blunderbuss” tonics of the other school.
My first example will be taken from Marshall Halls famous cases and refers to the Seddon murder, the first case in British courts where chemical evidence of the nature and duration of poisoning were admitted as fact by the presiding judge. The description runs:.
“Miss B. was taken ill and the family physician who was called found her to be suffering from acute diarrhoea and sickness.” Here we have our first symptom.
“As the days went by Miss B. got worse. Certain chemical fly-papers were used to destroy the flies which buzzed in large numbers round the bed of the invalid attracted by the pungent odor of the sickroom.” Note the “pungent” odor of the sickroom and one might say of the patient.
“She was a troublesome patient and would not take her medicine.” The prosecution did not see the signification of this symptom nor was it mentioned as being one other symptom of arsenical poisoning. But it is and reads, “The patient feels so ill, is so sure that she is dying that it seems useless to take the medicine.” This is not the refusal of Hyoscyamus or of Kali brom where the patient refuses the medicine because he is suspicious that it has been poisoned!.
So though these symptoms were not produced as evidence of arsenical poisoning they are indeed very good provings of the drug; vomiting, diarrhoea, prostration, weakness, offensiveness, fear and anxiety.
The weakness of Arsenicum is general, not like Phosphorus and Stannum in the chest, nor like Sepia, Ignatia, Nux and Sulph., where it is often located in the stomach.
The following cases are described as examples of homoeopathic prescribing in a wide and varied range of symptoms.
CASE I. Pulmonary congestion.
Mrs. E., aet. 30. Shivered yesterday. Very bad headache. < moving the eyes. Weakness. No strength to sit up in bed, feels as if had been ill for a week. Cough hard. Thirsty for sips of cold water often. Pain in the eyes is worse after sleep, on first opening the eye. Pain in the eyes is worse after sleep, on first opening the eye. The physical signs were those of decreased R.M. at the right base. T. 101., P.100.
When a patient with fever desires sips of water frequently one immediately thinks of Arsenicum. It is as important a symptoms in fever as the thirstlessness of Gelsemium and Pulsatilla.
The only other outstanding symptoms were those of the head and eyes.
Pain < moving the eyes has: Ars., Berb., Bry., Calc.s., Carb.v., Chin., Cupr., Gels., Hep., Kali nit., Lac d., Mang., Nat.m., Puls., Rhus., Spig., Sulph.
Pain < opening the eyes after sleep: Ars., Hydr., Led.
Ars. alb. 10M. was prescribed three-hourly and next day the temperature was 99, pulse 88. All symptoms improving. Recovery was uneventful. The chest signs cleared in a few days.
This case I look on as an aborted pneumonia.
CASE II. Pleurisy (interlobar).
Mrs. K., aet. 50 years, caught a cold. Now a bad cough and pain in the right chest, going through to the back about the level of the upper and middle lobes. T. 101. 6, P. 120. Thirst for small drinks often.
Looks very flushed. Belladonna, which also has a desire for small drinks often, was prescribed but without much effect.
It was then that one looked up the repertory for pain in the right lung and found that this was a typical Ars. pain and situation, particularly the direction of the pain to the back, like Kali bi.
Ars. alb. was prescribed and next day the pain was very much improved, the temperature had dropped and recovery was speedy. The guiding symptoms here were the thirst and the site of the pain.
CASE III. Exophthalmic ophthalmoplegia.
T.B., aet. 62. For a year prominence of both eyes increasing. Began right and then left. Sight is failing. OEdema of both canthi, mostly the inner. Investigated at the London Hospital. W.R. negative, x-ray negative for enlargement sella turcica. Papilloedema both discs. No tachycardia. No tremor. Various drugs were given without result. A more detailed record of symptoms was when taken:.
Very faddy; particular in his ways. His collar fidgets him. He cannot sit still for long; has no patience to sit still and read, e.g. Must be doing something. Restless hands and feet. It angry with his daughter because she is not tidy.
Very fond of fat; very fond of vinegar and pickles.
He was the typical fastidious Arsenicum type. I often find that this type is fond of fat and fond of pickles. The confirmation of a choice by what are perhaps trivial likes and dislikes is often very helpful. The desire for vinegar and pickles in Sepia I also find useful. They are not the first choice symptoms but confirmatory.
Ars. alb. 1M. was given and over a period of none months the exophthalmos has decreased rapidly and the last report of the oculist was that there was now no papilloedema and vision was 6/6 in both eyes.
The result here is very good, particularly as the only suggestion made at other clinics was to have a decompression of the orbit!.
This is an example of the clinic of the remedy on the drug type. There is no one method of choosing a remedy.
One cannot make bricks without straw, but using the material one has it is often possible to make a successful choice, it may be on history, on heredity, on acute symptoms or even on appearance. One should try if possible to get the complete picture and then to obtain the similimum, but the complete picture, though often sought for, is not always obtained.
CASE IV. Gastric ulcer, verified by x-rays.
Mrs. L. Pain and vomiting. The pain is acute and COMES ON WHEN EATING OR IMMEDIATELY AFTER. Few other symptoms were elicited except local symptoms such as that the pain was burning, another symptoms of Arsenicum.
The time after eating is important, not only from diagnosis but also as being typical of certain remedies, e.g., the vomiting of Phosphorus (this is often true of the vomiting of appendicitis) which occurs after cold water but only when the water has become warm in the stomach, perhaps about seven to ten minutes; or of Nux vomica when the pain comes often about one- half hour after eating.
Ars. alb. was given to this case with beneficial results.
CASE. V. Gastric ulcer, verified by x-rays.
Mrs. G., aet. 46. Pain and vomiting. Pain better for vomiting. The pain is felt more acutely on taking a deep breath. She is so tender that she is nervous of people touching her. She was chilly. Depressed; better with people. Irritable. Terribly weak, more than is justified by exertion. It is too much trouble to do anything. She admits to being faddy and over-tidy. She is found of fat, and likes hot food. The peculiar symptom, pain < by deep breathing, appears under: Ars., Caps., Lyc., Puls.
Here as in most outpatient work it is necessary to combine facts with experience. The general trend of the general symptoms led to Ars., with its tidiness as the outstanding feature. The the peculiar symptom was present and confirmed the choice. Ars. alb. was given which great benefit.
CASE VI. Asthma.
Mrs. M., aet. 32. Subject to colds (cf. Tub.bov.). Asthma last year during the fog. As soon as lies down; must sit up.
She is better up an d walking about. The cough is tight and the sputum frothy. She had hay fever this year only. She is chilly. Nervous coming to hospital. Shy; depressed. Sympathy irritates her. Appetite is good. She is fond of fat. She bleeds easily. Her breathing is better at the seaside.
The combination of hay fever and asthma always makes one think of Arsenicum. A frothy sputum is also Ars. The improvement in breathing on sitting up is another good Ars. symptom. So also is the restlessness which whatever the condition, is improved by yielding to the restlessness. In asthma this must rank as a peculiar symptom. Ars. is chilly, very chilly, is fond of fat and bleeds easily. Ars. is usually worse at the seaside, but this does not cancel the choice out.
Ars. alb. helped the patient considerably.
CASE VII. Headaches.
Mrs. P., aet. 53. Headaches getting worse for eighteen months. Pain is terrific. Cant lie down. Wants to move from chair to chair. Wrings her hands. Every month and lasts at least a day. She is chilly, fussy and likes fat. She preferred the classical symptoms of the Ars. temperament: Restlessness. Moves from chair to chair or bed to bed. Wrings her hands, shows anxiety. The headaches are periodical, which is often true of Ars. (cf. China). Chilly, fussy, and desire for fat clinch the tentative choice. Ars. alb. cleared the headaches completely.
CASE VIII. Heart failure.
G.H., aet. 65. Difficulty in breathing for six months, < if walking against a cold wind. Now swelling of feet. Cough with frothy sputum. Feels the cold; feels weak. Sleeps poorly. The heart was enlarged. B.P. 180/120. There was oedema of the shins. He is chilly. Wakes early. Cannot lie on his back. He is very precise in all his habits.
OEdema is one very prominent symptom of Ars. Weakness is another. So also is frothy sputum; and < walking against the cold wind is an Ars. symptom. His chilliness and fussiness confirm the choice.
It would often seem as if in outpatient work that the local symptoms are the first choice but it is not always so.
Often when the patient is relating his symptoms one picks out the prominent symptoms of the disease or the peculiar ones. There is a trend toward such and such a remedy and one automatically seeks to confirm this trend or otherwise by seeking the generals.
Ars. alb. was prescribed for this case with satisfactory results.
CASE IX. Chronic dyspepsia. X-ray negative for ulcer.
Retching and belching with occasional vomiting of food, about one and one-half hours after meals. Chilly mortal. Pain is < for a deep breath (cf.Case V). Worse cold weather. Nervous irritability about small matters. Worries about details. Tidy for a man. Conscientious about trifles. Disorder annoys.
Ars. alb. relieved considerably. During treatment he developed rodent ulcer at the outer angle of the eye. He went off on his own and had it removed. The connection between Ars. and malignant states is undoubted and there are cases on record where Ars. has cured at least local cancer such as rodent ulcer.
This patients mother had died of cancer. This was a case of prescribing on the constitution and it is a pity that he did not leave the rodent ulcer alone since it had appeared whilst under treatment with Arsenicum. The symptoms of ulcer without x-ray evidence of frank ulceration are suspicious of a possible malignant condition of the stomach even if only in a very early stage. The presence of the rodent ulcer proved that the constitution was prone to malignant change.
CASE X. Exophthalmic goitre.
Mrs. L., aet. 42. Tachycardia; tremor; enlargement of thyroid for about a year following upon mothers removal to the hospital with melancholia. Is very anxious about heart. Excitable. Worried about mother still. Irritable. Unreasonable (unusual admission in a woman!). Temper about trifles; if cannot get work done at the time. Magnifies trifles. Fussy about herself. Quick mentally and physically. Anxious anticipation.
her chief mental symptom is summed up in her anxiety about trifles: Anac. Ars., Bar.c., Bor., Calc., Caust., Chin., Cocc., Con., Ferr., Graph., Sil.
Another prominent symptom was anxiety on anticipation: Arg.n., Ars., Gels., Lyc., Med., Ph.ac.
The mental state, beginning and end, was anxiety, and this is essentially Ars. Ars.alb. helped a great deal. Things which had worried no longer did.
CASE XI. Rheumatoid arthritis.
Mrs. H., aet. 53. Generalized pain, < in fingers which are swollen and tender and in the hips and shoulders. Afebrile. She has a cough and sputum yellowish and lumpy. The bones feel as if bruised. (Eup.per.) She was chilly, worse in the morning. Faddy about most things. Worse for wet weather. Had an aversion to fat and to sugar. Appetite was poor.
Running these symptoms through Kents Repertory, Ars.alb. came through most, the others noted being Merc. sol., Phos., Nux, Sulph.
Ars.alb. was given with very marked improvement, both in the joints and general condition.
CASE XII. Carbuncle of the neck.
F.C., aet. 65. Carbuncle for three weeks. Incised at another hospital, but he has been too ill since to attend further. He has a temperature and the pain is unbearable and burning. T. 102.4, P. 100. He looks ill, anxious and restless. In addition he is thirsty and desires sips of water often.
Ars.alb. was given with cessation of the temperature and pain and healing commenced almost immediately.
CASE XIII. Postoperative pneumonia.
H.O. Acute appendicitis. On operation appendix found to be gangrenous. T. 100 next day with cough; next day T. 102, P. 110. Diminished R.M. at right base with some ronchi. He was restless, looked anxious, and thirsty for little drinks often. Ars.alb was given. Temperature was down next day and the physical signs began to disappear immediately.
CASE XIV. Postoperative fever.
Mrs. R., aet. 30. Operation for acute obstruction found to be due to inoperable carcinoma of the colon. Next day she was very ill. Looked distressed and anxious. Felt she wanted to move which eased her and though it was too painful to move her body she moved her head continuously. Rhus tox. was prescribed but without effect. She looked as if she would die. She was now thirsty for small drinks often but so weak spoke only in a whisper. Ars. alb 10M. was given and next morning she was reading the newspaper. This is always a good sign and shows a returning interest in life.
CASE XV. Peripheral neuritis.
Mrs. U., aet. 35. On waking one morning she had the most excruciating pain in both arms, a burning pain with the most intense numbness in the hands. The fingers felt puffy like small sausages. The burning pains were relieved by heat; she laid them on the hot water bottle for relief. Ars. alb. was given and next day the pain was very much eased but the numbness and inability to distinguish the size and shape of objects did not return for a week or so. She did not receive any drug but Ars., but recovery was complete.
CASE XVI. Retroperitoneal sarcoma.
Mr. B., aet. 60. Ailing for some months. Laparotomy showed an inoperable retroperitoneal sarcoma in the upper abdomen. He was given one month to live.
He was chilly, fussy, faddy, nothing was right. It was difficult to get a nurse to stay with him more than a week or so and some endured him for no longer than a day or so. He grumbled every day an all day about little things not being in order, his bedclothes, his handkerchief, his bedtable; everything had to be just so.
He was very weak physically, could scarcely walk a few steps without exhaustion. After stool he took hours to recover.
Now Ars.alb. has a very close relationship to malignant processes. On infrequent doses of Ars.alb., rising from the 30th to the CM., this patient lived for nine months and faded out without pain or intense discomfort and even without the realization of his impending end.
Of course something was lacking to clinch the cure, for the actual something was lacking to clinch the cure, for the actual tumor decreased amazingly, but what it is still eludes us, possible something lacking in the diet or the absence of some factor as in pernicious anaemia.
CASE XVII. Pneumonitis.
Mrs. V., aet.70. Suddenly chill; face flushed; stitching pain left side where fine crepitations could be heard. Thirsty for sips often, mouth parched and dry. White frothy mucus. T. 101, P. 100. She looked anxious. Belladonna was given but with no effect.
The voice was now husky and weak. The pain in the side was worse. She was terribly thirsty still, and still for small drinks. T. 102. 4, P. 110. Rales at both bases but more marked at the left. Ars. alb. was given with marked improvement. T. 99.8, P. 96 next day.
She was slow to clear but Sulph. hurried this along Sulph. is often a follower of Ars. where restitution and resolution are slow.
Recapitulating the prominent symptoms of Ars. alb. as demonstrated in the preceding cases :.
Burning: pain, tears, nasal discharges.
Burning lips, dry mouth. Thirst for small quantities.
Burning in the stomach. Pain and vomiting as soon as eaten.
Burning anus (cf. Sulph.). Excoriating diarrhoea.
Burning nd acidity, but burning better from heat!.
Midnight aggravation. (Asthma and angina.).
Periodicity, every seven and fourteen days.
Restlessness and anxiety (cf. Aconite but the condition is usually a more serious one than Aconite).
Sensitiveness leading to fastidiousness and worry.
Weakness. No desire to live. It is not worth while trying.
THE HOMOEOPATHIC TONIC. DEEP IN ACTION; DEEP IN CURE. LONDON, ENGLAND.