|LACHESIS, PART II|
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Homeopathic Materia Medica by Farrington
LACHESIS, PART II
( )Next we take the action of Lachesis on nose, throat and chest, so far as catarrhs are concerned. Lachesis produces nasal catarrh, watery discharge from the nose, which is often preceded by throbbing headache, worse in the left temple and forehead, which is relieved as the coryza establishes itself. Accompanying this coryza are sometimes vesicles about the nose, redness, puffiness of the face and lids, creeping chills over the body, palpitation of the heart, and great relaxation of the whole system ; hence it is suitable for a cold, which is apt to occur in relaxing weather, consequently in the spring of the year. Lachesis may also be used in ozaena of mercurial or syphilitic origin. Here you may compare KALI BIOHROMICUM which follows Lachesis well; and also NITRIC ACID, MERCURIUS, and LAC CANINUM. The last named drug cures syphilitic ozeena and angina when the corners of the mouth and alas nasi are cracked.
The cold may extend to the throat, and then we will find that the tonsils are enlarged, particularly the left, or, in the sick, with tendency from the left to the right tonsil. The throat, when examined, exhibits a bluish-red hue, not bright or rosy-red, the patient complains of frequent sense of constriction, as though the throat was suddenly closing up, or a sensation as though there was a lump in the throat which he must constantly swallow, but which as often returns. The throat externally is exceedingly sensitive to touch. Unless the tonsils are going on to suppuration, he will be better by swallowing solids, while liquids and empty swallowing increase the annoyance and pains. I except suppurating tonsils because, when they are large and stop up the fauces, nothing can be swallowed ; then the attempt to take anything is followed by a violent ejection of the same through either the mouth or the nose. But with the ordinary catarrhal sore throat, when the tonsils are not parenchymatously swollen, the swallowing of food often relieves the irritation for awhile.
The cold may travel farther down and involve the bronchial tubes, when a different class of symptoms may develop. The patient may suffer from tickling, irritating cough, which is especially apt to come on as he drops off to sleep, arousing him as if he was choking. He can bear nothing to touch the larynx or throat, so that he loosens his neck-band. These, briefly, are the catarrhal symptoms of Lachesis.
But suppose, while we are considering this locality, we look to more serious affections which may manifest themselves in these parts, diphtheria for example. Lachesis may be indicated in diphtheria of one or all of these parts. Symptoms for which you will be called upon to prescribe it, are mostly those that I have already given you, with these points in addition : The discharge from the nose is thin, sanious, and excoriating, a really dangerous objective symptom.. The throat is, if anything, a darker red than in the catarrhal state. The membrane is more on the left tonsil, or has an inclination to go from the left to the right. It early develops that gangrenous state which obtains in diphtheria, with the attendant foetid breath, and the increased danger of systemic infection. The tissues surrounding the throat are often infiltrated so that you have swelling of the glands about the neck, and also of the cellular tissue. The swelling may be so great that the neck becomes even with the chin and sternum. The lymphatic glands are swollen too, and have a dark-purplish hue and threaten suppuration. When pus does form, it is not a laudable pus. The child is drowsy, even though feverish, the heart, though 'beating more rapidly than natural, is evidently greatly weakened, as shown by the feebleness of the pulse and coolness of the extremities. This is the kind of diphtheria from which you can hope much from the use of Lachesis. The diphtheria may travel down the larynx, and the remedy still be indicated. You must not infer from what I have said that Lachesis is THE remedy for laryngeal diphtheria; but when it has the characteristic symptoms which I mention, it may be needed; the patient arouses from sleep smothering, and has a diphtheritic, croupy cough.
CROTALUS and NAJA like Lachesis have relieved in diphtheria. The former has been selected when the epistaxis is persistent; blood oozes from the mouth, not merely coming from the posterior nares but escaping from the mucous membranes of the nasal cavity.
NAJA has helped in casesjust like Lachesis when the larynx is invaded; the patient grasps at the throat, with sensation of choking, fauces dark red, foetid breath, short hoarse cough, with raw feeling in larynx and upper part of trachea.
LAC CANINUM is very similar to Lachesis in diphtheria. So is LYCOPODIUM. The latter remedy has aggravation of the symptoms from four to eight P.M. The right side is mostly affected. The child awakes from sleep frightened or cross and angry. APIS is to be distinguished by the oedema of the throat, the stinging pains, the blisters on the border of the tongue etc.
Again, you may find Lachesis of great service in affections of the lungs.
We may use it in asthma when there are present one or more of these few symptoms. The patient arouses from sleep with the asthmatic paroxysm and cannot bear the least pressure about the neck or chest, finally he coughs up a quantity of watery phlegm WITH GREAT RELIEF. This last is a neglected characteristic of Lachesis in asthma. I have succeeded with it in relieving an asthmatic for months.
In pneumonia, Lachesis may be useful but not in the early stages of the disease. There is nothing in the provings of Lachesis to suggest that it will be useful in pneumonia. It does not cause the engorgement of the lungs, the fever or the fibrinous deposit. But it may be indicated in the later stages of the affection when it assumes a typhoid form, especially when an abscess forms in the lungs. Brain symptoms such as low muttering delirium, and hallucinations, appear. The sputum is frothy, mixed with blood, and purulent, and the patient is bathed in a profuse sweat.
SULPHUR is perhaps the better remedy to prevent suppuration when there are no typhoid symptoms, but be careful how you give Sulphur, if tuberculosis has been developed by pneumonia. To do so, is almost like giving a person running down hill, another push. It will only hasten the end.
In chest affections, MAPS is sometimes of great service. It however affects more the right than the left lung, in which the morning pain is severe enough to prevent the patient's getting up. Both apices are diseased. There is a feeling of coldness in the chest after drinking. The cough is accompanied with intense pains in the chest, worse in the right apex as if it were torn out, and the sputum consists of black blood. It also causes a sensation as if the heart were being squeezed.
You may use Lachesis in phthisis, not to cure, but to relieve. Remember it when, in the course of typhoid fever or pneumonia, tubercles have been deposited in one or the other lung. You may use it in the advanced stages of tuberculosis of the lungs when the patient has a retching cough, which arouses him from sleep, and which ends in expectoration of tough, greenish muco-purulent matter, which is. gagged and vomited rather than clearly expectorated; when the patient sweats in every nap, the sweat being the most copious about the neck, shoulders, and chest; and when the strength is greatly reduced and the pulse indicates extreme prostration.
Next we turn our attention to the alimentary canal from the mouth down. I referred to the tongue in speaking of the typhoid condition. Lachesis is useful for weakness of digestion, in patients who, from some vicious habits, from abuse of mercury, or of quinine, or of alcohol, have their stomachs so exhausted, that even the plainest food causes indigestion. Acids especially disagree, although the plainest food will cause heavy feeling after eating. Sometimes a gnawing pain is relieved while eating or immediately after, but soon heavy, dragging feelings and other symptoms of indigestion show themselves. Among the cravings is that for oysters, which may sometimes not disagree.
The liver is affected by Lachesis. Like all the snake-poisons, it causes jaundice. The usual symptoms are present; even when abscesses form, it may be useful by reason of the tenderness on pressure, intolerance of clothing, and deep throbbing on the right side.
The bowel symptoms are not numerous, though they are important. We find diarrhoea caused by the drug, watery offensive stools, but more often constipation, with the peculiarity of the stools already mentioned. Especially may it be used in chronic diarrhoea with great debility and aggravation in spring weather. The tongue is smooth, red and shining. (KALI BI. has exactly the same kind of tongue.) The abdomen is bloated. The patient is worse from wines or acids. The patient is very sensitive to touch about the waist.
In this form of dyspepsia, it is very similar to Hepar. The latter remedy, however, has marked relief of the symptoms from the use of condiments.
Under HEPAR the plainest food disagrees. The cravings are unique. As if knowing instinctively what will "tone up" the stomach, the patient longs for condiments or wine. Eating relieves the relaxed feeling, but food annoys so soon as the digestive process begins its slow and imperfect work. The bowels move very sluggishly, even when the stools are soft.
CINCHONA, too, enfeebles digestion and induces, great weakness and languor after meals. It also has a craving for coffee-beans. Fruits induce diarrhoea with abdominal fermentation. Both cause fulness after eating; but only Cinchona has sense of fulness to hurting, with little or no relief from belching. Bitter eructations, bitter taste, belong to each the latter has the altered taste after swallowing, food retaining its normal taste while being masticated.
The discharges from the bowels are offensive, as is the flatus ; yellow watery stools, undigested. But the marked aggravation at night, after a meal, and the resulting prostration, are not at all like Lachesis. In dysentery, etc., when putrid or gangrenous changes occur, the choice is more difficult. Both have cadaverous-smelling discharges of a chocolate color, with coldness and great debility. And although the Cinchona is far preferable if the disease is of malarial origin, such a complication does not contraindicate the snake-poison. The apparently close similarity is also enhanced by the nervous excitability in both. Light touch is distressing, the epigastrium is sensitive, and clothing annoys in each remedy. But this in Cinchona is an increased general sensibility, while in Lachesis there is general torpor, with hyperaesthesia of the cutaneous nerves. The former is suitable when the offensive discharges follow a severe, rapidly exhausting inflammation; or, when the frequency and quantity of the evacuations have greatly' reduced the vitality, thus favoring retrogressive changes. If symptoms of hectic are present, the choice is rendered more certain. In addition, we may also refer to the well-known anaemic symptoms of Cinchona, paleness, ringing in the ears, easy fainting, etc., which show at once how it affects the blood.
MEREURIUS presents many points of similarity with Lachesis. The latter frequently follows the former, and also antidotes its abuse. There are loss of appetite, coated tongue, nausea, with oppression, and epigastric tenderness. Pressure in the pit of the stomach produces a deadly faintness. The stomach hangs heavily, even after a light meal of food of ordinary digestibility. The sensitiveness of the stomach to the clothing is a part of a symptom which is completed by a similar tenderness over both hypochondria, with fulness and upward pressure from the abdomen. The patient cannot lie on the right side. If hypochondriacal, he is suspicious, anxious, and restless at night, with vascular erethism and sweat. In fact this erethism is directly contrary to the torpid Lachesis.
In abdominal inflammations with suppuration, as in typhlitis, both remedies are useful and follow each other well. MERCURIUS has its ever-present perspiration without relief; stools slimy, or much straining, with or without stool. Lachesis follows when the symptoms threaten a typhoid condition. The patient can lie only on the back with the knees drawn up; if he turns on to the left side, a ball seems to roll over in the abdomen.
In rectum and anus, Mercurius has more persistent tenesmus; protrusion of the rectum, which looks inflamed and blackish ; Lachesis, more spasmodic tenesmus, with constriction of the anus, which tightly constricts the prolapsed rectum. Both have chronic constipation. The former induces much straining, with tenacious or crumbling stools; chilliness during defecation.
ARSENICUM intensifies the gastric and systemic weakness, to which we referred in the remedies just considered. While it is true that the patient does not fully realize his want of strength, and hence does not so much care to lie quietly, yet nevertheless, his actual amount of vitality is seriously reduced. In a word, he is excessively weak, without feeling so fatigued. Any exertion produces fainting. Taste is lost or is bitter, sour, and putrid. Stomach feels swollen as if full of water. Craving for acids and for coffee; the latter, as in Lachesis, agrees with the patient. There are burning feelings, red rough tongue, and anxiety and distress after eating, as subacute gastritis, which, no remedy better pictures. Nausea is frequent and often periodical (12 P.M.), and is accompanied with great prostration. The vomiting is of many kinds, but is distinguished from the bilious, slimy or bloody emesis of Lachesis by its irregular convulsive character, indicative of gastric irritability. Lachesis is adapted to the nervous weakness and trembling of drunkards; spasms of the stomach, spasmodic constrictions, relieved temporarily by eating ; vomiting of bile or mucus ; Arsenic to burning periodical pains, with sour acrid vomit, violent thirst, but vomits the water.
CADMIUM SULPH. to nausea, yellowish or black vomit, saltish rancid belching, cold sweat of the face, burning, cutting in the stomach; griping in the lower part of the bowels, cramps after beer. Both induce marked sensitiveness to touch upon stomach or abdomen, spots of burning soreness here and there over the swollen abdomen (peritonitis); offensive, bloody chocolate-colored discharges, as in dysentery, with constriction in the bowels, cutting pains in bowels. But in Arsenic, there is more lamenting with agonized expression ; restless moving despite the pains. The constriction of the intestines is torturing, the patient declares he cannot stand it, and rolls about in agony, despairing of his life. The extreme tenderness of the pit of the stomach denotes a more positive state of acute inflammation than Lachesis causes.
In the vomiting of yellow-fever, Lachesis has in addition, brown coating on the teeth, abdominal tenderness.
Arsenic has also spasmodic protrusion of the rectum, very painful; tenesmus with burning; haemorrhoids, especially in drunkards; they protrude at stool with burning. Alvine discharges are offensive, dark, sometimes involuntary, with great weakness and coldness. But Lachesis has less tenesmus recti, the distress there being attributable to a constriction of the anus not found in the other drug. Arsenic, moreover, causes more acridity of the stools, with rawness and excoriations of the anus.
All that I have here stated might be tersely described as a difference between two drugs, of which one causes intense irritability and acute inflammation of tissue, mental anguish and extreme prostration; the other, torpidity, with the loss of vitality, but associated with nervous excitability, constrictions, and cutaneous hyperaesthesia. Still, some minds require more attention to detail; and every one attains general mental impressions more accurately if they are formed with due attention to particulars.
When there is ulceration of the bowels, tendency to sloughing, with offensive, purulent, or bloody discharges, the two remedies are very nearly allied. Vitality is at a very low ebb, blood oozes from the cracked lips and tongue, and the extremities are cold. But even here, the best distinctions are the mental irritability of Arsenic., and the intolerance of pressure of Lachesis.
CARBO VEGETABILIS resembles Lachesis in weak digestion, complaints of drunkards, flatulent asthma, constriction of the oesophagus, annoyance from clothing about the Waist, offensive, bloody, decomposed, purulent stools, collapse, etc.
There is craving for coffee, but it does not relieve. Milk disagrees in both remedies; but only the snake-poison has craving for it. The Carbo veg. has aggravation from fats, tainted meats, or fish, oysters, foods causing flatulency, ices, vinegar, and sour cabbage—the latter principally on account of the flatulency it causes. Eructations are sour, rancid. Both drugs have relief from flatulent distension from belching, but Lachesis has an ill feeling in addition, which is relieved. Both drugs experience freer breathing after belching. In Carbo veg. this is expressed as the lessening of a tension and upward drawing which marks the costal attachments of the diaphragm ; in Lachesis, there is a relief after eructations, which seem to suffocate him. They come rapidly, and induce the ever-present Lachesis constriction of the throat. The latter remedy also has empty eructations, which intensify the pains.
CARBO VEG. has heaviness, fulness, sleepiness, after eating, with fulness of the abdomen almost to bursting. Burning in the stomach is also increased. This heaviness is very characteristic and is noted likewise in the abdomen, which seems to hang heavily; also in the head, which feels as heavy as lead. The burning is attended with a creeping feeling up to the throat. In Lachesis, the fulness and pressure is as from a load, and the sense of repletion induces lowness of spirits. There is, too, a feeling as if a lump was accumulating in the stomach and also in the bowels; burning, with hard abdominal distension, and a feeling as if a stone was descending; he must stand still or step cautiously. This lumping is presumably a part of the Lachesis constriction, which we have so often designated as highly characteristic. In Carbo veg. the flatus is more rancid, putrid, or when passed per anum, burning, moist, offensive. Its incarceration with burning is a cause of many of the symptoms, and is more in quantity than in the snake-poison. It also causes a bearing down upon bladder and sacral region. Lachesis relieves a gnawing gastralgia, when eating, lessens the pain ; Carbo veg. cures when there are burning, with a contractive cramp bending him double; the pains are paroxysmal and take his breath. The burning spreads up to the chest and down into the abdomen, seemingly following the sympathetic.
Tenesmus recti is most prominent in the Carbo veg., anal constriction in the Lachesis. It is this latter symptom which explains, as we have before observed, the ineffectual urging to stool; while in Carbo veg. the urging is fruitless on account of the pressure of flatus. Both have bluish, protruding piles, as after debauchery. This constriction distinguishes them as do also the headache and diarrhoea. In each there is throbbing headache; but Carbo veg. has more of the heaviness, and the diarrhoea is thin.
In typhoid forms, whether the specific fever, or as a sequel to peritonitis, dysentery, etc., the Carbo veg. causes the more perfect picture of collapse, while in Lachesis the cardiac debility, drowsiness, cool extremities, etc., indicate failing vitality, but not so near death as the following symptoms belonging to the former: Tympany ; legs cold, especially to the knees ; pulse filiform; breath cool; absence of discharges from the bowels; or, involuntary,' putrid, bloody, purulent diarrhoea.
In hernia, Carbo veg. has anxiety, as in Arsenic, but with uneasiness rather than restless change of place; and it resembles Lachesis in the annoyance of the clothing, foulness of parts if strangulated, etc. There is, however, more meteorism and foetid flatus.
GRAPHITES has anxiety, melancholy; tip of tongue blistered; feeling of a lump in the left side of the throat, over which the food seems to pass with difficulty; on empty deglutition, a constrictive retching from oesophagus up to larynx; must loosen the clothing after eating ; gastralgia, relieved by eating; chronic gastritis, especially after abuse of alcoholic drinks. Sensation of a lump in the stomach; flatulent distension of the abdomen, with congestion to the head; foetid flatus. Suffocative spells arousing from sleep, must jump out of bed ; compelled to eat something. Offensive stools.
But this remedy causes more flatulency than Lachesis. The gastralgic pains are burning and griping; and the feeling of a lump in the stomach is accompanied with a constant beating; the heartburn is rancid. The suffocative spells are usually worse after 12 P.M. instead of during or after a sleep at any time. And the constriction noticed on falling asleep is of the chest instead of the larynx. The offensive movements from the bowels are half digested, dark and pappy, indicating the imperfect digestion which is so characteristic of this remedy.
There is some resemblance in the constitutional symptoms of Graphites and Lachesis, since both are needed at times in the phlegmatic. But the former has as a distinguishing group: fat, cold, and costive; skin herpetic, rough, and disposed to crack and ooze a glutinous fluid.
Aside, then, from a few resemblances to the snake-poison, Graphites belongs more with Arsenic, Nux vom., and Lycopodium. The first two it resembles in gastritis and gastralgia ; the latter, in flatulency.
SULPHURIC ACID somewhat resembles the snake-poisons, especially in the ailments of drunkards. Its corrosive effects, however, are distinctively prominent, as shown in the violent inflammation of the alimentary canal. But the nervous system is so involved that several symptoms look like those of Lachesis; as epigastrium sensitive, constrictive feeling in the bowels, griping, cutting, twisting, with faintlike nausea; trembling, pale face, apprehensiveness; fluttering pulse; cramps in the pharynx; he cannot swallow; oesophageal stricture; great weakness, etc. Both likewise crave brandy.
The acid acts well when the patient is weak, emaciated, complains of trembling, but it is more subjective than objective. He is anxious and restless, must do everything hurriedly. The face is pale, and sometimes presents dry, shrivelled spots, especially when the haemorrhoids are Worse. Eructations are sour. The stomach feels relaxed and cold. Wine may palliate and spirituous liquors aggravate as in Lachesis. But the peculiarity of the Acid is, that the stomach rejects cold water, unless it is mixed with brandy. The abdominal muscles are spasmodically retracted. Stools are yellow, like Lachesis, but present a chopped appearance, and are stringy. The watery diarrhoea is very offensive. Piles are moist, burn, and may prevent defecation.
As the acid causes croupous formations, it should be remembered with Lachesis when the stools indicate such a condition in the intestine.
The acid also resembles ELAPS: drinks chill the stomach. But only the former has the relief from the admixture of spirit.
COLCHICUM deserves mention here, especially since, like Lachesis, it causes coldness or cold feeling in the stomach (ELAPS), intolerance of pressure of clothing (in provings, but not confirmed), burning in stomach, vomiting and purging, SPASMS OF SPHINCTER ANI, urging to stool, offensive flatus, offensive diarrhoea, sensitiveness to least touch, very much exhausted, slow breathing, feeble pulse. But there is generally present nausea, worse from the smell of food; if the patient sits or lies very quietly, the vomiting is suppressed (like VERATRUM). Senses too acute; a bright light, touch, or STRONG ODORS irritate him (like NUX VOM.). Vomiting and purging as in cholera morbus ; the sphincter ani contracts after each stool, with fruitless urging. The similarity, then, exists chiefly in the sensitiveness to touch and constrictions of sphincters with weakness, other symptoms being so different as to render a choice easy. (See also below.)
In cholera, Lachesis has been employed when the vomiting was renewed by the least motion, and the nausea was attended with a great flow of saliva. As Colchicum has precisely the same symptoms, other indications must decide.
In reflex irritation, as convulsions, with variegated, slimy stools in teething children, and rolling of the head, Colchicum resembles PODOPHYLLUM.
Belladonna, Lachesis, Bhus tox., and Baptisia, constitute a group serviceable in peritonitis, enteritis, etc.
BELLADONNA differs from all in the character of the inflammation. It is only when the affection becomes asthenic that the others are needed. Lachesis follows Belladonna when, especially in children with inflammatory diarrhoea, constipation suddenly sets in with abdominal swelling and tenderness, particularly at one spot. Or, if suppuration ensues and Mercurius fails. Or, again, if gangrene threatens.
RHUS TOX. requires drowsiness, the fever remaining high or increasing; restlessness; tongue dry, parched, brown, with red triangular tip; diarrhoea slimy, watery or putrid, yellowish-brown and bloody, involuntary during sleep; generally it is accompanied with tearing down the thighs, while Lachesis has painful stiffness from loins into thighs. In typhlitis, in which affection either may follow Belladonna, Rhus tox. has relief from pressing the swelling gently from below upwards; Lachesis, intolerance of touch.
In periproctitis, Rhus tox. may be needed if the inflammation is of traumatic origin; Lachesis, if an abscess forms and fails to point, the surrounding tissues present a purplish hue.
COLCHICUM compares with Lachesis when the prostration is extreme, with coma, hot abdomen and cold extremities; thready pulse; if raised, the head falls back and the jaw drops; the face is hippocratic, the tongue is protruded with difficulty, and the bowels move involuntarily. But the tympany is more marked in the former ; and the stools contain white flakes or shreds; the tongue is either thickly coated brown, or it is bright red, except at the root, where it is coated. According to provings and cases of poisoning, Colchicum does not cause sensitive abdomen below the epigastrium.
ARNICA develops a profound stupor, with blowing respiration, dry tongue, brown down the middle, distended abdomen, and involuntary faeces and urine. It may be distinguished by the ecchymoses, and the bruised aching, inducing restlessness, which latter is relieved if the patient's clothing is smoothed down and his position changed.
Among the remedies causing constriction of the anus, the following are worthy of notice: Bellad., Caustic, Nitric ac, Nat. mur., Ignat., Kali bich., Opium, Plumbum, Mezereum, Coccul.
The first has: pressing and urging toward anus and genitals, alternating with contractions of the anus ; spasmodic constriction of anus as in dysentery.
The second, CAUSTICUM, causes fruitless urging to stool, with anxiety and red face.
NITRIC ACID causes sticking in the rectum as from a splinter; the constriction occurs during, stool and lasts for hours afterwards; the rectum feels as if torn.
NATRUM MUR. has sensation of contraction in the rectum during stool, the faeces tear the anus; frequent ineffectual urging; spasmodic constriction of the anus.
IGNATIA induces a proctalgia; contraction, with cutting, shooting pains; contraction of anus worse after stool. Symptoms are inconsistent, irregular, fitful as in hysteria.
KALI BICH. has sensation of a plug, similar to Lachesis; diarrhoea, of a brown, frothy water, spurting out in the early morning and followed by tenesmus ani.
OPIUM, anus is spasmodically closed during the colic, with obstinate constipation. PLUMBUM is very similar.
But all these are readily distinguished by the characteristic symptoms of Lachesis: tormenting urging in the rectum but on account of constriction of the anus it becomes so painful he must desist. Protruded piles, with constricted anus.
Much nearer, and indeed almost identical here, is MEZEREUM; after the stool, the anus is constricted around the protruded rectum. In other respects, however, the two remedies are widely different.
KALI BICHROMICUM must also be remembered as a relative of Lachesis in dysentery. Both have red, cracked, smooth tongue; blackish stools; hence in severe or typhoid cases and further, they follow each other well. The offensive odor of the discharges distinguishes the latter; the jelly-like mucus, sometimes stringy, the former. A peculiar feature of COCCULUS is tenesmus recti after stool, with faintness, and yet peristalsis is lessened. (Compare IGNATIA.)
So characteristic is this offensiveness of the faecal movements in Lachesis that it becomes highly indicative of the drug in low forms of disease. You may confidently give Lachesis when this sort of stool exists. The rectum and anus are affected so that there is constant tormenting urging in the rectum, but not for stool. It is merely a spasmodic condition of the bowels with an. unduly irritable sphincter. Another symptom is, the patient is desirous of straining at stool, but cannot do it for pain in the sphincter ani; the rectum protrudes and is held by the constricted sphincter ; after stool there is often a sensation in the rectum as from the beating of little hammers. These symptoms are common enough in dyspeptics, particularly in those who have abused alcohol.
In peritonitis, Lachesis is indicated late when the fever still continues and is worse after 1 P.M. and at night. The slightest touch to the surface of the body is intolerable. Typhoid symptoms complicate the case. It may even be indicated when there is typhlitis after the formation of pus. It follows, particularly, BELLADONNA, BRYONIA or MERCURIUS CORROSIVUS. It is also similar to RHUS TOX. but it has more typhoid symptoms than has that remedy and so comes in later in the case.