The first impression would be to rebel against the use of such substances as Crotalus, Lachesis, Apis and other animal poisons, and it” is true that ” the lay mind must look with something like horror upon their administration; but when they are properly used and when we consider the dreadfulness of the necessity demanding them, and also when we have ascertained that there can be no substitute when demanded, and again that they are potentised and changed until they are perfectly pure, because reduced to a state of simple substance, the horror passes away from the mind. It is true that the diseases that call for the use of such substances as Crotalus are very grave. When at the bedside of a Crotalus patient one feels that death is very near, the subject is horrible to look upon, and the mother in regard to her child, or the husband, would immediately say, “Doctor, use anything in order to save the life; resort to anything in order to heal this sick one.”
The symptoms are peculiar in Crotalus. The remedy stands out by itself. Where can be no substitute for it, as there is no other remedy, taken as a whole, that looks like it. The other snake poisons form the nearest resemblance, but this one is the most dreadful of all, excepting, perhaps, the Ancistrodon contortrix (Copperhead). In the case of snake bites we get the most dire effects; we see death itself, we see’ the ending after a very rapid course, the very highest type of zymosis. These snake poisons are supposed to be cyanhydrates of soda and other salts. It is known that alcohol is the natural solvent of the cyanhydrates, and because of this alcohol has been used in great quantities in snake bites, and it has frequently prolonged and even saved life. If he lives through the violent attack he goes on forever manifesting the chronic effects, and from these we have collected symptoms. Dogs that have been bitten manifested the chronic effects of rattlesnake bite, and in them a peculiar periodicity has been manifested, viz., every spring as the cold weather subsides and the warm days begin. I once had the privilege of tracing up a dog that had been bitten by the Cenchris and had survived. It was bitten in the region of the neck, and in that region a large abscess formed every spring as long as that dog lived, until old age, when lie died from that disease. The periodicity in the snake poisons is related to the spring, to the coming on of the warm weather.
Another marked general feature in Crotalus, as in most of the other Ophidians, is that the patient sleeps into the aggravation.
The poison of the Crotalus horridus, in its earliest manifestations, is like unto the zymotic changes that we find in scarlet fever, in diphtheria, in typhoid and low forms of blood poisoning, those cases that come on with great rapidity, breaking down of the blood, relaxation of the blood vessels, bleeding from all of the orifices of the body, rapidly increasing unconsciousness like one intoxicated and besotted in appearance. A mental and physical prostration that is almost paralytic in character. Scarlet fever when it becomes putrid; typhoid when it becomes putrid, diphtheria with much bleeding and putridity. The body appears mottled, blue intermingled with yellow. Jaundice comes on with astonishing quickness, and the eyes become yellow, and the skin becomes yellow and mottled. Blue in spots. Black and blue spots as if bruised, intermingled with yellow. After hemorrhages the skin becomes extremely anemic. It is yellow, pale, bloodless. The body looks like wax. Hemorrhage from the ears, eyes, nose, lungs, from the mucous membranes everywhere, from the bowels, from, the uterus. A hemorrhagic constitution. Crotalus is indicated in disease of the very lowest, the most putrid type, coming on with unusual rapidity, reaching that putrid state in an unusually short time. One who has been poisoned rapidly sinks into this besotted, benumbed, putrid, semi-conscious state. There is a feeling as if death were coming over him As the blood oozes out it becomes black. It is sometimes fluid.
An awful state of nervousness prevails. Trembling of the limbs; tremulous weakness. On protruding the tongue it comes out quivering. Tired by the slightest exertion. Sudden prostration of the vital powers. A paralytic weakness prevails throughout. Twitching of the muscles, trembling of the limbs. Sliding down in bed occurs in the typhoid conditions where this remedy has proved of benefit, the forms of yellow fever with great prostration. This species of yellow fever has been cured by this remedy. Convulsions and paralysis. It has twitching of muscles something like chorea, trembling, localized spasms, hysterical manifestations.
The mental symptoms are well worth examining. The low form of delirium, muttering, talking to himself is a peculiar form of loquacity. It differs somewhat from Lachesis. Both have loquacity. The Lach. loquacity is so rapid that if anyone in the room commences to tell something the patient will take it up and finish the story, although he has never heard anything about it, so active is his mind. No one is permitted to finish a story in the presence of a Lach. patient. One will” commence to tell something. He will say, “Oh, yes; I understand it,” and he will go off on another line and finish up with something entirely different. Crotalus does that, too, but Crotalus will take it up and mumble and stumble over his words in a clumsy manner. It is a low passive state like intoxication; in Lach. it is wild excitement. “Delirium with languor, drowsiness, stupor.” That tells it. “Loquacious delirium with desire to escape from bed.” It is passive, however. His motions are slow. “Muttering delirium of typhus. Sadness.” His thoughts dwell on death continually. “Excessive sensitiveness. Moved to tears by reading. Melancholy with timidity, fear. Anxious and pale, with cold sweat. Irritable, cross, infuriated by least annoyance.” On motion there is vertigo, dizziness. On keeping still there is pain. On going to sleep there is pain, and he is roused by violent pain. The longer he sleeps the more severe that pain in the head.
He sleeps into his symptoms. All the snake poisons more or less sleep into troubles. The head troubles come on after sleep. He sleeps into head ache. The longer he sleeps the harder are the headaches. The head ache is so hard in the back of the head that it is almost impossible to raise it from the pillow. The muscles become so tired he has to take hold of it with his hands. This belongs also to Lach. A congestive headache with waxy face, yellow, purple, mottled face, as if there had been bruises. “Headache extending into the eyes. Bilious headache every few days.” Severe sick headache, together with dizziness, throbbing in the top of the head. Dull, pulsating headaches. “Dull, heavy, throbbing, occipital headaches,” or the whole head is in a state of congestion. He is confused and dazed. Head feels too large. Head feels full, feels as if it would burst. Headaches that come on in waves as if they came up the back, a surging of blood upwards, an orgasm described as if the blood rushed upwards. Headache with surging in waves and excited by motion or jar, by turning over in bed, by rising up in bed, or by lying down. Change of position will cause this surging. In Lach. it is described, and I have “seen it verified, as beginning away down in the spine and surging upward coincident with the pulse. Hemorrhage from the eyes. Yellow appearance of the eyes. “Blood exudes from the eye, burning in eyes; redness with lachrymation.” Pressure in the eyes as if the eyes would be pushed out from the head. Paralysis of the upper lids. Inflammation of the mucous membrane of the lids. Surging in the ears. “Sensitive to noises.” Dull aching and throbbing in the ears. Fetid, copious, yellow, offensive, bloody discharges from the ears. Blood oozing from the ears in drops in zymotic diseases, low forms of scarlet fever, or of diphtheria where there is oozing from the eyes and ears, and copious bleeding from the nose. The nose is the most common organ to bleed in zymotic diseases. The rush of blood seems to get relief from bleeding from the nose. In this medicine the congestion to the head is violent with bleeding from the nose. It has cured all forms of fetid discharge. Horrible, fetid, putrid discharges from the nose. Ozaena.
Inflammation of the parotid gland. Blueness and discoloration of the face. Yellow appearance of the face, a marked condition of jaundice. In girls who appear waxy or anemic, yellowish green, have for a long time missed the menstrual period and break out in pustules and pimples.
The patient often wakes up during the night grinding the teeth. The taste is bad, putrid. Inflammation of the gums. Bleeding from the mouth. Inflammation of the throat with bleeding of the throat. Burning in the throat and mouth. Trembling, quivering and swollen tongue. Trembling of the tongue when it is put out. Trembling of the hands when they are moved. Those cases of diphtheria that ooze blood from the nose and mouth are very low types, and are sure to die without a well-selected remedy. The throat will be filled up under such circumstances with a diphtheritic membrane that looks dark. There is bleeding all around it. Sore mouth with bleeding. Ulcers in the mouth. Ulcers after Merc. in those who are pouring forth saliva on the pillow at night. Bleeding ulcers in the mouth. Difficult swallowing. Malignant diphtheria. Cannot lie on the right side or back without instantly producing black, bilious vomiting. This is a wonderfully bilious remedy, sick headaches, vomiting of bile in great quantities. The various low forms of disease calling for Crotalus often begin with vomiting great quantities of bile, sometimes bile mixed with blood.
Pain in the stomach, coldness as if a piece of ice were in the stomach or in the abdomen. Stomach irritable, unable to retain anything, constantly throws up blood. Crotalus has cured ulceration of the stomach. It has greatly restrained the growth of carcinoma when there is much vomiting of bile and blood. Vomiting in many instances where the blood has no tendency to coagulate. Now, with all these ulcerations of the stomach, cancerous affections, low zymotic disease, jaundice is nearly always present; jaundice and more or less of bleeding; fever seldom runs high; sometimes the temperature is subnormal, but with oozing and bleedings, with dark hemorrhage from the nose and mouth and dark scanty, bloody urine containing albumen. The abdomen is greatly distended like the tympanitic abdomen of typhoid and the low zymotic diseases. Ulceration of the bowels, hemorrhage from the bowels. Much pain and soreness in the abdomen with numbness. Feeling in it as if it were made of wood. “Stool black, thin, like coffee grounds. Dysentery of septic origin from foul water, food, etc. Diarrhea from noxious effluvia.” Inflammation of the ovaries and of the uterus. Low form of putrid fever. Hemorrhages. Either dark clots or blood that has no tendency to coagulate and keeps on flowing. There is great trouble at the climacteric period. Hot flashes. Jaundice. Hemorrhage from the uterus or from other parts. Cancer of the uterus with much bleeding. Great offensiveness. Patient becomes yellow, jaundiced, great exhaustion, mottled appearance of the skin, swelling of the face, of the leg, especially along the course of the veins. Phlegmasia alba dolens. Worse from the slightest touch. Worse from jar, from motion.
There is some reason to think that this will be more or less a heart remedy from the great cardiac weakness it produces. But the other snake poisons like Naja, Lach. and Elaps have had more clinical application than this one. This one seems to prostrate the heart, but also to prostrate the whole body, and its complaints are more general. Mottled appearance of the limbs. Gangrenous appearance of the extremities.
Boils, carbuncles and eruptions are surrounded by a purplish condition of the skin, a mottled, blue, splotched or marbled state. It produces boils, abscesses and a condition somewhat resembling a carbuncle, with burning and violent pains, but the peculiar feature is the doughy center. Around the boil or carbuncle for many inches there is edema, with pitting upon pressure. The boil, or abscess, or carbuncle will bleed a thick, black blood that will not coagulate. Carbuncles that come upon the neck and upon the back begin with a pustule, and then several come and they are surrounded by little pustules and papules and there is pitting upon pressure. For these carbuncles you will need to study particularly Arsenicum, Anthracinum, Lachesis, Secale and Crotalus. They are the medicines that have in their nature malignancy and manifestation.
In puerperal fever there is a continued oozing of black offensive blood that will not coagulate; bleeding from every orifice of the body as well as from the uterus. Imagine a woman who is pregnant suffering from typhoid fever. She aborts and a low zymotic state comes on with the symptoms that I have described and with all the appearances as if she would bleed to death after the abortion. The blood will not coagulate and the flow continues. Or in a woman during a typhoid fever menstruation comes on. It is not a true menstrual flow, that is, it does not resemble the ordinary flow, because it is copious, dark and liquid, a continuous oozing with all the grave symptoms described, and especially the besotted countenance, the comatose state, the appearance as if she were intoxicated, lying as one dead. When aroused every muscle trembles; if the tongue is protruded it trembles, and there is inability to articulate. Crotalus may save her life. Would it be possible to think of graver states of sickness than such as are produced by the Ophidia? When a physician sees these symptoms coming on he immediately thinks of a class of remedies that can cover such a state, remedies like Baptisia, Arsenicum, Secale and the Ophidia, and sometimes Arnica, Phosphorus and Pyrogen.
In the more chronic conditions the individual manifests a terrible state as to his sleep. He rises from sleep as in a fright; has horrible dreams of murder, of death, of dead bodies and dead people, of associating with the dead and with corpses, of being in graveyards; even the smell of the cadaver is dreamed of. While he is awake he is tired, he is stupid, he cannot add figures, he makes mistakes in writing, he transposes sentences, and in words he makes mistakes in writing, he transposes sentences, and in words he transposes letters. He is unable to take care of his own accounts, for he cannot add up things that are at all particular. Sleep alternates with long and tedious periods of wakefulness. He is disturbed by any change to warm weather. Great irritability, sensitive to spheres, easily disturbed by his surroundings, and easily wrought up into a pitch of excitement are also features of this remedy. Following this up he is suspicious of his friends and is unable to reason upon a rational basis. He craves intoxicating drinks and is unable to resist the craving. This wonderful resemblance to old inebriates has led to the use of Crotalus in delirium tremens; it has the besotted countenance, the purple aspect of the face, the peculiar kind of hunger in the drunkard, the craving by spells for stimulants. There is every reason to believe that in fat, robust, besotted drunkards it may, if properly used, be a remedy deep enough to remove the appetite for strong drink.