Abrotanum: Homeopathic Remedy Profile

Abrotanum (Southernwood, Artemisia abrotanum) belongs to the Asteraceae. The prescribing image is narrow and unmistakable: a child whose legs are wasting while the appetite remains ravenous, or an adult whose rheumatism will not stay in one place. Boericke gives the register as tincture and all potencies. The classical prescription sits at 30C and upward, where a well-taken totality does what dosimetry cannot.

At a Glance

Source and Preparation

The remedy is prepared from a tincture of the fresh leaves and stems of Artemisia abrotanum, the aromatic shrub Southern Europe calls Lad's Love. Two prescribing registers share this Latin name and must not be confused. The herbal register (mother tincture Ø and low decimals D1 to D8) carries real dosimetry, and any pharmacological or toxicological statement about the plant belongs there. The classical register begins at 30C, contains no molecule of the crude drug, and is prescribed on the totality of the self-expressions of the organism. What is described below is the classical picture drawn from provings and cured cases, not a herbal indication.

Murphy places the remedy under Saturn and Moon. Clarke, Boericke and Phatak all describe it, and the small rubrics where its narrow keynotes are found repay slow reading.

The Essence of Abrotanum

Two ideas govern the whole materia medica: marasmus and metastasis.

Marasmus here is not a diagnosis borrowed from pediatrics. It is a state in which nutrition fails while hunger persists. The appetite is great, ravenous even, and the child still loses flesh, especially from the legs. Food passes undigested. The face grows old before its time. The neck becomes too weak to hold up the head. The picture is one of assimilation refused: the organism eats and does not receive.

Metastasis is the other axis. A trouble disappears from one place and takes up residence in another. Rheumatism leaves the joints and settles on the heart; mumps quits the parotid and swells the testicle; hemorrhoids flare as rheumatic pains subside; diarrhea is suddenly checked and stiffness of the neck begins the next morning. The self-governing principle has been driven off one surface and reappears on another. Homeopathy calls this alternation, and when there has been outside interference it calls it suppression. Abrotanum is one of the remedies that meets the state where the trouble has moved, and in some cases lets the earlier eruption return so that the deeper displacement can resolve. The keynote of metastasis links it to Platinum metallicum, with which it should be compared where a mental state alternates with a physical one.

Around these two pivots the rest of the picture arranges itself: the peevish, dulled mind that cannot bear conversation; the wrinkled, blue-ringed, hollow-eyed face; the great weakness that follows Influenza; the painful wrists and ankles of gout; the pressing sensation that lingers in the chest after pleurisy or a surgical drainage.

Clinical Portrait

Mind and Temperament

Feebleness and dullness of mind rule the mental picture. The patient is easily fatigued by conversation or by any mental effort and complains that thinking has become impossible, as though bodily and mental power had both gone. One proving symptom is the fear that the brain is softening. Beside this dulled indolence sits a difficult temper: peevish, cross, ill-natured, sometimes violent. The patient may feel like shouting; at other moments taciturn and gloomy. A stranger and darker note, present in the provings, is the wish to do something cruel, a feeling of having no humanity. In a wasted child the mental symptom that reaches the parent first is usually the whining, from a gnawing hunger that begins before a meal is finished.

Face and Head

The face tells the remedy. Skin dry, cold and wrinkled as though old; blue rings around dull, sunken eyes; hollow-eyed and pale. Angioma has been cured on the face, and acne with comedones is noted where emaciation is part of the state. Veins stand out on the forehead. The head cannot be held up because the neck is weak. The brain feels tired after any conversation. The scalp is sore, especially on the left side, and itches; hair falls out.

Nose

Nosebleeds are frequent, and in boys they accompany the constitutional wasting. The nose is dry.

Stomach and Abdomen

Here the peculiar sensation is diagnostic. The stomach feels as if it were hanging, or swimming in cold water. Pains are cutting, gnawing, burning, worse at night. Clarke cured with Abrotanum an indigestion in a middle-aged woman marked by vomiting of large quantities of offensive fluid, and the case belongs on any short list for gastralgia of this type. The abdomen is bloated and distended; hard lumps are felt in different parts of it; a weak, sinking feeling occupies the bowels. Tuberculous peritonitis has been treated with the remedy where the picture fits.

In the newborn, blood and moisture ooze from the navel, a small and specific rubric that has saved the remedy for many prescribers.

Rectum

Alternating diarrhea and constipation; food passes undigested. Where a diarrhea has been suddenly checked and joint pain follows, Abrotanum is thought of first. The remedy is also credited with destroying worms, especially ascarides, and stands beside Cina here. Hemorrhoids, protruding, burning to touch, sometimes with bloody stools and frequent urging, that appear as rheumatic pains abate, belong to the same movement of the disorder from one part to another.

Limbs

The wasting is characteristically of the lower limbs. A child's legs grow thin while the upper body is less affected; contraction of the limbs follows cramps or a colic; joints stiffen with a pricking sensation. The wrists and ankles are the seats of the gout: painful, inflamed, hot before there is swelling. Lame and sore all over; unable to move the limbs from rheumatism. Fingers and toes are cold, prickling, numb; chilblains itch.

Chest and Heart

Pain across the chest, sharp and severe in the region of the heart, of a rheumatic character. This is the classical picture of metastasis from a joint disease. After pleurisy, or after surgical drainage for hydrothorax or empyema, a pressing sensation remains in the affected side that impedes free breathing. Here Abrotanum follows Bryonia and Aconitum well and takes up the case where those remedies have left it. The pulse is small and weak.

Skin

Flabby and loose. Furuncles. Hair falls out. When eruptions have been suppressed, the skin becomes purplish. Angioma. Itching chilblains.

Female

Menses suppressed. A darting pain in the left ovary; twitching in both ovarian regions that seems to extend into the back. The back is weak with the ovarian pain.

Male

Hydrocele in boys, a small but reliable indication, especially in the same constitution that has the nosebleeds and the thin legs.

Fevers and Convalescence

Hectic fever, chilliness, marasmus that weakens rapidly. Great weakness after influenza, where the remedy stands beside Gelsemium and Kali phosphoricum. The choice among the three is settled on the mental state and on the presence or absence of the wasting.

Modalities

Worse:

• At night
• In cold air
• In foggy weather
• In wet weather
• From checked secretions, especially a suddenly stopped diarrhea

Better:

• From loose stools
• From motion (the sudden aching pain in the back is relieved by moving)

Relationships

Compare: Scrophularia, Bryonia and Stellaria on the general terrain; Benzoic acid in gout of the small joints, where the two remedies overlap and where the smell of the urine will often decide; Iodum and Natrum muriaticum in marasmus with good appetite; Agaricus, China, Ledum and Nux vomica at various points of the picture.

Follows well: Aconitum and Bryonia in pleurisy. The residual pressing sensation these two do not resolve is the exact indication Abrotanum takes up.

Complementary in the marasmic constitution: where the child is thin, cross and cold and does not thrive on food, Calcarea phosphorica is often the constitutional that follows Abrotanum once the acute wasting has been broken.

Clinical Uses

Failure to Thrive and Underweight in Children

The remedy's central indication. A child eats well, sometimes voraciously, and still loses weight; the legs are the first to waste; the face is old and wrinkled; the neck cannot hold up the head; the temper is whining and cross. The picture is a specific state of malassimilation, not a personality, and where it fits, 30C given once and observed is often enough to change the trajectory of a case that has resisted supplements for months. A repeated small dose over several weeks is used where the response is partial. Where the constitutional picture points to Calcarea phosphorica, that remedy usually follows.

Gout and Rheumatism That Moves

Painful, inflamed wrists and ankles; joints stiff with a pricking sensation before there is any swelling; ailments after suppressed gout. The characteristic that separates Abrotanum from the larger rheumatic polychrests is the movement of the trouble: from joints to heart, from one joint to another, from rheumatism to hemorrhoids and back. Where a patient reports that the joint pain went away and the piles began, or the reverse, the remedy is on the short list.

Convalescence After Influenza

Great weakness after the fever has broken, with the marasmic tinge (thin legs, cold hands and feet, the face pale and old) sets Abrotanum apart from Gelsemium, which is heavy and drowsy, and from Kali phosphoricum, which shows nervous prostration without wasting.

Sequelae of Pleurisy and Chest Surgery

A pressing sensation in the affected side after pleurisy, or after surgical drainage of hydrothorax or empyema, that impedes free breathing. This is the follow-on remedy, not curative of the acute inflammation, but reliable where that residual sensation lingers and free respiration will not return.

Chronic Alternating Bowel States

Alternation of diarrhea and constipation, food passing undigested, in the same constitutions in which rheumatism has been checked or an eruption suppressed. Here Abrotanum is thought of as a metastasis remedy first and as a digestive remedy second. The intestinal picture is one location the displaced disorder has settled in, and the totality including the earlier joint or skin state is what selects it.

Frequently Asked Questions

What is the leading indication for Abrotanum? Marasmus with a ravenous appetite, especially in children, with the wasting most marked in the lower limbs; and rheumatism or other disorders that move from one part of the body to another. Where both features are present, the remedy is close to specific.

What potency should be used? Boericke gives tincture and all potencies. In classical prescribing the acute or subacute picture (post-influenza weakness, the residual chest sensation after pleurisy, an acute gouty joint) is usually met with 30C or 200C. In chronic malassimilation of children, a single dose of 200C observed over weeks is preferred to daily repetition. LM potencies are chosen where the case requires a gently repeated dose over months.

How is Abrotanum distinguished from Iodum in marasmus? Both have great appetite with progressive emaciation. Iodum is restless, hot, dark, and driven; the patient must be doing something and cannot bear rest. Abrotanum is dull, peevish, weak in the neck and cold, and the wasting is most marked in the legs. The mental state usually settles the choice.

Can it be given after suppressed eruptions or checked diarrhea? That is one of its indications. Where a diarrhea has been suddenly checked and rheumatism or headache followed, or where an eruption was driven in and the joints or the chest began to trouble, Abrotanum meets the state and often lets the earlier expression return before resolving. This is prescription on the totality; it is not advice to reverse a treatment in progress.

References

• Boericke, W. Pocket Manual of Homœopathic Materia Medica and Repertory. Boericke & Tafel.
• Clarke, J.H. A Dictionary of Practical Materia Medica. Homoeopathic Publishing Company, London.
• Murphy, R. Nature's Materia Medica. Lotus Health Institute.
• Phatak, S.R. Materia Medica of Homoeopathic Medicines. B. Jain, New Delhi.