Homeopathic Materia Medica

Lectures on Homoeopathic Materia Medica, James Tyler Kent

Surgeon: This remedy comes up well after the study of Lachesis, for we find in the pathogenesis many features similar to those in Lachesis.

It has the mottled aspect and the same puffed and bloated appearance of the face. It is antidotal to Lachesis, to the poison of insects, to the poison of Apis and to animal poisons.

Ledum is a remedy for the surgeon, and is closely associated in traumatism with Arnica and Hypericum. The symptoms very much resemble such as follow certain kinds of injury, for instance an injury from stepping on tacks, from puncturing with needles, wounds that bleed scantily but are followed by pain, puffiness and coldness of the part.

Causation: Stepping on a nail and it pierces the sole of the foot or the heel, or he receives such a wound in the palm of the hand from a splinter, or he runs a splinter under the nail.

If, after such punctured wounds, the part becomes cold and then pale, paralyzed and mottled think of Ledum. The horse sometimes steps on a nail. If that nail goes through and strikes the margin of the coffin bone, tetanus will follow. It is known to be almost sure death. Put Ledum on the tongue of that horse and there will not be any trouble, for it prevents such conditions.

When tetanus comes on from punctured wounds in the palms or soles, or in other parts, think of Hypericum, or when you have a punctured wound to treat, give Ledum at once and you will prevent tetanus.

When the finger nails have been torn, or the nerves in sentient parts like the ends of the fingers have been torn and lacerated, Hypericum becomes the remedy.

For bruising of various parts, and when the patient feels as if braised all over, no matter how extensively he is bruised, Arnica is generally the remedy.

It may be said, for punctured wounds study Ledum; for lacerated wounds of sentient nerves, study Hypericum; for bruises, study Arnica; for open lacerations and cuts, study Calendula.

The conditions that come from the external, ought to be remedied to a great extent by external means. A solution of Calendula is excellent in conditions that come from the external, and it should be applied externally. When you have lacerated wounds and cuts with knives or other sharp instruments, apply Calendula, because the injury is external without internal effects.

The symptoms that arise from internal cause, treat with internal remedies, and symptoms that arise from external cause, when all that there is of the case is external, treat locally; in other words, for local causes use local means, and for internal or dynamic causes, use internal means.

Let internal wrongs be treated by the homoeopathic remedy and external or local conditions be treated by such soothing dressings as are most comfortable. Always protect surfaces that are exposed, and raw, and bleeding with something of a bland and superficial character.

Wounds must be dressed with as simple a means as possible, and there is no simpler dressing than Calendula, one part to four or six of water. The tincture will smart too much. Your open wounds will granulate most beautifully under Calendula, and you will have no constitutional effects. When the constitutional state is orderly and there is an open injury let the constitution alone, but put on some soothing application externally. In doing this there is no law to govern the action of the physician.

Air is an irritant to a raw part and will keep up an unnecessary discharge of pus, even from a perfectly healthy sore.

Calendula will keep it protected. The sides of a cut must be drawn together, and if it is perfectly tight it will heal itself by first intention. If it does not, then you may know there is a constitutional condition that you must ferret out and find the remedy for. Local treatment must then be suspended.

These remedies that I have mentioned, to a great extent, cover the management of wounds, and it is simple. Anyone has sense enough to draw together and close up a yawning wound, and to properly dress it. The muscles that naturally draw a wound open have to be overcome by stitches or by strappings. They do not belong to prescribing, they belong to the surgeon.

Coldness: The Ledum patient is very often subject to what may be called constitutional coldness, coldness to touch, coldness in the lady and coldness in the extremities with hot head, and again we see the other extreme, where the whole body is overheated, and the head also is in a state of great heat. There is throbbing and pulsating all over the body; the skin is purple or is too highly colored; he wants the covers all off at night. It is not uncommon to hear a patient, who has a Ledum headache, say that she wants the head out in the cold air, wants to put it out of the window, does not want any covering upon the head; delights to bathe it with very cold water.

Ledum has a bloated condition of the hands, face, and feet; bloated and purple from the knees down in certain dropsical conditions. With this purple, mottled, bloated condition from the knees to the feet the swelling as big as the skin will allow, and the pain excruciating.

The only relief that patient gets is by sitting, with the feet in a tub of ice cold water. I remember the first time I ever saw this in a patient. He was an old syphilitic, whose nasal bones had been eaten cut by syphilis, and his nose was a flabby piece of skin; it had no stiffening in it. He was a drunkard, and was extremely abusive to his family when drunk.

He had been for several years unwilling to work, having lost his ambition, and he would sit in the house and allow his wife to wait upon him. He had practically become a tramp, only he could not tramp, for this dropsical condition had come on and his feet were so badly swollen and sensitive that he sat in the house day after day. When I first saw him he had before him a good-sized old-fashioned wash-tub, and there he sat with the ice water two-thirds up to his knees and pieces of ice floating around on the top of the water, which he liked to have coming in contact with the skin.

When that ice was out he would put in more. The wife described his sufferings by saying he "suffered agonies something; dreadful."

Ledum took his feet out of the ice water so that he never used it afterwards. It caused the purpleness to disappear, the bloating went out of his feet, and he quit drinking. Ledum cured him of his syphilitic trouble, and he never had a return of that original state.

Pulsatilla and Ledum are the two principal remedies that want the feet in very cold water. But Ledum suited that man.

Bleeding: Where there are inflamed surfaces the tendency in Ledum is to bleed, and the blood is black. Ledum patients are full-blooded and plethoric, of a robust character. Such plethoric patients bleed easily, have red faces; they are fleshy, strong and of robust constitution. Hemorrhages sometimes occur in the chamber of the eye, hemorrhage of the nose, hemorrhage in cavities, bloody urine. Old painful ulcers that spread, that are mottled round about, in a constitution that always wants to be cold. The ulcers are relieved by cold,

Rheumatism: This remedy is of a rheumatic nature, rheumatic and gouty. It is a gouty medicine, having complaints in persons who suffer from gout, and have chalk stones in their joints, deposits in the wrists, fingers and toes.

The deposits go from below upwards. The gouty joints become suddenly inflamed and are relieved by cold. Ledum especially singles out the knee; it is suitable in old prolonged cases of inflammation of the kneejoint, of rheumatic knee-joint. You will find such patients sitting with the joint exposed to the cold, fanning the joint, or putting evaporating lotions upon the joint, such as chloroform, or ether, which give relief to the joints while evaporating to dryness.

Rheumatic and gouty extremities with pain and swelling; pain worse from motion, worse at night and from warmth of bed; better from cold applications with copious pale urine. The pains and swelling go upwards and the heart becomes affected.

Face: The face I have already described as puffy or bloated like the Lachesis face. It is a besotted face and looks very much like the face of an old drunkard. Ledum counteracts the effect of whiskey, and takes away the appetite for whiskey. Ledum is to whiskey what Caladium is to the smoking habit. You can break patients from the habit of smoking so that they go to the other extreme, and have an aversion to it.

It has erysipelas, as you might expect. It has a blue, mottled and puffed and sometimes oedematous appearance. It takes on an acute character and becomes burning. Phlegmonous erysipelas of any part of the body, but particularly of the face, or the injured part.

Urines: You might naturally suppose that a medicine that has such a gouty nature in it would have more or less kidney symptoms.

"Urination frequent, quantity diminished or increased, stream often stops during the flow."

"Burning in the urethra after urinating."

"Itching redness and discharge of pus."

It has red sand in the urine as marked as Lycopodium. It has great quantities of sandy deposit of various colors. When the patient is feeling at his best, there are great quantities of sandy deposits passing away. When there is little deposit in the urine, the gouty deposits in the joints become marked, and he does not feel so well.

It has another symptom that was verified by Lippe:

Copious clear, colorless urine, light in specific gravity and from its being light or deficient of salts in the urine we have an aggravation of the gouty manifestations.

Remember that the rheumatic tendency spreads upwards from the lower extremities, from the circumference to the centre.

"Menstruation too early, too profuse, bright red; absence of vital heat."

Genitals: Great coldness of the body at this time, yet the patient wants the cold air. Copious menstrual flow. Old gouty subjects, with mottled face with the puffiness that is not oedema, simply a venous stasis, with copious menstrual flow, with great pain during menstruation.

The uterus is extremely sensitive to touch, and the pelvic organs are. so sensitive that any deep touch becomes painful to the patient. Dysmenorrhoea in gouty subjects. It turns the constitution into order and prevents the after formation of gout. When such cases are very deep-seated, the uterine troubles will be cured in middle life, and the gouty appearance will come separately. The better the internal is, in an incurable disease, the worse the external becomes, and, when this is so the external trouble is essential to health, and so long as the external manifestations are in the extremities, and the joints are being increasingly affected, so long the internal is in a state of order.

When the remedy works in that way, do not change it and try to get something that will drive the external away. So long as the patient is improving and the external is growing worse, that is the right direction. Ledum acts in this direction. Its tendency is to make the complaints go away from the centre, for its complaints begin in the circumference and go towards the centre. It is sometimes impossible to manage a gouty patient without giving him some sort of explanation.

Lycopodium also keeps conditions coming to the surface. It will send them back to their own place in the externals when they have a tendency to go in. Lycopodium often causes a return of the red sand in the urine.

"Emaciation of suffering parts."

A nerve is injured by a puncture and a slight infection takes place, so that the wound becomes congested, with a mottled, oedematous appearance, and the part becomes cold, just such a condition as Ledum will cure. The nerve that supplies that part takes on an ascending neuritis, pains shoot along the nerve, the muscles that are supplied by that nerve dwindle and the part withers. We have in Pulsatilla a similar state.

"The diseased limb withers."

A Dictionary of Practical Materia Medica, John Henry Clarke

Ledum palustre. Wild Rosemary. Marsh Cistus. Marsh Tea. Labrador Tea. N. O. Ericaceae. Tincture of dried small twigs and leaves collected after flowering begins. Tincture of whole fresh plant.

Clinical.─Ascites. Asthma. Bites. Black-eye. Boils. Bruises. Deafness. Ear, inflammation of. Eczema. Erythema nodosum. Face, pimples on. Feet, pains in; tender. Gout. Haemoptysis. Hands, pains in. Intoxication. Joints, affections of, cracking in. Ménière's disease. Pediculosis. Priapism. Prickly heat. Punctured wounds. Rheumatism. Skin, eruptions on. Stings. Tetanus. Tinnitus. Tuberculosis. Varicella. Whitlow. Wounds.

Characteristics.─In the preface to his proving of Ledum Hahnemann says it "is suitable for the most part only for chronic maladies in which there is a predominance of coldness and deficiency of animal heat." Teste, who is one of the chief clinical authorities on Ledum, mentions that it is native to damp regions of the North of Europe, and that no animal except the goat eats it, on account of the strong resinous smell of its leaves, which "keeps off lice and prevents flour from getting mouldy." In Sweden a decoction of Ledum is used for freeing, oxen and pigs from lice. Linnaeus says that this same decoction, if taken internally, has cured "violent headaches and a species of angina." The leaves of Ledum are also used in Sweden in beer to increase its intoxicating power; and also in tanning. Led. is an example of a common article of diet being at the same time a very powerful medicine. Mérat and de Lens say Led. cures itch and scald-head, which Teste explains by its parasiticide action. This anti-parasitic action led Teste to think of Led. as a remedy for bites and punctured wounds, especially as certain symptoms of the proving seemed to agree with it. The success which has attended this use of Led. in mosquito-bites, stings of bees and wasps, rat-bites, needle-pricks resulting in whitlows, confirms the observation. "Redness, swelling and throbbing in point of index finger, from prick of a needle:" Led. aborted a felon in a few days (W. P. Wesselhoeft). Teste relates a case of punctured wound: A young lady fell with an embroidery needle in her hand, and the hand was pierced through and through. The wound was serious. There was no haemorrhage, but Teste noticed the intense cold which accompanies and characterises Ledum fever. Within a week Led. cured the patient. Yingling records (H. P., x. 400) a parallel case: A. J. M., 38, drove a rusty spike through his left foot near the arch of the instep, glancing to the inside of the foot without passing through the bone. This was at 5 p.m. At 8 p.m. this report was brought to Yingling: A few moments after accident the patient felt stiffening pains in the foot, running up the leg, and rapidly increasing in severity. Great chilliness with chattering of teeth followed. Lower jaw became somewhat stiff; general shivering; neck felt stiff; "can't endure it much longer." Led. 3x was sent, and rapid improvement took place from the first dose. A compress of Calend. 3x was also applied, an attack of tetanus being evidently aborted. Led. occupies the second place in Teste's Arn. group, in which are also Crot. t., Fer. magn., Rhus, Spig. The sphere of Led. is frequently identical with that of Arn., according to Teste; but Led. has a special action on the capillary system in parts where cellular tissue is wanting, and where a dry, resisting texture is present, as in the fingers and toes. "It is, perhaps for this reason that it acts better on the small than on the large joints;" hence its appropriateness in gout. The characteristic skin affection of Led. is thus described by Teste: Not so much a boil, as with Arn., as a sort of bluish or violet-coloured tuberosities, especially on the forehead, and an eczematous eruption, with a tingling itching, that spreads over the whole body, penetrating into the mouth, probably also into the air-passages, and occasions a spasmodic cough, which is sometimes very violent and might be mistaken for whooping-cough. The same phenomenon takes place with Rhus and Croton. "In a gouty subject I have seen cough precede by two days the breaking out of vesicles on the skin, which could not fail to suggest the use of Ledum. These vesicles, which had probably existed on the bronchial membrane, before showing themselves in the face, on the shoulders, etc., became quite apparent on the tongue, where they might be traced to its root." The Led. eczema is frequently concentrated on one leg, less frequently on both at once. [Ingalls (Amer. Hom., xxv. 210) commends a light paste of Ledum (equal parts of Led Ø., alcohol, and water) as an application for carbuncles, giving Led. 1x internally at the same time.] Dr. R. Hilbert, a German physician, has obtained very satisfactory results from the use of an infusion of the leaves of Ledum palustre as an expectorant in bronchitis. He states that the feeling of pain along the trachea, which is characteristic of the early stages of acute bronchitis, disappears after a few doses of the remedy. The fever rapidly subsides, especially in the case of children. In chronic bronchitis the infusion facilitates expectoration and lessens cough. It is particularly useful in bronchitis with emphysema of the aged, because of its action in rendering the bronchial secretion less viscid; in these cases, moreover, it lessens dyspnoea, stimulates the circulation, and lessens cyanosis (Cooper). Guernsey points out that Led. is appropriate to the remote no less than the immediate effects of punctured wounds: e.g., as when a patient says: "Ten years ago I stepped on a nail, and ever since then have had a pain running up to the thigh." The pains of Led. shoot upward (of Kalm. downward). A, very notable condition of Led. is < from warmth. This is at times so great that the patient can only get relief to his rheumatism by sitting with his feet and legs in cold water. Warmth of the bed is intolerable; he must get up and walk about. An octogenarian had rheumatism of left arm, chiefly elbow and wrist, coming on in the night or early morning. There was no more sleep for him unless he rose and took a cold bath, after which he could sleep. I cured him with Led. 30. As with Merc. the symptoms are < at night; but with Merc. there is "sweat without >," and the characteristic tongue and offensive mouth. The eye-symptoms of Led. are marked, and Nash says Led. 200 is unequalled as a remedy for "black-eye" from a blow; if there is pain in the eyeball itself Symphyt. will be necessary. Ecchymoses of conjunctiva. Slight injuries cause ecchymoses. Inflammation of ear, with deafness from getting cold (as having hair cut). The haemorrhages of Led. are bright red and gushing; uterine; respiratory. Haemoptysis alternating with attacks of rheumatism. (Raue puts it "coxalgia alternating with haemoptysis." Stens cured a young man who had violent stitch pain in right hip, followed by haemoptysis, this in turn followed by rheumatism of hands, with Led. 200 when the case was apparently on the point of sinking into rapid phthisis.) Suffering parts waste. Discolouration remains long in contused parts. Many cases of whooping-cough have been cured with Led. Lembke (quoted by Hoyne, H. W., xiv. 66) gives these indications: Before the paroxysms: Arrest of breathing. During: Epistaxis, shattered feeling in head and chest, rapid respiration. After: Staggering; spasmodic contraction of diaphragm; sobbing respiration. < Evening. The pains are sticking, tearing, throbbing. Pricking, biting sensations. Sensation of torpor of integuments, especially after suppressed discharge from ears, eyes, and nose. Sensation as if something was gnawing in temples, occiput, and ears. As if eyeball would be forced out. As if sand in eyes. Noises in ear as from ringing of bell, or from a wind-storm; as if ear was obstructed by cotton. Itching as from lice on chest; as of lump in throat. As of boiling in hip-joint. As if muscles of thigh in wrong position. As if knee beaten. Pain in ankle as from sprain; limbs as if beaten and bruised. Hot, tense, hard swellings. "Ledum has often been given to horses when they go lame and draw up their legs. The pains move upward" (Hering). E. Carleton (Med. Adv., xxv. 293) completed the cure of a case of primary syphilis, in which Aur. had done good, where these symptoms appeared: Feet held to the earth as by a magnet when attempting to move; when moving felt as if pricked with needles, the pain rising gradually from feet to head; every joint and muscle of body and limbs stiff and sore; sour night-sweats; great emaciation with loss of appetite. Led. 200, in water, cured completely and speedily. Suited to: Pale delicate persons. Complaints of persons who always feel cold and chilly. Rheumatic, gouty diathesis; constitutions abused by alcohol. Sanguine temperament (Teste). There is < from moving, especially moving joints; while walking; when stepping, > from rest. Symptoms are < evening and night, and before midnight. < From taking wine. < By covering; > by application of ice-water. < By warmth; ("the limb is cold, can't get warm; and gets < when it does become warm in bed").

Relations.─Antidoted by: Camph. (according to Teste Rhus is the best antidote). It antidotes: Effects of alcohol; Apis, Chi. ("Cinchona bark given for the debility produced by Led. is very injurious."─Hahn.) Compatible: Aco., Arn., Bell., Bry., Nux v., Puls., Rhus, Sul. Compare: Kalm. (bot.; Kalm. pains shoot down; Led. pains shoot up); Arn. (trauma. Led. follows Arn. when it fails to relieve soreness; punctured wounds); Crot. t. (skin cold); Hamam. (traumatic ecchymosis; black-eye), Ruta (bruises: Ruta, especially of periosteum Symph. of bone; Hyperic. of nerve) Apis (nightly itching of feet) Am. m., Nat. c. (blistered heels) Zn., Rhus, Glo., Nux, Sel., Fl. ac., Ant. c., Pul., Bovis., and Sil. (< from wine); Sil. (chronic rheumatism, extending from feet upwards; Sil. > covering up, Led, > uncovering); Lyc. > uncovering); Bry. (rheumatism < motion; Led. more gout of great toe, scanty effusion, tends to harden into nodosities; Bry., copious effusion. Led. hot swelling of hip- and shoulder-joints); Aco. (haemoptysis of bright red foamy blood) Rhus [gout and rheumatism affecting small joints (Rhod. also) Led. pains travel up; < warmth of bed (Rhus >); motion < (Rhus. >)]; Sul. (itch); Staph. (pediculosis); Merc. (bloody semen).

Causation.─Alcohol, abuse of. Hair-cutting. Suppressed discharges. Wounds: Bruises; Bites; Punctured wounds; Stings.

SYMPTOMS.

1. Mind.─Anxiety.─Timidity.─Tendency to anger and rage.─Vehement angry mood; vehemence.─Dissatisfied; hates his fellow-beings.─Desire for solitude.─Imperturbable gravity.─Morose and peevish humour.─Misanthropy.─Dementia.

2. Head.─Intoxication.─Stupefying dizziness, sufficient to occasion falling backwards or forwards, < by stooping or being in open air.─Vertigo, head inclines backward.─Raging, pulsating headache.─Pressing headache when head is covered.─A misstep causes the sensation of concussion of the brain.─Head bewildered, with painful shaking of brain, on making a false step.─Stupefying headache.─Pressive headache, as if whole brain were weighed down.─Tearing in head and eyes, which are inflamed, with fever in evening.─Violent throbbing pains in head.─Inability to bear any covering on head.─Itching, as if lice were crawling over scalp, and forehead.─Integuments of head easily affected by cold.─Pimples and boils on the forehead (as in drunkards).─Blood-boils on the forehead.

3. Eyes.─Itching in the internal canthi of the eyes.─Aching in eyes, esp. in evening, sometimes with burning.─Inflammation of eyes, with agglutination and tearing pains.─Violent suppuration of eyes, with discharge of fetid pus.─The tears are acrid, and make the lower lids and cheeks sore.─Burning lachrymation of eyes.─Pupils dilated.─Confusion of sight, with sparkling before eyes.

4. Ears.─Noise in ears.─Tinkling in ears.─Roaring in ears as from wind.─Ringing and whizzing in ears.─Hardness of hearing (r. ear) as from obstruction of the ears.

Nose.─The nose is painful when touched.─Violent burning in nose.─Bleeding in nose.─The blood is pale.

6. Face.─Paleness of face.─Face bloated, at one time red, at another pale.─Redness and tuberous eruptions on face and forehead, like those of drunkards, with shooting pain when touched.─Dry and furfuraceous tetters on face, with burning in open air.─Pimples and furunculi on forehead.─Violent and tearing pains in face at night, alternating with shootings in one of the teeth, and terminating in shuddering, followed by deep sleep.─Engorgement of the gland below the chin.

8. Mouth.─Stinging in forepart of tongue.─Exhalation of a fetid smell from mouth.─Mouldy or bitter taste in the mouth.─Buccal haemorrhage.

9. Throat.─Sore throat, with shooting pain during and after deglutition.─Sensation as if there were a plug in the throat, with shootings on swallowing.

10. Appetite.─Violent thirst for cold water.─Want of appetite and speedy satiety.─Contractive pain in sternum when eating quickly.─Nausea, with inclination to vomit, on expectorating.─Water-brash, with cramp-like pains in abdomen.

11. Stomach.─Pressure on stomach after a light meal.

12. Abdomen.─Pain in abdomen as if intestines were bruised.─Sensation of fulness in upper part of the abdomen.─Colic as if diarrhoea would set in, from umbilicus to anus (with cold feet).─Ascites.─Drawing pain in abdomen.─Gripings in abdomen, in evening. Dysenteric belly-ache.─Frequent discharge of flatus.

13. Stool and Anus.─Constipation.─Diarrhoea, during which the faeces are mixed with mucus and blood.─Blind smarting piles.

14. Urinary Organs.─Burning in urethra after urinating.─Stream of urine frequently stops during its flow.─Frequent want to urinate, with scanty emission.─Diminished secretion of urine.─Frequent and copious emission of urine.─Swelling of urethra.

15. Male Sexual Organs.─Violent and prolonged erections.─Pollutions of sanguineous or serous semen.─Inflammation of the glans.─Inflammatory swelling of penis; the urethra is almost closed.─Increased sexual desire.

16. Female Sexual Organs.─Catamenia too early and too copious; the blood is bright red.

17. Respiratory Organs.─Tickling in larynx.─Cough, preceded by suffocating suspension of respiration (and opisthotonos).─Fatiguing spasmodic cough, which resembles whooping-cough.─Tiresome cough, chiefly in morning, with yellowish expectoration and irritation in chest, and palpitation of heart.─Cough, with purulent expectoration, esp. in morning or at night.─Greenish expectoration of a fetid smell, during fit of coughing.─Hollow shaking cough, with expectoration of bright red blood.─Haemoptysis, bright blood.─Phthisis, preceded by history of neuralgia and rheumatism in head and limbs, with inflammatory tendency (Van den Berghe).─Tingling of trachea (bronchitis).

18. Chest.─Obstructed and painful respiration.─Spasmodic and sobbing respiration (double inspiration) as after weeping bitterly.─Respiration obstructed when going up stairs.─Constrictive oppression of chest, < by movement, and walking.─Burning in chest.─Pain in chest on breathing, as if there were something alive in it.─Shootings in chest, esp. on raising or moving arms.─Eruption on the chest, resembling sheep-rot.─Gnawing itching in chest, with red spots and miliary eruption.─Pain, as from excoriation under sternum.

19. Heart.─Pushing or pressing inward at l. edge of sternum; palpitation; also in haemorrhage.

20. Neck and Back.─Painful stiffness in back and loins after sitting.─Tearing from loins to occiput, esp. in evening.─Violent cramp-like pain above hips, with suspended respiration in evening.

21. Limbs.─Affections of, in general; knee-joint; hip-joints; toe-joints; gouty pain in; when striking the toes there is a coldness in the parts, and a gouty pain shoots all through the foot and limb; cracking of the joints, i.e., on moving them.─Heat in hands and feet in evening.─Long-continued warm sweat on hands and feet.

22. Upper Limbs.─Tearing and pressive pulling in arms.─Lancinating pains in shoulder, on raising or moving arms.─Aching pain in joints of shoulder, and of elbow, < by movement.─Rheumatism in r. elbow-joint due to urate deposit, on periosteum apparently.─Rheumatic pain in the joints of the arm.─Eruption, like sheep-rot, on arms.─Tearing pains in hands and fingers.─Fine stinging in hands.─Boring pain in first joint of thumb.─Arthritic nodosities in joints of hands and fingers.─Perspiration on palms.─Itching, miliary eruption on wrist.─Trembling of hands on moving them, or on grasping anything.─Panaritium.

23. Lower Limbs.─Rheumatic, paralytic pain in the coxo-femoral joint.─Pressure in the region of r. hip-joint, < during motion.─Rheumatic pains in hip, knee, and foot-joints.─Contusive pain, and pain as from excoriation in periosteum of femur, and in knees.─Pressure on l. thigh, posteriorly; as if the muscles were not in their right places, like pains of dislocation, in every position, but esp. violent when walking or when touched.─Tensive stiffness of the knee, which cracks and yields in walking.─Cramp-like tension in the knees, calves, and heels.─Weakness and trembling of knees (and hands) when seated or walking.─Hard and tight swelling of knee, with shootings and nocturnal aching and tearing pains, and hardness of whole leg.─Swelling of leg, above and below knee, with heat and drawing shooting pain.─Legs red and swollen with shooting pains in instep and ankles, and prickly pains up leg.─Pressure above l. inner ankle, < by movement.─Very severe gnawing itching on dorsum of both feet; always < after scratching; only allayed after he had scratched the feet quite raw; much < by heat of bed.─Obstinate swelling of feet; with intolerable pain in ankle-joint on treading.─Pressure on inner border of l. foot.─Stiffness of feet.─Pain in soles, when walking, as if they were galled; as if filled with blood.─Inflammatory or else oedematous swelling of legs and feet.─Incisive pains in toes, while asleep at night.─Swelling of fleshy part of great toe, with pain when treading with it.─Fine tearing in (l.) toes; podagra.

24. Generalities.─Arthritic, pressive, and acute pulling pains, or pains merely pressive in limbs, < by heat of bed in evening (till midnight).─Numbness and sensation of torpor in several of the extremities.─Tearing or shooting, pulsative and paralytic pains in joints, < by movement.─The pains in the joints are the only ones which are < by movement.─Gouty nodosities in joints.─Hard, hot, tense swellings, with tearing pains.─Dropsical swellings of some parts, or of skin of whole body.─Emaciation of affected parts.─Pains change location suddenly.─Coldness and want of vital heat.─Heat of the bed is insupportable, and occasions heat and burning in limbs; wants to uncover.─Sufferings are <, or come on, after getting warm in bed, compelling the patient to get out of bed, which affords them relief.─Leucorrhoea.─For complaints of people who are cold all the time, in bed, in the house, etc.; they always feel cold and chilly.─Pale delicate persons.─Affections of external forehead; heel; under part of heel; ball under the toes.

25. Skin.─Oedematous swellings, also of skin of whole body.─Hot, tensive, hard swellings, with tearing pains.─Dryness of the skin and want of perspiration.─Large, rough exanthema on the face.─Dry exanthema.─Whitlows or felons on fingers of a seamstress are often caused by needle pricks.─Itching < by scratching.─Itching and gnawing in skin, with burning after having scratched.─Gnawing itching, as if caused by lice.─Miliary eruptions.─Eruption, like rot in sheep, with desquamation.─Bluish spots over body, like petechiae.─Ecchymosis remaining a long time in bruised parts after pain and inflammation subside.─Dry, furfuraceous tetters, itching excessively (burning in open air).─Furunculi.

26. Sleep.─Great inclination to sleep during day, as when intoxicated; a kind of drowsiness with great wish to lie down.─Nocturnal sleeplessness, with restless tossing, jerking, fantastic visions and images on closing eyes.─Agitated anxious dreams.─Uneasy dreams, in which he changes from place to place, and from one subject to another.─Lascivious dreams, with emission of semen.

27. Fever.─Violent shivering and shuddering, with coldness in limbs.─Chilliness with thirst and sensation as if cold water were poured over the parts.─Morning and forenoon predominating chilliness with thirst.─General coldness, with heat and redness of face.─Heat without thirst more towards evening.─Perspiration all night, with inclination to uncover oneself.─Night-sweat, of putrid or sour smell.─Perspiration causes itching.─Intermittent fever.─Chilliness without subsequent heat, accompanied by thirst, esp. desire for cold water.─Heat all over without thirst; on waking up, body covered with perspiration, accompanied by itching of whole body.─Intermittent fevers with malignant rheumatic pains.─Heat in hands and feet in evening.─Fever in evening, with pain in head and eyes.─Sensation of great heat, alternating with sweats.─Perspiration easily excited by walking, esp. on forehead, and sometimes of a sour smell.

Keynotes and Characteristics with Comparisons of Some of the Leading Remedies of the Materia Medica (Allen's Keynotes), Henry Clay Allen

Marsh Tea (Ericaceae)

Adapted to the rheumatic, gouty diathesis; constitutions abused by alcohol (Colch.). Haemorrhage into anterior chamber after iridectomy. Contusions of eye and lids, especially if much extravasation of blood; ecchymosis of lids and conjunctiva. Rheumatism or gout; begins in lower limbs and ascends (descends, Kal.); especially if brought to a low asthenic condition by abuse of Colchicum; joints become the seat of nodosities and "gout stones." which are painful; acute and chronic arthiritis. Affects left shoulder and right hip-joint (Agar., Ant. t., Stram.). Emaciation of affected parts (Graph.). Pains are sticking, tearing, throbbing; rheumatic pains are < by motion; < at night, by warmth of bed and bed-covering (Mer.); > only when holding feet in ice-water (Sec.). Complaints of people who are cold all the time; always feel cold and chilly; lack of animal or vital heat (Sep., Sil.); the wounded parts especially are cold to touch. Parts cold to touch, but not cold subjectively to patient. In some affections, warmth of bed intolerable on account of heat and burning of limbs. Swelling: of feet, up to knees; of ankle with unbearable pain when walking, as from a sprain or false step; ball of great toe swollen, painful; in heels as if bruised. Intense itching of feet and ankles; < from scratching and warmth of bed (Puls., Rhus). Easy spraining of ankles and feet (Carbo an.). Punctured wounds by sharp pointed instruments, as awls, nails (Hyper.); rat bites, stings of insects, especially mosquitoes. Red pimples or tubercules on forehead and cheeks, as in brandy drinkers, stinging when touched. Long-remaining discoloration after injuries: "black and blue" places become green.

Relations. - Compare: Arn., Crot. t., Ham., Bellis, Ruta, in traumatism; Con., in long-lasting effects of injuries.

Leaders In Homoeopathic Therapeutics, Eugene Beauharnais Nash

Rheumatism begins in feet and travels upward (Kalmia opposite).

The swellings are pale, sometimes oedematous, and < at night, in the heat of the bed; uncovering or cold water relieves.

Ecchymosis; "black eye" from a blow or contusion; better than Arnica.

Rheumatism and rheumatic gout; joints become the seat of nodosities and "gout stones", which are painful.

Complaints of people who are cold all the time; lack of animal or vital heat; parts cold to touch, but not cold subjectively to patient.

Punctured wounds by sharp-pointed instruments, rat bites, stings of insects, especially mosquitoes.

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Ledum is a very valuable remedy for rheumatism. This complaint is confessedly a very difficult disease to cure by old school treatment. Seldom is a case of the inflammatory form completely cured by them. The great majority of their cases run from the acute into the chronic form, and last for life. They are often drawn all out of shape (their patients), or left with incurable valvular heart trouble. This is not the case under homoeopathic treatment. On the contrary the patients treated homoeopathically are generally cured, and very seldom left with any heart trouble, even if the disease commenced there, as it sometimes does. Oftener, of course, it begins in the back, extremities or joints generally, and then if treated allopathically with local applications it is driven to the heart, which cannot be reached with local applications, hence stays there until exudations occur and hardened deposits from upon the valves. Any homoeopathic physician guilty of treating a case this way, with such results, ought to lose his practice and his diploma.

I do not say this inadvisedly, for I have lived and practiced for thirty years past in a decidedly rheumatic district and know whereof I affirm. When we homoeopaths of the East condemn those of the West for the Quinine (in material doses) treatment of intermittents, we are reminded that we do not live in miasmatic districts so we are not authority and we can only reply that we know many physicians who do live there who cure their patients without the abuse of Quinine. But in this verdict of mine on rheumatism I cannot be turned off that way. Rheumatism is one of those diseases that presents plenty of symptoms and modalities to guide to the choice from a long list of remedies of the one appropriate to the case in hand. There is such a great difference in the results of applying the remedy according to symptomatic indications, and those arising from simply pathological prescribing, that one does not need long to experiment to be convinced. Indeed the pathological condition in this complaint does not figure largely in the account, for purposes of prescribing. But sensations and modalities do.

The Ledum rheumatism begins in the feet and travels upward. This is the opposite of Kalmia, which goes the other way. Ledum may be indicated in both acute and chronic forms of this complaint. In the acute form the joints are swollen and hot, but not red. The swellings are pale and the pains are worse at night and from the heat of the bed, wants them uncovered. This is like Mercurius, but with Mercury the profuse sweat without relief, and especially the characteristic mouth and tongue symptoms will decide. I have seen wonderful benefit from Ledum in such cases.

In the chronic form of the disease this remedy is equally efficacious. Here also we have the joints swollen and painful, especially in the heat of the bed, and painful, hard nodes and concretions form in the joints of feet first, then hands. The periosteum of the phalanges is painful on pressure. The ankles are swollen and the soles are painful and sensitive, can hardly step on them. This painful and sensitive soles of feet is also found under Antimonium crud., Lycopodium and Silicea, and I have relieved it, other symptoms agreeing, with each and every one of these remedies. In these case of rheumatic troubles the Ledum patient is unnaturally cold. "Lacks vital or animal heat", in this, again, resembling Silicea; but although the Silicea patient has chronic rheumatism of the feet, ankles and soles similar to Ledum, aggravated also at night, the warmth of the bed does not aggravate, but on the contrary he wants to be covered warmly. Under Ledum the relief from cold is so prominent that sometimes the only amelioration is from putting the feet into cold water. It is well to think of Ledum in all cases of rheumatism of the feet and study it up.

We must not leave this remedy without calling attention to its virtues as a remedy for injuries. We are apt to think of Arnica first, for bruises and the results therefrom, and, on account of its well deserved reputation, to forget that there are sometimes other remedies equally valuable. Ledum sometimes comes in to finish up a work that Arnica began well, but could not complete, even when Arnica was best at first, for it often removes the ecchymosis and discoloration more rapidly and perfectly. For black and blue spots from blows or bruises there is no better remedy than Ledum.

Then, again, we have Sulphuric acid, which is very useful in ecchymosis from the same cause, especially if occurring in cachectic or weakened constitutions, with tendency to purpura, or breaking down of the blood. This pathological condition would be attended with the characteristic symptoms of the drug. We often have ecchymosis into the conjunctiva or sclerotica, for which Nux vomica is specific, but for "black eye" from a blow of the fist no remedy equals Ledum in the 2c potency. Ledum is a good remedy for punctured wounds, such as the sticking of a nail into the foot, or an awl into the hand, etc.; also for stings of insects, especially mosquitoes, but this also needs modification. It makes some difference what kind of tissue is wounded by this kind of wound If a nerve, for instance, Hypericum would be preferable; if the periosteum, Ruta; if the bone, Calcarea phos., or Symphytum to promote re-union or repair. We must not forget to mention in connection with what has been said of Ledum in injuries of the eye that if there is great pain in the eyeball itself from the blow, Symphytum may have to be used. For all these affections I believe the 200th potency better than the lower preparations.