Abrotanum — southernwood, Artemisia abrotanum, a cousin of wormwood and cina — is the remedy of the child who eats and still wastes, and of the disease that will not stay where it started. Two ideas organise everything in its pathogenesis: wasting against appetite, and metastasis.
Lippe's Red Line gives the first in capitals: "RAVENOUS HUNGER; LOSING FLESH WHILE EATING WELL." Kent gives the second in a rule: "The changing of one so-called disease into another always calls attention to Abrotanum."
This guide profiles Abrotanum for clinical study from Boericke, Kent's Lectures, Nash, Clarke's Dictionary, Lippe's Red Line, Hering and Boger's Synoptic Key. The originals can be read in full — Boericke's Abrotanum, Kent's Abrotanum and Clarke's Abrotanum — through Similia's free digital materia medica.
The Abrotanum State
Boericke's frame: "A very useful remedy in marasmus, especially of lower extremities only, yet with good appetite. Metastasis. Rheumatism following checked diarrhœa. Ill effects of suppressed conditions especially in gouty subjects. Tuberculous peritonitis. Exudative pleurisy... Great weakness after influenza."
Boger compresses the constitution: "Numb, weak, tremulous and paretic. Can't hold up head. Exudations... True metastases; receding gout, etc. Alternations; piles with rheumatism... Emaciation; ascending; of legs."
Three words repay memorising there — exudations, metastases, alternations — because they name the remedy's three mechanisms. Fluid collects where it shouldn't (pleura, peritoneum, joints, the oozing navel); disease moves where it shouldn't (bowel to joints, joints to heart, parotid to testes); and complaints see-saw (diarrhœa with constipation, piles with rheumatism).
Mental and Emotional Picture
Cross and depressed. "Cross, irritable, anxious, depressed" (Boericke); Boger's "cross, irritable children."
The cruel streak. Clarke preserves the extraordinary rubric: "Feels she would like to do something cruel; no humanity" — Lippe's version, "violent, inhuman, would like to do something cruel." In a wasted, peevish child this trait, when present, is close to decisive.
Dulled thinking. "Thinking difficult. Feels as if brain softening" (Clarke), with the left brain "easily tired by conversation or mental effort" — and a curious secondary state after the drug ceases: excited, loquacious, happy.
Physical Affinities
Nutrition — the ascending marasmus. The core. Emaciation "most pronounced in lower extremities" (Nash), beginning in the legs and climbing so that the face wastes last — Kent: "that is the opposite of Lycopodium, Natrum mur. and Psorinum." With it: ravenous hunger, food passing undigested (lienteria), "skin flabby and loose" hanging in folds, the old wrinkled pale face with blue rings around dull eyes, comedones with emaciation, and a neck too weak to hold the head up (Lippe compares Aethusa). A hectic fever may attend — "great weakness and prostration... unable to stand."
Stomach. Cutting, gnawing, burning pains worse at night; "stomach feels as if swimming in water; feels cold" (Boericke — Boger compares Bufo); vomiting "of large quantities of offensive fluid" — a symptom Clarke personally confirmed in cure. Kent adds burning ulcerative pains "with suspicious vomiting."
Abdomen and stool. Distended, bloated abdomen with hard lumps; alternate diarrhœa and constipation; ascarides; hæmorrhoids with frequent urging and bloody stools — with the signature timing: "worse as rheumatic pains abate" (Boericke). And the infant keynote: oozing of blood and moisture from the navel of the newborn.
Metastasis and the heart. A suddenly checked diarrhœa "will be followed by violent cardiac symptoms" (Kent, ranking it with Ledum, Aurum and Kalmia); rheumatism that leaves the joints for the heart; mumps metastasising to testes or mammæ where Carbo veg and Pulsatilla fail. Kent's resurrection case — the woman surrounded by friends expecting her death, days after a liniment "cured" her knee — is the clinical archetype.
Chest. Exudative pleurisy — "it has cured pleurisy after Bryonia, which seemed indicated, had failed" (Kent) — and Boericke's precise post-surgical note: after chest operations for hydrothorax or empyema, "a pressing sensation remains." Lippe places it after Aconite and Bryonia in pleurisy on exactly that pressing residue.
Joints and back. Gouty, stiff, lame joints — wrists and ankles named — with "excessive pain before the swelling commences" (Lippe); pricking and coldness of fingers and toes; painful contraction of limbs (Ammonium mur comparison); nightly backache; sudden aching in the back better by motion.
Boys and infants. A small constellation the sources insist on: "nosebleed and hydrocele in boys" (Boericke), epistaxis of youths (Boger), the oozing navel, and marasmus itself — Clarke: "suited to affections of newborn children, and especially little boys."
Skin and vessels. Eruptions that come out on the face, are suppressed, and leave the skin purplish; furuncles (after Hepar); itching chilblains (Agaricus); falling hair; distended veins on the forehead.
Key Modalities
Worse from:
- Cold air; cold damp weather; fogs (Boger)
- Checked secretions — the master modality: suppressed diarrhœa, driven-back eruptions, receding gout
- Night — pains, backache, gastric distress
Better from:
- Motion
- Loose stool (Boger compares Natrum sulph and Zinc) — the reverse of the harm done by checking it
Keynote Symptoms
- Marasmus ascending from the legs; face wastes last
- Ravenous hunger while emaciating; food passes undigested
- Skin flabby, hanging in loose folds; old, wrinkled face with blue rings
- Metastasis: checked diarrhœa → rheumatism or heart; mumps → testes/mammæ
- Alternations: piles with rheumatism; diarrhœa with constipation
- Stomach as if swimming in water; cold
- Vomiting of large quantities of offensive fluid
- Oozing of blood and moisture from the newborn's navel
- Epistaxis and hydrocele of little boys
- Neck too weak to hold the head up
- The cruel, inhuman temper in a wasted child
- Exudations: pleurisy, tuberculous peritonitis; pressing sensation after chest surgery
- Great weakness after influenza (Boericke compares Kali phos)
- Worse cold air and checked secretions; better motion and loose stool
Clinical Applications
Marasmus and failure to thrive. The classic paediatric indication: the leg-first wasting with good appetite, flabby skin and old face — the full differential against Iodine, Natrum mur, Sanicula and Tuberculinum runs through the sources' own comparisons.
Metastatic and suppressed conditions. Rheumatism after checked diarrhœa; cardiac irritation after externally "cured" joint rheumatism; mumps gone astray. Where the history contains the word suddenly stopped, Abrotanum belongs on the shortlist.
Exudative states. Pleurisy after Bryonia fails or where the pressing sensation remains; tuberculous peritonitis; hydrocele of boys.
Gout and rheumatism. Stiff, pricking wrists and ankles, the pain out of proportion before swelling appears, in chilly patients worse in fog and cold damp.
Post-influenzal debility. Boericke's brief but valuable note — great weakness after influenza — beside Kali phos.
Ailments of the newborn. The oozing navel above all; a rubric Abrotanum nearly owns.
Differential Diagnosis
Abrotanum vs. Lycopodium, Natrum mur, Psorinum (direction of wasting). Kent's own rule: those three emaciate from above downward — the neck and face first; Abrotanum from below upward, legs first, face last. In a marasmic child, simply observing where the wasting began can split the field.
Abrotanum vs. Iodine and Tuberculinum. All three lose flesh while eating ravenously (Lippe brackets them). Iodine is hot-blooded, hurried, glandular; Tuberculinum restless, travel-hungry, taking cold on every exposure; Abrotanum is the cross, chilly, flabby child with the metastatic history.
Abrotanum vs. Sanicula. Shares the emaciation with old face and the dirty, flabby look; Sanicula adds its profuse sour foot-sweat and the water-loving constitution. Lippe lists it beside Abrotanum in both hunger and neck-emaciation rubrics.
Abrotanum vs. Ledum, Aurum, Kalmia (heart after rheumatism). Kent groups them for cardiac states following suppressed or receding rheumatism. Kalmia's heart complaints descend with shooting pains; Aurum adds its depression; Ledum its cold, puffy joints going upward. Abrotanum declares itself by the checked-diarrhœa or liniment history and the accompanying wasting.
Abrotanum vs. Aethusa (head-drop). Both infants cannot hold the head up. Aethusa is the milk-intolerant baby vomiting curds to exhaustion; Abrotanum the ravenous, wasting, cross one.
Repertorisation Tips
These rubrics carry Abrotanum in high grade:
- Generalities; EMACIATION; ascending and Extremities; EMACIATION; lower limbs
- Generalities; EMACIATION; appetite, with ravenous
- Stomach; APPETITE; ravenous; marasmus, with
- Generalities; METASTASIS
- Extremities; RHEUMATISM; diarrhœa, after checked
- Chest; RHEUMATISM; heart, going to
- Rectum; HÆMORRHOIDS; alternating with rheumatism
- Umbilicus; OOZING; newborns, in
- Mind; CRUELTY
- Face; OLD looking; children
- Neck; WEAKNESS; head, cannot hold up
- Generalities; SECRETIONS; checked; agg.
The fastest confirmation is the triad: ascending wasting + ravenous appetite + a suppression somewhere in the history. If the emaciation started at the neck, leave Abrotanum and re-check the downward-wasting remedies. Our beginner's guide to repertorisation sets out the method in more detail.
Deepening Your Study
- Boericke carries the marasmus formula, the exudative states and the post-chest-surgery note
- Kent's Lectures develop metastasis with the two great case-pictures — the liniment heart case and the failed-Bryonia pleurisy
- Clarke's Dictionary holds the cruel-child rubric, the stomach-swimming sensation and his own confirmed cure of the offensive vomiting
- Lippe's Red Line compresses the child-picture into capitals — the hunger, the wasting, the boys' constellation
- Boger's Synoptic Key gives the three-word skeleton: exudations, metastases, alternations
- Nash needs one line — and it is the right line: marasmus of the lower extremities with diarrhœa alternating with rheumatism
You can read all of these side by side through Similia's free digital materia medica. For the wasting differential, see the guides to Lycopodium, Natrum muriaticum and Tuberculinum.
