Stocking the First-Aid Kit with Remedies for Winter Exposure
Winter weather can vary dramatically, day by day. It is not uncommon for one day to be warm and unseasonably sunny, so that everyone goes out with the lightest clothing; only to be followed by an extreme swing of temperature to the coldest, below-zero depths. Where I live, this kind of fluctuation can take place within the span of a few hours: its only natural that many people are caught off guard.
Sudden temperature changes in such extremes can create the conditions for all the enjoyable outdoor activities that so many people love: skiing, snowboarding, skating, or simply taking walks in the freshly fallen snow. But these quickly changing conditions can also create opportunities for injury and misery, which can be easily addressed or avoided with good planning. If avoidance can’t be managed, first aid care is the next best thing.
Some of the most common and dangerous winter complaints are Frostbite and Hypothermia: While everyone knows that dressing warmly is a priority in cold temperatures, there are instances where we don’t often dress as we should, particularly if the weather is prone to sudden changes. Outdoor winter activities such as skiing, snowboarding, tobogganing, and skating involve a lot of exertion, enough movement to keep the body feeling deceptively warm despite the freezing temperatures around us. Kids and outdoor enthusiasts will always over do it: I have a few memories from my childhood where I simply refused to come inside, and spent much more time skating or tobogganing with my friends even though I knew I was starting to feel cold and tired. Those days always ended the same way: with painful, cramping hands and feet that hurt for what seemed like hours, frostbitten from too much exposure.
Children aren’t the only ones who suffer from the risks of frostbite and hypothermiaâ€”those whose livelihoods depend on working outdoors, such as construction workers or farmers, also run the risk. Smokers, babies, and the elderly are most vulnerable, as their circulation will be less than ideal as a result of the habit or age, or simply because they may lack the ability to keep moving. The best precautions always involve dressing appropriately, in a number of layers of clothing that can be removed and replaced depending on how warm or cold one feels. Choose appropriate fabrics which insulate the body and wick moisture away from the skin so that the body does not become chilledâ€”wool layers, for example, will insulate the body even if the fibres become wet. If you can’t move for any reason, or if you fall into icy cold waters while skating, ice fishing, or ski-dooing, then the risks of hypothermia and severe frostbite increase dramatically; so it is only reasonable to prepare for any contingency while outdoors.
Hypothermia is the condition of having an abnormally low body temperature. It can come on very slowly, making it difficult to notice that its happening. When the body becomes extraordinarily cold, all the systems begin to slow down – eventually to the point where death can result. Sometimes, hypothermia can actually save lives, especially where the body shuts down heart and brain function in order to limit the oxygen the body needs so that it can stay alive; in some of these cases, children have been successfully revived because of the limitations the hypothermia placed on their bodies.
Frostbite, or “chilblains”, as our old books refer to it, happens when a part of the body actually freezes. Mild frostbite doesn’t leave lasting damage, but severe frostbite can cause permanent damage and may even lead to amputation.
Symptoms of Hypothermia: What to Look For
When the body is cold, it tries to generate heat by shivering – it’s trying to warm itself. When hypothermia sets in, the shivering stops, as the body is now trying to conserve all the energy it can. This is one of the first warning signs of hypothermia. Other signs to look out for: disorientation and clumsiness, which takes place as body temperature drops; and an irregular heartbeat which takes place when breathing slows down. Frostbite and hypothermia can set in in minutes, if the temperature is extremely cold.
Mild frostbite or “frostnip” makes the skin look pale or waxy, but the colour returns once the skin is warm again. Severe frostbite begins with white or waxy looking skin, but as the damage progresses the colour becomes bluish, or grey. The cold feeling is replaced with numbness, and blisters often form on the surface of the extremity. when things progress to this degree, even more damage can be caused. Trauma injuries can result: a frozen finger can easily break in a fall; a frozen foot can suffer broken bones if walked on. Blisters can burst if they are placed under the pressure of a step, or inadvertently made to rub against the inside of a boot.
Frostbitten skin will burn if it is not warmed up properly, so this is no time to forget the Law of Similars: warm the frostbitten skin with cold water or snow until circulation is restored to the areaâ€”do not try to use warm or hot water for this purpose as permanent tissue damage will result. Keep in mind that as the body part warms up, the affected area may swell, itch, burn, or cramp painfully (which is what I remember to be my experience with this ailment) In cases of extreme frostbite, the skin will turn black; gangrene may set in, and amputation may be necessary.
Agaricus Muscarius is the first remedy that comes to mind for chilblains, as it produces the stinging and itchy sensations in the toes and feet that are characteristic of frostbite. If no other remedy is specifically indicated, use Agaricus.
Agaricus features the swelling, burning, redness, cramping, and skin eruptions that itch and burn. Some patients experience lasting redness after frostbite and symptoms of rosacea; some experience swollen veins with the cold skin. It is good to keep in mind that the more serious effects of hypothermia are addressed by this remedy, namely the irregular, tumultuous palpitation of the heart, which can take place when hypothermia has progressed. In general, these patients’ symptoms are all worse for open, cold air; worse after eating, worse after coitus, and worse before a thunderstorm. Slow movement brings about amelioration.
If the patient’s complaints worsen with exposure to heat, or more specifically from being in a warm room, think of Pulsatilla; especially if the part feels hot and itchy long after being thawed with cold water. If the thawed skin produces dark, red, itchy inflammations that are worse for cold and damp, think of Rhus Toxicodendron. Some other good remedies for the itching and coldness in skin or in fingers and feet include Abrotanum, Tamus, and Plantago. Abrotanum’s modalities are better for movement, worse for cold air and for suppression of any secretions. Tamus can be applied in a topical cream to soothe the itching; as can calendula, if the surface blisters break and the skin needs to be sterilized and encouraged to heal.
Nux Vomica is a good remedy to consider if there is superficial inflammation with bright red swelling and burning itch. We can recognize the need for this remedy when the skin begins to crack and bleed as it warms, as well as if we see the typical Nux Vomica emotional state: extreme irritation, anger, and a kind of denial/denouncement of the situation. Where there is bleeding, cracked skin or inflamed, swollen, painful red heels bathed in unpleasant-smelling moisture, we should think about Petroleum as a good remedy. The physical symptoms appear to be similar to Nux Vomica’s, but the mental state in Petroleum will be far more concerned with the approach of death and the need to settle affairs than it will be with anger and irritable frustration.
The patient who needs Arsenicum Album has suffered a more severe frostbite, where the tendency in the frozen skin leans towards gangrene. Blackish vesicles may be present on the affected parts. Don’t forget to look for the characteristic fussy anxiety and restlessness of this patient.
Consider Sulphur as a treatment if the chilblain has a tendency to suppurate, and if its burning itchiness only gets worse once the part warms up in bed. In cases where the swelling and itching is violent, think about Zincâ€”and look for the characteristic fidgety feet.
Hypothermia sets in when the core body temperature falls below 35°C (95’F); if the body has been cooled to less than 25°C (77°F) recovery is unlikely. As body temperature dips, the person becomes dreamy, unresponsive, and reluctant to move; the hands, feet, and abdomen feel icy cold to the touch. There may also be cramping, numbness, or paralysis, causing falls and accidents if the person tries to walk or move.
First, check breathing and pulse, and if necessary give artificial respiration. If you are certain that there is no heartbeat, use cardiac resuscitation. Once the person is revived, warming them becomes the next priority.
The best way to look after someone who’s hypothermic is to bring the person into the warm, and give them sips of hot, sweet drinks, making sure the drinks which are alcohol free. Warm the person up gently, so as to avoid overstraining the heart. Place warm-to-cool (not hot) water bottles, well wrapped, against the person’s body; but not against the extremities. Resist the urge to “restore” circulation by massaging the limbs, or encouraging the person to do “warm-up” exercises. Cover the body well with blankets. Though it sounds like a good idea, submerging your patient in a bath should not be done.
A hypothermic baby will be unusually limp and drowsy and refuse to feed, even though the baby’s face, hands, and feet may appear to be normal. The most effective way of warming a baby is to hold him or her against your skin in a warm bed. In the elderly, it is sometimes difficult to distinguish hypothermia from a stroke or heart attack, particularly if the hypothermia results not from a winter accident or outdoor exposure, but from something as every-day as not being able to heat the home properly for lack of funds, or for difficulty in repairing faulty heating equipment. These situations are an unfortunate reality for many elderly people, especially if they are used to living alone.
If the remedy Antimonium Tartaricum is indicated, the patient will experience a sensation of coldness running through the blood vessels. The face will be cold to the touch, and appear blue and pale, covered with cold sweat. The chin and lower jaw will be shivering; and in general the patient will experience chills, trembling, and muscular pains all over the body. Drowsiness, debility and sweat are big symptoms for this remedy. You will also hear lots of rattling mucus in the chest, as if it were filled and congested…but very little mucus is expectorated.
Arsenicum Album features faintness, icy coldness, and great exhaustion made worse after the slightest exertion. Pale coldness is everywhere: the face, which has a death-like colour with a bluish nose and open mouth; coldness felt in the stomach, coldness felt in the chest. Anxiety and agony are the facial expressions which indicate this remedy.
Camphora is indicated when the whole body feels icy cold, the blood pressure is very low, and the pulse is small and weak. These patients experience a sudden sinking of strength. The coldness in this remedy will pervade through to the tongue, and breathâ€”yet the patient will not allow himself to be covered. There is also great numbness, tingling, coldness and cramping, especially in the calves. Everything will feel cold to the touch.
Secale Cornutum is another remedy which refuses to be covered: even though the body feels cold to the touch, the patient feels the sensation of heat and refuses to bear the added warmth of blankets. In this remedy, the extremities will feel icy and cold, and appear blue, shriveled, bent backwards or splayed apart, and numb.
If the patient is icy cold and blue, but the head is hot and the breathing is laboured, quickened, and cold, think of “the corpse reviver”, Carbo Vegetabilis. These patients will have such difficulty breathing that they need to be fanned; the pulse is almost imperceptible as the blood stagnates in the capillaries.
If tremendous cramping is the major complaint, and convulsions or spasmodic affections which begin in the fingers and toes present themselves, consider the use of Cuprum Metallicum. Look for the characteristic blueness in the face, lips and nails.
The Veratrum Album patient will present with a stuporous, blank, dazed and seemingly indifferent appearanceâ€”what they used to describe as “sits in a stupid manner, noticing nothing”. The collapse state in this remedy is extreme, along with the coldness and blueness felt and presented by the patient. The face will be pale, with a sweaty forehead; the pulse will be feeble, but rapid. There is a sensation of a lump of ice, on the vertex; and all of the skin is blue and inelastic, clammy feeling to the touch.
If you’re concerned about potency, I find that carrying a kit with a number of remedies in the same potency can be very helpful. A 30c potency in these remedies will allow you to start with a moderate potency, which can be repeated as indicated; a 30c can also be a good potency to use dissolved in water for “plussing”. Most of these remedies can be easily located from health food stores or homeopathic pharmacies without too much travel or trouble; the 30c potency is one that is commonly carried in stores, which makes putting the first aid kit together and keeping it fully stocked easy to accomplish.
Our feedback mail includes a request for more comprehensive frostbite/hypothermia general management information to go along with the Homeopathic First Aid care described in the February article. Here is some of the best advice I’ve found:
“Lukewarm baths, of from 31 degrees C to 34 degrees C (88 degrees F to 93 degrees F) serve to awaken the slumbering irritability of the fibers in cases of apparent death (from freezing, drowning, asphyxiation) where the feeling of the fibers has been benumbed. While these baths are only palliative, they often prove themselves to be sufficiently effective, especially if at the same time coffee is given and the patient is rubbed (warmed) by hand.
—Aphorism 291, The Organon of Medicine, 6th edition, Samuel Hahnemann.
In the introduction to the Organon, Hahnemann also describes the time tested homeopathic (law of similars) treatment for frostbite. In a section of the Introduction titled “Homeopathic Folk Remedies”, he writes:
“Even the non-medical classes of people, endowed with a healthy sense of observation, found many times over through their experience in domestic practice, that this medical mode (application of the Law of Similars, or physical Homeopathy–my clarifications, ) was the surest, most thorough, and most infallible one. Frozen sauerkraut was placed on recently frozen limbs, or the limbs were rubbed with snow”. p.52
Rubbing limbs with snow has come under a lot of criticism as a practice lately, but the fact remains that if the body’s own heat is not very warm and the limbs can’t be warmed by being held against the armpits, back of the neck, or close to the genitals, and if the choice of warming oneself indoors is not readily available, applying a slightly less cold substance to the frozen part achieves exactly the required end described by Hahnemann. Snow usually happens to be readily available for this purpose, and as long as some form of respite from the elements can be found its temperature (higher than freezing) will effectively thaw frostbite that has not become too severe. If you can’t get out of the cold by going indoors, set up a camp and build a fire; allow your patient to rest and get warm with indirect exposure to the fire and use the snow to bring the frozen parts back to warmth. If you can bring a patient indoors, other options such as cool water baths or gentle warming by wrapping can help just as well.
Some medical authorities advocate rapid thawing, using water that is as hot as the patient can stand…but this is, for the most part, totally unnecessary in frostbite that is not severe. The big fear in advocating this kind of treatment is that gangrene will result to the frozen part; however, the big risk is that the high temperatures of the water will “cook” tissue, causing permanent damage. The intense swelling and pain caused by this treatment can also present its own damaging effects, and certainly cause more distress than is warranted. Use this method only if you strongly suspect that the frostbite is severe; and be cautious when you do, using water that is just a little closer to body temperature than it is “hot”. Remember that most people find getting into a hot tub (water temperature in the high 90’s) takes some time to get used to, even when their body temperatures are normal!
Further on in the Organon’s Introduction, Hahnemann elaborates on this practice of physically applying the Law of Similars, and advocates that the frostbitten limb be soaked not in water of the same temperature as the frozen part:
“1. The frostbitten limb was not restored isopathically by the perisistent employment of that degree of cold wherein the limb froze; it would have become quite lifeless and dead thereby. Rather, it was restored by a cold that only came close to the original temperature, and that was gradually toned down to a comfortable temperature (homeopathy), as frozen sauerkraut applied to a frozen hand at room temperature soon melts away and gradually warms up from 1 degree C (34 degrees F) to 2 degrees C and so on up to room temperature, even if the room is only 10 degrees C (50 degrees F), and thus the limb is restored by physical homeopathy.” (p.53)
These forms of treatment are still employed against frostbite, as they are the most gentle means of bringing back circulation and warmth to the frozen part without causing permanent tissue damage or excessive pain. The most important thing to remember in any treatment of these ailments is that rubbing or massaging the affected area can cause harm, so it must be avoided. If it is at all possible, bringing the person into the warmth of a shelter is the best way to start treatment–then, warming baths can be used to slowly bring the body temperature back up. It is safe to restore warmth to a person suffering from hypothermia using blankets and exposure to gentle heat, as well as some stimulant like the hot coffee Hahnemann includes in his description to encourage circulation back into its own activity. Applications of direct heat, such as from a fire, or using water that is too hot in a treatment bath will cause, at best, intense swelling, cramping, and general pain; at worst, this can cause tissue damage which can’t be undone.
If no success is achieved using these means, rush the patient to the hospital. Keep in mind that a dose of an appropriately fitting remedy on the way to the hospital may very well make that trip less urgent, or at least lessen the damage to tissue that may result. If a well chosen remedy can lessen the potential suffering for the patient, give it; that way when the patient arrives at the hospital less will need to be done. No one is advocating that these treatments are mutually exclusive.
The intention of the Homeopathic First Aid article was to specify individual remedies which can be used to lessen the pain and danger of harm resulting from frostbite and hypothermia: this was the focus and purpose of the article. General antipathic or allopathic methods of treatment, which Hahnemann elaborates in the Organon, can also be effective if one chooses to treat in this manner, or if one happens to be without homeopathic remedies. These methods are still advocated and widely used today, and have actually been in use successfully for several hundreds of years (thousands, if you’re Inuit, but who’s counting?).
The resources for the original article were:
Health Canada/ Healthy Ontario , January 14, 2004);
The Organon of the Medical Art by Samuel Hahnemann, Wenda B. O’Reilly, editor;
Notes from David Little’s First Aid Room on the Homepathic treatment of Frostbite and Hypothermia http://www.simillimum.com/
Clarke’s Dictionary of Homeopathic Materia Medica,
Boericke’s Pocket Manual of Homeopathic Materia Medica,
Dr. Roger Morrison’s Desktop Guide to the Materia Medica.