This remedy comes up well after the study of Lachesis, for we find in the pathogenesis many features similar to those in Lachesis. It has the mottled aspect and the same puffed and bloated appearance of the face. It is antidotal to Lachesis, to the poison of insects, to the poison of Apis and to animal poisons.
Ledum is a remedy for the surgeon, and is closely associated in traumatism with Arnica and Hypericum. The symptoms very much resemble such as follow certain kinds of injury, for instance an injury from stepping on tacks, from puncturing with needles, wounds that bleed scantily but are followed by pain, puffiness and coldness of the part. Stepping on a nail and it pierces the sole of the foot or the heel, or he receives such a wound in the palm of the hand from a splinter, or he runs a splinter under the nail. If, after such punctured wounds, the becomes cold and then pale, paralyzed and mottled think of Ledum. The horse sometimes steps on a nail. If that nail goes through and strikes the margin of the coffin bone, tetanus will follow. It is known to be almost sure death. Put Ledum on the tongue of that horse and there will not be any trouble for it prevents such conditions.
When tetanus comes on from punctured wounds in the palms or soles, or in other parts, think of Hypericum, or when you have a punctured wound to treat, give Ledum at once and you will prevent tetanus. When the finger nails have been torn, or the nerves in sentient parts like the ends of the fingers have been torn and lacerated, Hypericum becomes the remedy. For bruising of various parts, and when the patient feels as if bruised all over, no matter how extensively he is bruised, Arnica is generally the remedy. It may be said, for punctured wounds study Ledum; for lacerated wounds of sentient nerves, study Hypericum; for bruises, study Arnica; for open lacerations and cuts, study Calendula. The conditions that come from the external ought to be remedied to a great extent by external means. A solution of Calendula is excellent in conditions that come from the external, and it should be applied externally. When you have lacerated wounds and cuts with knives or other sharp instruments, apply Calendula, because the injury is external without internal effects. The symptoms that arise from internal cause, treat with internal remedies, and symptoms that arise from external cause, when all that there is of the case is external, treat locally; in other words, for local causes use local means, and for internal or dynamic causes, use internal means. Let internal wrongs be treated by the homeopathic remedy and external or local conditions be treated by such soothing dressings as are most comfortable. Always protect surfaces that are exposed, and raw, and bleeding with something of a bland and superficial character. Wounds must be dressed with as simple a means as possible, and there is no simpler dressing than Calendula, one part to four or six of water. The tincture will smart too much. Your open wounds will granulate most beautifully under Calendula, and you will have no constitutional effects. When the constitutional state is orderly and there is an open injury let the constitution alone, but put on some soothing application externally. In doing this there is no law to govern the action of the physician. Air is an irritant to a raw part will keep up an unnecessary discharge of pus, even from a perfectly healthy sore. Calendula will keep it protected. The sides of a cut must be drawn together, and if it is perfectly tight it will heal itself by first intention. If it does not, then you may know there is a constitutional condition that you must ferret out and find remedy for. Local treatment must then be suspended. These remedies that I have mentioned, to a great extent, cover the management of wounds, and it is simple. Anyone has sense enough to draw together and close up a yawning wound, and to properly dress it. The muscles that naturally draw a wound open have to be overcome by stitches or by strappings. They do not belong to prescribing, they belong to the surgeon.
The Ledum patient is very often subject to what may be called constitutional coldness, coldness to touch, coldness in the body and coldness in the extremities with hot head, and again we see the other extreme, where the whole body is overheated, and the head also is in a state of great heat. There is throbbing and pulsating all over the body; the skin is purple or is too highly colored; he wants the covers all off at night. It is not uncommon to hear a patient, who has a Ledum headache, say that she wants the head out in the cold air, wants to put it out of the window, does not want any covering upon the head; delights to bathe it with very cold water.
Ledum has a bloated condition of the hands, face, and feet; bloated and purple from the knees down in certain dropsical conditions. With this purple, mottled, bloated condition from the knees to the feet the swelling as big as the skin will allow, and the pain excruciating. The only relief that patient gets is by sitting, with the feet in a tub of ice cold water. I remember the first time I ever saw this in a patient. He was an old syphilitic, whose nasal bones had been eaten out by syphilis, and his nose was a flabby piece of skin; it had no stiffening in it. He was a drunkard, and was extremely abusive to his family when drunk. He had been for several years unwilling to work, having lost his ambition, and he would sit in the house and allow his wife to wait upon him. He had practically become a tramp, only he could not tramp, for this dropsical condition had come on and his feet were so badly swollen and sensitive that he sat in the house day after day. When I first saw him he had before him a good-sized old fashioned wash-tub, and there he sat with the ice water two-thirds up to his knees and pieces of ice floating around on the top of the water, which he liked to have coming in contact with the skin. When that ice was out he would put in more. The wife described his sufferings by saying lie "suffered agonies something dreadful." Ledum took his feet out of the ice water so that he never used it afterwards. It caused the purpleness to disappear, the bloating went out of his feet, and he quit drinking. Ledum cured him of his syphilitic trouble, and he never had a return of that original state. Pulsatilla and Ledum are principal remedies that want the feet in very cold water. But Ledum suited that man.
Where there are inflamed surfaces the tendency in Ledum is to bleed, and the blood is black. Ledum patients are full-blooded and plethoric, of a robust character. Such plethoric patients bleed easily, have red faces; they are fleshy, strong and of robust constitution. Hemorrhages sometimes occur in the chamber of the eye, hemorrhage of the nose, hemorrhage in cavities, bloody urine.
Old painful ulcers that spread, that are mottled round about, in a constitution that always wants to be cold. The ulcers are relieved by cold.
This remedy is of a rheumatic nature, rheumatic and gouty. It is a gouty medicine, having complaints in persons who suffer from gout, and have chalk stones in their joints, deposits in the wrists, fingers and toes. The deposits go from below upwards. The gouty joints become suddenly inflamed and are relieved by cold. Ledum especially singles out the knee; it is suitable in old prolonged cases of inflammation of the knee-joint, of rheumatic knee-joint. You will find such patients sitting with the joint exposed to the cold, fanning the joint, or putting evaporating lotions upon the joint, such as chloroform, or ether, which give relief to the joints while evaporating to dryness. Rheumatic and gouty extremities with pain and swelling; pain worse from motion, worse at night and from warmth of bed; better from cold applications with copious pale urine. The pains and swelling go upwards and the heart becomes affected.
The face I have already described as puffy or bloated like the Lachesis face. It is a besotted face and looks very much like the face of an old drunkard. Ledum counteracts the effect of whiskey, and takes away the appetite for whiskey. Ledum is to whiskey what Caladium is to the smoking habit. You can break patients from the habit of smoking so that they go to the other extreme, and have an aversion to it.
It has erysipelas, as you might expect. It has a blue, mottled and puffed and sometimes edematous appearance. It takes on an acute character and becomes burning. Phlegmonous erysipelas of any part of the body, but particularly of the face, or the injured part.
You might naturally suppose that a medicine that has such a gouty nature in it would have more or less kidney symptoms. "Urination frequent, quantity diminished or increased, stream often stops during the flow." "Burning in the urethra after urinating." "Itching redness and discharge of pus." It has red sand in the urine as marked as Lycopodium. It has great quantities of sandy deposit of various colors. When the patient is feeling at his best, there are great quantities of sandy deposits passing away. When there is little deposit in the urine, the gouty deposits in the joints become marked, and he does not fee so well. It has another symptom that was verified by Lippe: Copious clear, colorless urine, light in specific gravity and from its being light or deficient of salts in the urine we have an aggravation of the gouty manifestations. Remember, that the rheumatic tendency spreads upwards from the lower extremities, from the circumference to the center.
"Menstruation too early, too profuse, bright red; absence of vital heat." Great coldness of the body at this time, yet the patient wants the cold air. Copious menstrual flow. Old gouty subjects, with mottled face with the puffiness that is not edema, simply a venous stasis, with copious menstrual flow, with great pain during menstruation. The uterus is extremely sensitive to touch, and the pelvic organs are so sensitive that any deep touch becomes painful to the patient. Dysmenorrhoea in gouty subjects. It turns the constitution into order, and prevents the after-formation of gout. When such cases are very deep-seated the uterine troubles will be cured in middle life, and the gouty appearance will come separately. The better the internal is, in an incurable disease, the worse the external becomes, and, when this is so, the external trouble is essential to health, and so long as the external manifestations are in the extremities, and the joints are being increasingly affected, so long the internal is in a state of order. When the remedy works in that way, do not change it and try to get something that will drive the external away. So long as the patient is improving and the external is growing worse, that is the right direction. Ledum acts in this direction. Its tendency is to make complaints go away from the center, for its complaints begin in the circumference and go towards the center. It is sometimes impossible to manage a gouty patient without giving him some sort of explanation. Lycopodium also keeps conditions coming to the surface. It will send them back to their own place in the externals when they have a tendency to go in. Lycopodium often causes a return of the red sand in the urine.
"Emaciation of suffering parts." A nerve is injured by a puncture and a slight infection takes place, so that the wound becomes congested, with a mottled, edematous appearance, and the part becomes cold, just such a condition as Ledum will cure. The nerve that supplies that part takes on an ascending neuritis, pains shoot along the nerve, the muscles that are supplied by that nerve dwindle and the part withers. We have in Pulsatilla a similar state. "The diseased limb withers."