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Viola Tricolor Caselet

I remember very well a case that I reported to this society some years ago-a young woman who came to me from out of town. She was so crippled with rheumatism that she was brought in a coach. On obtaining her history I found that she had been under old school treatment for six months, had been having the salicylates and iodides galore. The stomach had been affected by powerful drugging and her rheumatic condition had steadily gotten worse. There was one silver lining in her misery however. She said to me "There was one thing they did do for me, though. They cured my eczema". I asked her how they did it and she told me of the various ointments that she had rubbed in religiously for weeks. That was the clue and I gave her sulphur btt. Inside of twelve hours there appeared an impetiginous eruption covering the scalp and backs of the ears, a copious exudation which matted the hair, giving such an unpleasant odor that she was forced to leave her boarding house. This responded completely in a couple of week to viola tricolor 3. The eruption dried up and the odor disappeared. As the eruption came to the surface the rheumatism became less severe and in a month's time, after treatment for that condition by the homeopathic remedies in conjunction with application of the positive breeze of the static electricity she was able to walk as well as any of us and has remained perfectly well ever since.

(from WML Love, Physical therapeutics as an aid to the homeopathic remedy in dermatology ; in Transactions of the Homeopathic Medical Society of the State of New York , 1913, Volume LVII)

Analysis by Will Taylor , MD

I'm struck, initially, by the gestalt recognition that this is a Tubercular case – i.e., that the pathology is an expression of the chronic tubercular miasm.

FACE - ERUPTIONS - eczema - accompanied by – impetigo – lists a single remedy, Bacillinum (Burnett)

Choudhury ( Indications of Miasm ) includes in his description of the secondary symptoms of tubercular disease,

Offensive discharges from behind and about the ears

Moist eczematous eruptions about scalp

Scalp is moist, perspiring copiously (children)

Scalp eruptions moist copious pus formation

Matted hair

Skin affections with glandular involvement

Eczema –Pustule

Impetigo

Swellings of joints or idiopathic synovitis, even rheumatic form

“Tendency to … rheumatism … are their day-to-day company in most cases after suppression of Tuberculosis.”

The nature of her eczema and acute rheumatic affection are typically tubercular, but she does not need a “typically tubercular” remedy – these expressions of disease are the center-of-gravity of her case, but are not the center-of-gravity of the tubercular miasm. We need a tubercular remedy with strong specificity-of-seat in exudative scalp eruptions and rheumatic affections of the joints, rather than a more “generically” tubercular remedy.

“Big” remedies or polychrests (“remedies of many uses”) that come to mind quickly here include Silica, Mercurius, Hepar, Tuberculinum, Lycopodium, and Calcarea carbonica. But it is not a polychrest that we need here; rather we're looking for a “smallish” remedy with a more focused symptom picture. I'll be happy with a “small” remedy accompanying these polychrests in the leading results of a repertorization of the few characterizing symptoms of the case.

Vinca minor comes quickly to mind with “ailments from suppressed eruptions” and the offensive, matting exudate of a scalp eruption best described as “plica polonica”. But a quick review of its pathogenesis fails to offer anything resembling her rheumatic disease.

A repertorizaiton of the characterizing symptoms of the case yields:

Nestled among the polychrests here (Mercurius, Hepar, Lycopodium, Calacarea carbonica, Sulphur , Silica, much as anticipated) and the generically tubercular remedy Tuberculinum, is perhaps the “small” remedy we are after – Viola tricolor.

Here is the same repertorization with a small-remedies weighting, underscoring the significance of finding a smallish remedy swimming among these polychrests:

Searching Ernest Farrington's Clinical Materia Medica for references to Viola tricolor, we can find:

“Vinca minor is also useful in plica polonica, a condition in which the hair is matted together. In these skin symptoms you may compare Vinca minor with several remedies; first with Viola tricolor. This is useful in crusta lactea, when the exudation is very copious. Like Vinca, it mats the hair together, but there is this peculiarity which always enables you to distinguish between the two, namely, Viola has urine with a peculiar pungent odor, which has been aptly compared to that of cat's urine.”

We don't have that confirmatory SEUO (striking, exceptional, unusual, odd) symptom in this case, but we do have another “seat” of action of Viola tricolor, which is not shared by Vinca – rheumatologic pain, as seen in the presence of Viola tricolor in the rubrics:

EXTREMITIES - PAIN - rheumatic

EXTREMITIES - PAIN - Joints - gouty

EXTREMITIES - PAIN - Joints – rheumatic

- credited to Hering and Clarke.

In Hering's Guiding Symptoms, we find the following relevant references:

Tissues

- Rheumatism or gout

- Articular rheumatism

- Impetiginous and eczematous diseases, especially crusta lactea

In Clarke's Dictionary of Practical Materia Medica, among 13 clinical indications, we find

- Crusta lactea.

- Plica polonica.

- Rheumatism

So what about the Sulphur given as the initial prescription?

This case presented in heavy suppression, with a picture of suppression-induced “one-sided” or defective illness; Hahnemann used the term “Einseitige Krankheite” ( Organon , aphorism 172). Perhaps the symptoms guiding to Viola tricolor could have been obtained by a careful review of the patient's historical eczema symptoms, but often enough this is not the case. Sulphur was given to obtain a reaction, in order to see a more full and characterizing expression of the disharmony of the organism. From Hahnemann's Organon, aphorisms 180-182:

“A medicine has been selected as well as possible but, due to the one-sided nature of the disease, it is only imperfectly homeopathic, that is, it is only partially analogous to the disease. Consequently, the medicine will arouse accessory ailments … at the same time, ailments of the disease itself … one has to accept the entire symptom complex that has now become visible as belonging to the disease itself, as the present true state, and to further manage it accordingly. The imperfect selection of the medicine, which was here almost inevitable on account of the all-too-small number of symptoms present, nevertheless thus renders the service of completing the symptom content of the disease and, in this way, it facilitates the finding of a second, more apt, fitting homeopathic medicine.”