ARSENICUM ALBUM(As2 O3)- Commentary by Boericke, Kent, Clarke, and Nash

Acidum arsenious: The white oxide of Metallic Arsenic, As2 O3. Solution and trituration

English: White arsenic, Arseniuous acid, Arsenic Trioxide
French: Arsenic, Oxyde blanc d’arsenic, Acide arsenieux
German: Arsenik, Arsenige Saure

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Status: unapproved

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Established Coronavirus Case where symptoms are well-established, aggressive protocol is outlined as under.

1) Arsenicum Album 30C, three doses, 5 minutes apart each followed by 1hour break. Repeat second set of three doses as above followed by 1 hour break.

2) Immediately after third dose of second set, Bacillinum 200C one dose.

3) Repeat above two sets three times daily. This will make a total of 18 doses of Arsenicum Album 30C and 3 doses of Bacillinum 200C.

This protocol to be followed on daily basis till the symptoms start abating and temperature normalizes. Then one set of steps 1 and 2 in the morning and one set in the evening.The second protocol can be administered for 1-2 weeks depending upon condition of the patient. Arsenicum Album 30C one dose morning, noon and evening followed by one dose of Bacillinum 200C

Mode of preparation:

5 centigrams are put into a vial with 4 grams of distilled water; the arsenic is dissolved by heating it, and water is added as it evaporates. Then 4 grams of alcohol are added to this and mixed well. One drop is then added from this preparation to one thousand drops of a mixture that is equal parts water and alcohol. Ten drops from this solution are added to a bottle containing ninety drops of alcohol. This is the second attenuation, and all the succeeding attenuations are made in this way. A second method used by Hahnemann was to triturate one grain of white arsenic with 100 grains of sugar of milk, making three triturations in succession, so that afterwards he would be able to make the remaining attenuations the liquid way

Pathology: Deep-sense of insecurity, lack of social confidence, Anxiety, Restlessness, Aggravation by cold, Worse after midnight, Thirsty for sips, Periodicity, Alternations of symptoms, Ulcerations, Burning pains.

HOMŚOPATHIC MATERIA MEDICA
by William BOERICKE, M.D.

Third to thirtieth potency. The very highest potencies often yield brilliant results.

A profoundly acting remedy on every organ and tissue. Its clear-cut characteristic symptoms and correspondence to many severe types of disease make its homeopathic employment constant and certain. Its general symptoms often alone lead to its successful application. Among these the all-prevailing debility, exhaustion, and restlessness, with nightly aggravation, are most important. Great exhaustion after the slightest exertion. This, with the peculiar irritability of fiber, gives the characteristic irritable weakness. Burning pains. Unquenchable thirst. Burning relieved by heat. Seaside complaints (Nat mur; Aqua Marina). Injurious effects of fruits, especially more watery ones. Gives quiet and ease to the last moments of life when given in high potency. Fear fright and worry. Green discharges. Infantile Kala-azar (Dr. Neatby).

Ars should be thought of in ailments from alcoholism, ptomaine poisoning, stings, dissecting wounds, chewing tobacco; ill effects from decayed food or animal matter; odor of discharges is putrid; in complaints that return annually. Anćmia and chlorosis. Degenerative changes. Gradual loss of weight from impaired nutrition. Reduces the refractive index of blood serum (also China and Ferr phos). Maintains the system under the stress of malignancy regardless of location. Malarial cachexia. Septic infections and low vitality.

Mind.–Great anguish and restlessness. Changes place continually. Fears, of death, of being left alone. Great fear, with cold sweat. Thinks it useless to take medicine. Suicidal. Hallucinations of smell and sight. Despair drives him from place to place. Miserly, malicious, selfish, lacks courage. General sensibility increased (Hep). Sensitive to disorder and confusion.

Head.–Headaches relieves by cold, other symptoms worse. Periodical burning pains, with restlessness; with cold skin. Hemicrania, with icy feeling of scalp and great weakness. Sensitive head in open air. Delirium tremens; cursing and raving; vicious. Head is in constant motion. Scalp itches intolerably; circular patches of bare spots; rough, dirty, sensitive, and covered with dry scales; nightly burning and itching; dandruff. Scalp very sensitive; cannot brush hair.

Eyes.–Burning in eyes, with acrid lachrymation. Lids red, ulcerated, scabby, scaly, granulated. Śdema around eyes. External inflammation, with extreme painfulness; burning, hot, and excoriating lachrymation. Corneal ulceration. Intense photophobia; better external warmth. Ciliary neuralgia, with fine burning pain.

Ears.–Skin within, raw and burning. Thin, excoriating, offensive otorrhśa. Roaring in ears, during a paroxysm of pain.

Nose.–Thin, watery, excoriating discharge. Nose feels stopped up. Sneezing without relief. Hay-fever and coryza; worse in open air; better indoors. Burning and bleeding. Acne of nose. Lupus.

Face.–Swollen, pale, yellow, cachectic, sunken, cold, and covered with sweat (Acetic acid). Expression of agony. Tearing needle-like pains; burning. Lips black, livid. Angry, circumscribed flush of cheeks.

Mouth.–Unhealthy, easily-bleeding gums. Ulceration of mouth with dryness and burning heat. Epithelioma of lips. Tongue dry, clean, and red; stitching and burning pain in tongue, ulcerated with blue color. Bloody saliva. Neuralgia of teeth; feel long and very sore; worse after midnight; better warmth. Metallic taste. Gulping up of burning water.

Throat.–Swollen, śdematous, constricted, burning, unable to swallow. Diphtheritic membrane, looks dry and wrinkled.

Stomach.–Cannot bear the sight or smell of food. Great thirst; drinks much, but little at a time. Nausea, retching, vomiting, after eating or drinking. Anxiety in pit of stomach. Burning pain. Craves acids and coffee. Heartburn; gulping up of acid and bitter substances which seem to excoriate the throat. Long-lasting eructations. Vomiting of blood, bile, green mucus, or brown-black mixed with blood. Stomach extremely irritable; seems raw, as if torn. Gastralgia from slightest food or drink. Dyspepsia from vinegar, acids, ice-cream, ice-water, tobacco. Terrible fear and dyspnśa, with gastralgia; also faintness, icy coldness, great exhaustion. Malignant symptoms. Everything swallowed seems to lodge in the śsophagus, which seems as if closed and nothing would pass. Ill effects of vegetable diet, melons, and watery fruits generally. Craves milk.

Abdomen.–Gnawing, burning pains like coals of fire; relieved by heat. Liver and spleen enlarged and painful. Ascites and anasarca. Abdomen swollen and painful. Pain as from a wound in abdomen on coughing.

Rectum.–Painful, spasmodic protrusion of rectum. Tenesmus. Burning pain and pressure in rectum and anus.

Stool.–Small, offensive, dark, with much prostration. Worse at night, and after eating and drinking; from chilling stomach, alcoholic abuse, spoiled meat. Dysentery dark, bloody, very offensive. Cholera, with intense agony, prostration, and burning thirst. Body cold as ice (Verat). Hćmorrhoids burn like fire; relieved by heat. Skin excoriated about anus.

Urine.–Scanty, burning, involuntary. Bladder as if paralyzed. Albuminous. Epithelial cells; cylindrical clots of fibrin and globules of pus and blood. After urinating, feeling of weakness in abdomen. Bright’s disease. Diabetes.

Female.–Menses too profuse and too soon. Burning in ovarian region. Leucorrhśa, acrid, burning, offensive, thin. Pain as from red-hot wires; worse least exertion; causes great fatigue; better in warm room. Menorrhagia. Stitching pain in pelvis extending down the thigh.

Respiratory.–Unable to lie down; fears suffocation. Air-passages constricted. Asthma worse midnight. Burning in chest. Suffocative catarrh. Cough worse after midnight; worse lying on back. Expectoration scanty, frothy. Darting pain through upper third of right lung. Wheezing respiration. Hćmoptysis with pain between shoulders; burning heat all over. Cough dry, as from sulphur fumes; after drinking.

Heart.–Palpitation, pain, dyspnśa, faintness. Irritable heart in smokers and tobacco-chewers. Pulse more rapid in morning (Sulph). Dilatation. Cyanosis. Fatty degeneration. Angina pectoris, with pain in neck and occiput.

Back.–Weakness in small of back. Drawing in of shoulders. Pain and burning in back (Oxal ac).

Extremities.–Trembling, twitching, spasms, weakness, heaviness, uneasiness. Cramps in calves. Swelling of feet. Sciatica. Burning pains. Peripheral neuritis. Diabetic gangrene. Ulcers on heel (Cepa; Lamium). Paralysis of lower limbs with atrophy.

Skin.–Itching, burning, swellings; śdema, eruption, papular, dry, rough, scaly; worse cold and scratching. Malignant pustules. Ulcers with offensive discharge. Anthrax. Poisoned wounds. Urticaria, with burning and restlessness. Psoriasis. Scirrhus. Icy coldness of body. Epithelioma of the skin. Gangrenous inflammations.

Sleep.–Disturbed, anxious, restless. Must have head raised by pillows. Suffocative fits during sleep. Sleeps with hands over head. Dreams are full of care and fear. Drowsy, sleeping sickness.

Fever.–High temperature. Periodicity marked with adynamia. Septic fevers. Intermittent. Paroxysms incomplete, with marked exhaustion. Hay-fever. Cold sweats. Typhoid, not too early; often after Rhus. Complete exhaustion. Delirium; worse after midnight. Great restlessness. Great heat about 3 am.

Modalities.–Worse, wet weather, after midnight; from cold, cold drinks, or food. Seashore. Right side. Better from heat; from head elevated; warm drinks.

Complementary: Rhus; Carbo; Phos. Thuja; Secale. Antidotal to lead poison.

Antidotes: Opium; Carbo; China; Hepar; Nux. Chemical Antidotes: Charcoal; Hydrated Peroxide of Iron; Lime Water.

Compare: Arsenic stibatum 3x (Chest inflammations of children, restlessness with thirst and prostration, loose mucous cough, oppression, hurried respiration, crepitant rales). Cenchris contortrix; Iod; Phosph; China; Verat alb; Carbo; Kali phos. Epilobium (intractable diarrhśa of typhoid). Hoang Nan. Atoxyl. Sodium arseniate 3x, sleeping sickness; commencing optic atrophy. Levico Water–(containing Ars, Iron and Copper of South Tyrol). Chronic and dyscratic skin diseases, chorea minor and spasms in scrofulous and anćmic children. Favors assimilation and increases nutrition. Debility and skin diseases, especially after the use of higher potencies where progress seems suspended. Dose. Ten drops in wine glass of warm water 3 times a day after meals (Burnett). Sarcolatic acid (influenza with violent vomiting).

Dose.–Third to thirtieth potency. The very highest potencies often yield brilliant results.

Low attenuations in gastric, intestinal, and kidney diseases; higher in neuralgias, nervous diseases, and skin. But if only surface conditions call for it, give the lowest potencies, 2x to 3x trit. Repeated doses advisable.

LECTURES ON HOMŚOPATHIC MATERIA MEDICA
by JAMES TYLER KENT, A.M., M.D.

Arsenicum Album

Generalities: From the time of Hahnemann to the present day Arsenicum has been one of the most frequently indicated medicines, and one of the most extensively used. In the Old School it is most extensively abused, in the form of Fowler’s solution.

Arsenic affects every part of man; it seems to exaggerate or depress almost all his faculties, to excite or disturb all his functions. When all our medicines have been as well proved we will effect wonderful cures. It is a substance easily proved because of its active nature, and from its very abuse we have learned much of its general nature.

While Arsenic impresses the whole economy and disturbs all the functions and tissues of man, there are certain prevailing and striking features in it.

Striking features: Anxiety, restlessness, prostration, burning and cadaveric odors are prominent characteristics.

The surface of the body is pale, cold, clammy, and sweating, and the aspect is cadaveric. In chronic sickness with great debility, anaemia, from long exposure to malarial influence, in the poorly fed and from syphilis this remedy is of great service.

The anxiety that is found in Ars. is intermingled with fear, with impulses, with suicidal inclinations, with sudden freaks and with mania.

It has delusions and various kinds of insanity; in the more active form, delirium and excitement. Sadness prevails to a great extreme. So sad that he is weary of life; he loathes life, and wants to die, and the Arsenic patient does commit suicide. It is a remedy full of suicidal tendencies.

The anxiety takes form also in the restlessness, in which he constantly moves. If he is able to get up lie goes from chair to. chair; the child goes front nurse to mother, and from one person to another. When in bed, unable to sit up, the patient tosses and turns from side to side; if he is able, he climbs out of bed and sits in the chair, keeps moving from one place to another, and when thoroughly exhausted, he gets back into bed again.

The restlessness seems to be mostly in the mind; it is an anxious restlessness, or an anguish, with the idea that anguish is a deathly anxiety. That is an effort to express it in the extreme. It seems that he cannot live, and it is not pain that drives him to anguish, but it is an anxiety intermingled with restlessness and sadness.

This state prevails in all diseases intermingled with prostration. An uneasiness comes in the early stage of disease, and lasts but until the prostration becomes marked. While lying in bed, at first he moves his whole body, moves himself in bed and out of bed; but the prostration becomes so marked that he is able to move only his limbs until at last he becomes so weak that he is no longer able to move and he lies in perfect quiet in extreme prostration.

It seems that prostration takes the place of anxiety and restlessness, and he appears like a cadaver. So remember that these states of anxiety and restlessness go towards the cadaveric aspect, towards death. This is seen, for instance, in the typhoid, where Arsenicum is indicated. At first there is that anxious restlessness with fear, but the increasing weakness tends towards prostration.

Running all through the remedy there is the burning mentioned as one of its most marked generals. There is burning in the brain, which makes him want to wash his head in cold water. This sensation of heat in the inner head with pulsation is ameliorated by the cold bathing, but when there is a rheumatic state that affects the scalp and outward nerves, and there is burning, the burning then is ameliorated by heat.

When the headache is of a congestive character, with the sensation of heat and burning inside the head, and there is a feeling as if the head, would burst, and the face is flushed and hot, that headache is better from cold applications and in the cool open air.

So marked is this that I have seen the patient sitting in the room with clothing piled on to keep the body warm and with the window open to relieve the congestion of the head.

Therefore, we say a striking feature belonging to this medicine is relief of all the complaints of the body from wrapping up and from warmth in general, and relief of the complaints of the head by cold, except the external complaints of the head, which are better from heat and from wrapping up. The neuralgias of the face and eyes, and above the eyes, are better from heat.

The burning is felt in the stomach; there is burning in the bladder, in the vagina, in the lungs. It feels as if coals of fire were in the, lungs at times, when gangrenous inflammation is threatened, and in certain stages of pneumonia.

There is burning in the throat and burning in all the mucous membranes. The skin burns with itching, and he scratches until the skin is raw, and then it burns, but the itching ceases; as soon as the smarting lets up a trifle the itching commences again. All night the itching and burning alternate, burning for a minute, when be scratches it until it is raw, but soon the itching begins again and it seems that he has no rest.

The secretions and excretions of Arsenic are acrid; they excoriate the parts, causing burning. The discharge from the nose and eyes causes redness around the parts, and this is true of all the fluids from the various orifices.

In ulcers there is burning, and the thin, bloody fluid discharged excoriates the parts round about. The odor of the discharge is putrid. If you have ever discovered the odor of gangrene, of mortified flesh, you know the odor of the Arsenicum discharges.

The stool is putrid, like decomposed flesh, putrid blood. The discharges from the uterus, the menstrual flow, the leucorrhoea, the faeces, the urine, the expectoration, all the discharges are putrid. The ulcer is so putrid that it smells like decomposing flesh.

Arsenic produces a tendency to bleeding. The patient bleeds easily and may bleed from any place. There is vomiting of blood; bleeding from the lungs and throat. Bloody discharge from the mucous membrane, at times, when inflammation is running high; haemorrhage from the bowels, kidneys, bladder and uterus; anywhere that mucous membrane exists, there may be haemorrhage. Haemorrhage of black blood and discharges that are offensive.

Gangrene and sudden inflammatory conditions like gangrenous and erysipelatous inflammations are common in Arsenic. Parts suddenly take on erysipelas, or parts that are injured suddenly take on gangrene.

Gangrene in internal organs, malignant inflammations, erysipelatous inflammation. No matter how you look upon the condition, no matter what it is called, if it is a sudden inflammation that tends to produce malignancy in the part it belongs to Arsenicum. Inflammation will go on in the bowels for a few days attended with a horribly offensive discharge, vomiting of clots of blood, great burning in the bowels with tympanitic condition.

You may almost look upon this as a gangrenous inflammation, so violent, sudden and malignant is it, and it has the anxiety, prostration, fear of death, and chilliness, the patient wanting to be covered warmly.

When with this inflammation of the bowels the patient is relieved by heat, it means Arsenic.

You should remember that Secale has a similar state; it has all the tympanitic condition, all the ulceration and prostration, all the offensive odor and expulsion of offensive clots, and all the burning, but the Secale patient wants to be uncovered, wants things cold, wants the windows open.

The only distinguishing feature between these two remedies in a case may be that Secale wants cold and Arsenicum wants heat, but this is the way we individualize in our homoeopathic prescribing.

When there is gangrenous inflammation in the lungs, we find the patient has been taken with a chill, there has been restlessness, prostration, anxiety and fear; as we enter the room we detect a horrible odor, and on looking into the pan we see the patient has been spitting up by the mouthful, black, foul expectoration.

Look and see if the patient wants to be covered warmly; if he is easily chilled, and heat feels good; then it is a hard thing to cover that case outside of Arsenicum. The prostration, the vomiting, the anxiety, the restlessness the cadaveric aspect are present, and where will you find a remedy with that totality outside of Arsenic.

I have many times gone a long distance to detect, from the very aspect of things, these symptoms that could be gotten while walking from the door to the bedside. Every symptom is Arsenic; he looks like in acts like it and smells like it. You may go to a patient with high grade inflammation of the bladder, with frequent urging to urinate, straining to urinate, and there is bloody urine intermingled with clots.

It has been found by the attending physician when he introduces the catheter to draw off the urine that clots dam up the catheter, a little is drawn off and then it stops. We have a history of restlessness, anxiety, fear of death, amelioration from heat, great prostration.

You must give Arsenic, not because there is inflammation of the bladder, but because it is a rapidly progressing inflammation, and because it is gangrenous in character. The whole bladder will be involved in a short time, but Arsenic will stop that.

So it is with all the internal organs, the liver, lungs, etc.; any of them may take on violent and rapid inflammation. We are not now speaking of the particulars, but only illustrating the general state of Arsenic, in order to bring out what runs through the whole nature of it.

We shall find when we take up the remedy and go through it in a more particular way these features will stand out everywhere.

Mind: The mental symptoms show in the beginning anxious restlessness, and from this a continuation towards delirium and even insanity with all that it involves; disturbance of the intellect and will.

“He thinks he must die.”

I went to the bedside of a typhoid patient once with all the general aspect I have described; he was able to talk, and he looked up at me and said:

“There is no use of your coming, I am going to die; you might as well go home; my whole insides are mortifying.”

His friend was seated on one side of the bed, giving him a few drops of water, and just about as often as he could get there with it he wanted it again.

That was all he wanted; his mouth was black, parched and dry. He got Arsenic. One of the characteristic features of Arsenic is thirst for small quantities often, just enough to wet the mouth. It is commonly used as a distinguishing feature between Bryonia and Arsenic for the purpose of memorizing the Bryonia has thirst for large quantities far apart, but Arsenicum little and often, or violent unquenchable thirst.

“Thoughts of death and of the incurability of his complaints.”

“Thoughts crowd upon him; he is too weak to keep them off or to hold on to one idea.”

That is, he lies in bed tormented day and night by depressing ideas and distressing thoughts. This is one form of his anxiety; when tormented with thoughts, he is anxious. In the delirium he sees all kinds of vermin on his bed.

“Picks the bedclothes.”

“Delirium during sleep, unconscious mania.”

“Whimpering and gnashing teeth.”

“Loud moaning, groaning and weeping.”

“Lamentations, despair of life.”

“Screaming with pains.”

“Fear drives him out of bed, he hides in a closet.”

These are instances of insanity that take on first a state of anxiety, restlessness, and fear. Religious insanity, with the delusion that she has sinned away her day of grace, the biblical promise of salvation do not apply to her, there is no hope for her, she is doomed to punishment.

She has been thinking on religious matters until she is insane. Finally she enters into a more complete insane state, a state of tranquility; silent, and with aversion to talk. So we see one stage enters into another; we have to take the whole case together; we have to note the course that the case has run in order to see it clearly and note that in one stage there were certain symptoms and, in another stage, other symptoms.

For instance, we know that in the acute conditions of Arsenicum there is either thirst for ice cold water, and for only enough to moisten the mouth, or there is thirst for water in large quantities and yet it does not quench the thirst; but this thirsty stage goes on to another in which there is aversion to water, and hence we see that in chronic diseases.

Arsenicum is thirstless. So it is in a case of mania; in the chronic state he is tranquil, but in the earlier stages, in order to be an Arsenicum case, he must have gone through the Arsenicum restlessness, anxiety and fear.

Fear is a strong element in the mental state, fear to be alone; fears something is going to injure him when he is alone; full of horror; he dreads solitude and wants company, because in company he can talk and put off the fear; but as this insanity increases he fails to appreciate company and the fear comes in spite of it. He has a violent increase of his fear and horror in the dark and many complaints come on in the evening as darkness is coming on.

Many of the mental troubles, as well as the physical troubles, come on and are increased at certain times. While some complaints, pains and aches are worse in the morning, most of the sufferings of Arsenicum are worse from 1-2 P.M. and from 1-2 A.M. After midnight, very soon after midnight sometimes, his sufferings begin, and from 1-2 o’clock they are intensified. Extreme anxiety in the evening in bed.

“Averse to meeting acquaintances, because he imagines he has formerly offended them.”

Great mental depression, great sadness, melancholy, despair, despair of recovery. He has dread of death when alone, or on going to bed with anxiety and restlessness. He thinks he is going to die and wants somebody with him.

The attacks of anxiety at night drive him out of bed. This is an anxiety that affects the heart, and so the mental anxiety and cardiac anxiety almost seem to coincide. A sudden anxious fear comes over him at night; he jumps out of bed with fear that he is going to die, or that he is going to suffocate.

It is full of dyspnoea, cardiac dyspnoea, and varying forms of asthma. The spells come on in the evening in bed or after midnight; from 1-2 o’clock he is attacked with mental anxiety, dyspnoea, fear of death, coldness, and is covered with, cold sweat.

“Anxiety like one who has committed murder.”

This is one form of his anxiety; he finally works up to the idea that the officers are coming after him, and watches to see if they are coming in to arrest him. Some unusual evil is going to happen to him; always looking for something terrible to happen.

“Irritable, discouraged, restless.”

“Restlessness, cannot rest anywhere.”

“As a consequence of fright, inclination to, commit suicide.”

The Arsenicum patient with this mental state is always freezing, hovers around the fire, cannot get clothing enough to keep warm, a great sufferer from the cold.

Chronic Arsenicum invalids cannot get warm; they are always chilly, pale and waxy, and in such invalids, after they have bad several unusual weak spells, dropsical conditions come on.

Arsenicum is full of puffiness and dropsy; oedematous condition of the extremities; dropsy of the shut sacs or of the cavities; swelling about the eyes; swelling of the face, so that it pits upon pressure. Arsenicum in these swellings is especially related to the lower eyelid rather than the upper, while in Kali carb. the swelling is more in the upper eyelid than the lower, between the lid and the brow.

There are times when Kali carb. looks very similar to Arsenic, and little features like that will be distinguishing points. If they run together in generals, then we must observe their particular peculiarities.

Periodicity: In the headaches we have a striking general feature of Arsenicum, brought out in their periodicity. Running all through this remedy there is periodicity, and for this reason it has been extensively useful in malarial affections which have, as a characteristic of their nature, periodicity.

The periodical complaints of Arsenic come on every other day, or every fourth day, or every seven days, or every two weeks. The headaches come on these cycles, every other, or third, or fourth, seventh or fourteenth day.

The more chronic the complaint is, the longer is its cycle, so that we will find the more acute and sharp troubles in which Arsenic is suitable will have every other day aggravations and every fourth day aggravations: but, as the trouble becomes chronic and deep-seated, it takes on the seventh day aggravation, and in the psoric manifestations of a long, lingering and deep-seated kind there is a fourteenth day aggravation.

This appearing in cycles is common to a good many remedies, but is especially marked in China and Arsenic. These two remedies are similar to each other in many respects, and they are quite similar in their general nature to the manifestations that often occur in malaria. It is true, however, that Arsenic is more frequently indicated than China. In every epidemic of malarial fever that I have gone through I have found Arsenicum symptoms more common than those of China.

These headaches bring out the interesting point that we mentioned above. Arsenicum has in its nature an alternation of states, and this carries with it certain generals. Arsenicum in all of its bodily complaints is a cold remedy; the patient sits over the fire and shivers, wants plenty of clothing, and wants to be in a warm room.

So long as the complaints are in the body this is so; but when the complaints are in the head, while he wants the body warm he wants the head washed in cold water, or wants the cold air upon it.

The complaints of the head must conform to the generals that apply to the head, and the complaints of the body must be associated with the generals that apply to the body. It is a difficult thing to say which one of these two circumstances is most general, and it is sometimes difficult to say which one is the general of the patient himself, because he confuses you by saying:

“I am worse in the cold,” but when his headache is on he says:

“I am better in the cold, I want to be in the cold.”

It is really only the head, and you have to single these out and study them by the parts affected. When things are so striking you must examine into it to see what it is that brings about modality.

You will see a similar state running through Phosphorus; the complaints of the stomach and head are better from cold, i. e., he wants cold applications upon the head with head sufferings, and wants cold things in the stomach with stomach complaints, but in all the complaints of the body be is ameliorated from heat.

If he steps out into the cool air, he will commence to cough, if he have a chest trouble. So we see that the modalities that belong to the part affected must always be taken into account. For instance, you have a patient suffering from neuralgia or rheumatic affections and these same pains, extend, to the head, then he wants the head wrapped up because they are ameliorated from heat.

But when it comes to cases of congestive conditions of the head, he then is better with his head very cold. Now, as I have said, there is an alternation of these states in Arsenicum.

I will illustrate by mentioning a case.

Once a patient had been dragging along with periodical sick headaches. The sick headaches were better from cold water, cold applications to the head, could hardly get them cold enough, and the colder the better. These headaches came every two weeks, and so long as they were present he desired cold to the head.

Then these periodical headaches would be better, for long periods; but when they were away he was suffering from rheumatism of the joints, which was also periodical, and also more or less tenacious, and when this rheumatism of the joints and extremities, with more or less swelling and oedema, was present he could not get warm enough; he was at the fire and wrapped up; he was relieved by heat, and wanted warm air and a warm room.

This would last for a period and then subside, and back would come his sick headaches and last for a while. That is what I meant by the alternation of states. Arsenicum cured that man, and he never had any of them afterwards.

The alternation of states sometimes means that there are two diseases in the body, and sometimes the remedy covers the whole feature in alternation of states.

I remember another case, which will illustrate this peculiar nature of alternation of complaints, which is shared by other remedies besides Arsenic.

A patient suffered from a pressure in the top of the head, such as I recently described to you under Alumen.

She would suffer for weeks from that pressure on the top of the head, and the only relief she could get was from hard pressure; she tired herself out with hard pressure and would contrive all kinds of weights to put upon the head.

That would go away in the night and she would wake up the next morning with constant urging to urinate. The irritable bladder alternated with pain on top of the head.

Alumen cured. In many of these anti-psoric remedies we have an alternation of states.

This illustrates the necessity for getting the symptoms of all the states that present themselves for cure, otherwise you will many times prescribe in a chronic case of psoric character and temporarily relieve it, when back comes another aspect of it.

You have only hastened the disease a little faster than it would go if let alone. But that is not homoeopathic prescribing. Be sure, when a remedy presents one state, that it is a clearly indicated in the other state, otherwise that remedy is not the similimum.

You must hunt until you find the remedy that has both states, or you will be disappointed. We sometimes do not discover this alternation of states until we have brought it back two or three times by incorrect prescribing.

Some people are so reticent and so difficult to get symptoms from that we do not always get these symptoms.

But you examine your record and you find where – you have made a foolish prescription, that you drove a new condition away and back came the first trouble, and you kept on with this see-saw business.

Now remember in doing this your patient is not improving, and that you must re-study the whole case, taking the alternating states into, account. In Arsenic, the head symptoms alternate with physical symptoms.

You will find running through certain remedies, as a part of their nature, that mental symptoms alternate with physical symptoms; when the physical symptoms are present, then mental symptoms are not trates the necessity for getting the symptoms of all the states that is determined it is a good point, but sometimes you do not find a remedy, because many of our remedies are not well recorded; they have not yet been observed in their alternations and marked as such.

We find in Podophyllum the peculiar feature that the headaches alternate with diarrhea; he is subject to sick headaches and to diarrhea, and one or other will be present.

In Arnica the mental symptoms alternate with uterine symptoms. The uterine symptoms, when ob served, look like Arnica, but these go away in the night and mental symptoms come on, the mind being heavy, gloomy and cloudy.

When you have remedies that have these manifestations it requires a greater depth of vision to see the alternation of states, because these things are not always brought out in the proving, for the reason that one prover had one group of symptoms, and another.

Yet a remedy that is capable of bringing out the two groups of symptoms is sufficient to cure this alternation of states. The periodical headaches of Arsenic are found in all parts of the head.

They are the congestive headaches with throbbing and burning, with anxiety and restlessness; hot head and relief from cold, There are headaches in the forehead, which are throbbing, worse from light, intensified from motion, often attended with great restlessness, forcing him to move, with great anxiety.

Most of the headaches are attended with nausea and vomiting. The sick headaches are of the worst sort, especially those that come every two weeks. In some of these old, broken-down constitutions you will find he is cold, pallid, sickly; he is always chilly and freezing except when the headache is on, and it is better from cold; the face much wrinkled, great anxiety and no desire for water.

Remember that it was said in the acute state of Arsenic there is thirst, thirst for little and often, dry mouth and desire for water enough to moisten the lips, but in the chronic states of Arsenic he is generally thirstless.

Headaches: There are headaches on one side of the head involving the scalp, one-half of the head, worse from motion, better from cold washing, better from walking in the cold air, though very often the jar or stepping starts up a feeling as of a wave of pain, shaking, vibration or looseness in the brain; such are the sensations and these are conditions of pulsation.

Then there are dreadful occipital headaches, so severe that the patient feels stunned or dazed. They come on after midnight, from excitement, from exertion; they come on from becoming heated in walking, which produces determination of blood to the head. Nat. mur. is a medicine. analogous to this in its periodicity and in many of its complaints. It has congestive headaches from walking and becoming heated; especially from walking in the sun.

The Arsenicum headaches are generally worse from light and noise, better from lying down in a dark room, lying with the head on two pillows. Many of the headaches commence in the afternoon from I to 3 o’clock, after the noon meal, grow worse into the afternoon, lasting all night.

They are often attended with great pallor, nausea, prostration, deathly weakness The pain is paroxysmal; violent head pain during the chill of an intermittent fever; headache as if the skull would burst during an intermittent fever. Arsenicum has this head pain of a congestive character in intermittent fever, as if the head would burst.

A peculiar feature of the thirst is that there is no thirst during the chill except for hot drinks; during the heat there is thirst little and often for water enough to moisten the mouth, which is almost no thirst, and during the sweat there is thirst for large drinks.

Thirst begins with the beginning of the heat and increases as the dryness of the mouth; he desires only to moisten the mouth until he breaks out in a sweat, and then the thirst becomes a desire for large quantities very often, and the more he sweats the more desire he has for water.

The headache is during the chill; it increases, so that it becomes a congestive, throbbing headache during the chill and heat; this grows better towards the end of the heat as the sweat breaks out, it is ameliorated by the sweat.

In chronic headaches, congestive headaches and malarial complaints, a tendency to shrivel is observed upon the skin; a prematurely old, wrinkled appearance of the skin comes on. The mucous membrane of the lips and mouth often shrivels and becomes wrinkled.

This is also found in the diphtheritic membrane of the throat as a peculiar feature of Arsenic, and belongs, as far as I know, to no other remedy. The exudation in the throat is leathery looking and shriveled.

A shriveled membrane is not a sure indication for Arsenic, but when Arsenic is indicated you would be likely to find this kind of membrane; such cases as are very malignant in character, very offensive, putrid, those with a gangrenous odor.

At times the head is in constant motion when there are complaints in the body, because parts of the body are too sore to be moved; then the motion of the head comes on because of restlessness and uneasiness, and he keeps it in motion even though it does not ameliorate.

The face and head are subject to oedema; dropsy of the scalp and erysipelatous inflammation of the face and head.

The scalp pits upon pressure and there is a little crepitation under it from pressure. The scalp is subject to eruptions and is very sensitive. So sensitive is the scalp that the hair cannot be combed; it seems as if the touch of the comb or brush when rubbing over the scalp went into the brain.

Constantine HeringSensitiveness is a feature of Arsenic; sensitiveness to smell and touch; over sensitiveness of all the senses. A peculiar feature that perhaps I have not brought out is the over sensitiveness to the circumstances and surroundings of the room.

The Arsenicum patient is an extremely fastidious patient. Hering once described him as “the gold headed cane patient.” If this is carried out in a woman who is sick in bed she is in great distress if every picture on the wall does not hang perfectly straight.

Those who are sensitive to disorder and confusion and the disturbed and made worse until everything is placed in order have a morbid fastidiousness which has its similimum in Arsenic.

Eyes: The eye symptoms of this remedy are very prominent. In old cases of suppressed malaria, in broken down constitutions, in pallid, sickly people who are subject to general catarrhal conditions, and such catarrhal conditions as localize more especially in the nose and eyes, the eye symptoms will be troublesome.

There are discharges from the eyes. It may be a conjunctivitis, in a general way involving the lids and the globe, going on sometimes to ulceration with thin, bloody discharge, increasing to thick, acrid discharge that excoriates the eye, making the canthi red and causing granulation with burning.

The burning is better from washing in cool water and also better from dry heat. Very often ulcers appear on the globe of the eye, often upon the cornea.

It has various kinds of hypertrophy beginning in patches that will form scars, and in old ulcerated patches little growth similar to a pterygium growing towards the centre of the eye and threatening blindness.

The inflammations are sometimes attended with swelling, burning and excoriating discharge; this swelling is bag-like in character, and so we find “baggy” lids and little bags forming under the eyes.

The face is waxy and pale, presenting the appearance of a broken down constitution or a dropsical condition.

The catarrhal state involves throat and nose, and it is sometimes difficult to separate the nose symptoms, from the throat symptoms.

The Arsenicum patient is always taking cold in the nose, always sneezing from every change in the weather. He is always chilly and suffers from drafts, and is worse in cold, damp weather; always freezing, chilled through.

These pale, waxy, broken down constitutions with catarrhal discharges from the nose on looking at a bright light become blind.

Sneezing and coryza with inflammatory conditions through the whole nasal cavity, throat, larynx and chest.

The cold begins in the nose and goes down into the throat, very often causing hoarseness with dry, tickling, hard, rasping cough.

It is a difficult matter to find remedies for a coryza that begins in the nose and extends into the chest with bronchial troubles; very often you require a change of remedy, as the chest symptoms often run to a different remedy. It is difficult to find a remedy that covers the symptoms of both nose and chest.

Arsenicum is the remedy for old, chronic catarrhal troubles of die nose where the nose bleeds easily, and he is always sneezing and taking cold, always chilly and pallid, tired, restless, full of anxiety in the night and has troublesome dreams.

The mucous membrane is easily inflamed, producing patches of red and ulcers that bleed easily. Great crusts form in the back of the nose.

There is a striking tendency too ulcerate in Arsenicum. If it is a sore throat it ulcerates; if colds settle in the eyes, they may end in ulceration; catarrhal troubles in the nose end in ulceration; and this ulceration tendency, no matter where the troubles locates, is a very strong feature of Arsenicum.

It is the remedy for catarrhal complaints of the nose and other places in broken down constitutions from syphilis or malaria, or a constitution that has gone through blood poisoning of some kind, either poisoning from a dissecting wound, or from erysipelas or typhoid fever or other zymotic states improperly treated, or poisoning with quinine and like substances that break down the blood and establish a state of anaemia. If an ulcer comes upon the leg, if a leucorrhea comes on, if any discharge is established the patient is relieved thereby.

Now let some of these discharges slack up and you have a chronic state apparently from retained secretions, but it is a form of blood poisoning. So it is with suppressed ear discharges, suppressed throat discharges, suppressed leucorrhea and ulcerations.

Arsenicum is one of the medicines that will conform to the anaemic state that follows each suppression. At the present day it is fashionable to use the cautery, to make local applications to stop leucorrhoea and other discharges and to heal up ulcers.

Now, when these external troubles go there is an anaemic state established in the economy, the patient becomes waxy and pallid, sickly looking, and these catarrhal discharges come on as a means of relief because of the suppression of some other condition.

For instance, since the suppression of a leucorrhoea the woman has had thick, bloody or watery discharge from the nose. It is frequently suitable to the constitution when an ulcer has been dried up by salves, or an old car discharge has been stopped by the outward application of powders. The doctor thinks he has done a clever thing in stopping such discharges, but he has only succeeded in damming up the secretions which are really a relief to the patient.

Such medicines as Sulphur, Calcarea and Arsenicum are suitable for the catarrhal discharges that come from these suppressions, in broken down constitutions.

Arsenic is also like unto the condition that has been brought about from the absorption of animal poisons. It goes to the very root of the evil, as it is similar to the symptoms brought on from a dissecting wound. Arsenic and Lachesis are medicines that will go to the cause at once and antidote the poison, establishing harmony and turning things into order.

The nose symptoms, then, of Arsenic are very troublesome and furnish and extensive part of the symptom image of an Arsenicum patient. They always take cold easily, are always sensitive to cold and the catarrh is always roused up on the slightest provocation.

When an Arsenicum patient is at his best he has discharge more or less of a thick character, but when he takes a little cold it becomes thin; the thick discharge that is necessary to his comfort slacks up, and then he gets headache and on comes thirst, restlessness, anxiety and distress.

This goes on to a catarrhal fever of two or three days duration, and then the thick discharge starts up again and he feels better; all his pains and aches disappear. It has been of great service in epithelioma of nose and lips.

Inflammation of the throat and tonsils with burning, increased by cold and better by warm drinks. There is redness and a shriveled condition of the mucous membrane.

When there is blood poisoning going on, as in diphtheria, and exudate appears upon the mucous membrane and it becomes gray and shriveled, ashy colored, and this sometimes covers the whole of the soft palate and the arches. It looks withered. He is prostrated, anxious, sinking, weak, not a great deal of fever, but much dryness of the mouth.

The catarrhal state goes down into the larynx with hoarseness, and into the trachea with burning, worse from coughing, and then comes constriction of the chest, asthmatic dyspnoea and dry, hacking cough with no expectoration.

This testing cough is attended with anxiety, prostration, restlessness, exhaustion and sweat, and the cough does not seem to do any good.

The cough is the early part of it and keeps on as a dry, rasping, harsh cough for several days without doing any good; and then asthmatic symptoms come on, when be expectorates great. quantities of thin, watery sputum.

There is constriction about the chest a great sense of tightness and wheezing, and he feels he will suffocate. Bloody mucus is expectorated at times, but the symptoms are more generally of a catarrhal character.

Symptoms of pneumonia sometimes appear with the rusty expectoration. The expectoration is excoriating. There is in the chest a sense of burning, as if coals of fire were in the chest, and it goes on to bleeding and liver-colored expectoration.

Arsenicum is a bleeding medicine, one that predisposes to haemorrhage, and bleeding takes place from all mucous membranes; commonly of bright red blood, but in this region the parts take on a gangrenous state and the hemorrhages become black and there are little clots like portions of liver.

The same are found in the vomited matter and in the stools. The expectoration is horribly offensive, so much so that you soon get the idea that there is a state of gangrene.

The patient is at this time going into a state that perhaps cannot be any better described than a gangrenous inflammation; there will be signs to indicate the inflammatory condition, and there will be the smell of the expectoration which you will detect as soon as you open the door,

The expectoration is a thin, watery fluid intermingled with clots. In the pan you will find this watery expectoration looking like prune juice, and in the midst of it will be clots of blood; the offensiveness is horrible. He has gone through the period of restlessness and is now prostrated, sinking, pallid, and likely enough covered with a cold sweat.

Stomach and bowels: When we come to the stomach we find everything that may be called a gastritis, vomiting of everything taken, even a teaspoonful of water, extreme irritation of the stomach, great prostration, horrible anxiety; dry mouth; a very little hot water will sometimes comfort him for a minute, but soon it must come up; cold fluids are vomited immediately. The whole oesophagus is in a state of inflammation; everything burns that comes up or goes down. Vomiting of bile and blood.

Extreme sensitiveness of the stomach is present; he does not want to be touched. Heat applied externally relieves, and there is a temporary relief from warm drinks; the heat is grateful. In the bowels we have much trouble; this remedy has all the symptoms of peritonitis; distension of the abdomen, a tympanitic state; cannot be handled or touched, yet he will keep moving because he is so restless, he cannot keep still, but finally he becomes so weak that exhaustion takes the place of restlessness.

Dysentery is likely to come on, with involuntary passages of urine and faeces, one or both, with haemorrhage from the bowels and bloody urine.

As the bowels move, we get the cadaveric odor to the stool, a smell like putrid flesh. The stool is bloody, watery, brown like prune juice, or black and horribly offensive.

Sometimes dysenteric in character with dreadful straining and burning of the anus; every stool burns as though there were coals of fire in the rectum; burning it! the bowels, burning all the way through. The pain in the abdomen is better from the application of hot things. The tympanitic condition is extreme.

Sometimes there is a gastro-enteritis that takes on a gangrenous character that in olden times used to be talked about as gangrene of the bowel, a mortification that always ended in death.

A thick, bloody discharge is passed with a horrible odor, all substances are vomited, the patient desires to be in a very warm room, wants to be well covered, wants hot applications and warm drinks, looks cadaveric and smells cadaveric, with a dry, pungent odor that penetrates everything, but if he wants the covers off, wants a cool room and windows open, wants to be sponged with cold water, and wants ice cold drinks then he must have Secale.

Bowels: I want to warn you against the too promiscuous use of Arsenic in the summer complaints of young babies, for dysentery and cholera infantum. It has so many little symptoms that are so common to these complaints. that if you do not look out and are not warned you will be likely to give your patient Arsenic, suppress some of the symptoms, changing the aspect of the case so that you cannot find a remedy for it and yet not cure the case with Arsenic.

There is a strong tendency to be routine and give Arsenic without a sufficient number of generals being present; i.e., if you give it on particulars and not on the generals of the case.

This medicine is full of diarrhea and dysenteric symptoms; in these conditions there will be the pallor, the anxiety, the cadaveric aspect and the cadaveric odors.

In the dysentery there is most distressing and frequent urging to stool, scanty, slimy, black, fluid, inky stools with cadaveric smell, great prostration, restlessness and pallor. In the bowel troubles, in low forms of disease, the stool becomes involuntary.

This is a condition of the rectum, a relaxation of the rectum, great prostration. Involuntary stool generally indicates either local or general exhaustion, and in this remedy there is terrible exhaustion, so that there is involuntary diarrhea in typhoid and in low forms of zymotic disease; involuntary urine.

Purging is sometimes present in Arsenic, but generally be does not have much purging, such as we find in Podophyllum, Phos. ac. Usually there will be little, frequent gushes, little spurts with flatus and the great exhaustion that occurs in cholera, little spurts with mucus, slimy, whitish stools.

Arsenic is not so commonly indicated in cholera, i. e., during the gushing period, but sometimes after the gushing is over and the vomiting and purging have passed, leaving a state of extreme exhaustion, we have a state that appears like coma, the patient looks almost as if dead, except that he breathes. We find, then, that Arsenicum will establish reaction.

Cholera infantum with great prostration, sinking and cadaveric appearance, great coldness, covered with told sweat, cold extremities, cold as death; cadaveric, sickly, foul, pungent, penetrating odor in the room from the faeces and urine and even of what is vomited.

The passages from the bowels are acrid, excoriating, causing redness and burning. Very often the burning extends into the bowels.

The rectum and anus burn, smarting all about the anus. It has tenesmus, painful, unbearable urging, great distress in the lower bowel, in rectum and anus, terrible state of anxiety of the patient and the pain is so violent and the suffering so intense, the anguish so intense, that he can think of nothing but death the fearfulness and frightful feelings are such as he has never experience in his life, and he feels confident these mean he is going to die.

This, like all other complaints, is attended with restlessness, and when not at stool he is walking the floor, going from bed to chair and from chair to bed. He will get on the stool and then back to bed, then he is hurried to stool again, sometimes he loses it.

Sometimes there is a chronic hoemorrhoidal state with burning, and the hemorrhoids protrude when at stool, he is much exhausted after getting back into bed after a stool, with these protruding lumps which are like grapes and feel like coals of fire. They are hot, dry and bleeding. Fissures of the rectum that bleed at every stool, with burning Itching and eczematous eruptions about the anus with burning.

This kind of pain may be felt anywhere in the body; burning is characteristic of Arsenic, stitching is characteristic of Arsenic. Now, put these together and the patient often describes it as being stuck with red hot needless all over him. This red hot sensation, which is a common feature all over, is felt at the anus, and especially when there are hemorrhoids, burning and sticking like hot needles in the hemorrhoids

At times when a patent is coming down with the early stage of a violent attack he will have all the rigor and chill that it is possible to find in the Materia Medica and that can be found in disease. Rigors and chills of violent character, and at such times he describes a feeling as if the blood flowing through the vessels were ice water. He feels a rushing through the body of ice cold waves.

When the fever comes on, he is intensely hot from head to foot, before the sweat has appeared, he feels that boiling water is going through the blood vessels. Then comes on the sweat and dyspnoea and all complaints in which he is prostrated and becomes cold.

While the sweat some times relieves the fever and pains, yet it is prolonged and attended with great exhaustion and does not relieve his exhaustion.

Many of his complaints are increased with the sweat; for instance, thirst is increased, the drinking is copious and does not relieve, it seems he cannot get enough and patients will say:

“I can drink the well dry,” or

“Give me a bucket of water.”

Such things are indicative of the state of thirst. During the fever he wants little and often; during the chill he wants hot drinks.

Arsenicum is a very useful medicine in the eruptions of the genitals with burning.

In little ulcers that burn, even when they are syphilitic; herpetic vesicles that appear upon the foreskin and upon the labia; chancre or cancroids with burning, smarting and stinging, but especially in those that are weak, that offer no willingness to heal, but that do the very opposite, that spread, those that we call phagedenic, those that eat from their outer margins, become larger and larger.

Ulcerations: Arsenic and Merc corr. are the two principal medicines for spreading ulcerations such as eat in every direction, very offensive. Such ulcerations as follow the opening of a bubo in the inguinal region where there is no tendency to heal.

A little, watery, offensive discharge keeps coming and extending, ulceration keeps spreading round about the opening, no tendency to heal.

Or the patient has been in the hands of a surgeon who has passed his knife down the threatening suppurating bubo and it has been followed by red, angry, erysipelatous appearance and shows no tendency to heal.

The edges have been removed by ulceration, and now the surface has cleared off, leaving a surface the size of a dollar; sometimes becoming serpiginous. These ulcers are sensitive to touch and burn like fire.

Genitals: In the male and female sexual organs there are many symptoms of importance. In the male organs a dropsical condition, dropsy of the penis, oedematous appearance, so that the penis is enormously swollen and looks like a water bag; the scrotum, especially the skin of the scrotum, greatly swollen and humid round about, the parts.

In the female the labia are enormously swollen with burning, stinging pains, hard and swollen. Erysipelatous inflammation of these organs, ulcerations, of a syphilitic character; these when such symptoms burning, smarting and stinging are present.

In the female, violent, burning pains in the genitals with or without swelling, burning that extends up into the vagina, with great dryness and itching of the vagina.

The leucorrhoeal discharge excoriates the parts, causing itching and burning with great suffering. Whitish, watery, thin discharges that excoriate; so copious sometimes that it will run down the thighs.

The Arsenicum menstrual flow is very often excoriating in character. Copious leucorrhoeal flow intermixed with menstrual flow, very profuse and very acrid.

Suppressed menstruation going on for months; amenorrhoea in prostrated, nervous patients, wrinkled, careworn, haggard facet.

Of course, Arsenic has a wonderful reputation in the old school for anaemia, and it is said to be as good as Ferrum for anaemia.

Ferrum and Arsenic are the strong drugs for anaemia, so that it is not to be wondered at that these pallid mortals find benefit from Arsenic.

“During menstruation, stitches in the rectum.”

“Leucorrhoea acrid, corroding, thick and yellow,” etc.

After parturition the woman does not pass the urine; no urine in the bladder; suppression, or the bladder is full and it does not pass.

In connection with this subject you will find Causticum the most frequently indicated remedy when you go back and the woman has not passed the urine and it is time that she should; you will frequently find it indicated when you have no other symptoms to go on. Aconite will be more frequently indicated than any other remedy if the infant has not passed the urine.

This is keynote practice and is to be condemned when there are other symptoms to indicate a remedy.

If there are no other symptoms study Aconite and Causticum and see if there is any reason why they should not be given.

Cancer: Another feature in connection with the woman, Arsenic is a wonderful palliative in cancerous affections, such as occur in the uterus and mammary glands.

Burning, stinging pains have entirely disappeared, in incurable cases, of course. It becomes one of the palliatives.

Larynx and chest: Arsenic has loss of voice, laryngitis, with dry teasing cough; a cough that does not seem to do any good; hacking constantly, dry, hacking cough.

Study its relation to asthma and difficult breathing, dyspnoea. Arsenic has cured some long standing cases of asthma of a nervous character; asthma that comes on after midnight, in patients who suffer from the cold, those who are very pallid, dry wheezing cough, must sit up in bed and hold the chest, anxious restlessness with prostration.

The heart symptoms are troublesome to manage when they get to be like Arsenic; the symptoms correspond to a state of great weakness, great palpitation, palpitation from the least exertion or excitement, great anxiety, anguish, weakness; he cannot walk, he cannot go upstairs, he can hardly move without increasing the palpitation; every excitement brings on palpitation.

“Severe paroxysms of palpitation or attacks of syncope during endocarditis.”

Arsenicum corresponds to most serious complaints of the heart, corresponds to many of the incurable complaints of the heart; i. e., when you see Arsenic corresponding in all of the symptoms with these marked cardiac affections, dropsy of the pericardium, etc., you have a class of cases that are very serious,

“Angina pectoris,” etc.

“Rheumatism affecting the heart,” etc.

“Hydropericardium with great irritability,” etc.

“Pulse frequent, small, trembling.”

“Pulsation through whole body,” etc., etc.

Again this goes on to another state when the heart becomes weak, pulse thread-like, patient pale and cold, covered with sweat, pulse very feeble. When this is not a state of the heart itself then Arsenic becomes a wonderful remedy; that is, it is capable of cure.

Fever: I want to say a few things concerning a few essentials, some few things most general to the Arsenicum type of intermittent.

You can read the general state of intermittent fever and fevers generally and apply what has been said.

Arsenic has all the violence of the chill that you can find in any remedy, with excitement, headache, prostration, dry mouth, desire for hot drinks and to be covered up warmly, with all the anxious restlessness and prostration that you can find in any medicine; but the time of the Arsenic case is an important thing.

A striking feature of the Arsenic time of chill is its irregularity, coming not twice alike, coming at any time. It has afternoon chill and after midnight chill, sometimes in the morning, sometimes at 3 or 4 P.M., sometimes at 1 P.M.

It has a striking periodicity in its nature. Hence it has an intermittent nature. It has a striking feature of thirst.

During the chill, while there is sometimes great thirst, he has aversion to cold things, hence can take only hot drinks, hot teas, etc.

During the fever the thirst increases because he has dry mouth, and he drinks little and often, just a teaspoonful to wet his dry mouth.

Water does not quench his thirst, for he wants but a tablespoonful, little and often. This runs on into the sweat with prostration, increased coldness, desire for copious drinks, unquenchable thirst for cold drinks.

The chill is attended with great aching in the bones, likely to commence in the extremities, and during the chill there is a great head congestion with purple fingers and toes.

Put these things together and the prostration that occurs with the awful anxiety, and you can most always in a general way pick out the Arsenic case.

But it has so many details in its chill, fever and sweat that if you take the details of symptoms and leave these general features out you will be likely to be able to cover almost any case of chills, i.e., you may think you will, but unless some of these general nates are present that stamp it as Arsenic you will fail.

It is one thing to stamp the whole case as Arsenic and another thing to say that these are Arsenicum symptoms.

So it is with China and Quinine; they have numerous particular symptoms, and yet to make the case a China or Quinine case the striking general features must be present.

Arsenicum Album

Materia Medica by John Henry Clarke

Clinical.-Abscess. Acne rosacea. Alcoholism. Amenorrhoea. Anaemia. Aphthae. Asthma. Atrophy. Bronchitis. Brown-ague. Caecum, affections of. Cancer. Cancrum oris. Carbuncle. Cholera Asiatica. Cholera. Cold. Coldness. Commissures, soreness of. Cough. Coxalgia. Croup. Dandriff. Delirium tremens. Depression of spirits. Diarrhoea. Diphtheria. Dropsy. Duodenum. Dyspepsia. Ears, affections of. Eczema. Endometritis. Enteric fever. Epithelioma. Erysipelas. Eye, affections of. Face, eruption on. Fainting. Fever. Gangrene. Gastric ulcer. Gastritis. Gastrodynia. Glandular swellings. Gout. Hay-asthma. Headache. Heart, affections of. Hectic. Herpes zoster. Hodgkin’s disease. Hydro-thorax. Hypochondriasis. Ichthyosis. Indigestion. Intermittent fever. Irritation. Jaundice. Kidney, diseases of. Leucorrhoea. Lichen. Lips, eruption round; epithelioma of. Locomotor ataxy. Lung affections. Lupus. Malignant pustule. Measles. Melancholia. Menstruation, disorders of. Miliary eruptions. Morphoea. Myelitis. Nails, diseased. Nettle-rash. Neuralgia. Neuritis. Nonta pudendi. Numbness. Peritonitis. Perityphlitis. Pityriasis. Plethora. Pleurisy. Pleurodynia. Pneumonia. Psoriasis. Purpura. Pyoemia. Pyelitis. Remittent fever. Rheumatic gout. Rheumatism. Rickets. Ringworm. Scaldhead. Scarlatina. Sciatica. Scrofulous affections. Sea-bathing, effects of. Sea-sickness. Shiverings. Stomach, affections of. Strains. Suppuration. Thirst. Throat, sore. Tobacco-habit. Tongue, affections of. Trachea, affections of. Traumatic fever. Typhus. Ulcers. Vomiting. Whooping-cough. Worms. Wounds. Yellow fever.

Characteristics.-Arsenic is the horse’s remedy; as Puls. is the sheep’s, and Antim. crud. the pig’s. The reprehensible fashion of “doctoring” horses with Arsenic is merely an abuse of a therapeutic fact. The horse is an animal on whose power of endurance and “wind” enormous demands are made, and Arsenic is the remedy for the effects of feats of prolonged endurance. The Arsenic habit of the Styrian mountaineers has arisen from the discovery of its power of strengthening the muscles both of the limbs and of the breathing apparatus. But in another way the horse typifies the Arsenic temperament. The mental symptoms of my drug, when pronounced, carry precedence of all others. The horse is an exceedingly nervous animal, constantly moving about, restless to a degree, and very prone to take fright-quite a picture of the Arsenic temperament. According to Teste Arsen. acts much more powerfully on vegetable-eating animals than on carnivora (opp. Nux v.); and it is suited to the effect’s of excess of vegetable diet, melons, strawberries, and fruits in general, especially watery fruits.

The arsenic-eaters of the Tyrol can take as much as six grains of white arsenic, or the sulphide, every two days. They maintain that it imparts a sense of invigoration and enables them to carry enormous loads up perpendicular mountains. According to one account it is resorted to by populations who live on vegetable food almost exclusively. “It strengthens the muscles,” an old indulger in the habit is reported to have said, “helps to digest our coarse bread and potatoes, and allows us to breathe freely and easily. Meat-eaters have no need for such a thing, but with us it is a necessity.” It is difficult to say how far this is a directly “tonic,” effect, and how far curative of the dyscrasia generated by the conditions of life. The fine skin and glossy hair of the young women among the arsenic-eating populations is remarkable, and is comparable to the fine coats of arsenic-fed horses. On the other hand, “staring coat” in animals, and “dry, rough, scaly, unhealthy-looking skin” in human beings are keynote indications for the remedy. In this connection may be mentioned the effects on the crew of the ship Zion, which carried arsenic as a portion of its cargo. This was exposed somewhat to the sun’s rays, and the crew noticed a peculiar smell. Soon they all began to notice themselves growing stout, and on reaching Philadelphia from England they had all gained much, one to the extent of two stones in weight.

Restlessness is one of the grand characteristics of Arsenic. Even the stupor of Arsenic is interrupted by fits of restlessness with anxious moaning. Patients are anxious, full of the fear of death, restlessness compelling them to frequently change their position. Hence the applicability of the drug in many nervous affections, notably chorea. Jerks and starts on falling asleep. Irritability, desperately angry; almost furious. Despair, hopelessness, unutterable misery. The irritability and sadness of malarial cachexias; of the cachexias of quinine, mercury, and syphilis. Low types of disease; typhoid states. Inflammations of great intensity with tendency to destruction of tissue. Burning, lancinating pains. Burning is another of the leading characteristics of Arsenic. No other remedy has it in more pronounced degree. The peculiarity of the “burnings” of Ars. is that they are > by heat (herein comparing with Capsic.). The burning in the throat is > by eating or drinking hot things. On the other hand cold food and cold drinks < stomach irritations; hence Ars. is of signal use for effects of eating ices and drinking ice-water. Arsen. affects the entire alimentary tract. The lips are so dry and parched and cracked that the patient often licks them to moisten them. The mouth is aphthous, ulcerated, or gangrenous. The stomach is so irritable that the least food or drink causes distress or vomiting, or stool or both together. Abdominal pains are intense, causing the patient to turn and twist. Haemorrhoids are exceedingly painful as if burning needles plunged in. States of lowered vitality. The Prostration of Arsen. is remarkable. With it there is the desire to move or be moved constantly. The patient is exhausted from the slightest exertion. Exhaustion is not felt while lying still, but as soon as he moves he is surprised to find himself so weak. The prostration seems out of proportion to the rest of his illness. Must lie down. Exhaustion from hill-climbing, breathless, sleepless. Thirst for little and often (Ant. t., Lyc.), wants it very cold and immediately rejects it (Phos. as soon as it becomes warm). Before and after the cough of Arsenic there is an attack of asthma (Phos.) Arsen. has a great place in acute coryza and hay-fever. The fluent coryza is corrosive, reddening the upper lip, and has more burning than either Merc. or Cepa. Also it is < out of doors, and > in warmth, which distinguishes it from Cepa especially. Arsenic is predominantly right-sided. The neuralgias affect the right side most; the right lung (“acute, sharp, fixed or darting pain in apex and through upper third of right lung”) is more affected than the left; also the right side of the abdomen, hence typhlitis. Many dropsical conditions are controlled by Arsen. Especially has it done brilliant work in cases of hydrothorax. It has been called the “liquid trochar,” on account of the expeditions way in which it will remove a watery effusion. The patient cannot lie down; must sit up to breathe; anxious; restless; < about 1 a.m.

It is suited to the full plethoric habit. Puffiness in one of its characteristics; and from this to dropsy. All mucous membranes are irritated. The skin is cold and clammy. Scurfy eruptions. Bran-coloured scales on head coming down to forehead. Arsenic has cured epithelioma of the lips and closely corresponds to the cancerous diathesis. Many cures of cancer have been reported under its use, both in the crude and in potencies. When the subjective symptoms of Arsen. are present, it will cure in the potencies. When the homoeopathicity is more crude the lower potencies will be required: in this case the Arsen. appears to act directly on the cancerous tissue and cancerous elements in the system.

Arsenic is a haemorrhagic: it acts on both blood and blood-vessels. Varices burn like fire. Anaemia, chlorosis, pyaemia all come within the scope of Arsenic, which corresponds also to states resulting from losses of blood, as venesection, metrorrhagia, haemoptysis.

The Conditions, especially of time and temperature, are all-important with Arsenic. Unless these correspond in the patient, failure will be more frequent than success. Arsenic is one of the greatest of periodics. I once treated some members of a family who all had attacks of fever of short duration, recurring regularly every six weeks, from living in rooms papered with arsenical papers. Its periods are: every day; every third or fourth day; every fortnight; every six weeks; every year. There is pronounced night aggravation, the pains are unsupportable with restlessness. < Midnight and after (Acon. is rather before midnight); < 3 a.m. There is < from cold and damp; > warmth. Arsen. loves warmth like Nux v., Psor., Hepar, Silic., Mag. mur. and other hydrogenoids, and herein is differentiated from Sul., Ant. crud., Iod., Apis, and Puls. Arsen. hugs the fire and likes warm wraps. < Lying on affected side, or with head low. > Lying with head high.

Relations.-Antidotes: To poisonous doses-milk, albumen, demulcent drinks, followed by emetics of mustard, Sulphate of Zinc or Sulphate of Copper (Tartar emetic is too irritating). Castor oil is the best purgative. Chemical antidotes: Animal charcoal, Hydrated peroxide of iron, Magnesia, Limewater. Dynamic antidote: Opium; it may be administered by clyster if not retained on stomach. Brandy and stimulants if there is depression and collapse. If urine is suppressed, Sweet spirits of nitre in large quantities of water.

Antidotes of potencies: Camph., Chi., Chin. sul., Fer., Graph., Hep., Iod., Ipec., Nux v., Sambuc., Tabac., Verat. Arsen. is antidote to: Carb. v., Chi., Fer., Graph., Hep., Iod., Ipec., Lach., Merc., Nux v., Phos., Sambuc., Strych., Tabac., Verat. Follows well: Aco., Agar., Arn., Bell., Cham., Chi., Ipec., Lach., Verat. Followed well by: Aran. d., Nux v., Iod., Sul. Rhus follows well in skin affections, especially in cases treated allopathically with large doses of arsenic. Complementary: All. sat., Carb. v., Phos. Similar to: Aco., Apoc., Arg. n., Bell., Bism., Calc., Can. ind., Carb. v., Chi., Ferr., Hyo., Ipec., Kreos. Lach., Lyc., Nux v., Phos., Puls., Rhus t., Sil., Tab., Verat. The restlessness of Ars. differs from that of Mag. c.; Ars. goes from room to room, from bed to bed; Mag. c. must get out of bed and walk the floor to relieve pain. The fear of death is not that of Acon., but is an anxiety and a feeling that it is useless to take medicine as they will surely die (more like Agnus). Bry. drinks much and seldom: Ars. little and often; Ars. eats much at a time, Bry. often and little.

Causation.-Chill in the water. Eating ices. Poor diet. Fruits, ailments from. Drunkenness. Effects of tobacco; of quinine; of iodine. Sea-bathing and sea-travelling. Climbing mountains. Strains. Fit of passion. Care. Grief. Fright.

SYMPTOMS.

1. Mind.-Melancholy, sometimes of a religious character, sadness, care, chagrin, cries and complaints.-Anguish, driving one out of bed at night, and from one place to another in the daytime.-Restlessness.-Great fear of being left alone.-Anger, with anxiety, restlessness and sensation of coldness.-Anxiety, restlessness, and excessive anguish which allows no rest, principally in the evening in bed, or in the morning on waking, and often with trembling, cold sweat, oppression of the chest, difficulty of breathing, and fainting fits.-Anxiety of conscience, as if a crime had been committed.-Inconsolable anguish, with complaints and lamentation.-Hypochondriacal humour, with restlessness and anxiety.-Fear of solitude, of spectres, and of robbers, with desire to hide oneself.-Indecision and changeable humour, which demands this at one time, that at another, and rejects everything after having obtained it.-Despair; he finds no rest, esp. at night, with anguish.-Despondency, despair, weariness of life, inclination to suicide, or excessive fear of death, which is sometimes believed to be very near.-Too great sensibility and scrupulousness of conscience, with gloomy ideas, as if one had offended all the world.-Ill-humour, impatience, vexation, inclination to be angry, repugnance to conversation, inclination to criticise, and great susceptibility.-Caustic and jesting spirit.-Extreme sensibility of all the organs; all noise, conversation, and clear lights are insupportable.-Great apathy and indifference.-Great weakness of memory.-Stupidity and dulness.-Delirium.-Delirium, with great flow of ideas.-Loss of consciousness, and of sensation; dotage; maniacal actions and frenzy.-Madness; loss of mind (from the abuse of alcoholic drinks).

2. Head.-Heaviness, sensation of weakness, and confusion in the head, chiefly in a room, mitigated in the open air.-Stupor and confusion.-Vertigo, principally in the evening, on shutting the eyes, on walking, or in the open air, and sometimes with tottering, with danger of falling, intoxication, loss of sense, obscuration of the eyes, nausea, and headache.-Tearing in the head, with vomiting, when raising up the head.-Pains, throbbing, oppressive, stunning, or drawing, shooting and burning in the head, often on one side only, and chiefly above one eye, or at the root of the nose, or in the occiput, and sometimes with inclination to vomit, and buzzing in the ears.-Tension, tightness, and pain as of a bruise in the head.-Headache > by applying cold water, or by walking in the open air.-Periodical headaches.-The pains in the head often occur periodically, and esp. after each meal, in the morning, at night, and in the evening in bed; and sometimes they are insupportable, and accompanied by tears and wailings, being mitigated for a moment by cold water, but returning much more strongly afterwards.-Sensation, on moving the head, as if the brain struck against the cranium.-Cracking or buzzing in the head.-Pain in the scalp and in the integuments of the head, as if they were ulcerated or bruised, greatly increased by the slightest touch.-Excessive swelling of the head and face.-Erysipelatous burning, swelling of the head (face and genitals) with great weakness and coldness; worse at night.-Gnawing or burning itching, scurfy eruptions, pustules, and corroding ulcers on the scalp.-Eruptions, white, dry, like bran; burning, itching on the forepart of the head; when scratching it burns and bleeds violently.-Burning, biting boils on the scalp, with sensitiveness to touch and cold.

3. Eyes.-Aching, burning, and shooting pains in the eyes, < by light, as also by the movement of the eyes, accompanied sometimes with a necessity to lie down, or with anguish which does not permit to rest in bed.-Eyes inflamed and red, with redness of the conjunctiva, or of the sclerotica, and injection of the veins of the conjunctiva.-Swelling of the eyes.-Inflammatory or oedematous swelling of the eyelids.-Inflammation of the eyes and lids, with severe burning pains.-Inflammation of the inner surface of the eyelids, preventing the opening of the eye.-Great dryness of the eyelids, chiefly in the edges, and on reading by the light (of a candle).-Corrosive tears.-Agglutination of the eyelids.-Spasmodic closing of the eyelids, sometimes from the effect of light.-Excessive photophobia.-Specks and ulcers on the cornea.-Eyes convulsed and prominent; look fixed and furious.-Pupils contracted.-Yellowish colour of the sclerotica.-Yellow colour, spots, or white points and sparks before the eyes.-Blue colour around the eyes.-Weakness, obscuration, and loss of sight.-Eyes dull and deep sunk.

4. Ears.-Squeezing, sharp pains, shootings, voluptuous tickling and burning in the ears.-Tinkling, roaring, buzzing and sound, as of bells, in the ears.-Sensation, as if the ears were stopped, and hardness of hearing, esp. to the human voice.

5. Nose.-Aching pains in the nose.-Swelling of the nose.-Swelling of and burning in the nose.-Violent bleeding of the nose.-Desquamation of the skin of the nose, in furfurs.-Knotty tumours in the nostrils.-Ulceration at the top of the nostrils, with flow of ichor fetid, and of a bitter taste.-Smell of pitch or sulphur before the nose.-Violent sneezing.-Great dryness of the nostrils.-Fluent coryza; with stopped nose, burning in the nostrils, and secretion of serous and corrosive mucus.-Cancer of nose.

6. Face.-Face pale, hollow, and cadaverous.-Yellowish, bluish, or greenish colour of the face.-Leaden and earth-coloured tint, with greenish and bluish spots and streaks.-Face discomposed, with distortion of features, or with eyes deep-sunk and having a dark circle around them, and nose pointed.-Distorted features; death-like countenance.-Redness and bloated appearance of the face.-Hard and elastic swelling of the face, chiefly above the eyelids, and esp. in the morning.-Swelling of the face, with fainting fits and vertigo.-Papulae, pimples, scurfy ulcers.-Rosacea and mealy tetters in the face.-Blackish tint round the mouth.-Lips bluish or black, dry and chapped.-Brownish band in the red part of the lips.-Skin rough and tettery round the mouth.-Eruption on the mouth and on the lips, near the red part.-Cancer of the face and lips with burning pain.-Hard knots and cancerous ulcers, having thick scurf with lard-like bottoms on the lips.-Lips excoriated, with a sensation of tingling.-Swelling and bleeding of the lips.-Swelling of the submaxillary glands, with contusive pain, and soreness on being touched.-Paralysis of the lower jaw.-Drawing stitches here and there in the face.

7. Teeth.-Sharp aching pains, or successive pullings in the teeth and gums, chiefly at night, extending sometimes to the cheek, to the ear, and to the temples; with swelling of the cheek and insupportable pains, which impel to furious despair, or which are aggravated when one lies on the diseased side, and mitigated by the heat of the fire.-Convulsive grinding of the teeth.-Sensation of elongation and painful loosening of the teeth, with swelling and bleeding of the gums.-Pain in teeth > by hot applications.

8. Mouth.-Offensive smell from the mouth.-Secretion of abundant tough, fetid, bloody saliva.-Great dryness of the mouth, or accumulation of saliva, sometimes bitter or bloody.-The mouth is reddish-blue, inflamed, burning.-Tongue bluish or white.-Ulceration of the tongue, with blue colour.-Torpor and insensibility of the tongue, as if it were burnt.-Tongue brownish or blackish, dry, cracked, and trembling.-Tongue a bright red.-Tongue white as chalk, as if painted white.-Tongue red with a silvery white coat.-Tongue stiff like a piece of wood.-Ulceration of the tongue on the anterior edge.-Swelling, inflammation, or gangrene of the tongue.-Angina gangrenosa (with aphthae).-Aphthae in the mouth.-Speech rapid, precipitate.

9. Throat.-Burning in the throat.-Scraping, sharp pain, with burning in the throat.-Inflammation and gangrene of the throat.-Spasmodic constriction of the throat and of the oesophagus, with inability to swallow.-Deglutition painful and difficult, as if from paralysis of the oesophagus.-Sensation of great dryness in the throat and in the mouth, which induces continual drinking.-Accumulation of greyish or greenish mucus of salt or bitter taste in the throat.

10. Appetite.-Bitter taste in the mouth, chiefly after having drunk or eaten, also in the morning.-Astringent, or putrid, or acid taste in the mouth.-Food appears acid, insipid, or too salt.-Insipidity of food.-Bitter taste of food, particularly of bread and beer.-Complete adypsia; or violent burning, choking, and unquenchable thirst, making it necessary to drink constantly, but little at a time.-Desire for cold water, for acids, for brandy, for coffee and milk.-Want of appetite and of hunger, frequently with burning thirst.-Insurmountable dislike to all food, chiefly meat and butter.-Everything that is swallowed causes a pressure in the oesophagus, as if it had stopped there.-Continual craving, with want of appetite and prompt satiety.-After a meal, nausea, vomiting, eructations, pains in the stomach, colic, and many other sufferings.-After having drunk, shivering or shuddering, return of vomiting and diarrhoea, eructations and colic.

11. Stomach.-Frequent eructations, particularly after having drunk or eaten, mostly empty, acid, or bitter.-Regurgitation of acrid matter, or of bitter greenish mucus.-Frequent and convulsive hiccoughs, principally in the night.-Frequent and excessive nausea, sometimes rising even to the throat, with inclination to vomit, necessity for lying down, sleep, swooning, trembling, shuddering, or heat, pains in the feet, &c.-Flow of water from the stomach, like water-brash.-Vomitings, sometimes very violent, and principally after having drunk or eaten, or at night, towards the morning; vomiting of food and of drink, or of mucous, bilious, or serous matter, of a yellowish, greenish, brownish, or blackish colour; vomiting of saguineous matter.-While vomiting, violent pains in the stomach, sensation of excoriation in the abdomen, cries, burning internal heat, diarrhoea, and fear of death.-Inflation and tension of the precordial region and of the stomach.-Excessive pain in the epigastrium, and in the stomach, chiefly on being touched.-Pressure in the stomach as from a stone, or as if the heart would burst, and excessive anguish in the precordial region, with complaints and lamentations.-Sensation of constriction, cramp-like pains, pulling, piercing, and gnawing in the stomach.-Burning in the pit of the stomach and stomach.-Inflammation or induration of the stomach.-Cramp in the stomach (2 a.m.).-Cancer in the stomach.-Sensation of cold, or insupportable heat and burning in the precordial region, and in the stomach.-The pains in the stomach manifest themselves mostly after a meal, or in the night.-Tetters on the pit of the stomach.

12. Abdomen.-Compression in the region of the liver.-Swelling of the spleen.-Excessive pains in the abdomen, principally on the left side, and often with great anguish in the abdomen.-Inflation of the abdomen.-Ascites.-Swelling of the abdomen as in ascites.-Hard bloated abdomen.-Violent cutting pains, cramp-like pains, digging, pulling, tearing, and gnawing in the abdomen.-Attacks of colic occur chiefly after having drunk or eaten, or in the night, and are often accompanied by vomiting or diarrhoea, with cold, internal heat, or cold sweat.-Burning pains with anguish.-Sensation of cold, or insupportable burning in the abdomen.-Pain, as from a wound in the abdomen, chiefly on coughing and laughing.-Swelling and induration of the mesenteric glands.-Much flatulency, with rumbling in the abdomen.-Flatulency of a putrid smell.-Painful swelling of the inguinal glands.-Ulcer above the navel.

13. Stool and Anus.-Constipation, with frequent, but ineffectual inclination to evacuate.-Tenesmus, with burning in the anus.-Involuntary and unperceived evacuations.-Violent diarrhoea, with frequent evacuations, nausea, vomiting, thirst, great weakness, colic, and tenesmus.-Nocturnal diarrhoea, and renewal of the diarrhoea, after having drunk or eaten.-Burning stools, with violent pains in the bowels, with tenesmus, thirst, worse after eating.-Burning and corrosive evacuations; faeces with mucus, or bilious, sanguineous, serous, painless, involuntary, &c., of greenish, yellowish, whitish colour, or brownish and blackish; fetid and putrid evacuations; evacuations of undigested substances.-Emission of mucus by the anus, with tenesmus.-Prolapsus of the rectum: with much pain.-Itching, pain as from excoriation, and burning in the rectum and in the anus, as well as in the haemorrhoidal tumours, chiefly at night.-Shootings in the haemorrhoidal tumours.

14. Urinary Organs.-Retention of urine, as from paralysis of the bladder.-Frequent inclination to make water, even at night, with abundant emission.-Incontinence of urine, which escapes almost involuntarily, even at night, in bed.-Difficult and painful emission of urine.-Scanty urine, of a deep yellow colour.-Urine aqueous, greenish, brownish, or turbid, with mucus-like sediment.-Sanguineous urine.-Burning in the urethra on making water.-Involuntary discharge of burning urine.

15. Male Sexual Organs.-Itching, shooting, and burning in the glans and in the prepuce.-Inflammation, painful and gangrened swelling of the genital parts.-Glans swollen, cracked, and bluish.-Swelling of the testes.-Erysipelatous inflammation of the scrotum.-Nocturnal pollutions.-Flowing of the prostatic fluid during loose stools.

16. Female Sexual Organs.-Venereal desire in women.-Catamenia too early and too copious, attended by much suffering.-Catamenia suppressed, with pains in the sacrum and in the shoulders.-Leucorrhoea acrid, corrosive, thick, and yellowish.-Scirrhus uteri.

17. Respiratory Organs.-Catarrh, with hoarseness, coryza, and sleeplessness.-Voice rough and hoarse.-Voice trembling or unequal; at one time strong, at another weak.-Tenacious mucus in the larynx and the chest.-Bronchitis, with difficult secretion of mucus.-Sensation of dryness and burning in the larynx.-Spasmodic constriction of the larynx.-Dry cough, sometimes deep, fatiguing, and shaking, principally in the evening after lying down, or at night, obliging the patient to assume an erect posture; also after drinking; on being in the fresh and cool air, during movement, or during expiration, and often with difficulty of respiration, suffocating, contractive pain, or sensation as of excoriation in the pit of the stomach and the chest; pain, as from a bruise in the abdomen, shootings in the hypochondria, in the epigastrium, and in the chest, &c.-Arrest of breathing with cough.-Cough excited by a sensation of constriction and suffocation in the larynx, as if by the vapour of sulphur.-Respiration oppressed, anxious, short.-Oppressed, laboured breathing, esp. when ascending a height; in cold air; when turning in bed.-Periodical attacks of cough.-Cough with expectoration of sanguineous mucus, sometimes with burning heat over the whole body.-Difficult expectoration, or scanty and frothy.

18. Chest.-Shortness of breath, difficulty of respiration, choking, dyspnoea, and attack of suffocation, sometimes with cold sweat, spasmodic constriction of the chest or of the larynx, anguish, great weakness, body cold, pain in the pit of the stomach, and paroxysm of cough.-The sufferings occur chiefly in the evening in bed, or at night, when lying down; also in windy weather, in the fresh and cold air, or in the heat of a room, or when warmly clothed, on being fatigued, on being angry, on walking, on moving, and even on laughing.-Respiration anxious, stertorous, and wheezing.-Oppression of the chest on coughing, on walking, and on going upstairs.-Constriction and compression of the chest, sometimes with great anxiety, inability to speak, and fainting fits.-Tension and pressure in the chest.-Stitches and pressing in the sternum.-Shooting pains in the chest and in the sternum.-Chilliness or coldness in the chest.-Shivering, or great heat and burning in the chest.-Heat, burning, itching in the chest.-Yellowish spots on the chest.

19. Heart.-Violent and insupportable throbbings of the heart, chiefly when lying on the back, and esp. at night.-Irregular beatings of the heart, sometimes with anguish.-Cramp in the heart.-Heart-beats irritable.-Palpitation with anguish, cannot lie on back; < going upstairs.-Palpitation and trembling weakness after stool; must lie down.-Palpitation after suppressed herpes or foot-sweat.-Angina pectoris.-Hydropericardium.-Fatty degeneration.

20. Neck and Back.-Å’dematous, painless swellings of the neck and of the lower jaw.-Tetters between the shoulder-blades.-Violent and burning pain in the back, powerfully aggravated by the touch.-Acute drawing pains in the back and between the shoulder-blades, which necessitate lying down.

22. Upper Limbs.-Acute drawing pains in the arms and in the hands.-Swelling of the arms, with blackish pustules of a putrid smell.-Acute drawing pains in the night, beginning from the elbow and extending to the armpits.-Acute pulling and shooting in the wrists.-Cramps in the fingers.-At night, sensation of fulness and swelling in the palms of the hands.-Excoriation between the fingers.-Hard swelling of the fingers, with pain in the finger-bones.-Ulcers at the extremities of the fingers, with burning pain.-Discoloured nails.

23. Lower Limbs.-Cramp in the legs.-Acute drawing pains in the hips, extending to the groins, the thighs, and sometimes even to the anklebones, with uneasiness, which obliges one to move the limb constantly.-Tearing and stinging in the hips, legs, and loins.-Tearing in the tibia.-Rheumatic pain in the legs, and esp. in the tibia.-Paralytic weakness of the thigh.-Pain, as from a bruise in the joint of the knee.-Old ulcers on lower limbs, with burning and lancinating pains.-Contraction of the tendons of the ham.-Tetters on the ham.-Cramps in the calves of the legs.-Affections of the shin-bones.-Burning and shooting ulcers in the leg.-Itching herpes in the bends of the knee.-Varices.-Fatigue in the legs and in the feet.-Swelling of the foot, burning, hard, and shining, with burning vesicles of a blue-blackish colour on the instep.-Corrosive and ulcerous vesicles on the soles of the feet and on the toes.-Pains in the fleshy part of the toes, as if they were galled by walking.

24. Generalities.-Paroxysms of suffering with anxiety, coldness, rapid failure of strength, and wish to lie down.-Burning, chiefly in the interior of the parts affected, or sharp and drawing pains.-Nocturnal pains, which are felt even during sleep, and which are so unbearable that they excite despair and fury.-Aggravation of suffering by conversation, as well as after a meal, in the morning on rising, in the evening in bed, on lying on the part affected, or during repose after prolonged exercise; mitigated by external heat, as well as by assuming a standing posture, or by walking, and movement of the body.-Return of sufferings periodically.-Å’dematous swellings, with burning pain in the parts affected.-Excessive indolence, and dread of all exertion.-Want of strength, excessive weakness, and complete asthenia, even to prostration, sometimes with paralysis of the lower jaw, eyes dull and deep, and mouth open.-Rapid failure of strength, and sensation of weakness as if from want of food.-Inability to walk; the patient is obliged to remain lying down.-When lying down, the patient feels stronger, but on rising, falls from weakness.-Deficiency of blood; dropsy of outer and inner parts; inflammation of mucous membranes; ulcers in the glands.-Emaciation and atrophy of the whole body, with colliquative sweats, great weakness, face earthy, and eyes sunken, with a dark ring surrounding them.-Violent convulsive attacks, spasms and tetanus.-Epileptic fits, preceded by burning in the stomach, pressure and heat in the back, extending to the nape of the neck, and to the brain, with dizziness.-Å’dematous inflation and swelling of the whole body, chiefly of the head and face, with enlargement of the abdomen, and engorgement of the glands.-Burning pains of inner or exterior parts (glands).-Emaciation.-Trembling of the limbs, chiefly the arms and legs.-Trembling of the limbs (in drunkards).-Stiffness and fixedness of the limbs, sometimes with sharp rheumatic pains.-Paralysis and contraction of the limbs.-Paralysis, especially of the lower extremities.-Fainting fits, sometimes with dizziness and swelling of the face.-Fainting, from weakness, with scarcely perceptible pulse.-Sensation of torpor in the limbs, as if they were dead.

25. Skin.-Desquamation of the skin of the body.-Skin dry as parchment, cold and bluish.-Yellowish colour of the skin.-Shootings, hot itching, and violent burning in the skin.-Reddish or bluish spots in the skin.-Petechiae.-Inflamed spots, as from morbilli, chiefly in the head, face, and neck.-Miliary eruptions, red and white.-Conical pimples, whitish or reddish, with burning itching.-Nettle-rash.-Eruption of painful black pustules.-Eruption of itchy pimples, small and tickling.-Eruption of small red pimples, which increase and change into gnawing ulcers, covered with a scurf.-Vesicular eruptions.-Herpes, with vesicles, and violently burning, esp. at night, or with coverings, like fish-scales.-Skin jaundiced; general anasarca; black blisters.-Pustules filled with blood and pus.-Tettery spots, covered with phlyctenae and furfur, with burning nocturnal pains.-Ulcers with raised and hard edges, surrounded by a red and shining crown; with the bottoms like lard, or of a blackish-blue colour, with burning pains or shooting, principally when the parts affected become cold.-Ulcers, hard on the edges, stinging, burning spongy; with proud flesh; turning black; flat; pus thin, ichorous (cancers).-Fetid smell, ichorous suppuration, ready bleeding, putridity, and bluish or greenish colour of the ulcers.-Thin crusts or proud flesh on the ulcers.-Spacelus.-Want of secretion in the ulcers.-Carbuncles (burning).-Inflammatory tumours with burning pains.-Warts.-Ulcers inform of a wart.-Chilblains.-Varices.-Discoloured nails.

26. Sleep.-Constant drowsiness, with strong and frequent yawnings.-Nocturnal sleeplessness, with agitation and constant tossing.-Drowsiness in the evening.-Coma vigil, often interrupted by groans and grinding of the teeth.-Unrefreshing sleep; in the morning it seems as if more sleep were needed.-Starting of the limbs when on the point of falling asleep.-During sleep, startings with fright, groans, talking, querulous exclamations, grinding of the teeth, convulsive movements of the hands and fingers, sensation of general uneasiness, and tossing.-In sleep, lying on the back, with the hand under the head.-Light sleep; the slightest noise is heard, though the patient dreams continually.-Frequent dreams, full of cares, threats apprehensions, repentings and inquietude; anxious, horrible, fantastic, lively and angry dreams; dreams of storms, of fire, of black waters and darkness; dreams with meditation.-In the night, jerking of the limbs, heat and agitation, burning under the skin, as if there were boiling water in the veins, or cold, with inability to get warm, stifling sensation in the larynx, asthmatic attacks, great agitation, and anguish at the heart.-Frequent waking during the night, with difficulty in sleeping again.-Sleeplessness, from anguish and restlessness, with tossing about (after midnight).

27. Fever.-Cold over the whole body, sometimes with cold and viscid sweat.-General coldness, with parchment-like dryness of the skin, or with profuse, cold, clammy perspiration.-Chilliness without thirst; worse after drinking; with stretching of the limbs and restlessness with external heat at the same time; when walking in the open air.-Shiverings and shuddering, chiefly in the evening in bed, or on walking in the open air, or after having drunk or eaten, and often with the addition of other sufferings, such as sharp pains in the limbs, headache, oppression of the chest, and difficulty of respiration, drawing in the limbs, anxiety and restlessness.-Universal heat, principally at night, and often with anxiety, restlessness, delirium, heaviness and perplexity in the head, dizziness, vertigo, oppression and pricking in the chest, redness of the skin, &c.-Febrile attacks, mostly in the morning or evening, often with shivering and heat slightly developed, burning thirst or perfect adypsia, quartan or tertian, or sometimes quotidian; sufferings before the attack, and sweats after, on going to sleep; apyrexia (or shivering or heat), with great weakness, dropsical affections, pains in the regions of the liver and of the spleen, dull or shooting headache, sharp and drawing pains in the limbs, in the back and in the head, pressure, fulness, tension, and burning in the stomach and in the epigastrium, prickings in the chest and in the sides, difficulty of breathing, anxiety, face puffed, earthy, &c.-Pulse irregular, or quick, weak, small, and frequent, or suppressed and trembling.-Pulse frequent in the morning, slower in the evening.-Frequent colliquative, or cold and viscid sweats; sweat at night, or in the evening on going to sleep, or in the morning on waking; partial sweat, chiefly on the face and legs.-Perspiration at the beginning of sleep, or all night; cold, clammy, smelling sour or offensive.-During perspiration, unquenchable thirst; after the fever, attack of headache.-Perspiration, which imparts a yellow colour to the linen and to the skin.-During the sweat, heaviness in the head, buzzing in the ears and trembling of the limbs.

E. B. Nash

Materia Medica Viva

No remedy is more restless than this one. The ACONITE restlessness comes in the earlier stages of inflammatory diseases, with fever of a high grade. ARSENICUM in the later stages, after the patient has become greatly reduced in strength, or in low grades of fever like typhoids. The ACONITE patient tosses to and fro in agony and fear. The ARSENIC patient is too weak to toss as the anguish and restlessness would incline him to. He cannot move himself around as he desires, but wants to be moved from place to place, or bed to bed, while the least exertion on his own part exhausts terribly. He has fear of death, but not like the ACONITE fear, but rather an anxiety and a feeling that it is useless to take medicine for he is going to die; he is incurable.

The mental restlessness is as great as the bodily. He has attacks of anxiety that drive him out of bed at night. Even when there is no pain at all he wants to be continually changing place, walking about if strong enough, without any other reason than that he can’t keep still. Often the first beneficial effect to be observed in cases calling for this remedy is that the anxiety grows less, the patient lies still, his pain is not so much less, but it does not make him so restless; he can bear it better. This is a good sign and is generally followed by amelioration of all the symptoms. It makes little difference what the disease, if this persistent restlessness and especially if great weakness is also present, don’t forget ARSENIC.

ARSENICUM leads all the remedies for burning sensation, especially in acute diseases. It is not by any means confined to acute diseases, but is often found in chronic affections, especially of a malignant character or tending to malignancy. I think perhaps SULPHUR outranks it generally for burnings in chronic affections. There is hardly an organ or tissue in the human system where these burnings of ARSENIC are not found. This burning, strange as it may seem, is greatly ameliorated by heat. Hot applications if they can be gotten in contact with the part, also heat of a warm stove or warm room. This is the exact opposite of SECALE CORNUTUM, for while the part is objectively cold, it still BURNS, but hot applications are intolerable; they cannot even bear to have it covered; with ARSENICUM, in throat complaints, in connection with acute catarrh, the burnings in throat and from the excoriating nasal discharge are ameliorated by hot application. The burning in throat is better from eating or drinking hot things. This is the chief modality which enables us to choose between this remedy and CEPA and MERCURIUS, for all three have fluent coryza. I once had a case of very severe gastralgia caused by suppression of eczema on the hands. I knew nothing of the suppression, but prescribed ARSENICUM because the pains came on at midnight, lasting until 3 A. M., during which time the patient had to walk the floor in agony, and there was GREAT BURNING in the stomach. She had but one slight attack after taking ARSENICUM, but, said she, when I visited her, “Doctor, would that remedy send out salt rheum?” Then I found out about the suppression which had been caused by the application of an ointment, and told her that she could have back the pain in the stomach any time she wanted it, by suppressing the eruption again. She did not want it. ARSENICUM is one of our best remedies for fevers of a typhoid character. So useful is it that Baehr says— “Since ARSENIC is, more than any other remedy, adapted to the worst forms of infectious diseases it seems wrong to delay its administration until the symptoms indicating it are developed in their most malignant intensity,” and further, “our advice, therefore, is that ARSENIC should be given more frequently than has been customary from the very beginning of the attack, and that we should not wait until the disease has fully developed its pernicious character.” I do not think this is sound reasoning or good advice, for I have never found any rule by which I could

decide from the beginning that a case would later on develop into a case of the pernicious or malignant character which would ever call for the exhibition of ARSENIC. While we need not wait for a case to develop to that “most malignant” intensity which calls for ARSENIC, we would not on the other hand be justified in giving ARSENIC or any other remedy in anticipation of a condition which might never come. ARSENICUM is not the only remedy capable of curing these malignant cases, and how do we know after all that it may not be MURIATIC ACID or CARBO VEGETABILIS that will be the remedy after the case is developed. There is no safe or scientific rule but to treat the case with the INDICATED remedy at any and all stages of the disease, without trying to treat expected conditions or future possibilities. It would be out of place here to give all the indications for ARSENIC in typhoids, as it would take too much space, and they can be found in Raue, Lilienthal or any good work on practice. ARSENIC is also one of our best remedies in intermittents, especially after the abuse of QUININE. Close individualization is necessary here as elsewhere.

ARSENIC profoundly affects the alimentary canal from lips to anus. The lips are so dry and parched and cracked that the patient often licks them to moisten them. The tongue is affected in various ways. It may be dry and red, with raised papillae; or red, with indented edges; or white as chalk or white paint; or lead colored; or dry, brown or black, especially in typhoids. The mouth is dry or aphthous, ulcerated or gangrenous. The throat the same. The thirst is indescribably intense and peculiar, in that notwithstanding its intensity the patient can TAKE ONLY A LITTLE WATER AT A TIME. The stomach is so irritable that the least food or drink causes distress and pain, or immediately excites vomiting, or stool, or both together. Cold drinks, ice-water, or ice-cream particularly, disagree and create distress. Vomits all kinds and grades of substances from water or mucus to bile, blood, and coffee ground substances.

The pains in stomach are terrible and aggravated by the least food or drink, especially, if COLD. The abdominal pains also are intense, causing the patient to turn and twist in all possible shapes and directions. Diarrhoea of all kinds of stools, from simple watery to black, bloody and horribly offensive, and finally the end of the tract is reached and we have haemorrhoids. Now in every one of these affections, ranging along the whole length of the canal, and from the lightest grade of irritation to the most intense inflammatory and malignant forms of disease, we will be apt to find everywhere present the characteristic BURNING of this remedy, in greater or lesser degree; and the not less characteristic AMELIORATION FROM HEAT, and also, though not quite so invariably, the MIDNIGHT AGGRAVATION.

ARSENICUM also has its sphere of usefulness in diseases of the respiratory organs. First, for acute coryza it stands in the front rank, the choice often having to be made between this remedy, CEPA and MERCURIUS. ARSENICUM has the fluent discharge which corrodes the lips and wings of the nose and more BURNING than the other two remedies. It often follows well after MERCURIUS, if that remedy only partially relieves.

ARSENICUM is particularly efficacious in many affections of the lungs, where the breathing is very much oppressed. Respiration is wheezing, with cough and frothy expectoration. Patient cannot lie down; must sit up to breathe, and is unable to move without being greatly put out of breath. The air passages seem constricted. It is especially useful in asthmatic affections caused or aggravated by suppressed eruptions, like pneumonia from retrocedent measles, or even chronic lung troubles from suppressed eczema. I remember a case of asthma of years’ standing to which I was called at midnight, because they were afraid the patient would die before morning. Found that her attacks always came on at 1 A. M. Gave ARSENICUM ALB. 30th, and she was completely cured by it.

The symptom by Rollin R. Gregg, “Acute, sharp, fixed or darting pain in apex and through upper third of right lung,” is a gem, and has enabled me to cure a number of cases of obstinate lung troubles. In the last stage of pneumonia of old people, with gangrenous expectoration, if the other symptoms correspond, this remedy has often saved life. The burning is often found here as elsewhere. ARSENICUM is also one of our best remedies in pleuritic effusions.

ARSENICUM also affects profoundly the nervous system. To the characteristic restlessness, of which we have said so much, is added great prostration. This prostration is present in most diseases, both acute and chronic, where ARSENIC is indicated. For instance, in typhoids there is no remedy that prostrates more. CARBO VEG. and MURIATIC ACID equal it, the difference being that the ARSENIC patient wants to move or be moved constantly, while with the other two remedies there is almost utter absence of any such show of life. Even if not confined to the bed, in acute or chronic diseases the patient is so weak that he is “exhausted from the slightest exertion;” must lie down.

Sometimes this extreme degree of prostration comes on very rapidly.

Here is a picture that shows a condition of things in chronic trouble calling for this remedy. “From climbing mountains, or other muscular exertions, want of breath, prostration, sleeplessness and other ailments.” This shows how weak the patient is, and this weakness may be coupled with various forms of disease. You may say it is common for sick people to be weak. True, but the ARSENICUM patient is weak OUT OF PROPORTION to the rest of his trouble, or apparently so; and it is a GENERAL PROSTRATION, not local like the sense of weakness in the chest of PHOSPHORIC ACID, STANNUM and SULPHUR; or in the abdomen like PHOSPHORUS; or in the stomach like IGNATIA, HYDRASTIS and SEPIA. Now I do not see how I can make plainer the value of prostration as an ARSENIC symptom.

When we come to the tissues we find our remedy almost universally present.

It attacks the BLOOD, causing septic changes, exanthemata, ecchymoses, petechia;, etc.

It attacks the VEINS; varices burn like fire, < at night.

It attacks the serous membranes, causing copious serous effusions.

It attacks the glands, which indurate or suppurate.

It attacks the periosteum.

It attacks the joints; causing pale swellings, burning pains, etc.

It causes inflammatory swellings with burning lancinating pains.

It causes general anasarca; skin pale, waxy or earth colored; great thirst (APIS none).

It causes rapid emaciation; atrophy of children.

It causes ulcerations, constantly extending in breadth. The ulcers BURN like fire, pain even during sleep, discharge may be copious or scanty, the base blue, black or lardaceous.

Anthrax BURNING like fire; cold blue skin dry as parchment, peeling off in large scales.

“Sphacelus,” parts look black or BUM like fire.

“Gangrene,” better from heat (worse, SECALE).

“Parchment” like dryness, or dry scaly skin.

The skin troubles of this remedy are mostly dry and scaly, and almost always burning. It is one of our best remedies for affections caused by retrocedent or suppressed exanthemata, also for suppressed chronic eczemas, etc.

But it is impossible and outside the scope of this work to mention by name all the affections of the tissues in which this remedy is useful.

Notwithstanding this, ARSENIC is not a panacea. It must, like every other remedy, be indicated by its similar symptoms or failure is the outcome. Its great keynotes are Restlessness, Burning, Prostration, and Midnight Aggravation.