Stramonium

(^ Belladonna.

Nux vomica. J Sulphur. j Sepia. I Lamium album.

Anacardium exerts a depressing influence on the system, not only, as to the mind, but as to the body as well. It produces a weakness of memory; this symptom we often meet with as the result of acute dis- eases; for example, the acute exanthemata, such as small-pox. The eruption of Anacardium is analogous to that of variola. Taking these two symptoms, loss of memory and eruptions simulating that of variola, we find an excellent reason for prescribing this remedy when loss of memory appears as one of the sequelae of that disease.

Ana- cardium may also be useful when this disturbance of memory occurs in old people, or as the result of softening of the brain.

In addition to this effect on the intellect, we find the emotional mind very much disturbed; the A?iacardium patient imagines that he hears voices afar off talking to him. Here it is something like Stramon- ium. He has a sensation as though he had two wills — one command- ing him to do what the other forbids. This is not an uncommon symptom in typhoid fever, in which disease plants which poison the blood, as do those under consideration, may be exceedingly useful.

This feeling, as if the patient had two wills, is also found under other remedies. You will find it, for example, under Lac/iesis, which, you

ANACARDIACE^e. 2IO.

will remember, has: "The patient thinks that he is under the con- trol of some superhuman power." A similar symptom is also found under Belladonna.

Another mental condition characterizing Anacardium is a propensity to swear. Now, do not suppose that I recommend Anacardium for the cure of profanity when it exists as the result of low morals; far from it. When, however, the propensity to swear comes as a result of mental disease, Anacardium may do noble work. I once treated a minister who exhibited a remarkable penchant for profanity; try as hard as he would, he could not help it.

This trouble did not affect him until he suffered from a peculiar headache, characterized by a sen- sation as if a plug were in the head. A?iacardium made a complete cure in his case.

Another remedy producing disposition to swear is Nitric acid; but I have never seen it do any good in these cases excepting after the abuse of mercury. I also wish to call your attention to a symptom of the drug, on the authority of Dr. Talcott, of Middletown, N. Y. , namely, inclination to commit suicide by shooting, a symptom which you will also find under Antimonium crudum.

We also find Anacardium a remedy for the bad effects of over-use of the mind; for mental fatigue, in other words. Mental exertion brings on a tearing headache, the pains being situated mostly in the fore- head and back part of the forehead. In other cases, the headache may assume a different phase, in which the patient complains of the plug-sensation spoken of above, or of a constrictive sensation as though a band were tied about the head. These headaches of Anacardium are associated with great mental irritability, which is not, however, always so great as to lead the patient to indulge in profanity.

Hypochondriasis is one of the marked features of Anacardium. The patient is apt to be clumsy and si lly in his behavior, and very much depressed. There is again this idea of duality, that his mind is separated from his body, that a stranger accompanies him. These symptoms of the mind frequently owe their origin to gastric disturb- ance. In the woman they may develop after child-birth. She im- agines that her child is not her own, that her husband is someone else.

The gastric symptoms of Anacardium are these, and they are very characteristic. You will note that the patient is hungry much of the time; he feels better while eating, but worse after eating. He is apt to have constipation; there is frequent desire for stool, but when an

220 A CUNICAL MATERIA MEDICA.

attempt to move the bowels is made, the urging passes away. The rectum seems powerless; he complains of a sensation as of a plug or of some foreign substance in the rectum; this symptom is not the me- chanical result of the retained faeces. Here again you notice the sen- sation as of a plug or some foreign substance interfering with the normal function of the organ. Now these symptoms that I have men- tioned are more common than we think.

When they do occur, we are more apt to think of Nux vomica, Ignatia, and Sulphur, and for- get Anacardium.

Especially does Anacardium resemble Nux vomica in the morning nausea. Like Nux, the former may be useful for the morning sickness of pregnancy; the patient is relieved while eating, but the symptoms re- turn soon after. There is also a resemblance in the mental symptoms of the two drugs. Wherein do they differ?

There is an essential differ- ence in the pathology of the cases calling for these remedies. While you will note that Anacardium has urging to stool, it also has in ad- dition a powerlessness or inefficiency of the rectum, thus exhibiting a paretic state which does not belong to Nux vomica, the last-named drug being suited to irregular peristaltic action of the bowels. Then, too, that sensation as of a plug in the rectum, is not found under Nux vomica.

Do not forget the distinction I have given you between Anacardium and Nux, I admonish you again, because I know we often give Nux when we should have given Anacardium.

Sepia is similar to Anacardium. This remedy has urging as if some foreign substance were in the rectum; a constant full feeling in the rectum, even after stool. In addition to this, it has inactivity of the rectum, so that even a soft stool is expelled with difficulty. It is true that these symptoms of Sepia almost always require the presence of some uterine disease to make it the remedy.

A French physician has recommended Anacardium as an invaluable remedy in internal haemorrhoids. He administers the drug in the thirtieth potency, several times daily, for several weeks. He claims to have made many cures; I have not been able to confirm his ex- perience.

The same physician uses Lamium album for external piles. This remedy has a headache accompanied by a peculiar backward and for- ward motion of the head.

Let us now study the action of Anacardium on the skin. We find

ANACARDIACE^. 221

it useful when the face is swollen, particularly on the left side, and covered with small blisters which have a pock-like appearance. These blisters are umbilicated; they may also occur on other parts of the body. They discharge a yellowish serum which hardens into crusts in the open air. The itching is extreme, so great, indeed, as almost to compel the patient to dig the nails into the skin. These cutaneous symptoms are often accompanied by some of the gastric symptoms just mentioned.

The A?iacardium occide?itale , or cashew nut, although the kernel is edible, causes a vesicular eruption, usually on the face, but on other parts of the body also, with almost intolerable itching, and as you might expect, it also causes umbilicated pustules, as in small-pox. It produces an erysipelatous eruption on the face, and this spreads from the left to the right. Now, this is in the proving. You remember that I said in my lectures on Institutes, when in a proving the symp- toms move in one direction, that the remedy producing the symptoms ought to cure a disease going in the opposite direction.

For instance, in the proving of Rhus tox. the erysipelatous inflammation ^oes from right to left, hence it cures erysipelas going from left to right. As this variety of Anacardium has symptoms like Rhus, but moving in an op- posite direction, it may act as an antidote to Rhus tox.

We shall now speak of the action of Anacardium orientate on the heart. Anacardium is indicated in palpitation of the heart, especially in the aged, when it complicates such slight difficulties as an ordinary coryza. This palpitation is often associated with defective memory.

We also find it indicated in rheumatic pericarditis characterized by sharp stitches through the cardiac region, these stitches being double, that is to say, one stitch is quickly followed by a second, and then there is a long interval.

Next we shall say a few words about the action of Anacardium on the spine, back, and limbs. Anacardium may be selected in diseases of the spinal cord. The symptoms which indicate it here are, sensa- tion as though a band were tied around the body; a feeling as though a plug were stuck in the spine so that any motion of the body gives rise to a pain as if the plug were sticking still further into the body. The knees, particularly, seem to feel weak in these spinal affections.

They feel as if paralyzed. The patient is scarcely able to walk, and in addition has a feeling as though the knees were bandaged tightly.

Looking into Bcenninghausen's works, you will find that Anacardium

22 2 A CLINICAL MATERIA MEDICA.

has an action on the knee-joint. The swelling of Anacardium is of a chronic character, and is attended by a sensation as of subcu- taneous ulceration.

Anacardium, you should remember, is not antidoted by Rhus tox., al- though, under some circumstances, it is an antidote to this remedy. But it is antidoted by the Juglans — also by strong coffee without sugar or milk.

Next we come to the different varieties of Rhus. Rhus toxico- de?idron, as I have already intimated, will be considered in full in my next lecture. I will now say a few words concerning Rhus radicans, and the antidotal treatment of Rhus poisoning. Rhus radicans is highly recommended for occipital headache associated with rheumatic stiffness at the nape of the neck.

Many antidotes to Rhus poisoning have been suggested. One of the best is Croton tiglium. This, when applied locally, and also when taken internally, produces an eruption almost identical with that of Rhus tox. First, an erythema appears, with decided inflammation and pitting on pressure. Small vesicles form, very close together, attended by almost unbearable itching, burning, and stinging. These vesicles fill with a yellowish serum, and finally break and form more or less thick crusts.

Ammonium carb. has also been suggested. It may be used both in- ternally and locally. It produces a fine red eruption, with great burn- ing and itching, worse at night.

Western physicians have of late been using Grindelia robusta. It is not much used here.

Arsenicum is to be thought of when the eruption is attended by fiery, burning pains in the skin and great restlessness.

Chronic Rhus poisoning finds its best remedy in Graphites, but Sul- phur and especially Sepia are also of great use in curing obstinate cases.

This Grindelia robusta, to which I have referred so briefly, has a remarkable action on the pneumogastric nerves. It seems to produce a paresis of those nerves, so that when the patient drops off to sleep he stops breathing and, of course, is aroused by the desire for oxygen. You see that it is allied here to Lachesis and Gelsemium.

LECTURE XXI.

RHUS TOXICODENDRON.

The drug of which I wish to speak this morning is the chief mem- ber of the Anacardiacese, namely, the poison-ivy or Rhus toxicodendro?i. You must remember it as complementary to Bryonia, a fact discovered by Hahnemann in his experience with an epidemic of war-typhus, dur- ing which he treated many cases, losing but two; the success he then gained was acknowledged on all sides. Many lives have since been saved by the exhibition of these two remedies in alternation; i. e., an alternation which consists in giving Bryonia when Bryonia symptoms are present, and Rhus tox. when the patient manifests symptoms call- ing for that remedy.

This is a legitimate alternation. We must also remember a fact of which I have spoken before, but which is so im- portant that I here reiterate it, namely, that Rhus tox. bears an in- imical relation to Apis mellijica. Although the symptoms of the two are superficially similar, for some reason which I cannot explain, these drugs do not follow each other well.

We find Rhus tox. forming the centre of a very large group of medicines. If we were to study them all comparatively, it would take several hours. For example, holding as it does important typhoid re- lations, it has radiating from it many drugs employed in typhoid states of disease. Bryonia, as I have already said, stands close to it. Then we have diverging in another radius Arsenicum , in still another Muri- atic acid, Phosphorus, Carbo veg., etc., with Baptisia and a number of others.

First, we shall study the action of Rhus tox. on the circulatory sys- tem. We find that it causes an erethism, an increase in the circula- tion; in other words, ebullitions of the blood. It acts on the cen- tral organ of the circulation, the heart. Thus we find it indicated in uncomplicated hypertrophy of that viscus, i. e. , hypertrophy not as- sociated with valvular lesions. From what cause? From the effects of over- exertion, as may frequently happen in athletes and in ma- chinists who wield heavv tools.

A CLINICAL MATERIA MKDICA.