[ Read before I.H.A., Bureau of Materia Medica, June 7, 1935.]
H. A. ROBERTS, M.D.
The Homoeopathic Recorder, Fourth Quarter, 1935.
Ledum was one of the remedies that Hahnemann proved and incorporated in the Materia Medica Pura. There were over 300 symptoms, and by six provers besides Hahnemann. In the Transactions of the I.H.A., over a period of many years I can find only two references to the action of Ledum, and those pertaining to the rheumatic effects with the peculiar modality of the remedy.
Hahnemann considered Ledum preeminently a remedy for chronic conditions. It covers the field of the psoric, syphilitic and sycotic miasms, with perhaps the strongest emphasis on the sycotic.
It has a close action to Arnica in some spheres but Ledum has a special action on the capillary system in parts where cellular tissue is wanting and where a dry resisting texture is present, as in the fingers and toes.
Ledum has been used with marked success in treating punctured wounds, stings and bites of animals and insects, especially where there is pain shooting upward from the wound and characteristic coldness accompanying the symptoms. Many think of the sphere of this remedy in punctured wounds to be only a present one, at the time of the injury; but sometimes such wounds will cause trouble for years afterward by symptoms arising from such injuries, and in such condition Ledum finds a valuable place, for even at a very late date it will be set in motion a curative action.
In the mental sphere there is a strong desire for solitude, which we may note in connection with the natural habitat of the plant, for it grows in out-of-the-way places. There is a strong aversion to people because they irritate; therefore the Ledum patient keeps by himself. He actually grows to hate people, through the irritation their presence causes him.
In the sensorium we find a great deal of vertigo, with the head sinking backward; vertigo that persists all day long, even when sitting still, but increases by stooping; and when walking in the open air falling forward as if the patient were intoxicated. With this vertigo is associated a sense of heat of the body, especially the face, with the pale cheeks and forehead, and without thirst. It is significant that with this remedy where there is heat it is an internal heat.
With all the conditions in Ledum, as a rule we find extreme coldness yet great < from heat.
The headaches have tearing pains in the head and eyes. The conjunctiva and whites of the eyes are swollen and highly inflamed. These tearing pains of the head and eyes are < lying and > sitting. The eyelids themselves are not affected but in the morning they are sealed with matter which is ill-smelling.
With the headache there is great internal heat (rather than external) and profuse sweating on the back and in the hair of the head. The headaches are characterized by a sense of pressure, mostly on the top of the head and in the forehead like a heavy weight; and they finally locate in the right temple.
On the surface of the head and in different parts of the body is the sensation of crawling as from vermin. This is an interesting symptom when we remember Linnaeus observation of its extensive use — before it was recognized by medicine — by farmers for the eradication of vermin on animals; it was fed in its crude state with the other fodder. In this connection, too, we may note again its use for the effects of insect bites, as may be found in our homoeopathic repertories.
In the eye Ledum is a remedy for contusions, preeminently with ecchymosis, especially of the lids; especially with extravasation of blood into the tissues.
There are haemorrhagic conditions even into the inner chamber. It is a remedy to be thought of in conditions following iridectomy, when there is haemorrhage and contusion.
There is marked dilation of the pupils; sensitiveness to light; flickering before the eyes, and inability to see things distinctly. When he looks at an object attentively there is a halo or flickering before eyes, making it impossible for him to fix his gaze steadily. Profuse lachrymation, the tears are acrid and smarting, excoriating the lower lids and the cheeks. There is an alternation of the character of the discharges; the secretions are by day watery and in the morning upon rising they are gummy.
The swelling of the face is of an erysipelatous nature, often starting from the bites of insects; associated with this is the sensation of coldness, notwithstanding the fever that accompanies it.
Ledum covers a great many of the eruptions on faces of young people, with dry pimples or red lumps; also the pimply eruptions of hard drinkers.
There are noises as of ringing of bells in the ears; roaring, often as from a heavy wind.
There is burning or burning pain in the interior of the nose, as from red-hot coals, which is < by pressure and blowing.
Sordes appear on the upper lip, with burning and itching.
There is soreness in the throat with shooting pains when not swallowing and only in the forenoon; or a sensation as of a plug in the throat with shooting pain on swallowing.
There is a bitter, musty taste in the mouth which causes qualmishness and nausea.
Upon beginning to eat there is sudden repulsion as though she had eaten too much, reminding one of Lycopodium; as though she had eaten too much, causing nausea. There is dislike to the customary tobacco smoking, but with no change in the appetite for food. This suggests the use of Ledum in breaking the tobacco habit.
There is frequent recurring hiccough.
A sudden digging colic under the navel is followed by a sudden flow of watery saliva from the mouth like water-brash. The abdominal pains are as if contused; cutting; pressing; often accompanied by diarrhoea or sensation as if diarrhoea were about to come on. This is at the same time associated with anorexia, normal taste, sudden flow of watery saliva and cold feet.
With the cutting pains of the stool we find a flow of blood from the anus and the pappy stools are mixed with blood; or there may be pappy stools mixed with blood but without pain.
The urinary symptoms are notable for the diminished secretion of urine, with frequent urging and reddish sand in the urine. The flow of urine often stops, and he must press on the urethra in order to pass urine. The stream is very thin but without pains; or there may be the cutting pain that is often characteristic of the Ledum symptoms.
There are nocturnal emissions and pollutions with bloody or watery semen. After the pollutions he is so exhausted he can scarcely drag his feet along.
There is dyspnoeic constrictions of the chest < by movement and walking; in going upstairs there is tightness of the chest, tight painful respirations of an asthmatic nature, with a sensation of suffocation. It is a remedy to be considered in whooping cough where there is intense tightness of the chest and before the cough comes on the child loses the breath as if about to be suffocated. During the paroxysm there is epistaxis. There is cough without expectoration; or again, cough severe and violent with profuse expectoration of bright red blood. There is a peculiar subjective symptom; as if something was a live in the chest, with uneasiness.
The expectoration of Ledum has a musty, moldy taste, and there is the chronic cough that lasts for a long time. With the cough is the characteristic of the remedy; coldness and deficiency of animal heat.
There may be suppuration of the lungs with a purulent greenish expectoration, after neglected pneumonias.
Phthisical conditions alternate with rheumatism. Haemoptysis alternate with rheumatism, the haemoptysis bright red, profuse with a severe cough; rattling and hissing in the air passages. Or coxalgia may alternate with violent cough in paroxysms.
On the chest and upper arms there is an eruption like varicella, with desquamation.
Ledum has severe pains in the shoulders; in fact, the key to the rheumatic conditions of Ledum lie in its action on ligamentous tissue. The rheumatic pains are severe in the shoulder joints, in the knee joints, and especially in the hands and feet, where there is a great deal of ligamentous tissue involved. Another peculiar thing about the rheumatism of Ledum is that the pains go from below upward. They are < from the warmth of the bed, from motion and in the evening.
Another peculiar symptom of Ledum is the tremor when sitting or attempting to walk of stand.
Pains which extend from the knees to the hips are greatly > by rubbing. The child will keep quiet and still so long as his limbs are rubbed. In other words, it has the characteristic bone pains of children to a marked degree, and they are > by rubbing.
In rheumatic troubles the legs and feet up to the knees become purple, mottled and swell and pit upon pressure. They can get no relief from the intense swelling except by holding the feet in cold water. In fact, the whole condition is > by bathing in cold water.
This is a remedy that we think of in whitlow as a result of punctured wounds, like needle pricks, or from splinters.
The pains of gout are particularly to be thought of in this remedy, especially pains in the feet with gouty nodosities. The ball of the great toe is painful and swollen, rendering it almost impossible to stand or to step.
There is intense itching on the top of the feet and ankles, < scratching, from the warmth of the bed, and > from bathing in cold water.
All conditions in Ledum are > by bathing in cold water; but there is also a sensation as if cold water were poured over the parts. The coldness of the patient is manifest on touching the body, but there is not necessarily subjective coldness.
In Ledum the warmth of the bed becomes intolerable because of the heat and burning throughout the whole limbs, whereas the heat and burning of Sulphur are confined mostly to the feet and soles.
The burning of Ledum is distinctive in that it is > by cold water bathing and < by the heat of the bed, especially the legs and feet, so they must be uncovered.
Its aptitude to ligamentous tissue, its gouty manifestations, its alternating habits of rheumatic and chest symptoms in phthisical subjects, in haemoptysis; the pains going from below upward; the bloody and exhausting emissions; the suffocative breathing in whooping cough before the cough begins; the sensation as if something was alive in the chest; sensation as if vermin were crawling in various parts of the body; the marked ecchymosis from contusions; the marked adaptability to the effects of punctured wounds; all these characteristic symptoms make a picture not infrequently indicated. A careful study of Ledum will convince us that it is a very valuable addition to our resources, especially in dealing with emergencies and chronic conditions.
DR. GRIMMER: This is a beautiful picture of Ledum conditions and if we study it, we shall have no trouble in recognizing the Ledum patient.
There is one experience I should like to recount, of a tubercular case, to illustrate the doctors statement about the effect on tuberculous conditions of the lungs. I had a man who was probably in his secondary stage of tuberculosis. He was coughing a little bloody expectoration and was up and around and able to get about and he fairly comfortable, but he had a strong indication for Ledum, which I gave him in the CM. potency. This remedy was given along about one oclock in the afternoon. At seven oclock that evening I was called hastily to come to the house, which was some distance away, to see the man, as he was having a severe pulmonary haemorrhage.
By the time I got there, he was dead, and the room in which he lay was like a slaughterhouse, he had bled so heavily.
Now, I think I made a mistake in giving Ledum too high. Of course, that is only one case, but we have had many warnings about some of our remedies, in our literature, about Phosphorus and Lachesis, especially, in tuberculosis, and the danger of giving these remedies too high, and I think Ledum falls into that group, from this one experience.
I wonder if others have had the same experience.
DR. CHARLES A. DIXON: I expected to hear Dr. Roberts say something about the pains in the wrist, which is so characteristic of Ledum. I want to add to it. It will often guide me to the remedy.
DR. COLEMAN: I was connected with the Metropolitan Hospital when it was the largest tuberculosis hospital in the world, consequently, I have had some experience in prescribing for tuberculous cases and I have never been able to see that Phosphorus, or any other remedy, even if it were not indicated and given wrongly, or given in any potency whatsoever, has had any bad effect on those cases.
I know that is a popular belief that Phosphorus or some of these other remedies should not be given to tuberculosis cases, but with this considerable experience with tuberculosis, I havent personally found that to be the case.
DR. K. A. MCLAREN: I should like to ask Dr. Roberts a question. In my own practice, very, very frequently I am called upon to prescribe for children with pains in the legs at night. Nearly all these children kick off the covers and get their legs out, and then wake up crying. I frequently have given Rhus and sometimes Pulsatilla to these cases, with varying success, and I should like to ask Dr. Roberts whether he thinks that Ledum would possibly fit the bill.
DR. FARRINGTON: The value of Dr. Roberts study of Ledum is shown in the fact that he gives definite modalities and characteristic symptoms by which he can determine whether he is to give Rhus tox., Pulsatilla, Phos. acid, or whether it may be, for any given ailment as, for instance, the so-called bone pains in children.
To my mind, this is one of the easier remedies to prescribe, because it belongs to that small group which, although having considerable coldness in some of them, as Ledum, a lack of vital heat, nevertheless, are made worse by warmth and better cold applications.
In gouty and rheumatic conditions we frequently see Lac caninum indicated not only by its well known alternation of symptoms from side to side, but because its pains are relieved by cold. The other two remedies which belong to this group are Secale and Pulsatilla.
Many years ago, when I was living in Kents Dispensary, my associate there, Dr. George Cooper, was taken ill with arthritis of the ankles and knees. Dr. Kent was called and prescribed for him, but he didnt improve. For several days, or perhaps a week, that poor fellow suffered intense agony with the pains in his ankles and his feet, and the only relief he got was by keeping his feet in a basin with ice water in it and ice floating around.
Dr. Kent was a little bit loath to confess the two or different remedies he gave. He gave Pulsatilla for one, but there was a peculiar alternation; sometimes the pains were more pronounced in the right foot and sometimes they were in the left, and then they would jump back to the right foot again.
After a while our great prescriber and teacher of materia medica woke up to the fact that he had found a new clinical symptoms, and gave Lac caninum and brought the boy out, but his heart was damaged so in later years he finally succumbed to an endocarditis.
Now, this matter of giving certain remedies in tuberculosis and other serious cases bobs up every now and then. The former speaker has said here he has treated many cases of tuberculosis and given remedies in all sorts of potencies and never found any ill effects, whether they were indicated or not. The experience of one man does not prove anything, conclusively at least.
I know a number of instances where remedies in too high potency, especially in lung troubles, with the extensive pathology, have undoubtedly done hard and put the patient in danger, and perhaps threatened the patients life.
Now, in that same dispensary we had a number of tubercular cases, and I remember one time going to see a colored girl about ten years of age. She had all the symptoms of extensive tubercular involvement of the lungs. I had a great idea of high potencies. We used them right along and hardly ever gave anything below the 50,000 in those days. I gave her a dose of Sulphur 55,000. Her temperature shot up to 103 and she began to cough great gobs of pus, and I was scared to death. I thought I had killed her.
While figuring and trying to find what I might give as an antidote, however, the temperature began to drop. The girl made a perfect recovery and I was saved the trouble of singing a death certificate.
Now, that is one instance, but I have seen others with other remedies and in totally different conditions. A woman of about sixty eight years of age had all the symptoms of Agaricus, especially the pains and tingling and crawling down the spine. I had a good old potency marked 59,000, and I gave her a dose of it and she nearly died. I told Kent about it afterwards. He was rather proud of his pupils. He said, “Farrington, prescribe just as well, but dont give such a potency as that or you are going to kill somebody.”.
DR. EDWARDS: Speaking of killing people, when Dr. Cooper was laid up with that attack of rheumatism, he sent me out early in the afternoon to see a man whom he prescribed for. I went down at eleven oclock, never asked what he gave, nor ever took a record, but it was a wonderful picture of Thuja, and I gave him Thuja and went back and told Cooper what a wonderful case I had made out of this. I had just gone into the Dispensary after graduating. I heard a knock at the door about half-past twelve, and they told me to come down. I told Cooper what I had done and that I had given a dose of Thuja 10M., and he said, “You have killed him.” and when I got there he was very much worse and died about half an hour afterwards.
My mother had cancer. I brought her down to see Kent. It took three days to go over her case and he gave her Graphites 35,000. She wasnt in very bad condition when she came down, but we walked up Twentieth Street, and by the time we reached Arch, she almost fell down. I brought her down in September and she died on the 28th of October, and Dr. Kent said that the remedy at that time was Thuja, and if he could have had that case at the beginning, he hadnt any doubt that Graphites would have been her remedy, about ten years before.
So, I think sometimes in the cases when they have a remedy and then have an aggravation we dont always recognize it and give a higher potency and get a very severe aggravation.
DR. UNDERHILL, JR.: While I was a resident physician in the hospital, I saw four cases of tetanus antitoxin. It was an old- school institution. Every one proved fatal, though every one received 20,000 units.
In my own practice I have never happened to come across a case of tetanus and couldnt say anything about that. My own little younger boy one time ran a manure fork clear through his foot. We had had the garden ploughed and purchased some manure to spread on it.
It was lunch time and the man left the fork in the pile of manure, and the boy went out and took the fork and jammed it clear through his foot into the ground. He screamed terribly and his foot into the ground. He screamed terribly and his mother ran out and pulled the fork out and called me up and I told her to soak it up in warm water and keep it soaked up all afternoon, and when I got home I would see to it; as long as it was not bleeding seriously, I thought a little bleeding would do it good.
I gave him a good dose of Ledum. He didnt develop any complications of any kind whatsoever.
For Fourth of July accident cases I give a dose of Ledum. We dont know anything about those cases. We dont know whether such a case will be a case of tetanus or wont.
For black eye I always use Ledum and find it far superior to Arnica. I have a good deal of affection for Ledum because it was the very first remedy I ever had any experience with along homoeopathic lines. Dr. Thacher asked me, “Have you any interesting cases on hand ?” I told him about the case that had the feet parked in ice water, the only case of that kind I ever saw, I never saw another case of rheumatism with the feet parked in ice water, and it had gone up to his knees, and he said, “That man needs Ledum. Would you mind if I fixed him up some ?”.
No, I didnt mind, because I had been soaking him in salicylates, and he wasnt getting any better; so he fixed up some medicine and said, “One powder here I am putting a little x on. Be sure you give him that first because the others will work better if you give him that one first.” So, I was duly impressed with that and gave him the “x” powder first and followed it up with sac lac. On my next visit I was better received. My stock was falling rapidly before that. Another visit or two would probably have been the end, not as far as the patient was concerned, but as far as I was concerned. The next day I was greeted a little better, though I couldnt see much difference. The next day after that he had his feet out of the tub of ice water and was altogether different.
The powders came to an end pretty soon and I had to go and beg for more, and you would hardly realize what a job that was, to go and ask for more powders. It didnt make me feel good, but anyway, I did it, and the case cleared up promptly. Dr. Thacher prescribed on this patient sight unseen. I had the courage to say, “You have been able to accomplish what I cant accomplish. I think I should like to look into the matter.” I will never forget the look of joy that came over his face, and he brought out two books, and that was my start in the study of homoeopathy.
DR. H. A. ROBERTS: The most valuable works we have are Hahnemanns Chronic Diseases and Materia Medica Pura, yet we neglect them constantly. Ledum is eminently brought out in these works.
For that reason I looked up our records, and in all our Transactions I found it mentioned only twice. It has been too much neglected.
Dr. Grimmer has spoken of haemoptysis in his case. I think you can put it down as an axiom, that an aggravation of a remedy will never produce a fatal condition unless that fatal condition is already foreshadowed. It may aggravate and hasten the fatal condition but it will not cause the fatal termination. It may be the exciting thing that will cause it.
DR. GRIMMER: What about a longer potency?.
DR. ROBERTS: The two hundredth would probably have saved your haemoptysis, because there is that alternation all through Ledum which is characteristic of the remedy.
Now, in regard to the bone pains that Dr. McLaren spoke of, Ledum will do the trick if it is indicated. There are the bone pains where the child wants to have his legs rubbed. Ledum will do the work very often and has relieved these children a great many times.
Dr. Dixon says I didnt say anything about rheumatism of the wrist. I spoke of the fibrous tissues in the places where they were not supplied with blood freely, especially in the fingers, toes and wrists. I brought that out, I think, and the relief from cold applications. Cold water is the keynote in those acute cases.