back Arsenicum Album

Synonym. - Arsenious Acid.

Preparation. - Triturations for the lower attenuations.

 

Arsenic is an irritant poison and has a specific action on almost every organ, tissue and secretion of the body.  It acts directly upon the blood composition, upon the tissues, and upon the nervous system.  The condition produced is one of asthenia, which characterizes the entire pathogenesis, and exhaustion of vital power, producing symptoms of impeded functional activity amounting in some cases to positive paralysis.   This exhaustion giving rise to lassitude, prostration, weakness, etc., is so peculiar to Arsenic, that it becomes at all times its most characteristic and important action, not resulting in all cases, as might be supposed, from organic destruction; but being present as a "sudden and complete sinking of the forces," due to functional causes alone.  Paralysis may also occur as a result of a persistent hyperemia and subsequent softening of the gray matter of the spinal cord. Of the tissues of the body the mucous membranes are most powerfully affected, producing irritation, inflammation, and ulceration.  This is noted especially in the digestive tract, where a violent destructive gastroenteritis is established.  The respiratory mucous membrane is also involved causing at first increased secretions.  Later the pneumogastrics are paralyzed.  Upon the serous membranes and the skin Arsenic produces its peculiar irritated and inflamed condition; in the former giving rise to copious effusions, and in the latter causing violent itching and burning followed by squamous and vesicular eruptions and ulcerations.  It excites inflammation of the kidneys, destroys the glycogenic functions of the liver, irritates the heart, resulting in vaso-motor paralysis, and causes fatty degeneration of all these organs (Phos.). Glandular action in general is first increased, then diminished. The blood corpuscles are affected, sometimes destroyed.  Arsenic has also the power of producing fever of an intermittent type, and resembles in its pathogenesis the many degrees of both acute and chronic malarial poisoning, but lacks the distinct stages, regular periodicity and complete resolution of Cinchona and Chin.sulph.  The leading peculiarities of Arsenic are its great restlessness, profound exhaustion, peculiar thirst, rapid emaciation, aggravation after midnight, and amelioration from warmth.

Mind. - Delirium at night, with great restlessness (Acon., Rhus tox.). Carphologia.  Sad, tearful, anxious mood (Ign., Lye, Natr. mur., Nux m., Puis., Khustox.).  Anguish and despair driving from one place to another for relief (Aur.).  Her desires are greater than her needs; she eats and drinks too much; walks too far. Sensitiveness; to the least noise.  Anxiety; at 3 a.m., with hot feeling or nausea; after 3 a.m.; evening after lying down.  Loss of consciousness.  Ideas crowd upon the mind, too weak to repel them and dwell upon one alone. Great anxiety and restlessness at 3 a.m. (Acon., Camph., Rhus tox.), driving out of bed.  Dread of death (Acon., Cimic., Agn., Nitr. ac, Sec.); sudden, when alone or going to bed.  Determined to commit suicide.  Fretful, discontented, fault-finding, capricious, easily angered (Bry., Cham., Nux v.).  Great fear and anguish, sees ghosts day and night (Acon., Puls.).

Head..- Vertigo, as if he would fall; evening; with stupidity; heaviness in the head ; with humming in the ears; goes off in the open air, but returns on re-entering the room.  Headache; throbbing; stupefying;  burning;  periodical.  Confusion and stupefaction in the head.  Intense headache, increased with light and noise (Bell.), with vertigo; worse on left side.  Sensation as if the brain moved, and beat against the skull during motion (Hyos., Glon., Rhus tox., Sulph., Sulph. ac).  Drawing pressive pain in right side of forehead.  Pain as if bruised or sore over the nose and in forehead, rubbing relieves temporarily. Throbbing over root of nose during motion.  Pain in right temple;  in vertex.  Neuralgia on left side of head; hemicrania.  Aching in occiput.  Pain in head and face, especially severe on left side.  Falling out of the hair (Graph., Hep. s., Nitr. ac, Phos., Sep., Sulph.).  oCan scarcely bear the head to be touched, scalp so sensitive.  oChronic eruptions with pustules and vesicles filled with pus.  oTinea.

Eyes.- Red.  Injected.  Staring.  Protruding.  Pupils dilated; contracted.  Lachrymation and itching in the eyes.  Blue spots in white of eye.  Eyeballs hot and burning sore.  Inflammation of the eyes and lids, with severe burning pain (Alum.), lachrymation and photophobia.  Feeling of sand in the eyes (Caust., Sulph., Ign., Natr. mur., Phyt.); evenings. Conjunctiva looks like a piece of raw beef.  Pulsative throbbing in the eyes, with every pulsation a stitch; after midnight.  Eyelids oedematous, often completely closing the eye (Apis, Kali carb., Rhus tox.).  Excessive photophobia (Acon., Bell., Sulph.).  Burning in margins of upper eyelids.  Dryness of the eyelids, as if the eyes were rubbed by them. Corrosive tears, making the cheeks and eyelids sore (Euphr., Merc. cor.; bland, Cepa). oOphthalmia of children; skin rough; dry, and dirty looking; photophobia and profuse acrid lachrymation; relieved by hot applications.

Ears.- Stitching pains in left meatus (Kali bi.) at night, from within outward.  Otalgia.  Roaring in ears (Bell., Calc, Graph., Kali carb.), with every paroxysm of pain.

Nose.- Swollen, and pouring forth a watery discharge. Watery excoriating discharge from the nostrils (Ailanth., Amm. carb., Arum, Cepa, Euphr., Lyc.).  Coryza; fluent and dry together; fluent with frequent sneezing (Acon., Gels.); with hoarseness and sleeplessness;  worse in morning;  burning and excoriating;  better in open air (Puls.); better in hot weather.  Pain in bone at root of nose. Soreness of mucous membranes. Burning and dryness in nose. Distressing stoppage at root of nose. Nosebleed.  oExtreme sensitiveness of smell, cannot bear even the smell of food.

Face. - Face deathly color; pale, yellow, cachectic look: swollen; sunken (Ant. crud.) ; covered with cold sweat; Hippocratic (Camphor, Verat. alb.).  Distorted.  Face expressive of great agony (Camph., Plumb., Verat. alb.). Twitching of muscles of face. Lips livid, blue, swollen, black and cracked; ulcerated. Lancinating pain along right inferior maxillary nerve.  Pricking twitching in one side of upper lip, worse when going to sleep.  Oedematous swelling of the face (Apis).  oCancer of face and lips, with burning pain.

Mouth.- Grinding of teeth while asleep (Hell., Hyos., Podo.).  Teeth seem longer; become loose (Merc, Nitr. ac, Rhus tox.); are sensitive to pressure and cold water.  Swollen, bleeding gums, painful to touch.  Jerking toothache at night, extending to temple.  Sore lips and ulcers in the mouth. Tongue: sides furred, red streaks in middle and red tip (Phyt., Rhus tox.);  whitish, fiery red, smooth, dry (Bell., Rhus tox.), and brown (Bapt., Rhus tox.); bluish white.  Violent burning on the tongue; gangrene.  Swelling about the root of the tongue. Externally and internally.  Dryness in mouth with violent thirst (Bry., Rhus tox.).  Painful blisters in the mouth and on the tongue.  Drinks often, but little at a time (Hyos., Cinch., Natr. ars.; reverse, Bry.).  Aphthae in the mouth.  Burning in the mouth, pharynx and oesophagus (Acon., Canth., Caps.).  Excessive thirst; drinking does not refresh. Burning thirst without especial desire to drink. Constant thirst for cold water, the smallest quantity of which could not be retained.  Bitter taste after eating (Bry., Cinch., Colo., Nux v., Puls., Sulph.).  Taste sweetish;  putrid.  Saliva profuse;  bloody;  frothy.

Throat.- Ulceration.  Diphtheritis. Inflammation and swelling internally and externally about root of tongue.  Dryness; with soreness, scraping and burning.  Dryness and burning in fauces, throat and oesophagus (Acon., Bell., Canth., Caps.).  Swallowing very difficult and painful;  sensation of constriction (Bell., Hyos.); paralysis of pharynx and oesophagus.  Burning when swallowing; food goes down to region of larynx, when it is ejected.  Burning in the oesophagus.

Stomach. - Loss of appetite (Alum.); loathing of food (Acon., Ant. tart.).   Hiccough after eating; at the hour when fever ought to have come. Unsuccessful eructations.  Water-brash.  Long-lasting nausea, anguish, with fainting tremor; heat all over, and shuddering; at 11 a.m. and 3 p.m., obliging him to lie down. Violent retching.  Violent and incessant vomiting; excited by eating or drinking (Nux v., Puls., Verat. alb.).  oStomach out of order from eating fruit, ice cream, etc.  Vomiting; of all nourishment as soon as it reaches the stomach; of ingesta (Acon., Phos., Verat. alb.); brown substance; mucus and green bile; blood and mucus.

Great anxiety about the epigastric region; at night on rising up.  Intense burning pains in stomach and pit of stomach (Ant. crud., Apis, Bell., Colch., Canth., Iris Phos., Verat. alb.);  with thirst anxiety and retching.  Drawing pain in pit of stomach, in evening when sitting, extending around to lower border of left ribs.  Internal chilliness in epigastric region.  Soreness in pit of stomach when talking, drawing breath or moving (Bry.).  Weak digestion.  Could not bear any wine.  Cramps in stomach (Acon., Ant. crud.).  Weight in stomach, as of a stone, after eating (Bry., Nux v., Puls.). Stomach tender to pressure (Ant. crud., Bry., Bell., Lyc.).

Abdomen. - Abdomen distended and painful (Apoc, Merc). Violent, burning pains, with intolerable anguish (Aeon., Canth.); better after stool. Cutting pains in abdomen (Acon., Coloc).  Pain over region of liver, worse from pressure.  Hypertrophy of the spleen.  Pain about the umbilicus, causing him to bend forward, worse on touch, or on attempting to raise himself, or to lie on his back. Pinching in hypogastrium, increasing to cutting, in morning, before, during and after diarrhoea.

Stool and Anus. - Painful spasmodic protrusion of rectum.  Burning in rectum after stool, with weakness and trembling in all the limbs. Ineffectual urging to stool.  Tenesmus, with burning pain and pressure in rectum and anus (Canth., Iris, Merc., Sulph.). Prolapsus ani (Podo.);  haemorrhoids; burning pain.  Evacuations excoriate the anus (Merc, Sulph.).

Involuntary stools (Arn.) and urine (Hyos.).  Stools black (Acon.); acrid (Merc, cor., Carb. v., Lept., Sulph.);  putrid;  slimy and dark green mucus (Aur. mur., Arg. nit., Merc, Puls., Sulph.);  dark, bloody, watery and painless;  dark colored;  offensive (Bapt.);  blackish-brown bilious, with griping; dysentery-like.  Diarrhoea with coldness of the extremities;  vomiting;  prostration.  Diarrhoea worse after midnight, also in morning after rising.  Diarrhoea, after chilling stomach by taking cold substances; from fruit and vegetables.  Haemorrhages from bowels; dark; offensive.  Constipation (Bry., Calc. c, Nux v., Op., Sulph.); with pain in abdomen.

Urinary Organs. - Burning in the urethra during micturition (Can. sat., Canth.). Involuntary micturition (Bell., Hyos.).  Urine scanty; passed with difficulty; burning during emission (Acon., Canth.); copious.  Suppression or retention of urine (Acon., Hyos., Stram.);  paralysis of bladder. Haematuria (Canth., Colch., Ham., Phos.);  albuminuria;  uraemia.

Male Organs. - Painful swelling of the genitals, and gangrene.  Glans blue, red, swollen, and cracked. Oedema of scrotum.

Female Organs. - Leucorrhoea profuse, yellow, thick (Hydras., Kali bi.), corroding (Kali carb.). oThin, whitish, offensive discharge, instead of the menses. Ovaritis. Menses too early, profuse (Ambr., Amm. carb., Calc. c, Nux v.);  exhaustion (Alum., Carb. an., Cocc);  dark blood.  Amenorrhoea.  Constant exhausting menorrhagia. L ancinations from abdomen into vagina.   Burning or tensive pain in ovary.  Pressive, stitching pains in region of right ovary;  sometimes extending into thigh, which feels lame.

Respiratory Organs.- Voice weak, trembling, uneven, hoarse.  Cough excited by smoky sensation, or as of vapors of sulphur (Cinch., Ign., Lyc.); or by constant titillation in larnyx (Amm. carb., Bell., Calc. c, Dros., Ign., Rhus tox., Rumex, Sang.); worse after drinking (Phos.) Spasmodic; asthmatic (Iod., Ipec); deep and dry; short; increasing after midnight.  Cough with bloody sputum.  Cough suffocating at night;  must sit up (Acon., Ant. tart., Samb.); after lying down ; on going into cold air.

Loss of breath immediately on lying down, in the evening, with whistling and constriction in the trachea.  Oppression, increased by stormy weather and heavy air, walking quickly, ascending, warm and tight clothing, but especially from changes of warmth and cold.  Wheezy respiration, with cough and frothy expectoration, looking like beaten white of egg.  Difficult breathing, with great anguish (Ascl. t.).  Oppression, want of breath; must spring out of bed at midnight.  Asthma.  Air-passages seem constricted (Ign.).  Oppression of breathing on walking fast, or ascending a height (Acon., Amm. carb., Ascl. t., Calc. c, Kali nitr., Merc).   Constriction of the chest, with great anxiety and restlessness evenings; great dyspnoea; face cyanotic and covered with cold sweat; great anxiety. Chilliness in interior of chest evenings.  Stitches in chest when coughing.  Very tenacious mucus in chest (Ant. tart., Kali bi.).  Burning in the chest.  Yellow spots on the chest.

Haemoptysis after loss of blood; burning heat all over, especially with pain between scapula; in drunkards, or from suppressed menses. oCatarrh in chest, great suffocation; child tosses about in agony.  oGangrene of the lungs, with green ichorous sputum.  Stitches and pressing in sternum.

Heart and Pulse. - Violent palpitation of the heart, especially at night, visible and audible, with anguish (Acon., Spig., Verat. alb.); after stool, with tremulous weakness, so that he has to lie down; irregular irritable heart.  Pulse accelerated;  irritable; quick and small; quick, weak and irregular (Acon., Ant. tart.); weak, scarcely perceptible (Acon.).  oAngina pectoris; sudden tightness above the heart;  agonized precordial pain;  anxiety, dyspnoea, etc.

Neck and back.- Nape stiff, as if bruised or sprained.  Stiffness in spinal column, beginning in region of os coccygis.  Bruised pain in small of back (Arm, Bry.).  Loss of strength in small of back.

Limbs. - Excessive weakness and exhaustion of limbs, obliging him to lie down.  Twitching, tremor, trembling. weariness of the limbs. Convulsions.  Contractions.  Paralysis.  Tearing in arms and limbs, worse lying on the affected side, better from motion of the affected parts.

Upper Limbs.- Drawing, jerking, and tearing from tips of fingers into the shoulders.  Hand and lower half of forearm dark and livid.  Pain in arm of that side on which he lies at night.  Burning ulcers on tips of fingers.

Lower Limbs.- Sensation as if lower limbs would break down on going up stairs.  Uneasiness in lower limbs; cannot lie still at night; has to change position of feet constantly, or walk about to get relief (Rhus tox.). Coldness in lower limbs.  Stiffness, especially of knees and feet, alternating with tearing.  Numbness of legs and feet; with tingling.  Feet pain as if sprained (Rhus tox.).  Tearing, sticking periosteal pain along the limb to the big toe.  Sciatica.  Paralysis.  Violent drawing, tearing pain in the right foot.  Drawing pain in legs, when resting feet upon the floor, while sitting.  Cramps in the calves (Sulph., Calc. c.,Camph.. Nux v., Sil.).  Oedematous swelling of the feet (Acet. ac, Apis, Colch.).  Sore pain in balls of toes while walking as if chafed.   Ulcers on soles of feet and toes.

Generalities. -Great emaciation (Ferr.).  Epileptic convulsions (Bell., Calc. c); frequent fainting. Great restlessness and anxiety (Acon.).  Sudden sinking of strength (Acon., Camph., Sec, Verat. alb.); from slight pain or other causes.  Great weakness and prostration (Bry., Phos., Sec);  scarcely able to walk (Ferr.).  The paroxysm of pain is frequently accompanied by other minor symptoms.  Oedema of the head, face, eyes and neck.  Faint, anxious and iveak, early in morning.  Pains intolerable, periodicalBurning pains (Carb. veg., Phos.), especially in inner organs, skin and ulcers. oAfter great exertions, climbing mountains, etc.  Nervous prostration.  Typhoid conditions.  Senses morbidly acute.

Skin.- White, pasty looking skin. Painful black eruptions. Miliary eruptions.  Parchment like dryness of the skin.  Petechias (Arn, Sec).  Pustules. Vesicular eruptions Desquamation from head to foot.  Formication with trembling.  Burning itching, painful after scratching.  Ulcer on leg, covered with gray crust, and surrounded by an inflamed crust border; burning and painful (Carb. v.).  Bran like, dry, scaly eruption (Nitr. ac).  Gangrenous aspect of sores (Carb. v., Kreos., Lach., Sil., Sec). oCancers with burning pains. oCarbuncles.

Sleep. - Frequent starting in and from sleep (Agar., Amm. carb., Bell., Bry., Hyos., Stram., Sulph.). Restless, uneasy sleep with moaning (Lyc., Puls.).  Dreams full of care, sorrow and fear;  thunderstorms, fire, black water, darkness; about death, etc.

Fever. - Shuddering, without thirst, worse in open air; after dinner; after drinking.  Intermittent fever, quotidian, sometimes tertian.  Fever at same hour for several days.  Remittent fever.  Irritative fever.  Typhus fever with restlessness, alternating with stupor.  Coldness of body, dry skin, alternate with cold sweats.  Chills and heat intermingled, or internal coldness, external heat, and red cheeks (Arn.); blue nails and lips during chill.  Internal burning, dry heat (Acon., Bry.);  after midnight, with anxiety and inclination to uncover; while vomiting, with thirst.  Heat beginning in stomach and precordial region, passing to rest of body at 2 a.m., warmth over whole body, sweat on face, feet, tension in hypochondria and epigastrium, causing colic and anxiety;  at night;  without thirst or sweat; at night, with restlessness, and with pulsations in limbs, hindering sleep, with thirst; with diarrhoea and enlarged spleen; chills every evening followed by heat.  Feeling as if the blood in arteries were boiling hot.  Sensation as if the blood coursed through the veins too rapidly or was too hot, with small, rapid pulse.  Cold, clammy (Cham., Digit., Kali nitr., Merc, Sec);  or sour and offensive sweat (Arm, Merc); copious.  During sweat unquenchable thirst; sweats on going to sleep, better after a little sleep; in bed causing faintness; about lower limbs at night, especially about knees.

Aggravation.- At night, especially after midnight (1 to 3 A.M.).

Amelioration. - From warmth in general.

Compare- Ant. cr., Apis, Arn, Bell., Camph., Carb. v.. Colch., Cinch., Graph., Hell., Iod., Kali bi., Lach., Merc, Nux v., Plumb., Phos., Rhus tox., Sec c, Tabac, Silic, Samb., Sulph., Verat. alb., Zinc

Antidotes.- Camph., Carb. v., Cinch., Chin, sulph., Ferr., Hep. s., Iodi., Ipec, Lach., Nux v., Samb., Tabac, Yerat. alb. To large doses: sesquioxide of iron, hydrated peroxide of iron; or precipitated carbonate of iron; juice of sugar cane, or honey water; lime water in copious draughts; emetics of sulphate of zinc; carbonate of potash and magnesia, shaken in oil; infusions of astringent substances; large quantities of diluent drinks.

Arsenicum Antidotes.- Carb. v., Cinch., Ferr., Graph., Iodi., Ipec, Lach., Merc, Nux v., Verat. alb. Lead poisoning, and evil effects of alcohol.

 

THERAPEUTICS. Arsenic has a wide range of action and is applicable in very many forms of disease.  It is a valuable remedy in all forms of malarial and adynamic fevers, and low types of disease in general, where tne proper indications are present.  The chief indication in intermittent fevers is the irregularity and inequality of the three stages.  The chill is not well defined, though the fever is, and often the sweat does not bring relief.  Often the chill and heat are intermingled. Withal^e usually have present the characteristic prostration and restlessness of Arsenic, and more or less gastro-enteric irritability. In long-standing cases the apyrexia is marked by symptoms indicating a bad state of the system- cachexia.  Often dropsical indications are present due to an enlarged liver or spleen.  Arsenic is also useful when in such patients neuralgia or headaches supervene, evidently due to the malarial poisoning.  It is said to be most often indicated in malarial fevers after the failure or abuse of quinine.  In typhoid fever Arsenic is indicated in the later stages where there is profound prostration, great restlessness and other characteristic symptoms.  Also in pyaemia, hectic fever, yellow fever and low types of disease. In eruptive fevers, especially scarlet fever of a malignant character, with similar symptoms; the eruption delays, or becomes pale, or livid with petechial spots.  Tendency to gangrene of throat.  Haemorrhagic measles.  Malignant diphtheria.  Arsenic is used by nearly all schools of practice, in the treatment of skin diseases.  Its characteristic eruption is bran-like, dry and scaly, with desquamations; also black eruptions, vesicles, pustules.  Petechia.  Gangrene, particularly the dry gangrene of old people.  Ulcers.  Carbuncles.  Cancers. In all skin diseases, especially those last named, Arsenic is indicated by the severe burning lancinating pains so characteristic of the drug. In all conditions characterized by great exhaustion and rapid sinking of strength, even collapse, Arsenic may be indicated.  This may be present in the diseases already named, but is especially liable to be associated with gastro-enteric troubles.  Gastralgia, gastro-enteritis, diarrhoea, dysentery, even Asiasic cholera, where Arsenic is a valuable remedy, the symptoms agreeing.  Hepatitis.  Enlarged liver.  Inflammation of the abdominal viscerse.  In general, dropsy of the thoracic and abdominal cavities, whether resulting from heart, liver or kidney diseases, Arsenic is a most important remedy.  Also in oedema, from simple puffiness about the eyes to swelling of the feet and limbs, and ending in general anasarca. In all such cases the general symptoms of Arsenic will be more or less present, according to the locality of the dropsical effusion and the nature of the disease causing it.  Arsenic is often the remedy for a weak irritable heart with palpitation; also for endocarditis, hypertrophy and hyper-pericardium.  In angina pectoris it will often give relief, when the dyspnoea is very great and the patient shows extreme anguish. In catarrhal affections of the respiratory tract Arsenic may be useful when the symptoms correspond. It is especially useful in asthma, worse after midnight, must spring out of bed, sits with chest inclined forward.  Hydrothorax from Bright 's Disease.  Emphysema with excessive dyspnoea, suffocative cough, etc.  According to Allen a valuable remedy "for the cachexia which leads to chronic disease of the lungs."  General anaemia with prostration, with or without cachexia.  Catarrh of the eyes and upper air-passages; ophthalmia and other eye inflammations, oedema, etc.; fluent coryza characterized by burning pain, photophobia, profuse acrid lachrymation, oedema, etc.; fluent coryza characterized by sneezing and a profuse acrid discharge, causing burning and smarting in the nostrils; often an excellent remedy in influenza, with these symptoms.  Inflammation of the oesophagus, with burning and spasmodic constriction on swallowing food.   Epithelioma of mouth, tongue or throat with burning pain.  Aphthae; ulceration and gangrenous sores in mouth.  The nervous affections in which Arsenic is useful are mostly neuralgic headaches and often neuralgias due to malarial influences; chorea; epilepsy; paralysis, especially of lower extremities; spinal paralysis from myelitis; hysterical paralysis; convulsions. Delirium tremens. Bad effects from tobacco chewing; abuse of quinine, iron or iodine.  Effects of poisoning from decayed or morbid animal matter, by inoculation, inhalation or swallowing.


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