DENGUE FEVER

Dengue fever also known as break-bone fever is a severe infectious disease characterized by pain in eyes, head and extremities.  The disease is transmitted by the infective bite of Aedes Aegypti mosquito. once bitten by the mosquito, it takes 3-14 days to develop the disease.  Dengue Hamorrhagic Fever (DHF) and Dengue Shock Syndrome(DSS) are the most serious forms of Dengue that may cause death.  Person with dengue hemorrhagic fever lacks blood clotting process. About 20-30% of people with DHF develop shock which is known as dengue shock syndrome.  Dengue commonly prevails in warm and wet areas of the world.  The disease is commonly spread during the rainly season.  It is highly recommended to see a doctor, once the symptoms of dengue fever are observed.


SYMPTOMS OF DENGUE FEVER


Symptoms of dengue fever occur in 5-6 days after the bite from infectious mosquito.  Sudden onset of fever with severe headache, muscle and joint pains are the primary symptoms of dengue fever.  Most common symptoms for dengue fever are: 
1.  Severe frontal headache 2.  Loss of sense of taste and appetite  3.  Nausea and vomiting     
4.  Liver and spleen enlargement  5.  Measles-like rash over chest and upperlimbs.  Clincally person suffering from dengue fever shows sudden drop in number of platelets (helps in blood clotting).  Reduction in platelets may cuase bleeding through gums and other internal parts of the body. 


RISK FACTORS OF DENGUE FEVER


Dengue fever is primarily caused by a bite of Aedes Aegypti mosquito. it is mainly caused by any one of the four dengue virus..DEN-1., DEN-2., DEN-3., and DEN-4.  Infection with one virus does not provide protection to the person from other three viruses.  However, the person gets life-long immunity from that particular virus, once treated.  It is a wrong belief that dengue is spread directly from person to person.  The dengue fever can only be transmitted to a healthy individual through mosquito bite.  Stomach, liver, and intestine.  Some patients with dengue fever may also show increase in concentration.


PREVENTION OF DENGUE FEVER


Prevention is the only cure for dengue fever.  To stop the spread of dengue fever, one must eradicate the cause of the fever, Aedes mosquito.  To prevent the growth and multiplication of Aedes mosquito, one must take precautions like:
1.  All water and air-coolers must be thoroughly washed and dried out before re use.  2.  One table spoon of petrol added in cooler water can help in preventing the breeding of mosquito.  3.  Overhead and other water tanks should be kept covered or air-tight.  4.  Unused or broken bottles, pots and tyres should not be left open.  5.  Accumulation of water in pots, unused utensils or containers must be avoided.  People who are constantly travelling in dengue prone areas may lower the risk by 1. wearing insect repellent with DEET. 2. Wearing clothes that completely covers the body. 3.  keeping the unscreened doors and windows closed.

REPERTORY

Complete 

[Complete ] [Fever, Heat]Dengue fever: Eup-perf., Acon., Bry., Rhus-t., Apis.., Aran., Ars., Arum-t., Bapt., Bell., Canth., Chin., Coloc., Ferr., Gels., Ham., Ip., Merc., Nux-v., Podo., Rhus-v., Sanic., Sec., Sul-ac.

Boericke

[Boericke ] [Fever]Type of fever:Dengue: Acon., Eupt-perf., Gels., Rhus-t., Ars., Bell., Bry., Canth., Ipec., Nux-v., Rhus-v.

Knerr

[Knerr ] [Fever]Fever:Dengue (breakbone): Eupt-perf., Acon., Bry., Rhus-t., Ars., Bell., Chin., Coloc., Ferr., Ham., Ip., Merc., Nux-v., Podo., Sec., Sul-ac. 

ENTERITIS


(ENTERITIS is compiled from Stedman's Medical Dictionary(for meanings), Symptom Diagnosis, Different Repertories, and Materia Medica's)

1. Enteritis:

Inflammation of the intestine, especially of the small intestine.

2. Chronic cicatrizing enteritis : regional enteritis

3. Diphtheritic enteritis:

Enteritis with the formation of a membrane or a false membrane. See Also: pseudomembranous enterocolitis.

4. Enteritis anaphylactica:

A hemorrhagic and necrotizing inflammation developing in the ileum (and also the colon) of sensitized dogs when they are fed a second dose of the sensitizing material. Syn: chronic anaphylaxis.

5. Enteritis necroticans:

Enteritis with necrosis of the bowel wall caused by Clostridium welchii

6. Enteritis polyposa:

Enteritis associated with polyp formation.

7. Granulomatous enteritis : regional enteritis

8. Human eosinophilic enteritis:

Segmental eosinophilic inflammation of the gastrointestinal tract in humans; suspect etiologic agent is Ancylostoma caninum; laboratory indicators are eosinophilia and increased IgE.

9. Mucomembranous enteritis :

An affection of the intestinal mucous membrane characterized by constipation or diarrhea (sometimes alternating), colic, and the passage of pseudomembranous shreds or incomplete casts of the intestine. Syn: mucoenteritis (2).

10. Phlegmonous enteritis:

Severe acute inflammation of the intestine, with edematous bowel wall infiltrated with pus.

11. Pseudomembranous enterocolitis:

Enterocolitis with the formation and passage of pseudomembranous material in the stools; occurs most commonly as a sequel to antibiotic therapy; caused by a necrolytic exotoxin made by Clostridium difficile. Syn: pseudomembranous colitis, pseudomembranous enteritis.

12. Regional enteritis:

A subacute chronic enteritis, of unknown cause, involving the terminal ileum and less frequently other parts of the gastrointestinal tract; characterized by patchy deep ulcers that may cause fistulas, and narrowing and thickening of the bowel by fibrosis and lymphocytic infiltration, with noncaseating tuberculoid granulomas that also may be found in regional lymph nodes; symptoms include fever, diarrhea, cramping abdominal pain, and weight loss. Syn: Crohn disease, chronic cicatrizing enteritis, granulomatous enteritis, distal ileitis

13. Tuberculous enteritis:

Enteric tuberculosis may be caused by bovine tuberculosis contracted through drinking of unpasteurized milk or swallowing of tubercle bacilli expectorated from cavitary lesions in the lung; may occur in the absence of obvious pulmonary t.

ENTERITIS

Enteritis is inflammation of the small intestine.

Causes

Enteritis is usually caused by eating or drinking substances that are contaminated with bacteria or viruses. The germs settle in the small intestine and cause inflammation and swelling, which may lead to abdominal pain, cramping, diarrhea, fever, and dehydration.

Enteritis may also be caused by:

· An autoimmune condition such as Crohn's disease

· Certain drugs, including ibuprofen, naproxen sodium, and cocaine

· Damage from radiation therapy

The inflammation can also involve the stomach (gastritis) and large intestine (colitis).

Risk factors include recent family illness with intestinal symptoms, recent travel, or exposure to untreated or contaminated water.

Types of enteritis include:

· Bacterial gastroenteritis

· Campylobacter enteritis

· E. coli enteritis

· Food poisoning

· Radiation enteritis

· Salmonella enteritis

· Shigella enteritis

· Staph aureus food poisoning

Symptoms

The symptoms may begin hours to days after you become infected. Symptoms may include:

· Abdominal pain

· Diarrhea - acute and severe

· Loss of appetite

· Vomiting - rare

Exams and Tests

A stool culture may be done to determine the specific type of infection, however, this test may not always identify the bacteria causing the illness.

Treatment

Mild cases usually need no treatment.

Antidiarrheal medication may delay the organism from leaving the digestive tract, and therefore may not be recommended.

Rehydration with electrolyte solutions may be necessary if dehydration occurs.

Persons with diarrhea (especially young children) who are unable to drink fluids because of nausea may need medical care and fluids through a vein ( intravenous fluids) .

If you take diuretics and develop diarrhea, you may need to stop taking the diuretic during the acute episode. Do not stop taking any medicine unless told to do so by your health care provider.

Outlook (Prognosis)

Symptoms usually go away without treatment in a few days.

Possible Complications

· Dehydration

· Prolonged diarrhea

Note: The diarrhea can cause rapid and extreme dehydration in babies.

When to Contact a Medical Professional

· Dehydration develops

· Diarrhea does not go away in 3 to 4 days

· You have a fever over 101 degrees Fahrenheit

· There is blood in the stools

Prevention

· Always wash hands after using the toilet and before eating or preparing food or drink. You may also clean your hands with a 60% alcohol based product.

· Avoid drinking from unknown sources, such as streams and outdoor wells, without boiling the water first.

· Use only clean utensils for eating or handling foods, especially when handling eggs and poultry.

· Cook food completely and properly.

· Store food appropriately in coolers.

SYMPTOM (DIFFERENTIAL) DIAGNOSIS

Enteritis (regional)

1. Constipation chronic:

Regional enteritis (Regional Ileitis): characteristics: In the late stage signs of chronic intestinal obstruction occur.

Chief signs: Fever, diarrboea(two to five stools a day, containg mucus, pus, and blood); palpable mass in right lower quadrant or lower midabdomen; chronicity; loss of weight; finally signs of intestinal obstruction and formation of external fistulous tracts; x-ray.

2. Diarrhea chronic:

Regional Ileitis (Regional Enteritis; crohn’s disease): Characteristics: Many cases have a diarrhea of two to six large stools daily which are watery, mushy, or semisolid, usually without visible evidence of blood or pus.

Chief signs: Usually an insidious onset; cramping or colicky abdominal pain (peri-umbilical or right lower quadrant); afternoon fever; presence of fistulas (perirectal abscess, fistula in ano, abdominal wall); general debility; emotional disturbances; may be a mass in the lower abdomen; abdominal distention; anemia, slight or moderate leukocytosis, elevated sedimentation rate; x-ray; laparotomy.

3. Iliac and inguinal region pain:

Regional enteritis (crohn’s disease): Characteristics: Persistent pain, localized tenderness, and even signs of peritoneal irritation in the right lower quadrant are present in acute terminal ileitis. In the chronic cicatrizing variety of ileitis and in diffuse ileojejunitis or ileocolitis, while the pain is most often periumbilical, it may sometimes be localized to the right lower quadrant.

Chief signs: Anorexia; weakness; weight loss; periodic attacks of diarrhea with mucus and blood in the stools; variable fever; abdominal distention; occasionally vomiting; may be a palpable lump, usually in the right lower quadrant; right lower quadrant tenderness; may be anal abscess or fistula; x-ray (small bowel study, string sign).

4. Umbilicial region pain:

Regional enteritis (Regional Ileitis): characteristics:In chronic cicatrizing ileitis diffuse ileojejunitis, or ileocolitis the pain is most commonly periumbilical; it is cramp like or wave like, worse one to two hours after eating and is followed or some what relieved by bowel movements. Late in the disease it may be diffuse, being caused by entercolic fistulas.

Chief signs: Fever, diarrboea(two to five stools a day, containg mucus, pus, and blood); palpable mass in right lower quadrant or lower midabdomen; chronicity; loss of weight; finally signs of intestinal obstruction and formation of external fistulous tracts; x-ray.

REPERTORY

KENT

[Kent ] [Abdomen]Inflammation (peritonitis,enteritis,etc.):

Acon., Ant-t, Apis., Ars., Bell., Bry., Colch., Hyos., Lach., Laur., Lyc., Phos., Pyrog., Rhus-t., Ter., Acet-ac., Arn., Bapt., Cact., Calc., Canth., Carb-v., Cham., Coloc., Crot-c., Crot-h., Echi., Ferr., Gels., Ip., Kali-c., Kali-chl., Kali-n., Merc., Merc-c., Mez., Nux-v., Op., Ox-ac., Puls., Sec., Sil., Sulph., Uran., vat., Verat-v., and many other drugs.

W. BOERICKE

[Boericke ] [Abdomen]Diarrhoea, enteritis:Acute:

Acon., Aeth., Aloe., Alst-c., Ant-c., Apis., Arg-n., Arn., Ars., Asaf., Bapt., Bell., Bism., Bry., Calc., Calc-p., Camph., Canth., Caps., Carb-ac., Carb-v., Cham., Chel., Chin-ar., Cinch., Corn., Crot-t., Cupr-acet., Cycl., Dulc., Elat., Eucal., Euph-c., Gamb., Gels., Grat., Ip., Iris., Jatr., Kali-bi., Mag-c., Merc-d., Nat-s., Nuph., Nux-v., Op., Petr., Ph-ac., Phos., Podo., Prun., Puls., Rheum., Rhust-c., Rumx., Sec., Sep., Sil., Sulph., Thuj., Verat., and many other drugs.

[Boericke ] [Abdomen]Diarrhoea, enteritis:Chronic:

Arg-n., Ars., Calc., Chap., Cinch., Coto., Cupr-acet., Ferr., Graph., Iod., Kali-bi., Liat., Merc., Nat-s., Ph-ac., Phos., Podo., Sulph., Thuj., and many other drugs.

BOENNING

[Boenning ] [Stool]Diarrhoea:Chronic:

Calc., Graph., Phos., Sulph., Abrot., Ars., Ip., Kreos., Nit-ac., Petr., Rhus-t., Sil., Ferr., Nux-m., Ph-ac., and other drugs.

BOGER

[Boger ] [Stool]Diarrhoea:Chronic:

Sulph., Ars., Calc., Phos.

PHATAK

[Phatak ] [Phatak A-Z]Diarrhoea:Chronic:

Sulph., Ars., Calc., Nat-m., Petr., Phos., Psor., Sil., Tub.

W.BOERICKE MATERICA MEDICA

ARG-NIT

Stomach.

BELCHING accompanies most gastric ailments. Nausea, retching, vomiting of glairy mucus. Flatulence; PAINFUL SWELLING OF PIT. Painful spot over stomach that radiates to all parts of the abdomen. Gnawing ulcerating pain; burning and constriction. Ineffectual effort at eructation. GREAT CRAVING FOR SWEATS. Gastritis of drunkards. Ulcerative pain in left side under ribs. Trembling and throbbing in stomach. Enormous distention. Ulceration of stomach, WITH RADIATING PAIN. Desire for cheese and salt.

Abdomen.

Colic, WITH MUCH FLATULENT DISTENTION. Stitchy ulcerative pain on left side of stomach, below short ribs.

Stool.

Watery, noisy, flatulent; GREEN, LIKE CHOPPED SPINACH, with shreddy mucus and enormous distention of abdomen; very offensive. Diarrhoea immediately after eating or drinking. FLUIDS GO RIGHT THROUGH HIM; after sweets. After any emotion with flatulence. Itching of anus.

GAMBOGIA

General.

The use of this drug in Homeopathy has been confined to its action on the alimentary tract. It produces a diarrhoea very similar to Croton. From its pathogenesis, it is very evident that it has very intense and definite action especially on the gastroenteric tract.

Stomach.

Feeling of coldness at edge of teeth. Great irritability of the stomach; burning, smarting, and dryness of the tongue and throat. Pain in the stomach after food. Tenderness in epigastrium. Pain and distention of abdomen from flatulence, after stool. RUMBLING AND ROLLING. Dysentery, with retained scybala, with pain in sacral region. Diarrhoea, with SUDDEN AND FORCIBLE EJECTION OF bilious stools. TENESMUS AFTER, WITH BURNING AT ANUS. Ileoceacal region sensitive to pressure. Profuse, watery diarrhoea in hot weather, particularly old people. Pain in coccyx.

JATROPHA

General.

Of value in cholera and diarrhoea. The abdominal symptoms are mot important. Suppressed measles (H. Farrington).

Stomach.

Hiccough, followed by copious vomiting. Nausea and vomiting, brought on by drinking, with acrid feeling from throat. Great thirst. VERY EASY VOMITING. Heat and burning in stomach, with crampy, constrictive pain in epigastrium.

Abdomen.

Distended, with gurgling noises. Pain in hypochondria. Pain in region of liver and under right scapula to shoulder. Violent urging to urinate.

Stool.

Sudden, profuse, watery, like rice-water. DIARRHOEA; FORCED DISCHARGE; LOUD NOISE IN ABDOMEN LIKE GURGLING OF WATER COMING OUT OF A BUNG-HOLE, associated with coldness, cramps, nausea, and vomiting.

CUPRUM ARS

Abdomen.

Gastroenteritis. Violent abdominal pain. Diarrhoea in phthisis. Cholera. (ARS.; VERAT.; CAMPH.) Rumbling and sharp cutting pain. Dark liquid stools.

CROTON-TIG

Stool.

Copious watery stools, with much urging; ALWAYS FORCIBLY SHOT OUT, with gurgling in intestines; worse, drinking the least quantity, or even while eating. Constant urging to stool, followed by sudden evacuation. Swishing sensation in intestines.

MAG-CARB

General.

Gastrointestinal catarrh, with marked acidity.

Abdomen.

Rumbling, gurgling. Dragging towards pelvis. VERY HEAVY; contractive, pinching pain in right iliac region.

Stool.

Preceded by griping, colicky pain. GREEN, WATERY, FROTHY, LIKE A FROG-POND'S SCUM. Bloody mucous stools. MILK PASSES UNDIGESTED IN NURSING CHILDREN. SOUR, with tenesmus (RHEUM.) Constipation after mental shock or severe nervous strain.

OPIUM

Abdomen.

Hard, bloated, tympanitic. Lead colic. During colic, urging to stool and discharge of hard faeces.

Stool.

Obstinate constipation; no desire to go to stool. ROUND, HARD, BLACK BALLS. Faeces protrude and recede. (THUS.; SIL.) Spasmodic retention of faeces in small intestines. Stools involuntary, black, offensive, frothy. Violent pain in rectum, as if pressed asunder.

THUJA OCCIDENTALIS

General.

Acts on skin, blood, gastrointestinal tract, kidneys, and brain.

Abdomen.

Distended; indurations in abdomen. Chronic diarrhoea, worse after breakfast. Discharges forcibly expelled; gurgling sound. Brown spots. FLATULENCE AND DISTENTION; PROTRUDING HERE AND THERE. Rumbling and colic. Constipation, with violent rectal pain, causing stool to recede. (SIL.; SANIC.) Piles swollen; pain worse sitting, with stitching, burning pains at the anus. Anus fissured; painful to touch, with warts. MOVEMENTS AS OF SOMETHING LIVING. (CROCUS), without pain.

ARS-ALB(FARRINGTON)

The most important sites for the Arsenicum inflammations are the stomach and bowels primarily, and next to these the heart. The inflammation in the stomach and bowels may vary from slight irritation to the most destructive gastritis enteritis. The mouth is dry, the tongue white as whitewashed, or in some cases with irritable stomach, the tongue is red with raised papillae. There is very distressing heartburn. Sometimes burning in the stomach like coals of fire is associated with the diarrhoea. The stools are undigested, slimy and bloody, and are attended with violent tenesmus and burning in the rectum. It this goes on, the stools become brownish or blackish, and horribly offensive, showing that it is indicated in most serious cases of enteritis and dysentery.

BELLADONNA(FARRINGTON)

This symptom sometimes occurs in lead colic. Then, too, we find Belladonna indicated in diarrhoea. It is particularly suited to a dysenteric diarrhoea, that is, a diarrhoea from cold with enteritis, the discharges being associated with considerable tenesmus(for you must remember that Belladonna has great affinity for sphincter muscles), the discharges being slimy and bloody.

LACHESIS(FARRINGTON)

Belladona, Lachesis, Rhus-tox, and Baptisia constitute a group serviceable in peritonitis, enteritis, etc.

RHUS-TOX(FARRINGTON)

In other abdominal inflammations assuming a typhoid type, Rhus may be indicated, as I have already said, whether the affection be peritonitis, enteritis, typhlitis, perityphilitis, or metritis. In diseases of the puerperal state, Rhus is a capital remedy when the symptoms are of a typhoid type.

PODOPHYLLUM(LILIENTHES)

Enteritis affecting the jejunum and ileum; fullness in right hypochondrium, with flatulence, pain and soreness, frequent but transient abdominal pains, with sensation of heat there; alternate constipation and diarrhoea.

EUPHORBIUM OFFICINARUM(LILIENTHES)

Gangrene following gastritis or enteritis, temperature continually falling; inflammation and swelling, followed by cold gangrene; great torpor; insensibility of parts affected; chilliness and shuddering over whole body; gangraena senilis.

GELSIMIUM SEMPERVIRENS(LILIENTHES)

Passive congestion of liver, bilious diarrhoea and relaxed gall ducts; flatulence in stomach with eructations from want of elasticity in muscular fibres; jaundice with prostration; clay-colored stools; acute catarrhal enteritis during damp, warm or cold weather; soreness of abdominal walls; vertigo, dim sight and fullness of head.

APIS MELLIFICA(LILIENTHES)

Distressing aching soreness of abdomen which will tolerate no pressure, or sudden knife like stabs through abdomen; urine scanty, dark, albuminous; absence of thirst or drinks little and often; oedematous puffing of face; sleepy, but cannot sleep from nervousness and fidgetiness. In severe cases, combined with enteritis, patient passes thin yellow stool with every motion of the body, as if anus and rectum were paralyzed. Sudden shrill cry in children from cerebral irritation.

CALCAREA IODATA(MATHUR)

Enteritis and entero-colitis of tubercular, emaciated children after attack of cholera infantum. Flatulent dyspepsia. Cholera infantum followed by enteritis of enterocolitis, Glands enlarged or indurated. Mesenteric glands.

ACONITE(MEDICAL ADVANCE)

In the early stages of enteritis mucosa of young children, it is a valuable remedy, and if it does not control the disease, it doubtless modifies its future course, both in severity and duration. Its use should be continued for several days, and if used low, at first, higher attenuations should be tried before changing to another drug.

VERATRUM-ALB(P): Enteritis with high fever.

HYDRASTIS (G.ROYAL): Chronic enteritis with feces covered by mucus.

BRYONIA (G.ROYAL): The extreme soreness, thirst, coated tongue, high temperature call for Bryonia in peritonitis, enteritis, typhylitis, etc.

MERCURIUS(G.ROYAL): It has served me for catarrhal enteritis with cutting, tearing pains and discharge of mucus with slight tenesmus; for appendicitis after the acute symptoms have subsided and you have tenderness in the region, with stools of blood, mucus and soft fecal matter.

PHOSPHORUS(G.ROYAL): Phosphorus is useful for chronic enteritis with diarrhoea as the ranking symptom of the group. The stools are often painless (China) worse in hot weather, cold drink and urging whenever the feces enter the rectum.

ARANEA DIADEMA - A VIEW OF DIFFERENT AUTHORS

WILLIAM BOERICKE, M.D.

All symptoms of Aranea are characterized by periodicity, and coldness, and great susceptibility to dampness. It is the remedy for the constitution favorable to malarial poisoning, where every damp day or place favors chilliness. Patient feels cold to the very bones. Coldness not relieved by anything. Feeling as if parts were enlarged and heavier. Wake up at night with hands feeling twice their natural size. Spleen swollen. Hydrogenoid Constitution, i.e., Abnormal sensitiveness to damp and cold, inability to live near fresh water, lakes, rivers, etc., or in damp, chilly places. (Nat-s, Thuj.).

FARRINGTON

Aranea was suggested by Grauvogl as one of the remedies for what he called the Hydrogenoid constitution which could not tolerate moisture. Under Aranea all the symptoms are worse during damp weather or from dwelling in damp localities.

Especially is this ftue with what we may call chronic intermittent fever, for which Aranea is the remedy when the symptoms are aggravated during every spell of damp weather.

Cinchona and Chininum Sulphuricum are both very similar to Aranea diadema in the periodical return of symptoms, and both are indicated in cases of swollen spleen, and of ague from living in damp places.

Cedron, of which it has been asserted that it will relieve the bite of rattlesnake and modify hydrophobia, may also be regarded as an analogue of Aranea diadema and of the spider poisons generally. It is said to act best in nervous, excitable and even voluptuous patients, especially females.

The febrile and neuralgic symptoms return with clock-like regularity. It is used in ague contracted in warm countries or in low, marshy lands, in which latter respect it offers some similiarity to Aranea. But the former remedy has won favor mainly in hot climates, while the later works well in chills predominates, heat being slight or wanting.

So far as proved, Aranea does not develop the extreme excitation of the other three spiders mentioned above still there is evidence that it affects the nervous system.

Aranea also cures diarrhoea, and these patients are often troubled with this disorder. The stools are watery, and are associated with great rumbling in the bowels, as if considerable fermentation were going on within.

There is a symptom of Aranea which i have not had the opportunity of observing in practice, and that is numbness of the parts supplied by the ulnar nerve.

Arnea also attacks the bones. It is especially indicated in disease of the os calcis(heel pain) when the patient complains of violent, dull, boring pain in that bone. This may be due to simple periostitis, or it may be associated with caries. Sometimes there is a sensation as if the bones felt like ice. This is purely subjective.

MEDICAL

All spider poisons powerfully affect the nervous system (Tarent., Mygale). Aranea diadema is the remedy for the constitution favorable to malarial poisoning, where every damp day or place favors chilliness. There is abnormal susceptibility to damp and cold. Patient feels cold to the very bones, cannot get warm enough. Inability to live near fresh water, rivers, lakes or in damp chilly places(Dulc., Nat-s.).

All symptoms of Aranea are characterized by periodicity and coldness and great susceptibility to dampness. Feeling of faintness with nausea, vertigo, trembling and cold sweating. Chill not better by external warmth, no sweat with fevers. Patient feels cold to the very bones. Coldness not relieved by anything.

Aranea diadema is a hemorrhagic remedy. Violent hemoptysis of bright red blood in debilitated subjects, bathing and damp places aggravate, coldness as if the bones were made of ice. Pains are like electric shocks. Headache relieved by smoking tobacco. Toothache after lying down at night. Creeping as of ants all over the body. Many symptoms occur on the right side.

COMMENTS: Aranea diadema has chilliness followed by little or no fever. Chill and neuralgic attacks at the same hour every day, every other day, week, month or regular period. Attacks are violent and sudden. Hydrogenoid constitution, abnormal sensitiveness to damp and cold inability to live near fresh water, lakes, rivers, etc. or in damp, chilli places (Nat-s., Thuj.)

COMPARE: (3) Cedr. - intermittents of hot climates, Aranea. of cold climates chiefly.

GRIMMER, A.H

Aranea (the cross spider) is one of our neglected and forgotten remedies not mentioned by Anschutz in his volume of new, old and forgotten remedies.

This remedy is of wide-range and profoundly deep in action, curing conditions which are of long standing, chronic and of an obstinate resisting nature to the ordinary remedies; in other words, it cures after other seemingly indicated remedies fail.

It deeply affects the nervous system, the blood and circulatory system, the bones and the glands, especially the liver and spleen. It depresses the mental sphere profoundly, causing deep despondency and longing for death like Aur.

It belongs to Grauvogl's Hydrogenoid group of remedies in its extreme sensitiveness to wet, cold, rainy weather and even bad effects from bathing. Remedies like Calc., Dulc., Rhus-t., and Nat-s., are in this group. It is a hemorrhagic remedy producing long-lasting, copious and too frequent menses. Metrorrhagia, bright colored blood. Dysmenia, spasms commencing in stomach. Viscous leucorrhea. From the respiratory organs violent hemoptysis in anemic debilitated subjects. Hemorrhage from wounds. Punctured wounds. General weakness even to a state of exhaustion is noted. Pain is an outstanding feature of this remedy, the pains are periodic at clock-like regular intervals like Cedr., but Cedr. is worse in hot climates and Aranea is aggravated in cold, wet or rainy weather.

LYCOPODIUM

Author: GEORGE VITHOULKAS, M.I.H and BILL GRAY, M.D.

Lycopodium is one of the deepest and broadest acting polychrests in the entire Materia Medica, potentially affecting all conditions known to mankind. Despite its wide application, however, there is a central thread which runs through the remedy and clarifies its highly interesting image.

The basic theme in Lycopodium has to do with cowardice, not only the fear of taking physical risks, but even more the type of cowardice seen in m0ral and social realms. Inside, the Lycopodium patient is constantly contending with a feeling of weakness and inadequacy; they fear that they will be incapable of fulfilling their responsibilities in life and so they tend to avoid responsibilities whenever possible. Externally, however, they present themselves in a much different fashion. They appear to be extroverted, friendly, courageous, powerful, and capable. And as a matter of fact, they are usually quite intelligent, capable and confident. Still, with their external facade belying their inner feelings of weakness, it can take skillful probing on the part of the homoeopath to discern the true pathological image of the remedy in the patient.

The central area in which Lycopodium shows itself in the early stages is in relationship to sex. The Lycopodium patient seeks situations in which the desire for sexual gratification can be satisfied without having to face the personal responsibilities which go with such intimacy. It is commonly observed in a carefully done homoeopathic interview that such patients may have a long history of one-night stands, in which the patient seeks satisfaction and then walks away withour further responsibility. If a sexual parter begins to show interest in marriage, however, the Lycopodium patient becomes fearful of the responsibilities and whether he will be able to live up to them. Usually, he will leave the relationship before becoming' 'penned in', by the responsibilities of marriage and children.

This relationship to sex is a superficial one. Gratification is the primary motivation; he (or she) wants it quick, easy, effortless, and without consequences. For example, if such a patient meets a secretary who is alone in an office, the first thought on his mind will be that this is a sexual opportunity, and he will be likely to make advances. Such patients may also visit prostitutes frequently, because this contact implies no responsibilities. It is not as if the Lycopodium patient's desire is so intense-as it is in Platina, for example, the Lycopodium constitution is too weak for such intensity, but when the desire does arise, the Lycopodium way of handling it is focussed upon the superficial gratification of the moment and the avoidance of responsibility.

Once married, the Lycopodium man or woman may well experience sexual dysfunction both because of fear of inability to perform and because of being constitutionally too tired for sex after years of dissipation. In the woman, there may be inability to have orgasm or a loss of desire; in the man, therre may be loss of desire or impotence in the form of either premature ejaculation or absence of erection. Internally, the Lycopodium patient feels a deep state of inadequacy and powerlessness, which is challenged most noticeably in the marriage relationship. It is a fear of failure especially in the eyes of others. Sensing this internal cowardice, Lycopodium compensates by presenting an image of being strong, courageous, and competent, but the bluff is called when the moment comes for performance and responsibility, as happens in marriage. At this moment, the Lycopodium fear of inadequacy and internal lack of power come forward and themselves interfere with actual functioning. So it is in the marriage situation where the administration of Lycopodium can have some of the most gratifying results in a patient of this type.

Because Lycopodium is one of the highly intellectual remedies, we see many such patients gravitating to professions calling for public functions such as priests, lawyers, school teachers, and even politicians. The performance of such public functions may be excruiciatingly painful to the Lycopodium patient. A priest may feel perfectly well before giving a semon, but upon reaching the pulpit and realizing that so many eyes are crutinizing him, he may suddenly suffer gastritis pains or severe anxiety. It may be possible for the person to carry out the task satisfactorily, but more often the physical or emotional suffering will seriously interfere with functioning. Again, this situation is a manifestation of anxiety in the face of responsibility, and the patient may well attempt to escape from his or her profession, sometimes seeming to be using the physical illness as an "excuse". Lycopodium is one of the main remedies exhibiting this suffering when in front of an audience, whereas Gelsimium is the primary remedy to remember when a patient complains of anxieties and physical symptoms occurring hours and days before a perfomance.

Eventually, the Lycopodium patient may end up becoming a loner. Again, the desire to avoid responsibility, and also the need to get away from people who are possessive of him or wish to tie him down to restrictive commitments, result in his being alone. Thus, it is not uncommon for Lycopodium to end up being spinsters or bachelors late into life.

Because of the desire to gain power to replace that which appears to be lacking inside, such a patient may become celibate in order to gain some control over the desire for instant sexual gratification. This is a tragile state of celibacy for the Lycopodium patient, however, sexual thoughts bvecome haunting and obsessive. After years of strenuous discipline, such a persone may become very pious and respected by all for purity and moralistic strictness, yet when presented with an opportunity may break down surprisingly quickly-only to immediately return to the disciplined state later with even increased fervor. The pious Lycopodium spiritual seeker can be nearly insufferable to deal with; they can be so extremely moralistic and rigid that no one dares to cross them. It is as if he must overdo the strictness in order to protect his inner weakness.

With time, the desire for gratification in sex may be replaced by the desire for power. Lycopodium is the only remedy listed so far under the rubric Love of Power. This clearly is a further attempt to compensate for the inner sense of weakness. It may manifest as a desire for power in the realm of politics or business, but it can also be seen as the desire for spiritual power in spiritual seekers. Again, it is an attempt to acquire poser from external sources in order to replace the feeling of a lack of inner strength.

In the second stage of development of Lycopodium pathology, the external bluff becomes even more exaggerated. The patient becomes dictatorial with those around who can be controlled. The Lycopodium man may be timid and passive with co-workers on the job who are not under his control, but be becomes a tyrant at home. The mother may be sweet with her neighbors but tyranical with her children. By exerting power over others, the patient attempts to generate a sense of personal power, just as he previously attempted to bolster his sense of power by seeking the admiration of others through lies and exaggerations.

It is also in the second stage that the Lycopodium cowardice becomes more intense and visible in a physical sense. At this stage, we see many fears and anxieties. Lycopodium can become terrified by almost anything-being alone, the dark, ghosts, even unfriendly dogs in short, anything he cannot control. For this reason, such a patient while basically a loner because of the fear of facing responsibility, is said to desire company, but in the next room.

There is a great fear of suffering of any kind in Lycopodium. It is a prime remedy in psychosomatic ailments, particularly those affecting the gastrointestinal tract. There is tremendous anxiety about health to the point that the patient becomes recognized as a hypochondriac. In this regard, a parenthetical remark might be made about the rubrics listed under Anxiety in the Repertory; there is Anxiety about Health, and Hypochondriacal Anxiety. It is not entirely clear what Kent menat when he made this distinction. The anxious hypochondriac is a patient easily recognised by both physician and layman alike; it appears that the most appropriate rubric for this state is Anxiety about Health. The rubric Hypochondriacal Anxiety shares many of the same remedies but also lists others not listed under Anxiety about Health; this may apply to the type of patient whose attention is endlessly focussed on fine details about their body, such as dry patches on the skin or easily breaking nails, but with little manifest anxiety. Ofcourse, the distinction between-these rubrics is a very fine one, and the best one can do is to produce conjecture about the actual truth.

In the third stage of pathology, we see further deterioration of the higher emotional and the mental levels of the patient. There has been a prolonged dissipation of energy either in the search for instant gratification or in the struggle to control it through celibacy; also much energy has been bound up in the tension between the inner state of cowardice and the outer attempt to compensate for it. Initially, there is a deterioration of mental functions noticed as a confusion or poor memory in the morning, and gradually this progresses to more marked memory loss and intellectual weakness. This deterioration or mental functioning is noticed by the patient, who has already experienced much energy loss and a kind of apathy resulting from oversatiation. These factors combined lead to a melancholy, a loss of interest in life, and a gradually deepening depression. Not surprisingly, as the melancholy develops, we see the fears disappear. As the various functions deteriorate even further, the patient degenerates into a state of imbecility or senility, such as we now commonly see populating our rest homes. In Lycopodium, this tragedy is further compounded by the fact that very frequently the senility occurs at a relatively young age.

On the physical level, the Lycopodium appearance is fairly distinctive. There is an emaciation of the face, neck, and upper torso. The tissues seem to waste away in these regions, while an excess of fat accumulates around the abdomen, the hips, and lower limbs. The face tends to the excessively wrinkled, particularly in patterns reflecting the prolonged anxiety and concern over what others think of them. The hair may become gray at an early age, and the person may appear considerably older than his actual age. The flaffing of the alae nasi which is described so frequently in the books is rarely seen in actual practice, because it is mostly limited to acute illness involving dyspnoea.

The primary region of action of Lycopodium centres on the genitals, the urinary tract, the gastrointestinal system, and the liver. Thus we commonly see in Lycopodium such ailments as impotence, frigidity, nephritis, peptic ulcer, colitis, hemorrhoids, liver disorders, etc.

The gastrointestinal tract in particular represents the qualities seen throughout Lycopodium. Just as there is a bloating of the ego-presentation in compensation for the inner sense of weakness, there is also a bloating of the intestines in reaction to weak digestion; the Lycopodium is "full of wind" and suffers severely after eating. There is easy satiety in Lycopodium both in regards to sex and to eating. Indulgence has spoiled the function, there then occurs a state of easy satiation, and finally suffering ensues. The Lycopodium constitution is too weak to handle over indulgence, but the Lycopodium patient desires foods which are pleasing to his taste, such as sweets and oysters, but is made worse by them. This suffering from over-indulgence is different from that in Nux-vomica. Nux vomica suffers because of an excessive degree of tension which releases too much HCI in the stomach and results in immediate suffering during and soon after eating whereas the Lycopodium patient suffers for hours after eating because of the weakened digestion. Just as with food, the Lycopodium patinet seeks instant gratification in sex, and then feels empty and unsatisfied after coition.

Lycopodium patients are constantly trying to control the tendency to over-indulgence, but even that doesn't work for them. In the sexual sphere, celibacy fails because the patient becomes obsessed by sexual thoughts, and eventually resorts to masturbation in order to release the tension. After indulging in the wrong foods over a long time, the gastrointestinal tract becomes disordered and flatulent, so the patient may resort to fasting to cleanse the system. But Lycopodium is worse from fasting, and the patient experiences headaches and mad moods even from skipping a single meal.

Weakness of digestion, of course, is frequently a consequence of liver dysfunction. Lycopodium is often indicated in patients with liver ailments, and it is interesting to note that the liver has been known since ancient times to be associated with headaches and melancholy.

Once the essential image of Lycopodium and the progression of its stages is under stood one need only to know enough Materia Medica to see corroborating symptoms in the patient in order to prescribe it with confidence. A common such symptom is-- complaints occurring on the right side, or progressing from the right to the left side. There is frequent burning of the soles of the feet, so that the patient may stick them out of the covers at night. Often the right foot will be hot and the left cold. Lycopodium patients sleep well on the right side and may not be able to sleep at all on the left side. Also, Lycopodium is one of several remedies which feels unrefreshed after sleeping and may be aggravated bya an afternoon nap as well. Ofcourse there is a strong desire for sweets, and the characteristic Lycopodium 4-8pm time of aggravation. Lycopodium could be compared with a wide varieties of remedies, ofcourse, especially of the purely physical image were considered, Focussing upon the essence as we have in this paper, we can see that Lycopodium is quite distinctive. As mentioned earlier, Gelsimium suffers from anticipation, but this occurs prior to the event and not so much during. Silica is a remedy which has a marked lack of self confidence, but this occurs more in relation to physical weakenss and actual inability to physically cope with too much pressure; it is a lack of confidence which intermittent from over-exertion, whereas the Lycopodium inner state of cowardice is a constant process which is present regardless of the degree of physical weakness. Calcarea carbonica is sometimes compared to Lycopodium, especially on physical symptoms, but there not such a lack of confidence, and overexertion leads to fear of insanity in Calcarea rather than cowardice. Natrum muriaticum is a remedy with a characteristic split between the inner and the outer states, but the Natrum muriaticum inner state is one of emotional and sentimental vulnerability rather than the sense of inadequacy felt by Lycopodium.