In the collection of provings of rhus toxicodendron made by Samuel
Hahnemann, and published in Vol. II. of the Materia Medica Pura, the
number of symptoms relating to the eye and its neighborhood is so large
as to lead to the supposition that, if the theory of homeopathy be a
correct one, this drug should prove of special value in the treatment of
diseases of the visual organs. Never did an hypothesis receive better
support when reduced to practice; and if the efficacy of the law of
_similia similibus curentur_ were compelled to rest upon a single test
to demonstrate its truth, few better selections could be made than that
of rhus tox. in the department of ophthalmology.
Many of the symptoms contained in the Materia Medica Pura are
indefinite, and the great majority of them point to apparently
superficial diseases, but when we consider the fact that at the time
these provings were made the science of ophthalmology, as understood at
the present day, actually had no existence, that the principle of the
ophthalmoscope had not yet been discovered, and that the methods of
precision in the examination and diagnosis of diseases of the eye now
available were at that time unknown, this is little to be wondered at.
And we are compelled to admire the industry and energy of the men, some
of them of our own day and generation, whose tireless labor has sifted
and arranged the numerous symptoms of this and other drugs and indicated
the method of their proper application to the various pathological
processes.
When the New York Ophthalmic Hospital was placed in charge of the
adherents of the homeopathic school, they were confronted by the fact
that no definite materia medica of diseases of the eye and ear, as such,
was in existence, and in order to ascertain the remedy for a given case
of disease they were obliged to take the conditions throughout the body,
and by comparing these with the general materia medica find a suitable
drug for the totality of the symptoms. Had they been content with simply
curing their cases in this routine way little would have been gained,
but they made it a rule to take down the special eye or ear symptoms in
each case with great care, and when a drug had cured a certain case of
disease the eye or ear symptoms which had disappeared under its use were
carefully noted. With a multiplicity of cases, and a systematic
verification of symptoms, a valuable special materia medica of these
diseases was compiled, and the curative properties of drugs in the
various pathological entities of the eye and ear were definitely
demonstrated and their characteristic symptoms for each disease mapped
out.
Under this methodical procedure the relative value of drugs apparently
indicated in these diseases gradually became better known; some,
although presenting many and varied symptoms, were found by experience
to be superficial and evanescent in their action, while others proved of
the greatest efficacy in the most serious lesions, and became
indispensable in the armamentarium of the physicians of the hospital
staff.
In the latter group, rhus tox. speedily assumed prominence as a drug of
special value in ocular disease, and this was enhanced by such a large
measure of success in its application over a wide range of affections
that it came to be regarded (at least in this hospital) as a veritable
sheet-anchor in ophthalmological work, and as time passed it was used
more or less in almost all the acute diseases to which the eye and its
adnexa are subject.
A prominent symptom of rhus is great swelling of the eyelids. This it
has in common with a number of other remedies, but differentiation
becomes less difficult when we remember that rhus is specially indicated
when swelling and œdema of the lids are the result of the deeper and
more serious lesions. After the operation for cataract, one of the first
symptoms indicating danger is œdematous swelling of the lids, and no
drug in the materia medica compares with rhus for insuring the safety of
the eye. When the pathological process becomes advanced, even to the
appearance of pus within the eyeball, still we may confidently rely on
this remedy, which has cured many such cases when they were apparently
hopeless. In all postoperative complications it is of the greatest
value, and too much emphasis cannot be placed upon this statement.
When a sound eye takes on sympathetic irritation from its diseased
fellow, the fact is first manifested by a certain amount of swelling of
the lids and more or less profuse lachrymation, the latter another
valuable indication for rhus tox. In this condition I have personally
used it many times with complete success, and it is the first drug to be
thought of in this extremely dangerous complication.
It is a well-known fact at the present time that rhus is particularly
applicable in rheumatic conditions, especially where these are resultant
upon a wetting or exposure to dampness. This, together with its nightly
aggravation, points to another sphere of usefulness in rheumatic iritis,
where it will prove all-sufficient when the characteristic symptoms
exist. In suppurative iritis and cyclitis it is very serviceable, no
matter what the cause.
The symptom “while he turns the eye or it is pressed, the eyeball is
painful, can hardly move it,” indicates its use in acute retrobulbar
neuritis, which causes this symptom exactly and is well known to be
frequently due to a rheumatic diathesis. The same symptom may call for
its use in tenonitis, in which the stiffness, difficulty of and pain on
moving the eye are specially prominent and which also has swelling and
œdema of the upper lid, chemosis of the conjunctiva, and protrusion of
the eyeball; all symptoms of rhus tox. The idiopathic form of this
disease is almost always rheumatic or gouty in origin, furnishing still
another indication for the remedy. In orbital cellulitis we have
swelling of the lids, chemosis, protrusion of the eyeball, almost
complete abolition of motion with pain on the attempt and also on
pressure, aching in and around the eye, with the probable formation of
pus in the deeper structures, all conditions curable by rhus tox., which
is one of the best remedies for this disease whatever may be its origin,
traumatic or otherwise, and has cured many of the most desperate cases.
In panophthalmitis, or suppurative inflammation of the eyeball, we find
the swollen lids, difficulty of, and pain on motion, chemosis of the
conjunctiva, severe pain in the eyeball, lachrymation, etc., again
indicating the remedy. Rhus tox. is one of the few drugs that have cured
this most fatal of lesions, and its success in restoring the integrity
of the eye, in some cases where this result has seemed almost
impossible, is a matter of record.
The symptom “heaviness and stiffness of the eyelids, like paralysis, as
if difficult to move the eyelids,” would seem to indicate its use in
ptosis, and this condition as well as paralysis of certain of the ocular
muscles, is curable by rhus tox., especially if due to wetting or
dampness. Such cures have been made frequently in the clinics of the
Ophthalmic Hospital. Erysipelas of the eyelids often presents the
characteristic symptoms of rhus. Of course the swelling of the lids is
always present, but many of these cases have in addition the chemosis,
hot lachrymation, the characteristic pains and aggravation,
restlessness, vesicular eruptions, etc., and it is a valuable and
efficient remedy when these exist.
Although rhus tox. is specially useful in the most serious inflammations
of the deeper and more important structures of the eyeball and
surrounding tissues, its sphere is not confined to these conditions
alone, but seems to cover almost all the acute diseases to which the
visual organs are subject. Given a rheumatic origin, especially if it be
from exposure to damp or wet weather, with profuse lachrymation (pain in
and about the eye) a tendency to chemosis of the conjunctiva, œdema of
the lids, photophobia, and the characteristic aggravation and
restlessness at night, and this valuable drug will rarely be found
wanting in any of the inflammations of the conjunctiva, cornea, or lids.
I have many times cured with it acute catarrhal conjunctivitis,
phlyctenular conjunctivitis and keratitis and ulcers of the cornea, and
have subdued the acute aggravations of conjunctivitis trachomatosa,
where the above symptoms, or some of them, were present. It is also
frequently successful in the treatment of abscess of the lid, which,
while not a serious, is an extremely painful disease.
Dr. W. A. Phillips, in an article published in the _Jour. of Oph., Otol.
and Lar._, July, 1899, page 224, recommends the use of rhus tox., “when
the ciliary muscle itself seems to be the special seat of trouble; when
its muscular tone is disturbed from previous straining, and when
inability is present after using the eyes for reading any considerable
time, notwithstanding optical correction.”
He has had much success with the drug in these cases and considers that
its action here is on a plane with that on lameness or soreness due to
rheumatism. In my opinion another factor may be spoken of. One of the
differential points between arsenic and rhus is that the arsenic patient
is _actually_ so weak that he cannot do what he would wish, while the
rhus patient _feels_ so weak that he cannot do it, but by making the
effort he can overcome his weakness and accomplish what he desires. This
seems to indicate in the rhus case an indisposition to exertion due to
want of _tone_ of the muscular system, and this explanation applied to
the ciliary muscle would account for the successful action of this drug
in the class of cases indicated.
I would not have it understood that I consider rhus tox. an universal
panacea for all the inflammatory diseases of the eye; all of these
affections are many times extremely variable in their presenting
symptoms and other remedies are frequently called for, but the drug
under consideration is one of the first importance and is most reliable
and efficient when accurately prescribed.
TREATMENT OF SARCOMA WITH THE MIXED TOXINS OF ERYSIPELAS AND BACILLUS
PRODIGIOSUS.