Ailanthus glandulosa. Tree of Heaven or Chinese sumach. N.O. Simarubaceae. Tincture from fresh shoots, leaves and blossom.
AILANTHUS produces effects resembling those of rhus, baptisia, arum tri., &c. It is a drug which illustrates well the advantages of studying together the effects of poisonous doses and of those used in the provings as found in the schema.
The former show a consistent, connected series of effects-a symptom-complex which called to mind in an observer cause of malignant scarlet picture with which disease he was familiar. This vivid picture would with difficulty have been picked out of and pieced together from the schema.
On the other hand, some pictures of less lurid colouring found in the schema would have been missed if we possessed only the toxic records.
PATHOGENESIS AND THERAPEUTICS.
The sudden onset with headache, vomiting, giddiness and photophobia is striking. The febrile condition is indicated by hot red face, headache, worse at the back of neck, rapid pulse and great restlessness-these are general fever symptoms, and even with the added vertigo and anxiety (found also in aconite and arsenic cases) are not distinctive.
Superadded to these-and here are the characteristic features-quickly come drowsiness and a heavy “besotted” appearance; the eyes are bloodshot, the pupils dilated, relations and friends are not recognized, the drowsiness deepens into semi- consciousness with muttering delirium, and the patient becomes comatose.
While these symptoms are developing, the red face changes to a more dusky hue and a patchy spotty rash develops on the forehead, face, chest, &c. The rash consists of miliary spots or patches and is bluish or livid, and after being emptied by pressure with the finger, the spots resume their colour but slowly. At the same time the throat is inflamed, purplish in colour, with (or without) small ulcers-some quite deep; the (or without) small ulcers-some quite deep; the tonsils and fauces are swollen, swallowing is painful. Full feeling and swelling of the neck, with enlargement of tonsils, parotids, submaxillary and thyroid glands may be present. Constipation or foetid involuntary stools may be present, together with scanty or suppressed urine. There are no records as to albuminuria.
This is a miniature of Malignant scarlet fever (for which one case of poisoning was mistaken) or it may even feature typhus fever. The poisoning cases develop and (if not fatal) subside in as many hours as these diseases require days for their development. Drugs, of course, do not produce the cycles of bacterial or Rickettsia toxins.
The drug is not much used in temperate civilized countries where sanitation is good, because such diseases as those just mentioned are not prevalent there. It is the patient’s condition, not the names of those diseases, state in measles with badly-developed rash might call for it, while a case of frank scarlet fever, even with bad throat symptoms, may not require it.
Diphtheria again, in pre-antitoxin days, has been benefited by ailanthus, and it might even now be required to supplement the serum or where the latter was too late to do good. In the drowsy, intoxicated state, with an ichorous foetid discharge from nose or throat, where the blood-poisoning symptoms predominate over the obstructive, ailanthus should be thought of. The usual discharge os irritating, and the child may picking at the nose; these will break and sore ulcerated areas follow, dusky and slow in healing.
It is also one of the drugs to be considered in Vincent’s angina.
Influenza or ” a chill” may have a symptom-complex like this: an excess of mucus arising without apparent cause, with salty expectoration from naso-pharynx (not ordinary nasal coryza) and soreness of throat and swelling of uvula which may lead to cough and headache. If these are followed by a hot, tingling feeling in the throat, descending into the windpipe, causing a choky feeling on inspiration, heat and tingling behind the sternum, and a raw, tearing sensation in the trachea on coughing, with or without chest pains and there or wheezing, ailanthus has enough localizing symptoms to warrant its use.
If with this a heavy, stupid feeling be associated, and dizziness and restlessness, with thirst for cold water even if the patient is chilly, the choice of this drug would be confirmed.
It is useful in non-febrile conditions with neuralgic pains in the limbs-shooting, tingling, numbness-extending up the back; and for headaches and stiff neck, night and drowsiness by day, with vertigo, dilated pupils, forgetfulness and difficulty in concentrating thoughts, ailanthus will also do good. Such a state may be found after excessive study or mental strain. The digestion may be disturbed at the same time-loss of appetite, nausea, whitish tongue, tympanites or empty feeling in the stomach, depression and sighing may be present in these or in the influenzal cases.
It has been recommended for hay fever with fluent corroding nasal catarrh and swollen dark red throat.
(1) A semi-conscious, stuporous condition with low delirium as seen in the “typhoid state”.
(2) “Malignant” states in acute exanthemata; petechiae.
(3) Conditions due to suppressed or undeveloped rushes in acute cases; dusky, bluish eruptions which should be bright.
(4) Foetor and acridity of discharges.
(5) Sore, swollen throat, livid and possibly ulcerated.
(6) Involuntary discharge of urine, and thin, offensive stools.
(7) Eyes suffused, face dusky, startled look when waked. fever, variola, diphtheria, typhus, influenza, hay fever, and some cases of septicaemia.
Lying down (toothache), pressure of clothes.
Sleeps best on right side, and lying on right side relieves bronchial affections.