Ruta graveolens. Rue. N.O. Rutaceae. Tincture from the fresh plant, before flowering.
RUTA is a drug with a limited but well-defined sphere. It appears to affect both injuriously and curatively the fibrous and bony tissues, especially in the vicinity of joints. Taken experimentally, it causes distress of pain such as would result from traumatism or over-exertion of the part affected, or of the body as a whole. It will cause a general bruised sensation, with aching tenderness and restlessness, and a future of the pain is that it is worse during rest and easier from moving about. This is experienced also in cases due to injury, strain, sprain, and over-exertion, and in some cases of rheumatism, and is, in some patients, noticed particularly in cold, damp weather. Ruta has this peculiarity in common with some other remedies,especially rhododendron and rhus. (These remedies may be memorized as “the three Rs.”
Back and Limbs-The nape of the neck, the shoulders, the “small of the back,” and the sacral region all experience such pains, described variously as a feeling of tightness and pressure (neck), as stitches, especially when stooping or sitting, or as a bruised pain when sitting after walking. They are relieved by pressure, as by lying on the back, and by moving about after a period of rest. The parts lain upon feel bruised. Similarly in the limbs, such pains come on after over-use of a part, or from rheumatism, or injury, and the joints are chiefly affected. Here stiffness is very noticeable, and that condition and pain are felt using the part-lifting an object, rising from a seat, & c. The tissues round a joint feel tight and shortened, and this imparts a feeling of weakness and insecurity, especially where the movement is “loaded”, as in the knees bearing the weight of the body, or the wrist when raising an object. The same modalities-relief from continued gentle movement, and aggravation in cold, wet weather-are experienced by provers and must be present in a patient if ruta is to be successfully used.
Digestive System-The ruta patient is drowsy and lethargic in the daytime, after eating, especially from eating meat. This may be due to (or at least associated with) indigestion- ruta causes gastric symptoms in the shape of soreness in the epigastrium and a gnawing, empty feeling there, and eructations. Great thirst (for ice-cold water) is induced and aversion for food as soon as eating is begun. In the abdomen a similar gnawing pain round the navel and in the right hypochondrium is felt. The lumbar muscles ache when at rest after exercise. Constipation is usually present or it may alternate with mucous diarrhoea; tenesmus, often in effectual, may induce prolapse of the bowel.
Genito-urinary Apparatus-Persistent desire to urinate, not removed by micturition, may be associated with the rectal symptoms and with pelvic (“uterine”) bearing down pains. Menorrhagia has been induced and the drug was formerly used as an abortifacient. It has consequently been used as an abortifacient. It has consequently been used in threatened miscarriage. In subjects with rheumatic symptoms as described, it would be indicated for metrorrhagia and spasmodic pains suggesting that condition. Acrid leucorrhoea may follow menstruation.
Ocular Symptoms- The effects of rue on the eyes are to cause aching and burning of the globes, worse on using the eyes and in the evening, vision is indistinct and blurred after using them, especially after fine work. A green halo is noticed around artificial lights.
Neck, Back and Limbs-The pains in all these parts are of a similar character-bruised, aching or lame feeling. Kent says, humorously but strikingly, that ruta ” has ” (i.e., causes or cures) “all the pains” described by all the adjectives that apply to pain.” To make them useful as clinical indications the modalities already noted must be presented. Fortunately they are few and clear and will be recapitulated later. The headache is frontal, extending to the temples, with soreness of the scalp felt on brushing the hair’ throbbing and stitching pains are the chief varieties. Pain in a small spot, likened to a nail being driven in, is another ruta symptom. The interpretation of the various pains seems to be an irritation of a subacute kind, occurring in fibrous tissues-tendons, ligaments, aponeuroses and sheaths of nerves, muscles, vessels or organs, and (not least) periosteum and cartilage. The “bone pains” are probably periosteal.
Clinically ruta has been used with success in pains apparently affecting these tissues in any part of the body, due to metabolic (?digestive) or traumatic causes. The violence is chiefly due to strain in the form of over muscles, Over-walking or other exercise, prolonged eyestrain from fine working or from slight error of refraction, especially astigmatism, are other forms. Accidental sprains and bruising are less frequent causes.
“Rheumatic” or “gouty” pains with the ruta modalities are equally amenable to its beneficial action: rheumatic or traumatic nodules of long duration, or observed some time after an injury, should suggest ruta. More recent cases will probably call for arnica or rhus. Chronic synovitis and bursitis are often benefited by rue,even when given by routine, as in housemaid’s knee,” or in ganglion about the wrist tendons. The ankles are also a favourite sit of its action, and experience has shown that periosteum or ligaments scantily covered are however, may lead to disappointment, and it is not homoeopathy unless guided by modalities.
Sciatic cases with pain descending from back to food claim the consideration of ruta as a remedy. Dyspepsia after fatigue, abdominal strain, or brought on by drinking milk may require ruta. If the digestive disturbance is accompanied by nettlerash or general pruritus without eruption this will form an additional indication. The itching is relieved or displaced by scratching. Rectal and vesical straining are also confirmatory signs; also prolapsus recti occurring after parturition and induced on commencing to defecate.
The alternation of constipation and mucous evacuations, associated with ineffectual straining and persistent desire to pass water, have led to the use of ruta in malignant disease of the rectum, and some striking cases have been narrated. A careful study of the complete Pathogenesy of this drug should be made where rectal carcinoma is being treated medicinally.
Eyes-The ocular symptoms of ruta, although accompanied by a lot, burning, are not due to acute conjunctivitis but to overstrain of the eyes on fine work in a poor light. There is lachrymation but little or no photophobia, and the evening aggravation (which is well marked) may be due to failing light or to the long use of the eyes throughout the day.
Mind-The mental state of a ruta patient is not striking. Fretfulness or irritability due to fatigue may be present; also anxiety in cases of metrorrhagia, with spasmodic uterine pains, suggesting impending abortion. In any case an evening aggravation is noticeable.
The modalities are definite.
(1) The character of the pains is not of great value as an indication, but bruised and aching feelings are prominent.
(2) The favourite sites are wrists, ankles, around joints or wherever periosteum or ligaments are thinly covered; also the sciatic nerves or intercostal tissues.
(3) evening aggravation: restlessness from pains, which are worse in the evening.
(4) Thirst for ice-cold water.
(5) Constant desire to urinate, not relieved by micturition.
(6) Named Disorders-Sprains, bruises, old injuries, dislocations, fractures; nodular thickenings, contraction of tendons (especially flexors) and fascia, occupational fibroses; rheumatism, bursitis, ganglia, periostitis; neuralgias, sciatica;p asthenopia and strabismus, with burning of eyeballs, from eyestrain; warts with soreness, especially on palms; rectal prolapse and possibly carcinoma.
From cold, damp weather, from remaining still and lying down, from first movement-
From motion, though the very first movement may be stiff and painful (rhododend., rhus, & c.). The patient is sensitive to cold and relieved by local and general warmth, but eyestrain is worse from warmth, relieved in open air. Lying on back (constituting pressure) relieves backache.