Poison oak. (Under the name Rhus Hahnemann published his proving of “R. radicans, also called Toxicodendron.” Botanists agree in recognizing no distinction other than that of habit between the two. Millspaugh (American Medicinal Plants) tells in his masterly account of the plant that he has seen the two varieties springing from the same root-stock. He advises that the tincture should be made from specimens of both. Rhus tox. is a shrub with erect stem from two to four feet high. The stem is devoid of rootlets. Rhus r. has more or less tortuous stems, four to thirty feet high, profusely studded with dark-coloured rootlets, by which it clings to its support. Our own Ivy (Hedera helix) in the same way may run along the ground, rooting at intervals if it cannot find a support, and growing to a great height if it can, and it may be an erect shrub with no rootlets and no tendency to climb. The two forms have been proved independently, and when necessary to distinguish them I shall name them R.hr. and Rh.t. When reference is made to both or either in this work I use the term Rhus without distinction. All other varieties of Rhus will be distinguished. N.O. Anacardiaceae. Tincture of fresh leaves gathered at sunset just before flowering time.
Clinical
Abortion. *Acne rosacea. After-pains. Amenorrhoea. Anus, fissure of. Appendicitis. *Appetite, lost. Beriberi. Bones, pains in. Caecum, inflammation of. *Chilblains. /Circulation, feeble. *Cyanosis. *Dengue fever. Diarrhoea, chronic. Diphtheria. *Dysentery. Dysmenorrhoea. Dyspepsia. Ear, *eczema of. *Ecthyma. *Enteric fever. *Erysipelas. *Erythema *nodosum. Exostosis. *Eyes, *inflammation of, choroiditis, sight, weak. Feet, pains in. Gastro-enteritis. Glands, inflammation of. Gout. Haemorrhages. Haemorrhoids. *Hands, pains in. Hernia. *Herpes. *Herpes zoster. *Housemaid’s *knee. Hydrocele. Influenza. Intermittents. *Jaw cracking in. Liver, abscess of. *Lumbago. *Measles. Menorrhagia. Metrorrhagia. Neuralgia. Ovary, tumour of. *Paralysis. Paraphimosis. *Pemphigus. Periosteum, pains in. Pleurisy. Pleurodynia. Pneumonia, typhoid. Ptosis. *Pyaemia. *Redgum. *Relapsing fever. *Rheumatism. *Scarlatina. *Sciatica. *Sleep, *restless. Small-pox. Spine, diseases of. *Sprain. Strictures. *Tongue, affections of. *Typhus fever. Urticaria. Warts. Wens. *Yawning.
Characteristics
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 Rheotannic 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-humored, 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, worse by rest better 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 *Bryonia, which has almost identical rheumatic pains with the opposite Conditions. Neidhard adds a note in Hempel’s *fahr which brings out a modification of this ” worse 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 characterized 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 *Bryonia, *Rhus has: “The more he moves the better he is,” whereas *Bryonia has “The more he moves the worse he is.” It is necessary to bear in mind this distinction or a wrong prescription will often be made. *Rhus has not only worse *during rest, but worse *after resting also. However, *Rhus and *Bryonia 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 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 *Aconite and *Arsenicum, but in a different way from either. With *Rhus it is due to the pain and soreness temporarily better 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 (especially 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 war 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 worse 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 (*Medorrhinum *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 *Belladonna 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
