When I was 11, I had the riveting experience of getting stitches for the first time, in my knee. The anaesthetic was given ineptly, the stitching was poor (probably because the pain was such that I couldn’t stay still), and after being bandaged up carefully I was told sternly “now don’t move your knee till your next appointment in two weeks”. After two weeks of immobility, the knee was painful and infected, I had fever, and at the next appointment I was given antibiotics and told to make sure I moved the knee constantly. What’s the relevance? Apart from yet another triumph for the British National Health Service in the 70’s? Read on, gentle reader…
On reading the proving of Rhus Tox, it struck me that so often our assumptions about things can be close, but not quite accurate. If a patient is worse when walking, that doesn’t necessarily mean that he will be better when sitting down or resting. If a patient is worse for lying down that doesn’t necessarily mean he will be actually ameliorated when sitting up – “not as bad as lying down” isn’t quite the same thing. Something else to take into account in case-taking and analysis.
Hahnemann saw fit to highlight the following in his introduction to Rhus Tox:
“Careful consideration and comparison of the symptoms of this remarkable and valuable medicinal substance enable us to perceive a great number of characteristic peculiarities in it.
“To mention one only: we observe this curious action (which is found in very few other medicines, and in these never in such a great degree), viz. the severest symptoms and sufferings are excited when the body or the limb is at rest and kept as much as possible without movement.”
We all have certain assumptions about Rhus Tox. Chief amongst them is that Rhus Tox is better for movement, the picture of the patient as having difficulties when beginning movement, but as movement continues his condition improves. Hahnemann however gives prominence to the aggravation from rest, from lack of movement. This allows us to see the difficulty on beginning of movement, and easing up as gentle movement continues, in context.
The symptoms from the proving define that context further, showing how aggravation from rest and lack of movement does not automatically mean amelioration from constant movement. For example, in the proving there are 61 mentions of walking. Out of these, 8 symptoms show clear amelioration from walking: 576, 699, 704, 706, 800, 805, 903, and improvement of an emotional symptom in 953. By comparison 45 symptoms show clear aggravation during or after walking.
I would say “I rest my case” – but in Rhus Tox that would cause aggravation…