Crotalus Horridus

(Rattlesnake poison)

There are drugs whose malign effects on the human body present an almost perfect picture of some disease. The glaring instances that occur to one being Belladonna and scarlet fever : who will diagnose between them, without some corroborative history ?

Arsenicum and ptomaine poisoning.

Mercurius cor. and dysentery.

Latrodectus matt. and angina pectoris.

Crotalus hor. and black water fever.

Where such correspondences occur, Hahnemann tells us that we have specifics.

Otherwise, merely to attach to disease-names drugs that have sometimes been found useful, or have a reputation for being useful for them, will lead to disappointment. It is only where their drug-pictures coincide that we may confidently expect dramatic results.

Of course any and all of these drugs may prove useful quite outside their complete symptomatology which, in ordinary practice, one seldom gets.

You do not wait for the complete scarlet fever picture before prescribing Belladonna, which can be useful in a very wide number of common complaints.

Only, the peculiarities — the " modalities "of Bell. must be these, to call for the drug.

For instance, it is one of our greatest headache remedies : but their characteristics must be those of Bell. viz, bursting, throbbing headache, usually with its fiery red hot face ; and here Bell. will cure, even where there is no sore throat, no high temperature, no red rash.

Or again, a very dry, stiff, smooth, swollen throat will suggest Bell., without the bursting head, or the bright eyes with dilated pupils. But throat, or head, or whatever it may be, must be of the Bell. type, or nothing doing. Patchy, septic throats with excessive, perhaps offensive salivation will not be affected by Bell.

They are outside its picture and its range of action.

Drugs become very dear to memory when one has once seen their extraordinary promptitude in rescuing someone near and dear from desperately threatening conditions. Such a drug is Crotalus horridus.

We have written of this elsewhere, but cannot omit it from our Drug Picture of rattlesnake.

A young R.E. officer, home from delimitation work on the Gambia and from frequent attacks of malaria and much quinine

which disadvantages pursued him home, sent down a message one morning, " I have got black water fever ". . . . And, oh ! the fearful rapidity of that deadly disease ! In a few hours inability to lift head from pillow : yellow all over ; chest going green : stool black with blood : urine nearly-black jelly. Then the starting of the dreaded black vomit, supposed to be fatal.

One can never forget the peculiar sound of that constant retching the following night, when we sent to beg Crotalus from a grandson of Hahnemann , an old man who lived in the neighbourhood.

Then Crotalus with a few doses (in alternation) of Phosphorus, prescribed by the homoeopathic doctor who had been called in, and who had had more experience of Phos. in hemorrhagic conditions ; and the rapid, glorious subsidence of all the terrible symptoms : so that the few fateful hours — the very few — gave life for imminent death. But of course the pace of remedies is a most important factor, and the pace of Phos. would have been quite inadequate for such a disease. . . . .A few weeks later, when a large palmar abscess supervened, very fierce and painful, with high fever, Crotalus came again to the rescue, and, the " basinful of pus " as the surgeon expressed it, having been let out, summarily finished the matter.

Never did abscess get well more quickly and completely. No wonder one learnt to regard that particular snake venom with peculiar veneration, and to use it enthusiastically again and again in septic conditions : — septic foci, even in the gums ; whitlows, abscesses, especially where there was much " spoilt " dark, uncoagulable blood. Its rival here being, perhaps, Lachesis' but one has an idea that Crotalus is more rapid, more deadly, and more yellow.

Another case of years ago : — a young girl, dying in hospital of malignant disease, her pitiable emaciation dark yellow, almost brown. Crotalus strikingly improved her appearance and her condition ; for the time, anyway.

And yet one more well remembered triumph for rattlesnake : a memory from medical school days. A surgeon lecturing to the students, faltered, sat down, turned yellow, buried head between knees in the effort to retain consciousness. He explained that he had been operating on a bad septic peritonitis the previous afternoon, when he had pricked the finger of one hand, and cut the other hand. There were already glands in both axilla.

The magic effects of Crotalus, " one of the homoeopathic medicines " was explained to him, and there was a rush to get the promised remedy and to deposit it at his house. Next morning a glad message came through, " Tell the students that I am much better." A fortnight later he was lecturing again, and lingered to speak his acknowledgements. " I took your medicine. I also took quinine. But the man who did the same thing at Charing Cross — died."

Hence Crotalus stays " grappled to one's soul with hoops of steel ", and in writing of the drug one desires that others should realize what a power resides in the poison of the rattlesnake — one of the deadliest and most rapidly fatal of all the snake poisons.

The Cyclopoedia of Drug Pathogenesy amply attests to that. But — the greater the poison the greater the remedy, provided you know how to prepare and use it. And here it is helpful to remember that, as Hahnemann proved and laid down, no poison is dangerous after the third potency, — that is " one in a hundred three times ; or one part in a million. But, not just mixed, however painstakingly !

The mixture would probably be irregular, imperfect — not safe. It must be " potentized " after the manner of Hahnemann , viz. one drop in a hundred of alcohol or water (according to its solubility) vigorously succussed ; and one drop of that (the first centesimal potency) in another hundred of the medium, again succussed, to make the second centesimal potency ; of which again, one drop in 100, once more well succussed, to give the third centesimal potency : one in a million. And here you may be perfectly happy in prescribing the most virulent remedies. Their power to harm is gone from them, leaving only their power to heal.

Our remedies for sepsis are so many and so convincing that people find it difficult to diagnose between them. The most frequently considered being Lachesis, Crotalus hor., Tarantula cub., Anthracinum, Pyrogen, Sepsin : while the less deadly, or at 'all events the less rapid cases, are brilliantly controlled by Hepar, Silicea, Mercurius, etc. But, as said, the pace of the disease must be taken into account : and the most rapidly fatal diseases are those of the tropics, and the most rapidly-acting remedies we have are the tropical snake and spider venoms.

Let us try to give suggestive differentiating symptoms. In Pyrogen, ceaseless movement, as a rule ; marked incoordination between pulse and temperature, such as a high temperature with low pulse-rate, or, less frequently, the reverse. In axillary abscesses one thinks, after happy experiences, of Tarantula cub. ; also for the virulent insect-stings of some hot summers ; and, since Tarant. cub. is said to be made from a rotten Cuban tarantula, it will probably come into line with Pyrogen and Sepsin.

The latter won its spurs in the South African War, where it proved remarkably curative of the dysentery that there prevailed (See Clarke's Dictionary). But one must not forget Anthracinum, with its great record not only for anthrax, but for septic states, and for boils and carbuncles with burning pains. (Ars.)

But our two most usual snake poisons being Lachesis and Crotalus hor., let us try to extract their diverse, and their common characteristics, as pointed out by various observers.

Allen (Keynotes), says, " In Lachesis, the skin is cold and clammy : in Crotalus, cold and dry. Crotalus has the greatest tendency to haemorrhages : Blood dark, fluid, offensive." " Hemorrhagic diathesis : blood flows from eyes, ears, nose and every orifice of the body : bloody sweat. " Purpura haemorrhagica ; comes on suddenly from all orifices ; skin, nails, gums."

But they are both hemorrhagic remedies : only Crotalus is even more so. And they have many other symptoms in common. Both have loquacity : both are worse for sleep, and sleep into an aggravation ; and both are intolerant of pressure and clothing about the abdomen : — Lachesis from its intense sensitivity to touch, pressure and constriction : Crotalus more probably from its specific effect on the liver. Both have blueness of parts ;

Lachesis especially so : both have yellowness and jaundice, but Crotalus most especially so. Crotalus more affects the right side ; Lachesis the left.

Nash (Crotalus) seems to have shown its greatest usefulness in diseases which result in a decomposition of the blood of such a character as to cause hemorrhages from every outlet of the body ; even the sweat is bloody. . . . Useful in diphtheria when the profuse epistaxis occurs which marks many cases of a malignant type.

In haemorrhages of the nose in an old man of broken down constitution, where none of the remedies usually applied did the least good, Crotalus acted promptly and no doubt saved the man's life. This was a patient of my own, and though he had frequent attacks before, he never had another after the Crotalus. As would be expected with such a remedy, there is great prostration at such bleedings.

Black Letter Symptoms

Yellow colour of eyes.

Blood oozes from ears.

Bleeding from nose and all orifices of body.

Tongue protruded.

Black vomit.

Jaundice : malignant jaundice ; dark hemorrhages from nose,

mouth, etc., dark scanty urine.

Easily tired by slightest exertion.

Sudden and great prostration of vital force.

Yellow fever : hemorrhagic tendency, oozing of blood from every orifice, and even pores of skin.

Skin yellow.

Vomiting of bile or blood.

Fetid, bilious or bloody stools ; liver tender ; heart weak ; fainting.

Fevers resulting from septic absorption and in purpuric cases of zymotic diseases ; puerperal fever.

Yellow colour of whole body.

Broken down constitutions.

Some Italic, Or Peculiar Symptoms

Delusions : as mistakes in keeping accounts : forgetfulness of figures, names, places.

Surrounded by imaginary foes or hideous animals.

Loquacious delirium : desire to escape from bed.

Suspicious and snappish.

Frightful headache. Cerebral congestion.

Epistaxis, in broken down constitutions or depraved state of blood ; blood thin, uncoagulable, dark : (?) with flushes of face, vertigo, or fainting.

Yellow colour of face : or livid, bloated ; purple ; face tumid ; blueness round sunken eyes : chalky : death-like : leaden coloured.

Distended red face.

Tongue and all round throat feels tied up : cannot speak a word.

Tongue swollen to nearly twice the normal size.

Swelling of tongue till there is no more room in mouth.

Tongue protruded.

Cancer of tongue with hemorrhages.

Tightness, constriction of throat.

Deglutition impossible, from spasm of oesophagus.

Malignant diphtheria : blood poisoning : oedema or gangrene of fauces.

Swelling, angles of lower jaw.

Unquenchable, burning thirst.

Nausea on movement.

Bilious vomiting.

Cannot lie on right side or back without dark green vomiting.

Everything looks yellow : at first everything looked blue.

Pylorus constricted.

Agonizing pain, or violent cramp, in stomach.

Cannot bear clothes around stomach and hypochondria.

Sinking sensation : craving for stimulants.

Haematemesis : little or no tendency to coagulate.

Pain in liver and top of shoulder.

Skin very dark brown.

Jaundice : malignant jaundice.

Red tipped tongue.

Urine jelly-like and red like blood.

Dysentery : of septic origin : excessive flow of dark, fluid blood, or involuntary evacuations.

Great debility and faintness.

Urine : extremely scanty, dark red with blood ; jelly-like ; green-yellow from much bile.

Dull, continuous aching pain, region of heart, down left arm and through to left shoulder blade.

Feels a drawing from sole of right foot through bone of leg.

Hering (Guiding Symptoms) gives the relationships of Crotalus.

Antidoted by Lachesis. Compare : Lachesis, Naja and Elaps. Crotalus is preferable in fluid haemorrhages, yellow skin (hence in yellow fever with black vomit, etc.), epistaxis of diphtheria. Naja has more nervous phenomena.

Lachesis has skin cold and clammy, rather than cold and dry : haemorrhages with charred straw sediment ; and more markedly ailments of the left side. Elaps. is preferable in otorrhoea, and in affections of the right lung. The Cobra poison coagulates blood into long strings. The Crotalus poison is acid : the Viper neutral.

The Rotten snake causes more sloughing than any other.

Kent has much to say about Crotalus hor., and he fully realizes its unique importance. . . .

The diseases that call for the use of such a substance as Crotalus are very grave. . . . Its symptoms are peculiar. There can be no substitute for it, as there is no other remedy, taken as a whole, that looks very much like it. The other snake poisons are nearest, but this is the most dreadful of all.

Alcohol has been used in great quantities in snake bites, and it has frequently prolonged or even saved life. . . . But, if he lives through the violent attack he goes on forever manifesting the chronic effects. . . . A peculiar periodicity has been manifested, every spring, as cold subsides and warm days begin. . . . The periodicity of the snake poisons is related to the Spring.

The patient sleeps into an aggravation.

In its earliest manifestation Crotalus is like unto the zymotic changes we find in scarlet fever, in diphtheria, in typhoid and in low forms of blood poisoning : cases which come on with great rapidity, breaking down of the blood, relaxation of the blood vessels, bleeding from all orifices of the body, rapidly increasing unconsciousness like one intoxicated and besotted in appearance. . . Scarlet fever when it becomes putrid : typhoid when it becomes putrid, diphtheria with much bleeding and putridity.

The body appears mottled, blue intermingled with yellow. . . . Jaundice comes on with astonishing quickness . . . black and blue spots intermingled with yellow. Haemorrhages (as already noticed). Crotalus is indicated in disease of the very lowest, the most putrid type, coming on with unusual rapidity, reaching that putrid state in an unusually short time. . . .

As the blood oozes out it becomes black.

Awful nervousness : trembling : tremulous weakness. Sudden and great prostration of the vital powers. The forms of yellow fever with great prostration. Loquacity.

But, with Lachesis the loquacity is so rapid that if any one in the room commences to tell something, the patient will take it up and finish the story, though he has never heard about it. No one is permitted to finish a story in the presence of a Lachesis patient. Crotalus does that too, but he will take it up and mumble, and jumble and stumble over his words . . . a low passive state like intoxication ; in Lachesis it is wild excitement.

He sleeps into his symptoms. All the snake poisons more or less sleep into troubles. . . . Headaches ; dull, heavy, throbbing occipital headaches : or whole head in a state of congestion. Head feels too full: as if it would burst. Headaches that come on in waves from the back : a surging of blood upwards. Worse change of position.

This is a wonderful bilious remedy : sick headaches, vomiting of bile in great quantities. Cannot lie on right side or back without instantly producing black, bilious vomiting.

Coldness like a piece of ice in stomach or abdomen. Has cured ulceration of the stomach : greatly restrained the growth of cancer of the stomach when there was much vomiting of bile and blood. . . . Cancer of uterus, etc. . . .

Boils, carbuncles and eruptions are surrounded by a mottled blue, splotched or marbled state. But the peculiar feature is the doughy centre. Around the boil or carbuncle for many inches there is oedema, pitting on pressure : and it will bleed a thick, black blood that will not coagulate. In puerperal fever there is a continuous oozing of black, offensive blood that will not coagulate. In abortion, with like bleeding. Or in menstruation during typhoid, with dark, liquid offensive continuous oozing.

Sleep terrible. Rises from sleep in a fright : has horrible dreams of murder, death, dead bodies ; even the smell of the

cadaver is dreamed of. Suspicious. Craves intoxicating drinks : delirium tremens. Kent thinks that, properly used, it may remove the appetite for strong drink.