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Homeopathic Materia Medica by Farrington
(arum-t)The so-called "Jack in the pulpit" is the first drug in the order for our consideration. This drug has an interesting history. Some twenty-five years ago, there appeared an epidemic of scarlet fever, in the course of which, nearly every case that was not promptly cured in the beginning died. The percentage of losses under homeopathic as well as under other systems of treatment, was truly frightful. The reason for this was, we had no remedy which covered the symptom's of the epidemic. In a poor family, living in a small street, there were five children sick with this epidemic form of scarlatina. The physician who was called to attend them, had lost so many cases under the usual remedies, that he thought it useless to have recourse to these. He thought it better to try something new. Arum triphyllum had only been experimented with, to a certain degree, but still it had been known to produce certain symptoms which led him to the selection of the drug, which he administered in a low potency. All the cases recovered. It was afterwards prescribed in other cases during the same epidemic, with marked success. From that time to this, Arum triphyllum has been looked upon as a valuable drug in the treatment of diphtheria, malignant forms of scarlet fever, and also other fevers having a typhoid form.
In scarlatina, we may use Arum triphyllum when these symptoms are present: There is an excoriating discharge from the nose and mouth making the nose and upper lip raw and sore. The tongue swells; its papillae are large and red, giving it that rough feeling comparable to the cat's tongue. The throat is very sore, and the tonsils are very much swollen. Often, too, there is a dry cough which hurts the child so much that he cringes under it and will involuntarily put the hands to the throat as if to modify the pain. The discharge from the mouth, too, makes the lips and surrounding parts of the face sore, cracked and bleeding, the saliva itself being very acrid; scabs form; the child will not open its mouth. He is excitable and irritable in mind as well as in body. Thus, you see that Arum triphyllum is an exceedingly irritating drug. The child is restless, tosses about, is cross and sleepless at night. The eruption may come out very well and there may be double desquamation. At other times, the rash is dark and imperfectly developed; the child picks and bores its fingers into its nose, or nervously picks at one spot till it bleeds. In mild cases, the urine may be quite profuse, or if it is not, the appearance of profuse urination is a sign that the remedy is acting well. ' In very bad cases, however, those in which the malignancy shows itself in both the internal and external symptoms, you will find developed a perfect picture of uraemia, during which, the child tosses about the bed unconscious and has this involuntary picking at one spot or boring the finger into the nose; and the urine is completely suppressed. The brain is very much irritated, as shown by the restless tossing about and the boring of the head into the pillow. In such a case, Arum triphyllum may save the patient, although, at the best, the case is an exceedingly doubtful one.
I have never seen inflammation of the brain yield to Arum triphyllum, unless some one or more of these symptoms were present; either irritation about the throat, mouth, or nose, or else this peculiar picking or boring at the nose or at one spot till it bleeds. I think that it would be indicated only when the cerebral inflammation came from the suppression of some violently acting poison, such as we find present in scarlatina or diphtheria. Nor would I think of giving Arum in uraemia if it arose in the course of ordinary Bright's disease. I do not think it would be the remedy unless the symptoms already referred to are present.
Arum triphyllum has a marked effect on the larynx. It produces a hoarseness which is characterized by a lack of control over the vocal cords. If the speaker attempts to raise his voice it suddenly goes off with a squeak. With this symptom you may use Arum in clergyman's sore throat.
Possibly the most similar remedy here in this hoarseness, and in this uncertainty of voice is GRAPHITES, which is an excellent remedy to give singers when they cannot control their vocal cords; when they get hoarse as soon as they begin to sing and the voice cracks.
Another remedy is SELENIUM. The patient gets hoarse as soon as he begins to sing.
Now let us study for a few moments the analogues of Arum triphyllum ; and first of all we will consider
NITRIC ACID. This was formerly the only remedy we had for scarlatina maligna. It has that excoriating discharge from the nose. No remedy has it more marked, not even the Arum. The discharge from the nose makes the nostrils and lips sore. This is attended with great prostration. The throat is extremely sore and is covered with membrane. This membrane is of a diphtheritic character, and is either dark and offensive or else yellowish-white. The mouth (whether the disease be diphtheria or scarlatina) is studded with ulcers, ulcers which appear principally on the inside of the cheeks, on the lips and on the borders of the tongue. This ulceration is accompanied by salivation, the saliva usually being watery and very acrid, and not thick and ropy. The pulse frequently intermits every third or fifth beat. This is a very bad symptom. Nitric acid is also preferable to any of the other remedies in diphtheria with these excoriating discharges when the disease advances and affects the stomach (whether or not the membrane in these cases spreads to the stomach, I cannot say); when with great prostration and membrane in the throat and nose, there is distress and uneasiness referred to the stomach, with total rejection of all food.
MURIATIC ACID is still another remedy in these malignant cases of scarlatina and diphtheria. Under this remedy there is the most intense prostration. The patient seems to have scarcely life enough to move. He is worse at about ten or eleven o'clock in the morning. The mouth is studded with ulcers having a black or dark base and dipping deep in. They tend to perforate the parts on which they are situated. Often, too, with the Muriatic acid, you have the intermittent pulse of Nitric acid, but in addition to that, involuntary stool and urine.
In addition to Nitric acid and Muriatic acid in cases having these dangerous groups of symptoms you will think of ALCOHOL. You will remember that Grauvogl found that diphtheritic membrane was dissolved and its growths destroyed by several substances, one of them being Alcohol. So this substance has become a remedy for diphtheria. Alcohol in the form of brandy and water tends not only to destroy the growth, but also aids in counteracting the terrible prostration.
LYCOPODIUM is similar to Arum triphyllum in scarlatina and in diphtheria. It has a similar discharge from the nose, usually associated, however, with dull, throbbing headache at the root of the nose or over the eyes. The nose is so stuffed up that the child cannot breathe at night. The patient bores and picks at the nose just as under Arum triphyllum. You will find in the Lycopodium case that the diphtheritic deposit travels from the right to the left. The patient is always worse from sleep even after a short nap. He suddenly awakens from sleep, crying out as if frightened ; nothing can be done to pacify him. He is irritable and peevish. In still worse cases calling for Lycopodium, you will find the child unconscious and in a deep sleep. The lower jaw drops, the urine is scanty or even suppressed, and what does pass stains the bedding or clothing red and deposits a red sand. The breathing is rapid and rather rattling and a little on the snoring. Every symptom points to impending paralysis of the brain.
AMMONIUM CAUSTICUM was first suggested by Dr. J. P. Dake for diphtheria appearing in the nasal cavities with a burning, excoriating discharge from the nose and great prostration. The symptoms above mentioned led Dr. Dake to use the remedy in an epidemic which appeared in Nashville, Tennessee.
Lastly, let me mention AILANTHUS. The history of this drug is as follows: Dr. P. P. Wells, of Brooklyn, had two cases of poisoning in children. As he states it, it would certainly seem that he had to treat malignant cases of scarlatina; but there being no such epidemic about at the time, he looked for other causes, and found that they had been chewing the blossoms of the Ailanthus. This told him at once that the Ailanthus would probably become a remedy in scarlatina. He made provings of the drug, and found that the proving only confirmed what he had already learned from these poisoning cases. Since then this remedy has been used many times and successfully too. A year ago I attended a poor child with scarlatina. The child lay in a stupor with mouth wide open. The throat was swollen, the nose stuffed up, and what little rash there was out on the body was dark and mixed with dark bluish spots. I gave Lycopodium without any benefit whatever. The child grew worse instead of better. I then thought of Ailanthus, and gave it in the sixth potency, with the result of completely curing the child. I believe that the patient would have died had it not been for the Ailanthus. Wherein does Ailanthus resemble Arum triphyllum ? It resembles it in the acridity of the discharges. There are excoriating discharges from the mouth and nose, making the lips sore. We find a' similar swelling of the throat, both inside and outside. So far as these superficial symptoms are concerned, you have identical cases. But there is a great difference to be recognized in the other symptoms. The Ailanthus patient becomes drowsy and lies in a stupor, hence it is indicated when there is torpidity rather than the restless tossing about as under Arum triphyllum. The Ailanthus rash comes out imperfectly; it is dark red or bluish, and is mixed with petechiae.
Some little time ago, some members of the class requested that I would speak of the remedies useful in diphtheria; so, while I am on the subject of Arum and its analogues in this affection, I will take the opportunity to accede in part to that request.
BAPTISIA TINCTORIA, you know, has long enjoyed a great reputation in typhoid fever. It has lately been used in diphtheria, and in scarlatina also when the child is very much prostrated and lies in a half-stupid state almost like one intoxicated. The face is dark red and has a besotted look, and the discharges from the mouth and nose are horribly offensive; so much so, indeed, that one might suppose that gangrene of the affected parts had taken place.
RHUS TOX. we find indicated in pretty severe cases, when the membrane is dark in color and bloody saliva runs out of the mouth during sleep. These symptoms are associated with inflammation of the glands about the neck, with a dark, erysipelatous hue.
PHYTOLACCA DECANDRA we find useful when, in the beginning of the disease, there are creeps and chills and backache. The patient is weak, and feels faint when he sits up in bed. On looking into the throat you find it dark red, almost purple. There is great burning in the throat, with aggravation from hot drinks.
AMYGDALA AMARA, when there are sharp, lancinating pains through the swollen tonsils. The palate and fauces have a dark red hue, and the patient is very much prostrated.
NAJA TRIPUDIANS is to be administered when there is impending paralysis of the heart. The patient is blue. He awakens from sleep gasping. The pulse is intermittent and thready. Dr. Preston, of Norris-town, has been very successful with Naja when the symptoms I have mentioned were present.
APIS MELLIFICA is, I think, indicated in diphtheria. From the very beginning the child is greatly prostrated. There is not much fever; in fact, there is a suspicious absence of heat. The pulse ranges from 130 to 140, and is very weak. At first, you find the throat having a varnished appearance as though the tonsils and fauces were coated with a glossy red varnish. The membrane forms on either tonsil, oftener on the right than on the left, and it is thick like wash-leather. The tongue is often swollen. If the child is old enough, he will complain of a sensation of fulness in the throat, which necessitates swallowing but making the act very difficult. The uvula, in fact the whole throat, is oedematous and swollen. The RIMA GLOTTIDIS is swollen, red, and oedematous, making breathing difficult. In some of these cases the breath is very foetid, while in others it is not so in the least. In some cases there appears a red rash over the body; this rash greatly resembling that of scarlatina.
ARSENICUM ALBUM is called for in rather severe cases of diphtheria when the throat is very much swollen both internally and externally, when the membrane has a dark hue and is very foetid. There is a thin, excoriating discharge from the nose. The throat is oedematous, just as it is under Apis. The patient is restless, especially after midnight. The urine is scanty. The bowels are constipated, or else there is an offensive watery diarrhoea.
NATRUM ARSENICOSUM is the remedy when there is a dark purplish hue to the throat, with great swelling and great prostration and without much pain.
KALI PERMANG. is useful when the membrane in the throat is horribly offensive. The throat is cedematous, and there is a thin discharge from the nose; the main characteristic of the drug being this extreme fcetor.
LACHESIS is called for when the membrane forms first on the left tonsil and spreads thence to the right. How are you to distinguish it from other drugs which act in a similar manner ? By the following symptoms : The symptoms are worse from empty swallowing, and they are often relieved by eating or swallowing solid food. There is a constant feeling of a lump on the left side of the throat; this descends with each act of deglutition, but returns again. Sometimes, on arousing from sleep there is a feeling as if there were needles in the throat, which creates suffocation. Sometimes, when the tonsils are very much swollen, fluids return through the nose. The fauces are of a dark purplish color, and there is great prostration. The heart is weak in its action. There is aggravation after sleep, and the throat is sensitive to the slightest touch.
BELLADONNA is not a prominent remedy in diphtheria. When you do give it in this disease, make sure that it is the remedy or you will lose valuable time. It may, however, be the remedy in the early stages when the violence of the attack calls for it, when there is congestion of the head before the membrane has formed.
Other remedies than those just mentioned are frequently indicated, for example, KALI BICHROMICUM, IODINE, BROMINE, MERC. BIN., MERC. CYAN., and others. The indications for these you will get in future lectures.