back Lachesis Mutus

Synonym.- Trigonocephalus Lachesis. Natural order.- Ophidia. Common name. - Lance-headed Viper of Brazil. Preparation.- Triturations of the venom.

GENERAL ANALYSIS.

Acts upon the cerebro-spinal system, and more especially upon the pneumogastric. The nerve centres are poisoned, and as a result, prostration, convulsions and unconsciousness ensue, while from the influence of the pneumo-gastric we obtain irritable conditions of the throat, larynx, bronchi and heart, yet not passing into distinct inflammation. As a further result of the poison, the blood becomes inoculated, decomposition sets in, the fibrin of the blood is destroyed, and we have, resulting ecchymoses, haemorrhages, asthenic inflammations, abscesses, malignant inflammations, gangrene, pyaemia; and with all, and as a result of all, a general typhoid condition. The chief characteristic of Lachesis is the aggravation of all its symptoms after sleep.

CHARACTERISTIC SYMPTOMS.

Mind. - Memory weak (Agar., Ambr., Anac, Kreos., Merc, Natr. mur., Nux m., Phos. ac); makes mistakes in orthography (Lyc.). Confusion as to time. Great mental activity, ideas crowd rapidly {Coff. c, Cinch.). Loquacious; in the evening. Constantly changing from one subject to another (Cimic), with mocking jealousy, satire, ridiculous ideas, frightful images (Hyos.). Indifference. Great sadness and anxiety on awaking in the morning (Natr. mur.). oProud {Plat., Strain.)', jealous (Apis, Hyos.); suspicious. oThinks herself under superhuman control.

Head. - Vertigo in the morning on waking (Alum., Phos., Nitr. ac); momentary, on closing the eyes (Thuja). Headache, extending into the root of the nose (Merc. iod.). Headache with flickering before the eyes. Eush of blood to head. Heat in head. Pressive headache, with nausea. Headache in left frontal eminence; deep internal. Headache over the eyes and in the occiput, every morning on rising. Throbbing headache over right eye. One-sided headache; pains intense, extend to neck and shoulders, with tension in muscles. Neck stiff (Rhus tox.); tongue paralytic. Pressing, bursting pains in the temples; better when lying down. Sticking and boring in vertex. Heaviness, like lead, in the occiput (Carb v., Chel.); can scarcely raise head from pillow, with vertigo. Sensitiveness of scalp in left temple from vertex down, and left side of face on touch or moving muscles, a sensation as if sunburnt. Numbness and crawling on left side of head, when touched or on moving the muscles in the evening and morning with crawling. oHair falls off ( Graph., Merc, JVitr. ac, Phos., Sep., Sulph.); worse during pregnancy; aversion to sun's rays (Bell., Glon., Natr. carb.).

Eyes. - Dimness of vision; black flickering before the eyes; often makes reading difficult. Fog before the eyes (Kali iod., Merc, Puls., Sulph.); bright blue rings, filled with fiery rays, about the light; zigzag figures. Sensitive to light. Lachrymation. Sticking, drawing pains in and above the eyes.

Ears. - Pain in ears, with sore throat. Tearing, extending from the zygoma into the ear. Whizzing, as from insects in the ear. Hearing diminished.

Nose.- Coryza, preceded by headache (Hydras.); and stiffness of nape; discharge watery, with red, sore nostrils; scabs in the nose (Merc). Nosebleed; blood thick and dark. oNosebleed in amenorrhea, typhus, etc. oParoxysms of sneezing in hay asthma. Many symptoms end with catarrh.

Face.- Pale, earthy, gray color of face (Ars.). Erysipelatous inflammation of the face (Bell., Graph., Hep. s.,Rhus tox.). Heat and redness of the otherwise pale face. Tearing in zygoma, extending into the ear. Left side of face and lower jaw swollen and sensitive to touch. Trifocal neuralgia, left side, orbital; heat running up into the head. Feeling of stiffness of the malar bone, coming from the cer- vical glands. Itching of the face.

Mouth.- Toothache, tearing, jerking, sticking (Puls.); often extending through jaw to ear; periodic; after waking; after eating (Ant. crud., Nux v., Staph.); from ivarm and cold drinks. Feeling as if the teeth were too long when bitings them together. Gums bleeding; swollen; spongy. oTongue dry, red, black, stiff, cracked (Bapt., Bell., Naja, Rhus tox.); swollen and covered with blisters. oDifficult speech; tongue heavy (Mur. ac); cannot open mouth. oTongue trembles when protruded, or catches behind the teeth. Burning pain and rawness in mouth, then apthous and denuded spots. Mouth sore, parched, dry, apthous (Borax, Hydras., Merc, Iodi.).

Throat. - Hawking of mucus, with rawness in the throat. Dryness in throat at night on waking, without thirst. (Apis, Nux ni., Puls.). Throat seems swollen, as if two large lumps came together, on empty siu allowing; better from swallowing food. Feeling of a crumb of bread left sticking in the throat, obliging her to constantly swallow. Tonsilitis; worst on left side; choking when swallowing; or when swallowing, pains from throat to ear (Ainbr., Bell., Kali bi., Hep. s.); neck sensitive to touch (Apis). Pain and soreness begin left side of throat. Liquids cause more difficulty in swallowing than solids {Bell.). External throat very sensitive to touch (not painful, but an uneasy sensation); in evening on lying down, with suffocative sensation; even to touch of linen.

Stomach. - Appetite variable; at times good, at others no ap- petite at all. Thirst, with dry tongue and skin. Desire for oysters. Eructations, which relieve; amounting to vomiting. Dyspepsia; worse after eating (Cinch., Nux v., Puls.). Stitches extending into the chest. Gnawing in stomach; relieved after eating, but returns when stomach gets empty. Painless gnawing. Pressure in stomach; after eating; with weakness in knees. Great discomfort of having clothes tight around the waist (Bry., Calc. c, Crot.).

Abdomen. - Tearing and cutting pains in right side of abdo- men. Abdomen distended and hard; hot; sensitive; painful (Acon., Bell.). Sensation as if ligaments from stomach were stretched, so that she must wear clothes very loose. Drawing from anus to umbilicus. Feeling of emptiness in the abdomen. Ulcerative pain about Jiver; inflammation and abscess. oSwelling in esecal region; must lie on back, with limbs drawn up; typhlitis. oAbdomen hot, sensitive; painfully stiff from loins down thighs; peritonitis; pus formed.

Stool and Anus. - Burning in anus during and after stools (Ars., Canlh., Merc, Natr. rnur., Sulph.). Constriction of rectum; of anus. Protrusion after stool. Beating in the anus, as with little hammers. Stool lies close to anus without passing and without urging. Spasmodic pain in anus before and after stool. Closed feeling in anus, tormenting, constant urging in the rectum, not for stool Stools watery offensive, dark (Ars.); watery, frequent, sud- den, about midnight, offensive, ammoniacal; soft, bright yellow; pasty putrid. Obstinate constipation (Alum., Nux v., Op., Plumb.). Hemorrhoidal tumors, protruding (Aloe, Calc. c., Mur. ac, Puls.), owith stitches at each cough or sneeze.

Urinary Organs. - Urine frequent. ofoaming, black. Pressure in bladder, with frequent urging. Sticking, cutting pains, or soreness in fore part of urethra. Inefficient urging to urinate.

female Organs.- o Menses scanty, feeble, but irregular; blood black. Labor-like pain during menses (Caul., Cimic, Puls.). o Uterine and ovarian pains; relieved by a flow of blood. oPains, like a knife thrust into abdomen. Uterus will not bear contact even of bed clothes; they cause uneasiness. oHot flashes; metrorrhagia and other troubles during climacteric period (Sang.).

Respiratory Organs.- Hoarseness; rawness, scraping and dryness in larynx (Acon., Caust., Cham., Phos.); sensitive to touch (Acon., Spong.); necessity to swallow; constant necessity to hawk. Voice will not come because something in larynx prevents, which cannot be hawked loose, though mucus is brought up. oSuddenly something runs from neck to larynx, and interrupts breathing; awakens him at night; spasm of glottis. Larynx and throat painful on bending head bachzvard. Pain in sternum at night, with burning in chest; under left heart. Larynx sensitive; cannot bear anything about the throat (Apis); causes suffocation. Cough worse after sleep; caused by pressure on larynx; dry and haching; caused by touching the throat; from tickling the throat; from crawling in ulcers in throat; from contact with open air, from smoking (Ign.); in evening on lying down. Constantly obliged to take a deep breath (Ign.); worse when sitting. After a long wheezing cough, suddenly spits up profuse, frothy, tenacious mucus. Shortness of breath; attacks of suffocation (Acon., Ars., Apis, I pec, Phos. ) . Oppression of the chest; in sleep. Spitting large quantities of ropy mucus.

Heart.- Constriction about the heart (Cact.). Cramp-like pain in the precordial region, causing palpitation, with anxiety. Feels beating of the heart, with great weakness. Irregularity of beats in the heart (Cact., Laur.). oRestless, trembling anxiety about the heart; suffocation on lying down; weight on chest; heart feels constricted; rheumatism of heart. oFainting, with pain in heart; nausea; pale face; vertigo.

Neck and Back. - Stiffness of the nape of the neck (Kali c, Ign., Phos., Rhus tox.); sensitive to external pressure. Pain in small of back, as if lame and weak (Rhus tox.). Drawing pains in small of back; extending into hips and legs.

Limbs.- Great weakness in both arms and legs. Aching pains in shin bones. Weakness in knees after eating. Ulcers on lower extremities (Ars., Lyc.). Perspiration on feet. Red, bluish, painful swellings of legs and feet.

Generalities. - Weakness of whole body in morning on rising. Emaciation with suffering and weakness. Trembling as from anxiety, without anxiety. Sudden jerking of whole body when sitting. Starting from below. Necessity to do everything rapidly. Great physical and mental exhaus- tion, in mornings. Fainting, with pain in heart; nausea; pale face; vertigo. Pricking, pulsating, tearing pains (Puls.). oConvulsions; epilepsy (Bell., Calc. c., Cupr.). Affected parts look bluish. oRestless tossing about, with moaning in children with sore throat. Restlessness and longing to get into the open air. Great inclination to lie down, especially after eating. Rheumatic pains, first in the left side, then in the right. Feels bruised in the morning after waking. Slight touch intolerable. oComplaints mostly on left side of body. Obliged to wear clothes loose; cannot bear the contact.

Skin. - Sore spots become fungoid, dark-red, brownish, with whitish spots, burning on wiping. Superficial ulcers, foul at the bottom (Merc, Nitr. ac); black-bluish appearance. Miliary eruption; rash appears slowly, or turns black or bluish. Erysipelatous eruptions. Carbuncles, with purple surroundings. Old scars break open and bleed; the open spots dark-red, looking like a flat sponge. Itching over the whole body.

Sleep. - Sleepiness, without being able to sleep (Bell., Cham., Op.). Tossing and moving during sleep. Lively and wide wake in the evening. Restless sleep, with many dreams and frequent waking. Waking in fright at a trifle. Amorous dreams. Dreams with meditation.

Fever. - Chilliness in back (Abies can.); commence in small of back (Caps., Ewpat. per/.). Coldness in evening, with chattering of teeth. Shivering during the heat. Chill runs up the back; on alternate days. Icy coldness of the feet; with oppression of chest. Heat as from orgasm of blood; mostly at night (Calc. c). Heat particularly in hands and feet, evenings; burning in palms and soles (Sulph.). Perspiration at night (Calc. c, Cinch., Phos., Phos. ac, Sil., Sulph.). oIntermittents, recurring every spring, or after suppression in the previous fall, by quinine.

Aggravation. - After sleep; in morning; in evening; after eating; from acids or alcoholic drinks; from sun's rays; from extremes of temperature.

Amelioration. - From loosening the clothes; from eructations.

Conditions. - Often useful in ivomen during climacteric period. In persons of a phlegmatic constitution, with disposition to melancholia and indolence. Persons with dark eyes and dark complexions.

Compare. - Apis, Ars., Bell., Caust., Cinch., Hep. s., Lactic ac, Lyc., Merc, Naja, Nitr. ac, Phos., Puls., Rhus tox., Sulph., Tarent.

Antidotes.- Ars., Bell., Merc, Nux v., Phos. ac; Heat, Alcohol, Salt. Acids disturb the curative action.

THERAPEUTICS.

A knowledge of the general clinical range of Lachesis is very readily inferred from the preceding general analysis and pathogenesis. It is especially useful in diseases characterized by blood decomposition and tissue degeneration on the one hand, and the peculiar nervous phenomena upon the other, while the two combined present a perfect picture of the general action of the drug, only applicable, however, in the individual case when the symptoms of the latter correspond with those of the drug. It is a valuable remedy in all adynamic and typhoid types of disease, where the symptoms correspond, whether the case be a true typhus or typhoid fever, or the condition accomonying asthenic inflammations, ulcers, suppurating wounds, abscesses, malignant diseases, eruptive or otherwise, gangrene, pyaemia, etc. The discharges, whether from the bowels or from ulcers, etc., are always offensive, and in case of local inflammations of whatever nature the affected parts present a bluish or dark purplish appearance. Tendency to ecchymosis and bed sores. In typhoid fever haemorrhages of decomposed blood. Purpura haemorrhagica. Indolent ulcers. Varicose ulcers. Carbuncles. Erysipelas. Pustular and other eruptions, which turn black or bluish. Fungus haematodes. Yellow fever, with characteristic haemorrhages, etc. Scarlatina of a malignant type, dark eruptions, or none at all, virulent throat symptoms, advanced stages, signs of blood poisoning, great prostration. Lachesis is valuable in a great variety of nervous troubles. Convulsions epileptic and hysterical. Chorea. Tetanus. Paralysis; left-sided; after apoplexia, or cerebral exhaustion. Progressive locomotor ataxia. Neuralgia of the spine. Coccyodynia; myelitis; neuritis; sciatica. Mania. Dementia. Melancholia. Delirium tremens. Mania after over-study. The characteristic delirium is of a low, muttering type. In mania loquacity predominates. Neuralgic headaches. Meningitis. Threatening apoplexia, especially in drunkards. Retinitis apoplectica, whether idiopathic or secondary; absorbs the haemorrhage. Haemorrhages into optic nerve, also in eye chambers. In these and other similar eye affections dimness of vision is the most prominent symptom. Defective sight after diphtheria, a paralysis of accommodation, requiring far-sighted glasses (Gels.). Keratitis. Ulcers on cornea. Orbital cellulitis, especially following operations for strabismus. Amblyopia, with lung or heart affections. Dark epistaxis in typhoid also in amenorrhoea. Coryza. Hay asthma. Chronic nasal catarrh. Facial neuralgia, especially left side. Facial erysipelas, dark, bluish hue, infiltration into cellular tissue. Gangrene of the mouth. Haemorrhage from the gums. Syphilitic ulceration of mouth and throat. Lachesis is a very valuable remedy in tonsilitis, pharyngitis and other forms of sore throat. The left side is most often affected, or beginning on right side and going to left. The throat symptoms are well defined and have been fully detailed under their appropriate head, and need not be repeated.

According to Hering, there is no remedy so often effective in breaking up an attack of quinsy at its inception, nor in promoting resolution in the later stages. A most valuable remedy in malignant diphtheria, and malignant ulcerations of the throat, the fauces and pharynx presenting a purplish appearance, great prostration and other characteristic symptoms. Gangrenous sore throat. Elongated uvula, constant inclination to hawk, hacking cough; chronic irritability of fauces. Lachesis is useful in a variety of affections of the lower air passages. Aphonia from paralysis or oedema of the vocal chords. Laryngitis, catarrhal, croupous or diphtheritic, with the sensitiveness of throat, suffocation and other symptoms already mentioned. Spasms of the glottis. Whooping cough. Subacute and chronic bronchial catarrh. Asthma, paroxysms awaken from sleep, intolerance of pressure about neck and chest, relief from expectoration. Hay asthma. Only useful in pneumonia when typhoid symptoms supervene, especially after abscesses have formed. The threatening paralysis of the lungs, greatest difficulty in breathing, with long lasting attacks of suffocation. Hydrothorax, suffocative fits, waking from sleep, cyanotic symptoms. Emphysema. Nervous cough of reflex origin, especially from uterine or ovarian disease.

Lachesis is an important remedy in the female sexual sphere. It is especially useful in ovarian disease, the left ovary being most often affected. Ovarian neuralgia. Ovaritis. Ovarian tumors. Pelvic cellulitis and peritonitis. Acute general peritonitis, pus formed, typhoid symptoms. Puerperal metritis, metro-peritonitis, offensive lochial discharge. Endo-metritis. Dysmenorrhea. Hot flashes. Metrorrhagia and other troubles during the climaxis. Cancer of the uterus. Displacements of the uterus. In all uterine and ovarian diseases the chief symptom is an intolerance of clothing or bed clothes about the abdomen, which, with other characteristics of the drug, may indicate its use in any disease of the pelvic viscera. Mastitis, bluish appearance. Cancer of the breast. Extreme sensitiveness of the nipples. Phlegmasia alba dolens. Syphilitic ulceration, especially of external genitals. Vaginal fistula? becoming gangrenous. Subacute or chronic cystitis, especially from uterine disease. Post-scarlatinal nephritis. Sometimes useful in dyspepsia and gastralgia. Gastritis in drunkards or after Mercury. Hepatitis, liver swollen, painful and sensitive, throbbing, intolerance of clothing, abscess forming, typhoid symptoms supervening. Gall-stones. Jaundice. A valuable remedy in typhlitis. Fistula in ano. Haemorrhoids, with stitches in tumors from every cough or sneeze; strangulated from constriction of sphincter. Chronic diarrhoea, watery offensive stools; in drunkards; during hot or relaxing spring weather; reflex from uterine irritation; in the course of adynamic diseases. Often useful in cardiac troubles. Pericarditis. Rheumatism of the heart. Hypertrophy. Angina pectoris. Keflex functional disturbances, especially from ovarian or uterine disease. Atheromatous arteries, chronic aortitis. Threatened heart failure after exhausting diseases. Cyanosis neonatorum. In all cardiac troubles the terrible dyspnoea is a prominent indication. Intermittent fever recurring every spring, or after suppression in the previous fall by quinine.


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