Septic states have kept the medical profession in bondage and fear since the dawn of medical history, and physicians have resorted to this thing and that thing as a possible cure, only to find they were following another will-o’ -the-wisp. As homeopathic physicians, we all need to have brought to our minds the wonderfully rich field for the treatment of these septic conditions that Hahnemann and his followers have provided ; and it gives us assurance to realize that these profound states produce the best indications for remedies. I wish to emphasize that the remedies I speak of are but a few of the many that we might select, for there is hardly a remedy but may be used with the best results in these conditions when the indications call for it; and there is no field in surgery that will bring anywhere near the reward in satisfaction in seeing the patient brought from seeming death back to life and full recovery, by the exhibition at the proper time and in the proper form of the indicated remedy.
A remedy not often thought of in septic states, yet one which is very valuable indeed when its characteristic indications are present, is Arnica. Arnica is suited to those low septic conditions, especially those brought on from traumatic injuries to the tissues. The part is exceedingly sore, and the patient complains of every part he lies on being sore to the touch. The skin is mottled, ecchymosed, and there is a tendency for carbuncles of a deep bluish colour, and abscesses which have a very decided tendency to burrow in the tissues. There is bleeding of the parts affected. There is a peculiar fever, the legs and body being cold, while the head is hot. The mouth is foul. In fact, there is nothing about Arnica that does not show this degenerative foulness. The eructations are like rotten eggs. The stools become involuntary, bloody and offensive.
Where erysipelatous infection takes place in a punctured wound, and there is great swelling and edema of the parts, with smooth, red, shiny skin, and exquisite sensitiveness-a sensitiveness all out of proportion-we think of Apis. The patient complains of sudden, sharp, stinging pains. If the wound is in the fingers, the stinging pains extend upward to the shoulder, for these stinging pains always extend toward the centre and are always of that intense stinging quality that causes the patient to cry out. The inflammation is very largely of the venous type, and phlebitis may develop and become very troublesome.
With all these conditions we may get the general symptoms calling for Apis, for unless these constitutional symptoms are present it is not indicated ; fever without thirst ; sleepiness and drowsiness, only to be suddenly roused by the intensely sharp pains; scanty, albuminous urine; and aggravation of all conditions from 4 to 8 p.m.
Another remedy to come under our consideration is that which has been used so extensively by the routinist in septic states on a purely empirical basis. Arsenicum album accomplishes splendid work in profoundly septic states when it is given on its individual indications, but unless it is strongly indicated, given as a matter of routine, it will never accomplish the end the prescriber seeks to attain. The predominant symptom of Arsenicum is its intense restlessness. This restlessness is aggravated from midnight to 3 a.m. The periodicity of Arsenicum is very marked. Another peculiarity of Arsenicum is the aggravation from cold and damp, and relief from warmth. There is intense thirst with the febrile conditions, but it is for a sip of water only, but he calls for it very often. The pains of Arsenicum are burning and stabbing, but a marked peculiarity of the remedy is that with the intense burning pains, there is relief from heat.
A remedy that has served me in good stead is Arum triphyllum.This represents a very profound poisoning of the general constitution. It is more apt to be indicated in diversified or cryptogenic septicemia, where the whole system is engulfed as it is in some of the puerperal septic states. Its symptomatology is peculiar. The skin presents a mottled appearance. There is extremely high temperature, all the secretions are exceedingly excoriating. The nostrils are obstructed, yet the coryza is exceedingly watery and burning, causing the patient to breathe through the mouth. When the patient drinks, the fluid comes out through the nose. The tongue is cracked and bleeding, as well as the lips. There is a delirium, or semi-delirious state, and a peculiar symptom in these delirious states of Arum triphyllum that has often been verified is the quivering of the left upper lid. Another characteristic symptom is that the patient persistently and insistently bores his fingers into the nostrils and picks at them until they bleed. As soon as the blood appears the patient seems satisfied and will cease for a time. This remedy may be called for only occasionally, but where it is indicated it will do wonderfully good work.
The snake venoms are always to be considered in association with septic states, whether these be localized or general. There is no class of remedies that presents such possibilities in combating these dread states. Let us consider Lachesis for a moment. Probably the most outstanding symptom of Lachesis is its exquisite sensitiveness to touch, whether it be touch of the infected part or of the general system. This aggravation is from the slightest touch rather than from the firm touch, and there is amelioration from heavy pressure. There is always the sense of constriction, especially about the neck, but it may be limited to the part affected. Most of its complaints are to be found on the left side, or beginning on the left side. The hemorrhages of Lachesis are very dark, fluid blood. It is characteristic that small wounds bleed much. This is because of the venous stasis, instead of the arterial hemorrhage. Therefore we get the blue colour of the skin, and mottling. The inflammation has a tendency to go on to suppuration. The septic conditions where we most often find this remedy indicated are surgical fevers, gangrene, carbuncles, where there is a tendency for sloughing of the parts affected. The patient is worse after sleep; in fact, the aggravation begins before the sleep ends. There is aggravation from warmth and from a change to warmer weather. Often we find this aggravation as the warm spells of spring come on . The nervous system is very strongly affected, and there is trembling and tremor of the parts affected. The patient is profoundly weak, physically and mentally. Thus we have in the leading remedy of the reptile family many of the peculiar symptoms that may frequently be indicated.
In connection with the snake poisons, I would point to the peculiar symptoms of Vipera which make it so valuable in septic conditions. It produces all of the profound blood-poisoning states of its family, but there is also intense aggravation from the affected part hanging down; a feeling as if the part would burst. This is the result of the venous inflammatory state.
The hemorrhages are frequent, and again they are venous rather than arterial. In the profound states, especially if there is coma, a peculiar symptom of Vipera is that pressure upon the abdomen, which is usually tense, invariably causes distension of the facial muscles. There is marked mottling of the skin, becoming almost black, and a peculiarity of this mottling is that some of the patches are cold to the touch, and there is great tendency to sloughing. Vivid spots appear on the hands or feet, with a red streak following the course of the veins upward to the body. A study of all our snake remedies will reward the physician who has to deal with septic states.
The spider poison, Tarantula cubensis, has all of the restlessness and hysterical tendency of the Tarantula hispanica, but with it, it has the added symptomatology of malignant suppuration and unhealthy abscesses, especially carbuncles, with burning, stinging pains, great weakness and diarrhcea. The pains are intense and most troublesome, and their effect on the nervous system is to produce hysterical manifestations. The parts affected are usually of a purplish hue, with a tendency to slough-again venous stasis. This remedy is to be compared with Lachesis and Vipera.
Rhus tox. can be of immeasurable service to the physician in these desperately sick patients from septic conditions. Probably the most outstanding indication for Rhus is its lameness, stiffness and soreness. This is particularly so when the patient is first moved. It ranks with Arnica in the bed being hard and the parts laid on being sore and lame. It is aggravated very much from touch. In Rhus conditions, there is a tendency for the inflammation to follow up the tendons, causing them to become inflamed and sore, along with the constitutional symptoms. The parts become very red, shining and there is swelling, often covered with small white vesicles. In erysipelatous swellings with this eruption it is one of the first remedies for us to consider, as in cellular inflammations. The glands become swollen, hot and painful. With all complaints there is restlessness, aching and soreness ; better from motion, but aggravated from beginning to move. Rhus tox will abort many of these septic states almost at their beginning, and it will be curative even after the condition has been thoroughly established, when these characteristic indications are present.