The Poison Ivy grows in thickets and low grounds in North America, flowering in June. It was introduced into England as a plant in 1640. In 1798 Dufresnoy of Valenciennes first used it as a medicine. It was brought to his notice by the cure of a young man of an herpetic eruption (dartre) of six years' duration, through his being accidentally poisoned with the plant. Dufresnoy used it successfully in eruptive diseases, paralysis, rheumatism, and amaurosis. The milky juice, which turns black on exposure, is used as a marking ink (like Anacard.) and as an ingredient of varnishes for finishing boots. The tincture contains Rhoitannic acid (C18H28O13) and Toxicodendric acid, a poisonous, volatile principle. A peculiarity of the plant is that it is more poisonous during the night, and when bursting into leaf, or at any time in June or July when the sun is not shining upon it. Absence of sunlight, together with dampness, seems to favour the exhalation of Toxicodendric acid. "An acrimonious vapour, combined with carburetted hydrogen, exhales from a growing plant of the Poison Oak during the night. It can be collected in a jar, and is capable of inflaming and blistering the skin of persons of excitable constitution who plunge their arms into it" (Porcher, quoted by Millspaugh, from whose work I take the above facts). Those who care for Signatures will not fail to connect the cardinal aggravations of Rhus—at night and from damp—with the increased virulence of the plant at night and in damp atmosphere. (One prover of Rh. ven. was not influenced by contact with the leaves when his skin was dry, but only when perspiring; and the worst poisonings with Rh. divers. happened to persons when moist and heated.) Millspaugh relates instances of Rhus poisoning: Out of ten men employed to clear a piece of land of shrubs among which the Poison Vine greatly predominated only four escaped: "Most of the men soon began to show signs of being tired, and at the end of the fourth day six of them were flat on their backs too sick for anything." Actual contact with the plant is not necessary in order to produce its effect. One sultry day in June a young lady drove a croquet ball across a lawn to a clump of Poison Ivy that grew beside it. Knowing her susceptibility she reached under the plant and drew out the ball without touching a leaf. During the evening of the same day her face began to itch and burn, and in the night it swelled so that the eyes were not merely closed, the lashes even disappeared in the swelling. It took nearly two weeks for her to recover. Millspaugh summarises the effects of Rhus (the majority of poisonings have been caused by Rh. rad.) as follows: First redness and swelling of the affected part, with intolerable itching and burning, followed by vertigo, weariness, and a sort of intoxication. Infiltration of face and eyes, and agglutination of the lids after sleep; great restlessness, pain, thirst, and fever. The surface of the skin becomes after a time studded with confluent bullae where the cellular tissue is loose, then a dermatitis follows resembling erysipelas; this may spread rapidly and finally be communicated to the mucous membranes. This is followed by swelling of the mouth and throat, cough, nausea, and vomiting. Rheumatoid pains develop about the joints, and a painful stiffness asserts itself in the lumbar region, while the legs and arms become numb. Confusion of mind and delirium may then set in, during which the patient may become so ill-humoured, restless, and anxious that he will jump out of bed. Concomitants are: Inflammation of eyes, dilation of pupils, weak vision, sometimes diplopia; epistaxis; brown-coated tongue with triangular red tip; swelling of parotids; difficult swallowing; griping; diarrhoea; profuse urination; oppression; rapid pulse; prostration; soreness of muscles, < by rest; > by exercise; sleepiness; chilliness followed by fever and copious sweat.—The American provings were made with Rh. rad., and the majority of the poisonings have occurred from this plant. Though it is not certain that Hahnemann used Rh. tox. at all, or exclusively, Jahr gave a separate presentation of the Rh. rad. symptoms. H. C. Allen (quoted Critique, vi. 409) notes in Rh. rad. a periodicity which marks it as a great antipsoric. It is, he says, on deeply psoric or tubercular constitutions that its toxic effects are most felt and longest lasting, and these constitutional effects "seem ineradicable without the antipsoric." One case of his showed a return of symptoms at 12.45 a.m. on July 5th, each year during sixteen years, except the year 1898, when the previous use of Tuberculinum, a dose once each month, prevented an attack; and modified the 1899 attack. Guernsey considers Rh. rad. deeper acting than Rh. tox., being indicated in phlegmonous erysipelas, especially where it begins in ankles and moves gradually up the leg, moving in the deeper tissues, no fever; and for axillary glands when the swelling is very deep and hard. Farrington gives as distinctive indications for Rh. rad.; Occipital headache with rheumatic stiffness of nape. Drawing tearing pains in legs. Pleurodynia when the pains shoot into the shoulders. Mahony (M. A., xxvi. 109) reports a case of eczema on perineum and scrotum with sweat in cleft of nates, both relieved in a week with Rh. rad. 12, twice daily.—Hahnemann quickly perceived the keynote of the Rhus symptoms: "We observe," he says, in his preface to the proving, "this curious action (which is found in few other medicines, and in these never to such a great degree), viz., the severest symptoms and sufferings are excited when the body or the limb is at rest, and kept as much as possible without movement. The opposite of this, namely, an increase of the symptoms by movement, is much more rarely, observed." He contrasts Rhus with Bry., which has almost identical rheumatic pains with the opposite Conditions. Neidhard adds a note in Hempel's Jahr which brings out a modification of this "< by rest" which is of the greatest practical importance, as I can testify. Neidhard says that the disease in which he has made most use of Rhus is a form of rheumatism common in North America, and characterised by the following symptoms: "Rigidity, paralytic weakness of the joints, with stinging pain along the tendons and muscles. Swelling and redness on or near the joints. Rheumatism of the hip-joint and wrist seem to be most effectually controlled by its action. The greatest rigidity and pain is experienced on first moving the joints after rest, and on waking up in the morning. After the joints are moved for a while the pain is lessened." Contrasted with Bry., Rhus has: "The more he moves the > he is"; whereas Bry. has "The more he moves the < he is." It is necessary to bear in mind this distinction or a wrong prescription will often be made. Rhus has not only < during rest, but < after resting also. However, Rhus and Bry. complement each other: it is not unusual for the Conditions of a case to change under one of these remedies, and then the other will be required. Hahnemann says "these two antagonistic sister remedies "—each in its place—successfully met the typhus which prevailed in the countries desolated by the war which raged from the summer of 1813 and onwards. Of 183 cases treated by Hahnemann in Leipzig not one died. This restlessness of Rhus will be found to qualify the symptoms in a large proportion of the cases in which it will be called for. It is as restless as Acon. and Ars., but in a different way from either. With Rhus it is due to the pain and soreness temporarily > by movement; or a nervous internal uneasiness which makes the patient want to be on the move when there is no particular pain present (Nash). The presence of restlessness is a leading indication for Rhus in fevers, typhoid and other. Other indications are—clouded sensorium, stupefaction, muttering delirium, dry tongue. The characteristic tongue of Rhus is dry or dark coated, with triangular red tip. In intermittents a characteristic is "Cough during the chill." Hahnemann pointed out another keynote of Rhus: "Multiplied experience has taught me that Rhus is the most efficacious and the specific remedy for the frequently fatal effects of over-lifting, inordinate exertions of the muscles, and contusions." He was, of course, led to this inference by the "bruised and sprain-like pains" and "stiffness" of the provings. Rhus is in the front rank of vulneraries. It meets threatened abortion from a sprain; and also prolonged after-pains and other effects of the strain of a severe labour; axillary abscess from this cause has been cured with Rhus. Straining, rheumatic coughs. Ailments from straining a single part, muscle, or tendon; over-lifting, particularly from stretching high up to reach things. There is an analogy to this in the dreams—dreams of great exertion: rowing, swimming, working hard at his daily occupation. Rhus has cured many forms of paralysis: Rheumatic paraplegia from getting wet, lying on damp ground; sleeping in damp sheets; after exertion; after parturition, sexual excess, or fevers. Ptosis. Paralysis of single limbs. Numbness of parts paralysed. Facial neuralgia, lumbago, and sciatica (esp. of left side), with restlessness; coming on after a wetting or after a bath are cured by Rhus. The neuralgic pains and eruptions make Rhus a perfect simillimum in many cases of herpes zoster. Fever-blisters round mouth. Howard Crutcher relates (M. A., xxii. 38) how after standing on a wharf with his right side exposed to a cold wind from the river he began to have severe pains shooting up the ulnar nerve, a steady ache uniform throughout arm and forearm, but extremely severe in structures beneath deltoid. The pain was much < in a warm place; it did not interfere with movement. At 8 p.m. Crutcher took Rhus 30 dry on the tongue, and almost immediately he was called into the open air again. In thirty minutes the pain was decidedly better; in ninety minutes it was gone. A case of Rhus poisoning reported by Morey (Med. Cent., February, 1898; H. W., xxxiii. 309), showed an effect on the menstrual period, and was remedied by Crocus. Miss M. was severely poisoned by Rh. rad. (it is called "Ivy") in July, 1895, during her menstrual period. She was treated with Bell. and Rhus internally, and an Oxide of Zinc ointment externally, and appeared to make a rapid recovery. On September 1, 1897, without further known poisoning, another similar attack developed during the menstrual period, and frequent minor attacks had occurred in the two years, always at the time of the menses. Later on she had another attack which developed rapidly and greatly alarmed her. The menstrual flow commenced a week before she came to Morey, was very scanty, dark, and clotted, as had been the case for sometime. The flow had scarcely well begun when it ceased suddenly and the eruption appeared. Croc. was given, and the first dose re-established the flow, which was normal in appearance and quantity, and the eruption at once disappeared. Peculiar Sensations are: As if intoxicated. As if asleep. As of a weight behind right orbit. As of a band strapped across forehead. As if head were swelling out. Brain, as if loaded; as if torn; as if loose; as if fluctuating; as if a quantity of blood shot into it when stooping. As if muscles of back of head screwed together. As if a hundredweight on nape of neck. As if a veil before eyes. As of sand in eyes. As if lids difficult to move. As if jaw would break. Teeth as if being torn out; too long; loose. As if tongue had been skinned. As if a hernia about to protrude. As if pharynx inactive or paralysed. Stomach, as if overloaded; as if a stone in; as if pit of stomach swollen or drawn together. Hypochondria and abdomen as if beaten. Digging as if caused by a worm. As if a knife in right abdomen. As if something torn loose in abdomen, chest, and inner parts generally. As if a lump lay like a pressing heavy weight in abdomen. As if one side of rectum grown up. As if everything would come out of rectum. As if breath were stopped at pit of stomach. As if sternum were pressed inward. As if sprained or dislocated: back, jaw, arms, wrist, hip, knee, ankle. As if one had been lying in an uncomfortable position. As if bruised in right side of lumbar vertebrae and in small of back. As if flesh of small of back had been beaten. As if back were broken. As if some one were pressing on left shoulder. As if hand were held in hot water. Hand, as if withered; as if lame; as if pins pricking points and palmar surfaces of first phalanges of fingers. Rectus cruris muscle as if bruised. As if hamstrings and tendons of limbs too short. As if knee too-short. Legs (and right foot) as if made of wood. Feet and ankles as if asleep. Heels as if stepping on pins. As if running nails under skin of heels. As if walking on needles. Joints as if bruised. As if bones ached. As if sinking through bed. As if something forced him out of bed. Bones, as if being scraped; as if flesh being torn loose from them. As if whole body was burning. As if cold water poured over him. As if blood ran cold through veins. As of subcutaneous ulceration. As if inner parts grown together. Peculiar Symptoms are: Craving for cold drink and laborious dreams. Herpes alternating with asthma and dysentery. Chokes easily on swallowing. Swallowing = pain in middle of back. Anorexia in palate and throat. Nausea in chest. Taste of blood with cough (no blood being raised). Coldness in left tibia. Scalp sensitive, < turning hair back. Hour-glass contraction of abdomen. The symptoms are: < By touch; > by rubbing. < From riding; blows; jars; sprains. < By rest; and commencing motion; > continued motion. (Lying down > colic and diarrhoea.) Lying on hard floor with pillow under back > pain in back. Must hold head to > weight in it. Bending head back > pain in occiput; = pain in head and down spine. Limbs lain on fall asleep; no sweat on them. < Side lain on. Lying on left side = palpitation and pain in heart. Swallowing = pain in back. Inclination to stretch. Stretching = cracking in knees; soreness in abdomen. Unwonted exercise = paralysis. Over-exertion = palpitation; < coxalgia. < Evening; night; morning after sleep. Sensitive to cold open air; raw north-east winds. Effects of drinking cold water; getting wet, especially after being heated, cold bathing; sea bathing. > By warmth and hot applications. < Warmth of bed. Sciatica is > by warmth from exercise. < Change of weather; damp, stormy weather; before a storm; snowstorm; in autumn; in winter. Nausea < after eating. Craves cold water, which is vomited immediately.