Clematis erecta. N.O. Ranunculaceae. Tincture from fresh leaves and stems.
CLEMATIS is one of the so-called sycotic or antisycosis drugs, by which is meant drugs directed against the late effects of gonorrhoea or the results of its suppression.
The skin is inflamed by clematis, and the eruption is either a simple erythema with much burning, or more frequently it is distinctly vesicular, the little blisters being filled with yellow or turbid fluid and having an indurated base; or the vesicles may become pustules, and they may break and ulcerate, induration being a feature of the ulceration. The ulcers may become covered with dry discharge, i.e., by “scabs,” or may have a thin, offensive (ichorous) discharge and may spread at their edges. The spots itch violently and the irritation is worse from washing in cold water, which causes burning. Crawling, smarting and stinging are alternative sensations in the spots, but whatever the sensation it is worse from washing in cold water and from the warmth of the bed.
Genito-urinary System.-The urinary symptoms of clematis are : (a) Tingling and burning in the urethra lasting after micturition; (b) with urging to urinate and involuntary straining; (c) there is a slow, feeble stream, apparently due to narrowing of the urethra by urethritis; (d) the flow is intermittent; (e) the patient cannot always completely empty the bladder, and the urine may (f) dribble away after the flow seems to have stopped.
Associated synchronously with the urinary symptoms are those of the male genital organs, and these are important because this is the chief clinical sphere of clematis, as will presently be pointed out. Orchitis comes on, especially right-sided, with pain in the testis and spermatic cord and the ilio-inguinal nerve. The testicle is heavy, hard, and tender to touch, and drags on the cord. With the inflammation of the urethra and testes there are often violent erections, causing pain.
There may be ilio-inguinal neuralgia without orchitis or epididymitis.
Mental.-The physical lesions mentioned are of a depressing nature, consequently mere low-spiritedness is neither surprising nor significant from the clinical point of view; hardly more so is discontent, but dread of impending misfortune may become of value as an indication for the drug. A mental state which is both constant and of importance as an indication is “fears to be left alone yet dreads company,” which may be interpreted as fearing some form of assistance may be needed and dreading what it may be-an understandable mental complex, especially when we come to using the drug therapeutically. In chronic cases mental confusion and faulty memory may replace feelings for fear and dread.
Head.-Dull pain in the temples with a confused feeling is the chief form of headache from clematis. The scalp is the seat of eruptions such as have been described, especially located on the neck at the junction of skin and hairy scalp. Many spots also appear on nose, cheeks and lips. The submaxillary glands become enlarged and throbbing, and sensitive to touch, the right side being the more painful, and the pain extending to ear, eye and temple.
Mouth and Teeth.- Toothache and facial neuralgia are produced. The pain in chiefly on the right side, it is worse from the warmth of bed, and fro holding warm fluid in the mouth, and at night, from moving the jaws or smoking tobacco. It is also definitely worse from lying down, i.e., from the position, apart from warmth, &c. Cold air or water in the mouth gives temporary relief. The teeth feel too long, the gums are soft and sore, and salivation may be present.
Black and Limbs.- Bruised, stiff pain in the back, worse from stooping, and pain and swelling in the joints of fingers and hands, comprise the rheumatic phenomena of the drug. After the ailments have lasted some considerable time, loss of flesh takes place, pulsations are felt in the body, and twitchings of muscles occur. These phenomena are worse from walking and at night, and some of them from eating, ex.gr., abdominal symptoms, the inguinal region feeling sore and swollen especially on the right side.
The urinary and genital symptoms in provers would occur simultaneously; in patients the former would precede the latter. in severe cases the early stage would be better met by cantharis, to be followed in a few days by clematis if the constitutional symptoms agreed. The same remedy would follow the case into the stage of epididymitis and into the beginning of inflammatory stricture. Involvement of the right side would be a further indication for it.
Face and Teeth.- The toothache and neuralgia suitable for clematis are clearly indicated in the pathogenetic section.
Back and Limbs.- Lumbago and arthritis, especially Gonorrhoeal rheumatism, with the clematis modalities are frequently benefited by this remedy, and the same may be said of the rheumatoid symptoms sometimes following dysentery.
Mind.- Apart from the physical ailments which cause the mental depression, clematis is not called for in mental diseases. The symptom “fears to be left alone yet dreads company” is rather an indication for the drug in the physical ailments than of use in concrete diseases of the mind.
Eyes.-Clematis has been used for conjunctivitis in pale, delicate, so-called scrofulous children, and for iritis, rheumatic or syphilitic. The symptoms are worse at night. Vision is dim, as from a veil before the eyes. It is recommended for iritis; Hughes says he “has every confidence in it in both the rheumatic and syphilitic forms of the disease.”.
(1) Vesicular eruptions, with serve itching and above- mentioned modalities.
(2) Orchitis and epididymitis, especially if due to supposed suppression, worse on right side.
(3) Enlargement and hardening of lymphatic glands, especially inguinal.
(4) Gonorrhoea and stricture the result of gonorrhoea.
From warmth of bed (eruptions, toothache), when lying flat (toothache), from washing in cold water, right side (testis, teeth, glands), 3-5 p.m. (debility).
From holding cold water in mouth, or drawing in cold air (toothache temporary).