Arsenicum Album ars.

Great prostration,* with rapid sinking of the vital forces.* Fainting.

The disposition is: a. Depressed, melancholic, despairing, indifferent. b. Fearful, restless, anxious, full of anguish. c. Irritable, sensitive, peevish, easily vexed.—Dunham.

Mentally restless, but physically too weak to move; cannot rest in any place ; changing places continually ; wants to be moved from one bed to another, and lies now here, now there.

Anxious fear of death; thinks it useless to take medicine, is incurable, is surely going to die; dread of death, when alone, or, going to bed.

Burning pains > by heat, is very characteristic.

Burning pains, the affected parts burn like fire.

Excessive anxiety; great anguish; extreme restlessness; fear of death.

Burning thirst, without special desire to drink; the stomach does not seem to tolerate, because it cannot assimilate cold water; it is wanted but he cannot drink it.

Great thirst for cold water; drinks often but little at a time, simply to moisten the dry mouth and lips; eats seldom but much.

Teething children are pale, weak, fretful, and want to be carried rapidly.

Cannot bear the smell or sight of food (Colch., Sep.).

Desires: acids, beer, brandy, wine, coffee, warm food, milk, fruits and vegetables.

Aversions: sweets, meats, fatty things, farinaceous food; loathes even the thought of food.

Gastric derangements: after cold fruits; ice cream; ice water; sour beer; bad sausage; alcoholic drinks; strong cheese.

Bad effects from decayed food or animal matter, whether by inoculation, olfaction or ingestion.

Diarrhœa after eating or drinking; stool scanty, dark color, offensive odor, followed by great prostration.

Rapid emaciation: with cold sweat and great debility (Ver.—of affected parts, Tub.).

Excessive exhaustion from least exertion.

Exhaustion is not felt by the patient while lying still; when he moves he is surprised to find himself so weak.

Skin: dry and scaly; cold, blue and wrinkled; with cold, clammy perspiration; like parchment; white and pasty; black vesicles and burning pain.

Breathing: asthmatic; must sit or bend forward; springs out of bed at night, especially after twelve o'clock; unable to lie down for fear of suffocation; attacks like croup instead of the usual urticaria.

Complementary: All. s., Carbo v., Phos., Pyr.

After midnight (1-2 A. M.; 1-2 P. M); from cold; cold drinks or food; when lying on the affected side or with the head low.

From heat in general (rev. of Sec.) except headache, which is temporarily $>$ by cold bathing (Spig.).

Quotidian; tertian; quartan; double tertian and quartan. Anticipating (Bry., Cinch., Nux). Every fourteen days. Yearly (Lach., Nat.). Irregular, both in type and stage (Nux). Remitting and relapsing both tend to typhoid and typhus, especially after abuse of Quinine.

Septic, typhoid, typhus or yellow fever.

All periods—mostly afternoon paroxysms, 1 to 2 P. M.; 12 to 2 A. M.; 3 to 6 P. M.; 5 P. M.; 12 M. Every fourteen days (Cal., Cinch., Puls.).

Anticipates, one hour every other day.

Yearly return of complaints (Carbo v., Sul., Thuya).

Fever without chill—2 A. M.; 4 P. M.; 10 P. M.

Afternoon intermittents of nursing children, without chill, must be covered, and very thirsty; fever lasting all night.

Characteristic; 1 to 2 P. M.—12 to 2 A. M. Anticipates. "Sleepy, night before the paroxysm."—H. V. MILLER. Time.—Not characteristic. 5 A. M.—5 P. M. Anticipates or postpones. "Restless sleep, night before the paroxysm."—HAHNEMANN.

"Sleepiness night before paroxysm."—H. V. MILLER.

Yawning and stretching; malaise; debility; weakness; headache; vertigo; great weariness and inclination to lie down; slight creepings over the back after drinking; cutting pain in chest and bowels like knives, and watery diarrhœa; shuddering. Every morning stretching of limbs, gaping, emptiness in head, anxiety, thirst, and immediately after drinking chilliness and crawling.

No thirst. Headache, with vertigo and pale face; pain in bowels and watery diarrhœa. Prodrome.—Great thirst. Canine hunger, headache, with flushed face and palpitation of the heart.

Without thirst; irregularly developed; never clearly defined; simultaneously, or alternating with heat; mingling of heat and chilliness; all ameliorated by external warmth (Ign. —aggravated by external heat, Apis, Ipec.). Irregular chills at any time of day. Shuddering when walking in the open air. Generally little if any thirst during chill, then prefers hot drinks; if thirsty, frequent drinking but little at a time, but drinking increases the chilliness and causes shuddering, nausea and vomiting (drinking hastens and aggravates chill and causes nausea, Eup. perf.—causes headache, Cimex—every drink causes shivering and chill, Caps.); oppression of the chest (Apis); coldness of abdomen (Men.); blue nails and lips (Nux); tastelessness of food; shuddering without thirst, worse in the open air. Internal chill, with external heat and red cheeks; coldness of body and dryness of the skin; burning heat of skin, cold to the touch; headache.

Coldness of the whole body; pale, sunken face; very sickly appearance; lips pale, rigor, pains in limbs, back and chest; breathing impeded, restless, trembling.

Crawling in the evening, with stretching of limbs and anxious restlessness. Chill gradually increasing to shaking rigor.

Concomitants of chill: colic and nausea. diarrhœa, unconsciousness, drawing, tearing in limbs, thighs feel as if beaten, cramps and contraction in chest, difficult breathing, desire to urinate and frequent urination; hunger.

With the shivering and coldness, aggravation of other complaints. Coldness and chilliness renewed after drinking and after eating.

"Chill in forenoon not relieved by anything; external coldness, with cold, clammy sweat."—HERING.

Chill or chilliness without thirst; if there be thirst during chill except for hot drinks, do not give Arsenic.—H. N. GUERNSEY.

Irregular; mingling of heat and chilliness; chills alternating with heat; ameliorated by external heat. Thirst slight, if any for hot drinks. Chill.—Regular; violent chill over whole body, with icy cold hands and feet; external heat increases chill. No thirst during chill.

Light, irregular, mingling with heat, > by external heat. Thirst, if present, for warm drinks.

The hot stage of the fever is intense, long lasting, dry, burning and pungent to the touch, with inclination to uncover (Apis, Sec.) and insatiable thirst for cold water; drinks little and often, with vomiting after drinking several times. Internal, burning, dry heat at night, must be uncovered. Burning heat as if hot water were poured over one, or as if hot water were coursing through the blood-vessels (Bry., Rhus). Oppressed breathing (Apis); great restlessness, and pressing, burning pain in region of the spleen. Burning pain in stomach and bowels.

During chill and heat, aggravation of previously existing symptoms. Heat following the chill is dry, burning, unbearable, lasts three or four hours, with painful pressure and tension in both hypochondria; fulness in epigastrium; pressing pain in forehead; restlessness, anxiety and unquenchable thirst; sometimes a great desire for acids and acid drinks.

Dry, burning, intense, as if hot water were coursing through the blood vessels. Great restlessness; uncovering brings relief. Insatiable thirst; drinks little and often. Heat.—With distended veins and congestive headache, often delirium. Wants to uncover, but chilly when uncovered. Rarely any thirst; if any, at close of heat. Hunger instead of thirst.

Dry, burning, intense; great restlessness; uncovering >; unquenchable thirst, drinks little but often.

This stage is as variable as that of chill—with unquenchable thirst for large quantities of cold water (Cinch.), which causes vomiting. Sweat, with cessation of all the previous symptoms (Nat.—of all except headache, which is increased, Eup.). Sweat; sometimes offensive and sour smelling. Sweat during first sleep, or during entire night; cold, clammy sweat. Sweat with excessive thirst. Sweat with thirst, coming on several hours after the heat, or, which is oftener the case, there is no sweat at all, the dry heat continuing all night. After the paroxysm—with or without sweat—great weakness and prostration and a desire for stimulants, wine or coffee. There is more headache than in the hot stage, unless there be copious sweat (most intense in hot stage, Nat.). Drinks large quantities in sweat; little and often in chill and heat.

With the various stages of the fever always appear other symptoms.

Rarely occurs, light if any; but cold and clammy. Unquenchable thirst for large quantities of cold water, with vomiting after drinking. Sweat.—Debilitating; profuse. On being covered, he sweats profusely all over. Sweating during sleep. Thirst returns; for large quantities, or little and often.

Often wanting; if any cold and clammy; great thirst for large quantities of cold water, with vomiting after drinking.

The mental restlessness, physical weakness and profound pros- tration are always present in every form of fever.

Anxiety, fear of death, fears disease is incurable, < when alone or when retiring.

Incomplete stages; obscurity of either chill, heat or sweat.

Sides furred with red streak down the middle (Ant. t.) and red tip; yellowish-white; brown; bluish. Water tastes bitter; desire for acids; brandy. Aversion to food (aversion to meat, Arn.).

Sides furred, with red streak down the middle. Tongue brown; blue; desire for acids; aversion to food. Tongue.—White; yellow. Thick, dirty coating; taste too acute; food tastes bitter; too salt; hungry.

Weak, small, easily compressible. Very frequent in morning, slower at night. Pulsations through whole body (Arn., Nat.). Burning or cold sensations in the blood-vessels (Rhus).

Weak, small and easily compressible. Frequent in morning; slower at night. Pulse.—Hard; full; quick. Uncommon distension of blood-vessels.

Never clear of symptoms. Great debility; lassitude; weakness of all the limbs and constant inclination to lie down (Arn.). Face pale, sunken, sallow, clay-colored, bloated; dull aching in region of liver and spleen, painful on pressure, with sensation as if swollen. Abdomen bloated (Apis); fœtid, watery, diarrheic stools, which are very debilitating; urine scanty and turbid. Constant desire for acids or something refreshing. The patient is constantly chilly and must be in a warm room. Gen- eral anæmic appearance (Eup., Cinch., Fer.). Skin pale, often covered with cold perspiration. Icterus after the fever. Fevers contracted at sea-shore watering places, coming on in the autumn, or “wintered over” and not coming on until spring (Gels.).

“The paroxysm is not complete. One (especially the cold) stage is generally wanting.”—CARROLL DUNHAM.

The following admirable analysis of the indications for Arsenic in intermittent (or other) fever is by Dr. Wurmb in *Homœopathische

Clinische Studien*, 1, p. 179:

“Arsenic is one of those few drugs whose action is distinguished not alone by its intensity, but equally by its extent; it involves the entire organism. Every system, every organ of the body, every nervous filament, is so subjected to its powerful influence that we are not able to say which of its symptoms are primary, which are secondary, and where the focus of its action chiefly lies.

We see the entire nerve-life attacked in all directions, from the slightest excitement to the most violent irritation; from the mere sensation of weakness to actual paralysis, and then we see, like- wise, another series of disturbances arise from its action, which advance in regular gradation from the most inconsiderable acceler- ation of the circulation to the most violent febrile storm; from the slightest irregularity in the vegetative sphere to a cachectic dyscrasia; yes, even to decomposition and destruction of the organic substance.

“In addition, we remark the striking similarity between the symptoms of chronic arsenical poisoning and those of the inter- mittent cachexy, as well as the fact that Arsenic has the property of causing the periodical recurrence of symptoms in so high a degree as to surpass in this respect all other drugs; in a word, no other drug known to us has such a power of affecting so intimately and so variously those organs that are especially affected in inter- mittent fever, and none corresponds so well as Arsenic does to all the requirements of a remedy for intermittent.

“Arsenic is indicated in cases which are distinguished not only by weakness in the vital power and deterioration of the organic substance, but also and at the same time by symptoms of excita- tion of the circulation, or of the nervous system alone, or of both together. Again, it seems to be more especially indicated the more malignant the influence from which the disease has sprung.

Marsh-miasm is the chief of these influences; in this originate the most serious and most dangerous cases of fever, and in these

Arsenic is often the only remedy that will rescue the patient.

Again, the longer the disease has lasted the more is Arsenic generally indicated, because the more deeply have the organs and tissues been affected, the more nearly has the patient’s condition approached that known as the intermittent cachexia, and which so nearly resembles the arsenical cachexia. Especially is this the case when the liver and the spleen have become swollen.

“The intermittents which find their homeopathic remedy in

Arsenic present in their paroxysms the following peculiarities:

The paroxysms are general, violent and of long duration; the stages are either distinctly developed and equally proportioned to each other, or else, as is most frequently the case, one of the stages is absent or is very feebly present; if the latter be the case, it is generally the cold stage which fails, and the hot is all the more violent. The more intense the heat, the longer it continues, the higher the degree of development of the accompanying excite- ment in the vascular system, and the more burning and insatiable the thirst, the better is Arsenic indicated. The sweating stage may be altogether wanting, or the perspiration may be very copious; it breaks out generally several hours after the hot stage and lasts a long time.

“With the paroxysms are associated many distressing acces- sory symptoms, which are connected, some with the disturbances in the nervous system, some with those of the vascular system, e. g., spasms, pains, delirium, paralyses and the anguish and rest- lessness that are so characteristic of Arsenic.

“The apyrexia is not pure, but is disturbed by symptoms of the most various kinds; restlessness, sleeplessness, spasms, di- gestive disorders, feeling of weakness and general prostration, and it is especially characteristic for Arsenic that after every paroxysm there is a notable increase of prostration.”

Arsenicum. Cinchona.

Great weakness and prostration; pale, sunken face; fetid, watery diarrhœa; abdomen bloated; great desire to lie down. Apyrexia.—Sweats easily; exhausting night-sweats; pain in both hypochondria; complete loss of appetite.

Arsenicum is often given (by some homeopaths) in alternation with Cinchona or some of its alkaloids in this disease; but with the above comparison, to those who differentiate, there ought to be little danger of confounding them. Where one is indicated the other never is. Fowler's solution, and massive doses of the lower triturations of Arsenicum, frequently repeated, are wholly unnec- essary in the treatment of intermittent or any other fever. If the remedy be indicated, the potentized drug will effect a more prompt and radical cure.

Arsenicum is probably more often indicated than any other remedy, in the so-called "dumb ague," "masked intermittent," so often met with after abuse of Quinine. Also, in the afternoon intermittents of nursing children—who never have chills, and from whom it is impossible to obtain many indications—it fre- quently suffices to complete a cure. The general constitutional symptoms are guiding.

In typhoid and continued fevers no remedy perhaps is so often abused as Arsenicum, when it is too frequently repeated in the 3x or 6x for "typhoid fever" not for the symptoms of the patient.

In the characteristics of Arsenicum will be found such complete indications for its use in any stage of typhoid, typhus or yellow fever that the baneful effects of a routine practice may be avoided.

Time, 1-2 P. M. or 12-2 A. M. is always guiding.