Rhus toxicodendron, the poison ivy, owes its activity to a nonvolatile oil. Direct contact with the plant, is absolutely necessary for the production of ivy poisoning. Some authorities state that the poison is a glucosid but this is disputed by others. When applied locally, there results itching and vesicular eruption of the skin. The mucous surfaces are very apt to become involved; they become reddened and tumefied. Phlegmonous infiltration and abscesses are among the possible terminal pathological conditions following the exposure. It directly excites inflammation. Halsey states, "Specific vascular poisons are substances which, without causing any destruction of tissue or necrosis of the tissues, act only on the vessels, perhaps also on the lymphatics, dilating them and rendering them abnormally permeable. There are certain toxic substances, probably proteid in their nature, which belong to the group of the so-called toxins. Among these is Rhus toxicodendron, which causes active hyperemia and serous infiltration of the tissues." In the vesicles produced by Rhus are found leucocytes and large numbers of red cells.

When taken internally, diarrhea, dysentery, and colicky pains appear. The stools may be bloody, and if enough of the drug has been taken to produce systemic poisoning, a typhoid-like condition appears.

A characteristic property of Rhus is the production of rheumatic pains, generally distributed over the body. These pains are aggravated by rest and they apparently have their seat in the fibrous tissues.

In general, the intoxication produced by the drug closely resembles that which occurs as the result of such diseases as rheumatism, septicemia, erysipelas and typhoid fever.

It has been found that rabbits may be successfully immunized to extracts of

Rhus toxicodendron and that their serum in doses 1 c.c will protect guinea pigs from 5-6 lethal doses of the poison. [Chemical Pathology. Wells.]

Therapeutics

Rhus toxicodendron: This is a remedy very often useful in many common ailments, when its few striking, characteristic, guiding symptoms are in evidence. The patient who requires Rhus is quite likely to suffer from subacute or chronic rheumatic diseases and is, as it were, a sort of human barometer, sensitive to weather changes even before they actually occur. Before a storm, when rain is threatening, he feels sore all over, particularly in his joints, which are even more stiff and lame than usual. He is restless, especially at night, is unable to remain long-in one position, he must move, yet in commencing to move experiences much difficulty and pain and is stiff like a "rusty hinge." The more he moves, the more limber he becomes, until he straightens up and walks with tolerable comfort and ease, although soon he tires and must rest again, only to be compelled to go through the same performance once more.

This restlessness is found in all conditions to which Rhus is applicable and the remedy is never indicated when this symptom is absent. In this respect Rhus and Bryonia are, therefore, diametrically opposite. In lumbago, Rhus toxicodendron is usually the first remedy required, especially when the cause has been muscular strain or exposure to cold and dampness. The back is painful and stiff; stooping is practically impossible, the patient is constantly endeavoring to find a more comfortable position, but finds most relief from lying flat on the back upon something firm or hard.

Another guiding symptom of this remedy is found in the appearance of the tongue which, although it may be coated reddish brown and is dry and cracked, always has a red triangular tip as a distinctive feature. This indication is of decided value in throat conditions and especially in typhoid fever, where Rhus is often a sovereign remedy. The Rhus patient is a thirsty one, wants plenty of water and craves cold milk particularly. In typhoid fever these features, together with the muscular soreness, restlessness and offensive, yellowish and brown stools, at times involuntary, will lead to the choice of this medicine.

Sciatica will demand Rhus toxicodendron, when the trouble has been brought on by strain, or by exposure to cold and wet, or is the result of chilling, due to checked perspiration from exposure to draft. The pain is severe, tearing in character, gives the sufferer no comfort, but compels him to seek ease by a constant change of position, which gives temporary relief. Heat, or a hot application, is agreeable. At night the trouble is decidedly worse.

In scarlet fever this remedy is frequently required where the eruption is slow in appearing and rough or miliary in character. Swelling of the parotids is common and these may, at times, suppurate; the throat is edematous in appearance, the tongue as above described, and the weakness, restlessness and characteristic thirst will all be present.

Pneumonia, when it assumes a typhoid character, will frequently demand Rhus toxicodendron. The expectoration will be bloody or rusty, and a reliable indication is a bloody taste while coughing.

Erysipelas demands this remedy when the temperature is high, the general characteristics already described are present and when the eruption is vesicular, rough and dusky in appearance. The scalp, genital organs, or face are often the parts affected and in facial erysipelas, the eruption quite commonly commences on the left side and extends to the right.

Rhus toxicodendron is of much value in the treatment of eczema and here the vesicular nature of the eruption, together with itching and burning especially bad at night, will confirm the choice. In dermatitis venenata caused by poison ivy, this remedy, if given in a highly potentized form, will often give most remarkable relief. Herpes zoster frequently needs Rhus toxicodendron and the indications are those already sufficiently described.

Rhus toxicodendron will, therefore, as has been suggested, be found useful in many different diseases when its characteristic indications are prominent and these should always be present in greater or less degree, if success with this remedy is expected.

Characteristic Symptoms Of Rhus Toxicodendron

1. Aching in left arm with disease of the heart.

2. Vesicular and pustular eruptions, with burning and itching.

3. Putting hands out of bed covers brings on a cough.

4. Restless at night, has to change position frequently.

5. Corners of mouth ulcerated and sore, or chafed around the genitals.

6. Menstrual flow causes biting pains in the vulva.

7. Swollen around the ankles, after sitting too long, particularly in traveling.

8. Soreness as if beaten in the hypochondriac region, and still more in abdomen, worse on the side on which he lies, worse when turning and worse when beginning to move.

9. Lameness, stiffness and pain on first moving after rest, or upon getting up in the morning; relieved by continued motion. Worse before a storm, from getting wet.

10. Pains as if sprained, ailments from spraining and straining; lifting, particularly from stretching the arms high up to reach things.

11. Complaints after getting wet in a rain while overheated.

12. Typhoid, low, mild delirium, stupefaction, insensibility, restlessness, tongue red, dry and cracked, abdomen distended, loose, dark brown stools.