Ailanthus Glandulosa
Generalities: This
medicine is especially suitable in the low zymotic forms of sickness, such as we find in
diphtheria and scarlet fever, in blood poisoning and in symptomatic typhoids, especially
those cases that are characterized by capillary congestion in spots, red mottled spots.
Scarlet: Perhaps the
most striking manifestation of such a low type of sickness is malignant scarlet fever. The
regular rash does not come out, but in its place red spots, roseola-like, make their
appearance; the usual uniform spread of the eruption has failed, or has been suppressed, and
there is bleeding from the gums and nose, and dreadful tumefaction in the throat.
The countenance is purple and besotted, the eyes are congested and there
is even bleeding from the eyes. There is an appearance of great prostration, but it is
really stupefaction; he seems stupid and benumbed.
If you look at the throat you see it is covered with little purple
patches, intermingled with an oedematous appearance similar to that found in Baptisia. It is a low
depressed type of sickness.
De composition of the blood is going on rapidly. The blood that oozes is
black. The child is going into a state of stupor and it is with difficulty that he can be
aroused. Sometimes blisters are formed on the ends of fingers, or here and there over the
body. From the mouth and nose come foetid odors. The child is going as rapidly as possible
into a form of malignant disease.
Sometimes the disease comes on as a light febrile attack, but from taking
cold and suppressing some of the natural manifestations the case takes on a low typhoid form
and whereas you had at first only a simple remittent, the case has now assumed a state of
prostration with a very rapid heart, foetor, purpleness or blueness, a passive congestion
with purple blotches of the skin, causing a mottled appearance.
When a disease turns so suddenly blood poisoning is going on and a
symptomatic typhoid state appears. A remittent that turns into a sharp zymotic state in the
course of twenty-four hours, a diphtheria that takes on this form with stupidity and mottled
skin are examples of such a type of sickness.
Mind: The mental
symptoms accompanying this state are interesting. I read from some nows I have made. A
continued dreamy state of mind though awake. Child cries all the time. Sees little animals
like rats running around.
Feels a rat or something small crawling up the limb and over the body.
There seems to be constant loss of memory, even the things spoken of a moment ago go right
out of the mind. Constant forgetfulness. All past events are forgotten. Past events are
forgotten or remembered as belonging to someone else, or as matters read.
That is in keeping with the dreamy state, it seems as though those things
that are past appear as in a dream, as if he had dreamed them. Cannot concentrate the mind
in any mental effort; cannot answer questions correctly; is as if in a semi-conscious state,
and finally he goes into complete unconsciousness.
There is in the earlier stages of this zymotic state great anxiety and
restlessness, later there is stupor and indifference to everything. Continual sighing with
depression of spirits; extremely irritable, semi-conscious, finally unconsciousness, stupor,
delirium and insensibility; muttering delirium with sleeplessness and restlessness.
This mental state is such as occurs in zymotic sickness; the chronic
illness has not been well brought out. Dr. Wells used this remedy in
a number of cases, as it was at that time an epidemic remedy for scarlet fever, in Brooklyn,
and many patients were saved by it. It seemed to be able to change the character of the
malignant forms of scarlet fever into a mild type.
Face: In addition to
the symptoms of the text it has been observed that the hair falls out and flashes of light
play before the eyes on closing the lids at night.
"Pupils widely dilated; copious, thin, ichorous and bloody,
discharge from the nose."
That is in the zymotic states in scarlet fever.
"Nostrils congested. Great prostration and a countenance indicating
much distress. Face dark as mahogany."
That is in suppressed scarlet fever. Purple, bloated and puffed, besotted
face. This remedy is one not very much used, and it is not very often indicated, but it is
very useful when indicated. You will not very often see this particular type even in
malignant scarlet fever. You will often see such a scarlet fever running to a number of
other remedies, but this remedy corresponds to one of the most malignant types, and its
commonest use will be in an epidemic in which the cases largely run to the malignant type.
There are three common types of scarlet fever. In one season you find the
cases are mild and simple, the typical eruption is present and comes on speedily without any
great amount of fever. Such cases will often run their course with good nursing, a warm room
and plenty of clothing without much medicine.
Skin: The skin is
bright red, smooth and shiny. The case is not serious. In other epidemics you will find only
an isolated case of this kind, while the majority of cases present marked trouble in the
throat; the rash is scanty when present, and congestion of the head and spinal symptoms come
on with pain in the back of the neck.
Throat: The throat is
dreadfully swollen and inflamed, bright red and very painful. Then there is a third type in
which the throat is severely swollen, all the mucous membranes are swollen, and the whole
tendency is toward ad poisoning or zymosis with enlargement of the glands, puffiness of the
skin and a great deal of fetor; the skin is dusky and the eruption is scanty, sometimes
hardly visible from beginning to end.
These cases will almost all die if let alone; they are very serious. The
old authors call these three forms "scarlatina simplex, scarlatina anginosa," and
"scarlatin. maligna."
In some epidemics you will see all three of the appearances; in some
families you will see two forms.
One child will have a mild in type, and another will have it more
severely with zymotic blisters here and there, on the ends of the fingers, and these will be
attended with foetor; as soon as the blisters break ulceration will take place if the child
live long enough; but these are the deadly cases, the malignant type.
Even when the rash does not come out in the low forms of scarlet fever,
the impression of the finger makes a white mark which will be slow to fill up. The more
marked that is, the lower the type. The more zymotic the type the more sluggish the
circulation, and in this remedy especially is this state present.
The congested condition of the skin is present even when there is no
rash, a passive congestion of the veins.
Quite a number of medicines have that, but Veratrum viride produces
such a vaso-motor paralysis that a line upon the skin made by pressure will remain a long
time. In all these zymotic complaints there is a foetid odor that is sometimes cadaveric,
sometimes like stinking meat; this will be found in the low types of disease where this
remedy is indicated.
"Throat much swollen, dark red, almost purple in color. Diphtheria
with extreme prostration. Throat livid, swollen; tonsils prominent and studded with deep
ulcers."
The throat and tonsils very often appear as if they would pit upon
pressure like a dropsical state. In some of these zymotic cases where a reaction ought to
take place a diarrhea sets in that is horribly offensive; a critical diarrhea. With these
zymotic states there is pain in the back of the neck and head no matter what the name of the
disease is.
"Breathing hurried, irregular, heavy. Burning in the palms and
soles, hunts to find a cool place to put them. Feels a rat running up the leg. Feeling as if
a snake crawled up the leg."
These mental symptoms occurred in one of my provers. In low, adynamic
forms of disease characterized by sudden and extreme prostration,
"Vomiting, pulse small and rapid purplish appearance of skin."
"Electric thrill from brain to extremities."
"Chill at 8 A.M. with chill, heat and sweat."
During the chill vomiting of food and piercing pain over the hip. Chill
is preceded by malignant eruption, especially on the face and forehead.
"During chill hunger, empty feeling, intolerable pain in back of
neck, upper part of back and hip joint."
That pain in the back of the neck is a common forerunner of low types of
fever. It generally precedes a congestive attack of great violence characterized by fullness
of the head with heat.
Skin: This miliary
rash spoken of in the text, looking like measles, is when the scarlet fever rash or the
measles rash does not come out in its uniform fashion, but in patches, little circles here
and there and is dark.
"Irregular, patchy, livid eruption, disappearing on pressure and
return ing very slowly; interspersed with small vesicles, worse on forehead, head, neck and
chest. Eruption appeared scantily for two days with sore throat and mild fever" .
This eruption is like the petechiae that we see, in typhoid forms of
disease. The record of this remedy in scarlet fever makes it worthy of further study; it
ought to be reproved that we may have a fuller understanding of it.
"Eruption plentiful, of a bluish tint. Typhoid scarlatina."
"Eruption is slow to make its appearance, remains livid."
"Body and limbs covered with an irregular patchy eruption of a very
livid color."
Here you see but one type of scarlet fever. This low type of fever
sometimes needs Sulphur or Phosphorus, or Belladonna, or Baptisia, or Lachesis. That you may be able to distinguish one from
the other and keep the picture of each remedy clearly in mind requires a prolonged study of
the Materia Medica.
It is an easy matter to compare remedies for yourself after you have
first studied each one separately.
You can then bring out many comparisons, and especially in this case at
the bed side. If you go to the bedside with a good knowledge of the generals of Materia
Medica you will be surprised at the number of symptom pictures which will come into your
mind, called up by the signs of the sickness.
When you go to the bedside of scarlet fever you should not call to mind
the names of these medicines you may have heard recommended for scarlet fever; let the
appearance of the patient bring to mind such remedies as appear like this patient,
regardless of whether they have been associated with scarlet fever or not.
When you see the rash perhaps you will say that looks like an Aconite rash but there is
such scanty zymosis in the nature of Aconite that it is no longer thought of. Belladonna is not suitable, for in that remedy the rash is shiny and
smooth, the typical Sydenham rash.
On the other hand, you will say Pulsatilla has a measly rash, and often associated with a low
form of fever, but not so low as the typhoid type, so Pulsatilla goes out of your mind.
You now think of the remedies that are typical of all zymotic states; the
prostration, the aggravation after sleep, general stupor and delirium, and almost at a
glance you see Lachesis, the type of such forms of disease.
Its picture comes into your mind speedily. You see another case of
scarlet fever where there is a scanty rash, the child before you keeps on picking the skin
from the lips and nose, lies in a state of pallor and exhaustion, no rash to speak of, urine
nearly suppressed; almost in a moment you think of Arum triph. It is the aspect of things that will call the remedy to the mind. In
another case you have all the purple appearance I have spoken of in this remedy; horrible
foetor a good deal of sore throat, and the child cannot get water cold enough, wants a
stream of water running down the throat all the time; you may safely trust to Phosphorus. In these low types of sickness there is always something to tell the
story if you will only listen, study and wait long enough.
Lectures on Materia Medica- James
Tyler Kent
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