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Homeopathic Materia Medica by Farrington



LACHESIS, PART III

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LACHESIS causes in the male an increased lasciviousness with diminution of the physical powers. The mind is a prey to all sorts of allurements, but erections and emissions are imperfect.

Upon the female organs, Lachesis acts very powerfully. It seems to have special affinity for the ovaries, particularly the left ovary; ovaritis, ovaralgia, tumor, may be relieved, when there are tenderness to pressure of the clothing and other characteristic symptoms of the drug. Menses scanty, feeble, blood lumpy, black, and very offensive; pains in the hips, bearing down in the left ovary,—all better when the flow is established. The uterus is intolerant of the least pressure.

Lachesis may be used in puerperal metritis, especially when the lochial discharge is foetid. The face is purple and the patient unconscious.

It may even be indicated in ovarian tumors when the disease shows a tendency to extend from left to right, even when suppuration has taken place. It is especially called for after HEPAR or MERCURIUS when there is great adynamia.

In syphilis, Lachesis is called for as an antidote to Mercury or when the chancre becomes gangrenous. Its characteristics are its peculiar sore throat, the blue surroundings of the ulcers, nightly bone-pains, violent headache, and the phagedenic chancre.

The syphilitic ulcers on the legs are flat and have blue surroundings ; caries of the tibia; the parts are sensitive and livid ; ulcers in the throat; bone-pains at night; all after abuse of Mercury.

The bluish ulcers ally it with : HEPAR, ASAFCETIDA, LYCOPOD., SILICEA, ARSENIC. The pimples, blisters, or pustules surrounding the ulcers ally it with: ARSENIC, PHOSPHORUS, LYCOPODIUM, MERCURIUS, HEPAR,. SILICEA, etc. The burning in the areola, with: ARSENIC, LYCOPODIUM, MERCURIUS, SILICEA. The offensive pus, with : ARSENIC, ASAFOSTIDA, LYCOPODIUM, SILICEA, SULPHUR, HEPAR. The ulcers being flat, with : ARSENIC, ASAFCETIDA, LYCOPODIUM, MERCURIUS, SILICEA, PHOSPHORIC ACID, etc. If they become black or gangrenous, with : ARSENIC, SECALE C, SILICEA, PLUMBUM, CARBO VEG., EUPHORBIA, MURIATIO ACID. But Lachesis has the burning most marked when the ulcer is touched. The surrounding skin is mottled. Ulcers on the legs tend to spread superficially (rather than deeply, as, for example, in KALI BICH.), the discharge is scanty, and the strength is failing. Dark blisters surround the ulcers and the skin around is dead. Sometimes the discharge ceases, the patient is stupid, cold, the leg becomes oedematous, and a bluish-red swelling along the course of the veins, shows that phlebitis exists. All this looks like ARSENIC, CARBO VEG., BUFO, SECALE C, CINCHONA, etc. But Arsenic presents more vascular excitement and nervous irritability with the prostration. Carbo veg. induces still greater prostration than Lachesis, cold sweat, cool breath, collapse. The ulcer has a cadaverous odor. In mild cases there is no resemblance at all between the two; for the Carbo veg. causes much burning, rawness in the folds of the skin ; borders of ulcer hard, but not oversensitive, as in Lachesis.

HEPAR should be remembered as a concordant of Lachesis, and especially because it is so useful after abuse of mercurials. The areola of the ulcer is very sensitive, but there is a sore, bruised feeling along with hyperaesthesia. And although the suppurating part may turn bluish, and the patient experience weakness, yet there are no evidences of loss of vitality and gangrene, such as suggest the later indicated drug, Lachesis.

LYCOPODIUM is a complement of the snake-poison. If syphilitic ulcers appear in the throat, they are dark grayish-yellow, worse on the right side. The forehead exhibits a coppery eruption and the face is sallow, often furrowed, but lacks the small red bloodvessels, which shine through the yellow skin, in Lachesis. Chancres are indolent. Condylomata are pediculated. Ulcers on the legs refuse to heal, with tearing burning, worse at night; they are made worse by poultices or by any attempt to dress them. The pus is often golden-yellow. Flatulent dyspepsia.

NITRIC ACID, should it seem similar in phagedenic chancre, ulcers on the tibia, etc., may easily be distinguished by the irregular edges of the ulcer, which also presents exuberant, easily-bleeding granulations; and its mouth and throat symptoms, by the cracks of the commissures of the lips, sensation of a splinter in the throat, etc.

KALI IODATUM, exhibits quite a different train of symptoms from Lachesis : Gnawing, boring bone-pains ; throbbing and burning in nasal and frontal bones; greenish-yellow, excoriating ozaena; papules ulcerating and leaving scars; rupia; chancres with hard edges and curdy-pus ; ulcers deep-eating;, violent headache, much more severe than in the snake-poison, and causing hard lumps on the head. Tendency to interstitial infiltration of soft tissues and also of bones, thus more extended than with Lachesis, which infiltrates only the soft tissues.

In the uterine and ovarian symptoms of Lachesis, your attention is directed to the following comparisons :

PLATINA has profuse, dark menses, instead of scanty; and the hauteur is much more pronounced. The nymphomania is accompanied with titillation and tingling of the genitals or with vaginismus. In ovarian affections, this drug has relieved after Lachesis failed; as in suppuration of the ovary, the pus having been evacuated under the action of the latter. The pains are burning, with violent bearing down.

PALLADIUM HAS relieved induration and swelling of the right ovary, as has Lachesis. Mentally the two are widely different. The former develops an egotism, which manifests itself in the patient's concern for the good opinion of others; consequently her pride is often injured. Mental emotions aggravate the ovarian pains, as in the snake-poison, but in a different way. The Lachesis patient is ecstatic or at least excitable; the relating of stories moves her to tears. The PALLADIUM patient is easily-agitated in society; a lively conversation or some evening entertainment increases her pains and tries her mentally and bodily.

In ovarian affections, APIS stands closely allied to Lachesis. But it acts more on the right ovary than on the left. There is a bruised, sore feeling, or stinging, burning. At other times the pains are described as lancinating.

In prolapsus uteri or during the menses, the bearing down seems to be in the right ovary; pains followed by a scanty dark mucus.

Both have pains from left to right ovary; but in Apis this is experienced while stretching. There is also a strained feeling in the ovarian region, very characteristic. The pains may ascend in either; but in Apis they are in the right ovary with pain also in the left pectoral region, and cough.

Mentally there is considerable similarity. (See Mind.) Both have jealousy, with talkativeness and increased sexual desire; restlessness, with bustling manners.

ARSENIC affects the ovaries and uterus, and has metrorrhagia of dark blood; increased sexual desire. But this powerful agent affects more the right ovary, with marked burning, tensive pains and restlessness, which is somewhat relieved by constantly moving the feet; menstrual colic, better from warm applications.

LYCOPODIUM reverses the Lachesis direction of pains, shooting from right to left. Its gastro-enteric symptoms are also always present.

GRAPHITES also affects more the left ovary, and also relieves when pains in the right ovarian region are followed by a discharge from the vagina, but constitutionally this drug and Lachesis differ.

A marked symptom of Lachesis is the relief of pain when the blood flows. Compare: MOSCHUS, drawing, pulling at beginning of menses, ceasing with the menstrual flow. ZINCUM, relief of boring in left ovary (just like Lachesis).

PLATINA and AMMONIUM CARB. have pains continue with the flow; the former even with a profuse discharge; the latter with flow between pains.

Now, the heart, circulation and fevers. Lachesis, as I have already intimated, affects the circulation markedly ; it causes flushing of heat, as at the climaxis, rush of blood headward, with coolness of the feet, palpitation of the heart, with feeling of constriction about the heart as if tightly held in cords. These latter symptoms, with the oppressions of the chest, the dyspnoea on awakening, inability to lie down, have led to the use of Lachesis in hydrothorax and hydropericardium when dependent on organic disease of the heart.

Lachesis is indicated in general dropsy when the urine is dark, almost blackish, and contains albumen, and the skin over the oedematous parts is dark bluish-black. I remember a man, sixty years of age, who had just this sort of dropsy, and continued to live for six months under the action of Lachesis, and whose death, when it came, was painless. It is especially useful in the ascites after scarlatina and the ascites of drunkards when the above symptoms are present.

In renal and vesical affections, Lachesis is to be selected more by the general than by the local symptoms. For instance, in albuminuria or morbus Brightii, the respiratory symptoms, aggravation after sleep, and blue surface are more characteristic than the urinary symptoms. In cystitis the drug is indicated when the offensive mucus introduces the universal characteristic of tendency to putrescence. And the more this offensiveness of the urine is disproportionately intense, when compared with the time of the vesical retention of the mucus, the more likely is Lachesis the remedy.

In haematuria, the drug, like its powerful rival CROTALUS, is called for when the symptoms 6ccur as an evidence of blood degeneration as in low fevers; hence there is the characteristic deposit of disintegrated blood-cells, of fibrin, etc., presenting the appearance of charred straw. In albuminuria after scarlatina, there is dropsy from delayed desquamation, and the urine is black or contains black spots. This spotted appearance is precisely like HELLEBORUS. Other remedies causing black urine are COLCHICUM, NATRUM MUR., CARBOLIC ACID and DIGITALIS. APIS, AMMONIUM BENZ., ARSENICUM, BENZOIC ACID, ARNICA, OPIUM, CARBO VEG., KALI CARB. and TEREBINTHINA produce dark turbid urine. Only Lachesis, however, has the foaming urine and the general characteristics already referred to.

HELLEBORUS is to be distinguished by the sensorial apathy, muscular weakness, pale puffed face and jelly-like mucous diarrhoea, which accompany its dropsy. The patient may breathe better when lying down, which is the converse of Lachesis and Arsenicum.

DIGITALIS with blackish, scanty turbid urine, faintness from weak heart with bluish face, looks very much like Lachesis here. In the latter there is more laryngeal constriction, as well as oppression and constriction of the chest; in the former, the suffocative constriction is as if the internal parts of the chest had grown together. Digitalis has also sinking or faintness at the stomach as if life was becoming extinct.

TEREBINTHINA has urine smoky and turbid, depositing a sediment like coffee-grounds. It is often indicated in dropsy after scarlatina. The sediment contains disintegrated blood corpuscles. Haematuria, dyspnoea. The patient must be propped up in bed. There is great drowsiness. The tongue is dry and glossy. Clinically, Terebinthina has proved useful in the early stages of renal disease, when congestion predominates ; that is, before renal casts appear in any great quantity. It causes more intense burning and pain in the back than Lachesis, and the urine may have a violet odor. In typhoid fevers, both renal and alvine discharges resemble those of Lachesis. Foetid stools, haemorrhages from the bowels, caused by ulceration; the blood is dark, sooty and looks like coffee-grounds. Foetid urine; disintegrated blood in the urine. In addition, Terebinthina causes stupor, dry, smooth, glossy tongue and great weakness. But it is distinguished by a preponderance of tympanitis, with burning which is accompanied with a smoothing of the tongue, as if it had lost its papillae.

APIS simulates Lachesis in post-scarlatinal dropsy; for both remedies have albuminuria, scanty urine which is dark from decomposed blood, and dyspnoea. But Apis usually requires thirstlessness; pale waxen skin and an eruption here or there resembling nettle-rash, red pimples or an erysipelatous rosy appearance of the anasarcous limbs. In cases of renal disease the urine may be scanty and albuminous without blood, the remedy being required on account of its well-defined heart symptoms, or its mental restlessness, etc. Thus far it needs no differentiation here. But if the urine is dark, turbid, blood-mixed, depositing a coffee-like sediment, if there is orthopnoea with cold legs, bronchial catarrh, great difficulty in breathing until phlegm is raised, spasmodic constriction of the larynx, the choice may demand further comparison. ARSENICUM cures when the urine looks like dark dung-water, renal casts are abundant. The dyspnoea is noticed more when the patient attempts to lie down in the evening and again arousing him after 12 P.M. ; it is relieved by the expectoration of mucus. In Lachesis the dyspnoea is worse when, after lying down, he drops off to sleep; relief follows the hawking loose or coughing up of a small amount of thick adherent mucus, and there is far more annoyance from the contact of the clothing than there is with Arsenicum. In the latter, the clothing is torn loose lest its pressure smother the patient; in the former, there is added a cutaneous hyperaesthesia.

COLCHICUM causes an intense congestion of the mucous membrane of the stomach and bowels, and also of the kidneys. The urine is dark, turbid, bloody and as black as ink, containing albumen. Dropsy. But it is readily distinguished from Lachesis by the prominence of the irritation of the sphincter vesicae with tenesmus of the bladder after urination. It is especially indicated in gouty patients, who at the same time suffer from a nervous weakness, which is combined with hyper-sensitiveness. If this latter symptom seems to resemble Lachesis, we may readily distinguish by the general effects of Colchicum; oversensitiveness to touch (except perhaps the tympanitic abdomen), senses too acute, especially over-affected by strong odors; gastric symptoms are prominent ; mental labor fatigues, causing inability to fix the thoughts or to think connectedly; headache, skin of scalp feels tense; coated tongue, nausea; great weakness, yet easily irritated by external impressions. A peculiarity of Colchicum is that if there are copious salivation and urinary secretion, the stools are scanty and attended with tenesmus, and VICE VERSA.

I need not dwell upon the fevers of Lachesis, because I mentioned them in speaking of the mental symptoms of the drug. I may, however, speak of the intermittent fever, it being indicated in cases which recur in the spring time in spite of the use of quinine in the fall. The chill comes on at one or two o'clock in the afternoon ; during the chill and here is a symptom which is characteristic, the patient feels that he must have clothing piled on him, not so much to keep him warm as to keep him still. (Desire to be held is also under GELSEMIUM). The fever is characterized by burning pungency, by the oppression of.the chest and the heart, and by the associated drowsiness or loquacity.

CARBO VEG., like Lachesis, has annual return of the paroxysms, loquacity during hot stage, thirstlessness during the fever, oppressed breathing. The patient is very weak from protracted disease and abuse of quinine. But the thirst is most during, not before the chill; the chill is often accompanied with cold breath, coldness of the knees, even when wrapped up in bed. Flushes of burning heat in the evening attacks, without thirst. Flatulency. One-sided chills, left side generally. Collapse more marked.

CAPSICUM agrees in : thirst before chill; desires warmth ; chill begins in the back; irregular, intermittent pulse. But with the red pepper the chill commences in the back, and spreads thence; the thirst continues into the chill, and drinking aggravates (see ELAPS). The patient is relieved by hot applications, as by jugs of hot water to the back.

MENYANTHES is preferable when the disease manifests itself as coldness of the tip of the nose, ear-lobes, and tips of fingers and toes. Feet to knees icy cold. Hands and feet icy cold, rest of the body warm. When Lachesis is called for in such irregular cases, with cold nose, etc., the livid skin and great weakness, as shown by the filiform pulse, are sufficiently distinctive.

Agreeing more accurately are the following, all of which produce weak or thready pulse, coldness or blueness of the skin, and of course, the greatest prostration : CARBO VEG. (see above).

VERATRUM ALBUM; but the chill is associated with thirst; and (if internal) runs downward, not upward. Skin blue, cold, inelastic; hands blue; face, mouth and tongue cold; breathing oppressed and labored; heart weak. Heat has no palliative effect; cold, clammy sweat, worse on the forehead.

ARSENIC, external heat relieves; mouth and tongue cold; face blue ; single parts of the surface blue. Anxious restlessness despite the great debility; cold, clammy sweat. Suffocative attacks of breathing.

CAMPHOR, icy-cold surface, but hot internally, so he throws off the clothing; face deathly pale; limbs blue; generally hot breath. Spasms; or, if conscious, voice altered. Sopor follows.

HYDROCYANIC ACID, marble coldness of the whole body. Pulse feeble or imperceptible. Long-lasting faints. Drinks roll audibly down the oesophagus. Clutches at the heart as if in distress. Spasms, especially muscles of back apd jaw are stiff.

HELLEBORUS, muscles relaxed; suddenly he falls, with coldness, cold sweat on the forehead; slow pulse. Horrible convulsions, with extreme coldness. Rheumatic pains in the knees.

DIGITALIS, like the snake-poison, weakens the heart. The skin is very cold. Copious sweat, but heart symptoms are not relieved. Pulse intermits every 3d, 5th, or 7th beat; very slow pulse. It will be remembered that Lachesis has oppression of the chest, with cold feet. As the latter becomes warmer, the oppression lessens.

SECALE c., cold surface; sunken, pale face and blue lips. Will not be covered. Tingling in the limbs; holds the hands with the fingers widely spread apart. Cold, clammy sweat. Speech feeble, stuttering.

HYOSCYAMUS resembles Lachesis in chill up the back, objective coldness of the body, convulsions, delirium. But the chill is worse at night, and spreads from the feet to the spine, and thence to neck. The lowering of the temperature is accompanied with slow arterial action, drowsiness, or with delirious and excited talk, picks at the bed-clothing, fears being poisoned, hallucinations, fibrillar twitchings, etc.

LACHNANTHES, like Lachesis, causes glistening eyes during the chill, icy coldness of the body, relieved by warmth. But only the former has brilliant eyes, circumscribed red cheeks, with the fever and delirium.

LYCOPODIUM follows Lachesis. It is needed in fevers when the patient becomes drowsy or stupid ; coldness, as if lying on ice. One foot warm, the other cold—an important symptom. Feels as if the blood ceases to circulate.

In intermittent fever the chill begins in the back, as in Lachesis. It is worse from 4 to 8 P.M., or at 7 P.M. ; hands and feet numb and icy cold. Sour eructations or vomit are almost invariably present, especially between chill and heat. Thirst mostly after the sweat. Desires only hot drinks.

APIS here,. as in many other instances, favors the snake-poison. Both are suited to old or to maltreated cases ; afternoon chill, oppression of the chest, nose cold, pulse fluttering, skin of hands and arms blue, and general appearance of collapse. But the bee-poison has aggravation from heat, Lachesis not; the former has much more marked the oppression of the chest, with consequent smothering. The tongue is red, raw, and covered on tip and borders with vesicles. Thirst during and not before chill. Urticaria.

 

CUPRUM combines coldness with convulsive phenomena. Icy coldness of the whole body. Severe cramps in the extremities, with cold sweat, blue surface; also collapse. Urine suppressed. Employed successfully in the cold stage of cholera, after Camphor; but also useful in other forms of collapse. For instance, it has antidoted snake-bite, with cramps, delirium, and finally, torpor.

Lachesis may also be indicated in scarlet fever, but not in the Sydenham variety of the disease, but in those forms which have a malignant tendency. The child is drowsy and falls readily into a heavy sleep. The rash comes out very imperfectly or very slowly, and has a dark purple hue. It may be interspersed with a miliary rash. It is apt to be complicated with a membranous deposit in the throat having the character I have already described to you when speaking of the remedy in diphtheria. The cellular tissue of the throat is inflamed, and threatens suppuration. The cervical glands are swollen. On looking into the throat, you find it to be dark red with a dirty white deposit on the tonsils, especially the left. The tongue is coated dirty yellow at the base, and the red papillae show prominently through this coating.. The pulse is weak and the surface of the body cool. There is apt to be dark blood oozing from the mouth and nose.

The majority of physicians make a mistake in instituting their treatment of scarlatina. A mistake in the beginning means one of two things, a long, tedious illness, or a short one ending with death. The mistake made is to give BELLADONNA in every case. Let us look for a moment at the differences between BELLADONNA and LACHESIS. Both remedies have the strawberry tongue, the throbbing headache, the red face and the high fever. Belladonna is ONLY indicated in the sthenic type when there is an active delirium. The throat is bright red in color. The pulse is full and bounding. The rash is bright red and smooth.

The general symptoms of Lachesis have been so far included in what has been said that they need not be dwelt upon. In carbuncle and in cancer, however, we think of it when the surface is swollen around the carbuncle, and pus forms very slowly. Lachesis, given under these circumstances, increases the quantity and improves the quality of the pus. The patient's strength will improve greatly.

In malignant pustule, Lachesis may be used, but you should accompany the remedy with brandy. That is an experience of Dr. Dunham.

I will next say a few words respecting the modalities of Lachesis. Modalities, as you know, express the mode or manner by which symptoms are qualified. They are therefore important in the study of drugs and especially in differentiating allied remedies. Two medicines, for instance, may induce supraorbital pains of a shooting character. But if one has the pains modified by pressure, the other by sleep, we are thus enabled to distinguish them in practice. Modalities then qualify symptoms, and are as essential as adjectives to nouns. Care must be exercised, however, that they be not substituted for the symptoms they modify. Too often we see cases reported, the only homeopathic resemblance between which and the remedy selected is a mere modality; as, for instance, worse after sleep.

The modalities of Lachesis, then, are as follows:

WORSE.—During sleep, especially the throat symptoms, choking, which arouses him; worse after sleep, especially in the morning.

TIME OF DAY.—Generally worse from noon until 12 P.M. Still there are some prominent symptoms aggravated in the morning and forenoon. This is partly owing to the bad effects of awaking, though as some symptoms appear later in the morning, we may ascribe them to causes then at work. For instance the patient has vertigo on awaking, yet this returns on closing the eyes, at 11 A.M. Headache in the left frontal eminence in the morning. Weakness in the morning on rising. Finger tips numb. On sitting up quickly in the morning, breathing becomes slow, difficult and whistling.

In the evening and before 12 P.M., we find the following especial exacerbations: Throat sensitive; craves oysters; diarrhoea; dry, hacking cough. Chill beginning some time between noon and 2 P.M., but fever is marked evening and night, worse before 12 P.M.

TEMPERATURE, WEATHER, ETC.— Worse in the cold air, from change of temperature and in the warmth of the bed (see below under Motion, etc.). Worse from getting wet, wet weather, windy weather. Worse before a thunderstorm. Worse from sun. Worse in the spring. Better often from warmth, wrapping up, near the stove, etc. Excessively cold or excessively warm weather causes debility.

MOTION, REST, POSITION, ETC.— Worse on and after rising from bed; worse while sitting and better after rising from a seat; better lying in bed on the painless side, but worse from warmth of bed (see above under Temperature) and from lying on the painful side. Some symptoms are better from moving, but not if continued long.

TOUCH, PRESSURE, INJURIES, ETC.— Almost invariably worse from touch, however slight. Useful for the bad effects of injuries, as penetrating wounds, with much haemorrhage or gangrene.