Arsenicum album

REMEDIES FOLLOWING THE FIRST OR PRODROMAL STAGE OF TYPHOID FEVER

ARSENICUM ALBUM

The remedy that is very likely to be necessary if the case goes on from bad to worse, notwithstanding the use of one or more of those already noticed, is Arsenicum album. I know that some who are considered authority have taught that Arsenicum throughout its pathogenesis more closely resembles in all its stages a genuine typhoid than any other, and, therefore, that it is good practice to give it from the beginning, and all through, without much regard to differentiation between it and other remedies, except it be to drop in (interpolate) for particular symptoms some other remedy in alternation for the purpose of quieting those symptoms, while Arsenicum keeps getting in its work in a general way.

Acting on such authority, I inclined in my earlier practice to that way. But I found after a while that cases treated thus would oftener run the whole course than otherwise; first, because many cases did not need Arsenicum at all, and of course were not benefited; next, because even in the cases where it was the remedy the continued dosing that I did with it hindered re-action, sometimes, I fear, greatly damaging, if not killing, my patient, with the remedy which, properly used, might have cured him.

I saw such a case in consultation with a Jersey City physician, who was holding his patient down with Arsenicum 3d in oft repeated doses, with an occasional dose of Mercurius corrosivus 3d for the particular symptoms of tenesmus. That patient, a strong young man, after a very long sickness, recovered, I think, in spite of bad treatment. I know there is a better way, for I have tried both and proven it to my satisfaction.

I will not here undertake to give all the symptoms set down in the text-books that may be found present in an Arsenicum case, but rather what I have found to be the “Leading” ones—where the powers of life seem to be greatly exhausted; great restlessness and anxiety, which is manifested by constantly moving head and limbs, while trunk lies still on account of too great weakness; tongue either red, dry, cracked, or black and stiff; excessive thirst for little at a time; burning in stomach or bowels, or both; meteoristic distension of the abdomen; diarrhœa watery, brownish, or bloody and offensive; all worse at midnight, especially about one o’clock. Here are only a few symptoms, but every Arsenicum case has them, or a good share of them, sure. The prostration is very great, and so is that of Carbo veg. and Muriatic acid, but in neither of these two is the prostration accompanied by the excessive anguish and restlessness of Arsenicum. They have gotten past that. The thirst of Arsenicum is no greater than that of Bryonia, but Bryonia wants large quantities at long intervals, while Arsenicum cannot take large quantities at a time, for it distresses and nauseates, or causes vomiting. The excessive restlessness occurs equally under Arsenicum and Rhus toxicodendron, but there is not the same degree of prostration with Rhus toxicodendron. The patient can, and does, turn, or throw, himself from side to side, and seems to be temporarily relieved thereby, while if the Arsenicum patient makes out to move himself he is greatly exhausted and made worse.

The general aggravation of Rhus toxicodendron is also during the latter part of the night, but not so characteristically at one o’clock. I think that of all the remedies we have so far considered, Rhus tox. and Arsenicum come nearest together, and I have found very few cases of typhoid where after Rhus tox. had done all it could (unless it cured the case which it sometimes does), Arsenicum was not the next remedy.

Now, with Arsenicum, as, indeed, with any other remedy, the earlier positive indication for its use is recognized, the better the effect following its administration, either to cure at once or at least to so greatly modify the case as to render the further conduct of it comparatively easy.