Monday, 21 March 2016

How to Differentiate Rhus tox and Bryonia in Fever, Part 2



There is no replacement for the disciplinary learning of medicines. But are we really in close connection with our drugs? Is it not the truth that the technology has deviated us from following the Hahnemannian methodology of prescribing? I am not against progress and development, but the system suffers from this neglect. Eventually it's the patient who becomes the scapegoat. I am on a quest to relearn the materia medica, to get to know the drugs intimately and to discern the points of similarities and differentiation between them. There are no shortcuts in learning. Dr. Hering has rightly said
“THEY WHO UNDERTAKE THE PRACTISE OF MEDICINE CHIEFLY BY THE AID OF EXTRACTS AND REPERTORIES, WILL ALWAYS CONTINUE MERE NOVICES, WILL NEVER ACCOMPLISH WHAT BELONGS TO SKILL, FOUNDED ON SCIENCE AND CARRIED OUT PRACTICALLY, WITH DILIGENCE AND CARE.”

When new into practice, it takes time to gain the trust of the people around us, to gain their confidence, to begin their history with us. I say history because, for a homoeopath, it is important to cultivate a good relation with our patients. It is a bond, that often lasts the test of time, the test of diseases, sometimes even the test of criticisms. We learn the little things and the big things about them and they understand the depth of homoeopathy and willingly give it time when needed. The treatment process have to begin somewhere. Very many patients like to make small beginnings, take baby steps, feel the waters before taking the plunge. Often, these beginnings are with a stuffy nose here, a cough there, a fast relief for a toothache or a handy remedy for a fever. The most familiar remedies are the most useful during this period. It maybe almost correct to say that the medicinal chest is surely incomplete without these two saviours, Bryonia and Rhus tox.

In a previous post on a comparison of fevers between the two drugs (read here)) , I have outlined the general similarities and differences. It doesn't give an actual picture of their indications in the specific circumstances.
In this post, I intend to give a more detailed comparison of the two drugs in several types of fever. Bryonia and Rhus tox are non anti psoric.

Though materia medica is not based on a pathological classification, comparison from a practical point of view, becomes easier when done on disease diagnosis. But it is not possible to allocate a symptom or a group of symptoms to a single diagnosis. Overlapping will occur.


INFLUENZA, BRONCHITIS, PNEUMONIA
Both bryonia and Rhus tox furnish abundance of symptoms in influenza. As well known, bryonia is slow in onset, slowly developing it's symptoms as days go by. The patient feels a little unwell, there is headache, running nose, red eyes with lachrymation. It proceeds to the throat and larynx producing hoarseness. It then settles into the chest producing bronchitis or could go on to pneumonia. The face appears puffed up. There are body pains. The cough is a dry hacking cough, with pains as if the chest would burst. In pneumonia, the right side is commonly involved. The chest pain could be due to pleuritis as well. Bryonia prefers perfect quiet and rest. Motion increase the headache, the general ache the cough and the chest pain. Warm room is intolerable but warm applications may be bearable in sinusitis. Bry wants the windows open. There is an aggravation of cough from eating,during evening and at night. The febrile state shows a 9pm aggravation, the chill or the heat, whatever the case maybe. Bryonia is indicated in damp climates. The complaints in bryonia is brought out from overheating, suppressed perspiration, taking cold etc.

The rhus tox too has its complaints from suppressed perspiration in damp climates, taking cold.  The headache differs here in that the brain feels loose and the pericranium is sore to touch. In bry, it is more of a bursting or throbbing type. The headache of rhus tox is more by getting the head wet. The coryza is usually thick. Both bry and Rhus tox have epistaxis,though more marked in bry. There may be hoarseness, but it is on beginning to talk which gets better with talking. The cold proceeds to the chest producing bronchitis or pneumonia. There could be a pleuritis here as well. The cough is again dry, teasing cough aggravated at night or in the morning. The respiratory symptoms of rhus tox are not as marked as that in bryonia. The restlessness and the joint pains that accompany the fever are relieved by motion and aggravated by rest. But the continuous motion weakens the patient. While bry doesn't like warm or closed rooms, rhus tox is better in warm rooms and aggravated by cold air.

In general, both bry and Rhus tox have dry mouth with intense thirst. The thirst is for cold drinks but it brings on chills and cough in both.


TYPHOID

While talking of typhoid, there are gastro intestinal symptoms, which make these drugs indicated in other related conditions. I will be mentioning them here.

Bryonia is indicated in fevers marked by gasro intestinal localisations, in fevers marked by gastro hepatic complications. The prominent symptoms to look out for here are, the modalities. There is loss of appetite, nausea, vomiting, bitter eructations and bitter taste in the mouth. These complaints are aggravated after eating. The general modality of aggravation from motion applies here as well. The nauseating feeling and the vomiting comes up every time the patient moves. The abdominal pain and it's modalities are very marked in bryonia. Any movement is painful, even the movement during breathing causes such a discomfort that the patient tries to hold the breath. The bryonia patient lies perfectly quiet in bed with knees drawn up. While the general complaints of bryonia are relieved by pressure, the abdomen is sensitive to it. The pains are stitching, burning. Though the patient desires cold water, the stomach is comfortable with warm drinks. In fact, the bry comes down with a disordered stomach from becoming overheated, taking cold or drinking ice water when overheated. The patient cannot bear the heat of the room,though heat application is desired. Bryonia is indicated in acute hepatitis, especially of right lobe. The nature and modalities of pain remain the same. Bryonia is indicated for gastrititis and gastro enteritis too

Bryonia is well known for constipation. There is no urge for stool, and little hard pieces are passed after few days. Any mucous will be discharged separately. In diarrhoea, there is early morning passage with distension and colic. Any motion causes urge to stool. In fact, there may be no stools at night, if he keeps perfectly quiet in bed. Bryonia is indicated in dysentery as well.

In rhus the gastric symptoms are not so prominent as in bryonia. There is pain in the stomach and nausea after taking cold things. Rhus tox has more of fullness and heaviness with a distended abdomen. The abdominal colic has modalities similar to that of in Byronia.

The diarrhoea of rhus tox is characterised by copious, watery, bloody stools. There maybe involuntary stools at night. Rhus is indicated in inflammation of any tissues of the abdomen, peritonitis, enteritis typhillitis. Dysenteric discharge drives him out of bed at 4am.

In typhoid, the stage at which rhus tox is to be given is more advanced than bryonia. There is inflammation of glands of the abdomen. There may be haemorrhage of black blood from the bowels. But both bryonia and Rhus tox are not indicated in the severe forms of typhoid fever. Of the two, it is more often that rhus tox is indicated than bryonia.

Hahnemann’s treatment of TYPHUS using these two drugs is widely known. Some even believe that both the remedies were given together. That is not correct. The facts should be verified before coming to such conclusions. In his Lesser Writings, Hahnemann has given a detailed description on the treatment of TYPHUS. He has given the indications for bryonia, and at what stage rhus tox is to be given. Reproducing the lecture in verbatim would make this post lengthy.

Rhus tox has fever blisters, the lips are dry, parched and bleeding. The corners of the mouth ulcerate. The whole mouth is raw and bleeding including the tongue. There is a putrid and metallic taste. The tongue is thickly coated in bryonia. The skin of rhus tox is at first dry and reddened. Then measles like eruption appears on the skin.


EXANTHEMA
Rhus tox is indicated in scarlet fever. The fauces and the uvula are red and swollen with vesicles on them. Coarse eruptions. Rhus is also indicated when the rash has been suppressed with inflammation of glands and much sore throat.

Bryonia is indicated when the sensorium is involved due to suppression of eruptive fever. It does not produce a picture of real meningitis. Apart from the fever, headache, vomiting the symptom to look out for in bry is the continued lateral motion of the lower jaw.

These are some of the major indications of bryonia and rhus tox in fevers. Bryonia and rhus tox in rheumatism is accompanied by fever and swollen joints. The  pains in bryonia are relieved by rest while rhus tox has pain during rest and prefers to keep it in motion. Bryonia is also indicated in postpartum breast engorgement. Rhus tox is effective in cellulitis and inflammation of glands.

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