Aloe Socotrina — Homeopathic Remedy Profile

Aloe socotrina belongs to the Asphodelaceae, prepared from the resinous gum of the Socotrine aloe leaf. Its picture in the materia medica runs along one axis: portal congestion. The abdominal veins fill; the rectum grows lax and hot; a hard stool falls out unnoticed while flatus passes, and an early-morning urge drives the patient from bed. Boericke, Clarke and Phatak place it among the great rectal remedies, complementary to Sulphur.

At a Glance

Source and Preparation

Aloe socotrina is prepared from the inspissated juice of Aloe perryi, the Socotrine species of the Asphodelaceae, historically sourced from the island of Socotra. Trituration or spirit solution of the gum yields the mother tincture; potencies extend across the scale.

The potency register decides everything at this point. In tincture and low decimals, Aloe is a laxative acting on the mucosa by molecular contact; the cathartic effect and its ordinary cautions apply. From 30C upward there is no aloin in the preparation, and the caution against habitual cathartic use no longer applies to the same object. What acts then is the dynamic preparation, meeting the self-governing principle of a patient whose portal system is congested and whose rectum has lost its confidence. The two registers share a Latin name and almost nothing else.

Historically Aloe is one of the oldest known purgatives and appears as a leading ingredient in a large number of proprietary aperient formulas. Boericke lists it as usable at "trituration, tincture and all potencies," meaning no restriction of scale for the classical prescriber.

The Essence of Aloe

The picture is not built up from a striking mental keynote. It comes from below. A weight settles in the pelvis; the abdomen bloats after eating, more on the left, along the colon. There is a sensation as if a plug were wedged between the pubis and the coccyx. Gas rumbles and gurgles, then suddenly the patient must go, uncertain whether wind or stool will come. What follows is not always relief. The stool is bright yellow, jelly-like, or lumpy in water; sometimes a hard piece drops out and the patient is surprised to find it later in the linen. The rectum has forgotten how to hold.

Around this center the rest of the case arranges itself. The liver aches under the right ribs, worse when he stands upright, so he stoops. A dull, pressive frontal headache comes in winter and yields to a summer diarrhea, the two alternating year by year. The lumbar spine drags. Hemorrhoids protrude in a cluster and take cold water gratefully. The patient tires easily, dislikes mental work, and is out of humor in cloudy weather.

Clarke and Boericke both mark this as a picture for the aged, the phlegmatic and the sedentary. Old beer-drinkers, women of relaxed constitution, and elderly patients with broken-down vitality supply the type. Allen calls it "adapted to weary people with very broken-down constitutions." It is a remedy for people whose whole abdomen has become slow, hot and heavy.

Clinical Portrait

Mind and Temperament

Ill humor comes with cloudy weather, with constipation, or after eating. He is dissatisfied and angry with himself. Sadness in the morning gives way as the day goes on. Life feels a burden; mental labor is aversive; lassitude alternates with sudden mental activity. There is a fear of men, a startling at slight noises, and the strange complaint that persons about him seem to be stepping too hard or too quickly.

Children of this type are emotional, chattering and laughing between complaints. Hysteria may show. During pain the patient is extremely excited and easily angered, wanting to destroy the object of wrath, better after tea or a mild stimulant. Time passes too slowly.

The mental state is subordinate to the abdominal state. It is not the leading indication, and Aloe is not chosen on temperament alone. Where the bowel picture is clear, these mental features confirm it.

Rectum and Stool

This is the field on which the remedy stands. Every morning on rising there is a hasty desire for stool; he must run from bed to toilet. The urge returns immediately after eating and drinking, sometimes while still eating. Passing flatus brings a sense of insecurity: he is uncertain whether wind or stool will come out, and often both do. An involuntary soft stool while passing wind is the typical form — Murphy calls it a "lack of confidence of the sphincter ani." Stool escapes with flatus, or while urinating, or as he strains for one the other passes.

The stools themselves are various. Watery, mushy, lumpy, gelatinous, jelly-like with soreness after; bright yellow; small, brownish, half-fluid; bloody; occasionally solid pieces passed involuntarily. The image of a child going around the house dropping little hard, round, marble-like stools belongs to this remedy alone. So does its reverse — a hard stool that escapes at night in bed while the patient sleeps.

Sensation of weakness and loss of power of the anal sphincter runs through the whole. Burning in the anus and rectum, pulsation, itching, bearing down and the insecurity of the sphincter combine to make hemorrhoids unbearable at night. The diarrhea is worse in early morning, worse in hot damp weather, worse from cold taken in a damp room, worse from oysters, worse from beer, worse from vinegar and after chagrin.

Abdomen

The abdomen is full, heavy, hot and bloated, more on the left side, more along the colon, worse after eating. There is rumbling and gurgling. Great accumulation of flatus presses downward, causing distress in the lower bowel. The pains are colicky, twisting and griping, so the patient must sit bent forward; they are relieved when a burning, offensive flatus is passed. A weak feeling comes on as though diarrhea were about to appear. The pelvis feels as if filled with hot water. A pulsating pain circles the navel and shoots from the umbilicus down to the rectum.

Around this abdominal picture cluster the colitis and Crohn's cases Murphy lists in the clinical index. It is not the acute inflammation that indicates Aloe; it is the chronic abdominal plethora, the heaviness, the sense of insecurity in the rectum.

Hemorrhoids and Portal Congestion

Aloe belongs to the small circle of portal-congestion remedies with Sulphur, Nux vomica and Aesculus. Its hemorrhoids protrude like a bunch of grapes: blue-purple, external, tender, bleeding often and profusely, hot to the patient and sore to the touch. Cold water relieves. Ointments aggravate the burning, as they do in Sulphur. After stool there is a cutting feeling as though more were to come, and the hemorrhoids protrude further — sore, hot, bearing down. Sharp, burning stitches in the anus and rectum prevent sleep. There is constant bearing down in the rectum, worse standing, worse during menses.

The whole abdomen shares the state: veins full, liver dragging, pelvis heavy. Aesculus shares the venous piles with Aloe but lacks its insecurity of the sphincter; Nux vomica shares the sedentary origin and portal congestion but has ineffectual urging where Aloe has too much urging altogether.

Liver

Fullness and uneasiness under the right ribs, tension, heat and pressure. Pain in the liver is worse on standing, so that he bends forward. Sharp pains dart into the liver on drawing a long breath. Chronic jaundice with bilious states, coated tongue, foul breath and a sensation of fullness in the hepatic region complete the picture. On the liver-health side of the case Aloe stands beside Podophyllum as one of the portal-congestion prescriptions, sharing with it the characteristic alternation between head and abdominal symptoms.

Head

The headache is dull and pressive, worse from heat, better from cold applications and from closing the eyes. It sits above the forehead with heaviness in the eyes, so heavy that the patient partially closes them. Nausea accompanies it. Congestion to the head compels the patient to sit up. Alopecia with chronic headache, dryness of the hair, and sensitive spots on the scalp round out the head picture.

Carroll Dunham's often-cited case belongs here. An old man carried a heavy, incapacitating frontal headache each winter; it vanished each summer, replaced then by a diarrhea; the two alternated for years, and both yielded to Aloe. The alternation is not incidental. Boericke and Clarke both record it as the characteristic form of the remedy.

Back and Lumbago

Pain in the lumbar region, worse from movement in one entry and better from movement in another; the sacrum is worse for sitting and better for moving about. Sharp pain through the sacrum extends to the loins. A creeping sensation begins in the sacrum and travels through the bones of the whole body. The characteristic alternation is with the head: lumbago yields as the headache appears, and returns as it goes.

Female

Menses are too early, last too long, and are too profuse; the flow is dark and clotted. The uterus feels heavy, so heavy she cannot walk much on that account, and prolapses. Labor-like pains draw from the loins down into the legs. Bearing down in the rectum is worse standing and during menses. Menopausal hemorrhage and heavy congested uterus with labor-like pains are recorded. Leucorrhea of bloody mucus, preceded by colic, appears in the menopause picture of the sedentary, plethoric type. The uterine indication and the rectal indication run together; each aggravates the other, and the remedy meets them at once.

Male and Urinary

Aloe has a distinct old-man's urinary picture: enlarged prostate with bearing-down sensation and incontinence, the sphincter of the bladder sharing the weakness of the sphincter of the rectum. Every time on passing urine there is the feeling as though a thin stool would escape with it. Burning pain when urinating, frequent urging worse at night, and scanty, hot, high-colored urine appear together. Offensive sweat on the genitals, sensitive epididymis, cold scrotum with relaxed skin, involuntary emissions during siesta and sexual irritability after eating fill out the male sphere.

Dunham's second case belongs here. An old man with enlarged prostate and incontinence of urine, whose diarrhea also would not settle, was given Aloe; incontinence and diarrhea cleared together. The two weaknesses share a source in this picture: one relaxed pelvic floor, one lax sphincter served on either end.

Skin, Mouth and Other Regions

The itch appears each year as winter approaches, especially on the legs. Spots that are scratched become sensitive. Ointments aggravate the burning at the anus. Furuncles come with disordered liver. A golden color to the skin follows the jaundice in some cases.

Lips are dry, cracked, swollen, sore at the corners, bleeding; the tongue is coated yellowish-white or shows yellow ulcers; the taste is metallic, bitter, or like ink or iron. The nose bleeds on waking, with coldness of the tip and redness in cold air. Vertigo comes on movement, on going up stairs, or on turning quickly, and carries with it the same sense of insecurity that pervades the bowel.

Modalities

Worse:

• Early morning, driving from bed
• Summer, heat, hot damp or hot dry weather
• After eating or drinking
• Standing, walking
• Sitting (for the sacrum)
• Beer, oysters, vinegar
• Chagrin, after mortification
• Yawning, chewing

Better:

• Cool open air, cold applications
• Cold water to the anus
• Passing offensive flatus
• Closing the eyes (for the head)
• Tea, mild stimulants (during anger)
• Moving about (for the sacrum and back)

The heat aggravation runs through the whole picture. Hemorrhoids, headache and abdominal fullness all yield to cold in this remedy where in others they do not.

Relationships

Complementary: Sulphur. Clarke rates Aloe of equal importance with Sulphur in chronic diseases with abdominal plethora, and the two follow each other well in practice.

Antidoted by: Sulphur, mustard, camphor (temporarily), and Nux vomica.

Compare:

• Sulphur: the closest, and often the constitutional background. Sulphur has the early-morning diarrhea; Aloe adds the insecurity of the sphincter, the hemorrhoids like grapes, and the cold-water relief. Ointments aggravate both.
• Podophyllum: profuse, painless early-morning diarrhea, prolapse of rectum, alternation of head and bowel symptoms. Podophyllum is more painless and gushing; Aloe more full and heavy.
• Nux vomica: sedentary habits, portal congestion, hemorrhoids, but with ineffectual urging where Aloe passes too easily.
• Lycopodium: left-sided bloating and hepatic complaints; hunger during the state, as in Aloe.
• Phosphorus: sense of insecurity of the rectum, stool escaping without effort.
• Mercurius solubilis: dysenteric stool; but Mercurius has tenesmus where Aloe has weakness.
• Aesculus: the venous piles compare closely; Aesculus lacks the alternation and the anal weakness.
• Ailanthus: the dull, frontal headache compares.
• Gambogia and Ammonium muriaticum: abdominal and diarrheic symptoms.

Clinical Uses

Hemorrhoids

The Aloe hemorrhoid is external, protruding like a small bunch of grapes, blue and tender, hot and sore, bleeding often and profusely. It is worse after stool, worse standing, and better with a cold compress. Sharp burning stitches in the anus keep the patient awake. Boericke lists it among the specifics for this state, with the strong caveat that the whole abdominal picture must correspond: the sense of insecurity, the morning urge, and the relief from cold. In practice 30C or 200C is used, chosen by the fullness of the case.

Diarrhea, IBS and Colitis

The early-morning diarrhea, the sudden urging, the insecurity of the sphincter, and the involuntary escape of stool with flatus indicate Aloe in IBS and in ulcerative colitis where the abdominal plethora dominates. Murphy records its use in cholera, dysentery, hospital diarrhea, and diarrhea after chagrin. The stool is bright yellow, jelly-like, or lumpy, sometimes with pieces "like frog spawn." The griping is relieved by passing offensive flatus. In acute states 30C is repeated after each stool until the urging settles; in chronic states higher potencies, less often, following the case.

Portal Congestion and Liver Complaints

Where a patient carries a heavy, hot, congested abdomen with piles, dragging liver pains worse on standing, and headaches that alternate with bowel trouble, Aloe belongs among the first remedies considered. It is not competing with Sulphur here; it is often finishing what Sulphur begins, or preparing the ground for it.

Alternations Between Head and Bowel

Boericke describes the pattern plainly: "periodic headaches which alternate with lumbago" and headaches which alternate with intestinal and uterine disorders. Dunham's winter-headache / summer-diarrhea case is the standard citation. Nash records another: a child, constipated from birth, who screamed all the time he was held to stool and could not pass it even after an enema; yet when not trying, he passed solid pieces in bed without knowing. Cured with Aloe 200C. These alternations, in the aged and in children alike, are the signature.

Prolapse and Old-Age Incontinence

A relaxed pelvic floor with prolapse of uterus or rectum, incontinence of stool and urine, and bearing down in the pelvis defines the geriatric indication. Dunham's second case, the aged man with enlarged prostate whose incontinence and diarrhea both yielded to Aloe, remains the pattern. The remedy meets the whole relaxed condition, not one leaking sphincter at a time.

Frequently Asked Questions

Is Aloe socotrina the same as the aloe vera gel used on the skin?

It is not. Aloe socotrina is the dried, resinous gum of Aloe perryi, a different species of the same family. The homeopathic preparation is a trituration or spirit solution of that gum. aloe vera gel is a different plant and a different pharmacy. Murphy states plainly at the head of the entry: "This is Aloe socotrina, not Aloe vera." The safety and clinical data attached to aloe vera products do not transfer to homeopathic Aloe socotrina, nor the other way around.

Does the herbal purgative caution apply to Aloe 30C?

No. The herbal aloe is a well-known cathartic in tincture and low decimals; that action is molecular and dose-dependent. From 30C upward the aloin is no longer present in the preparation, and the cathartic caution does not apply to that form. The dynamic preparation is chosen on the totality of the case, chiefly the rectal insecurity and abdominal plethora, and given as a single dose or short course. The caution belongs to the mother tincture register, not to 30C and above.

How is Aloe told from Sulphur when both have early-morning diarrhea?

Both have the diarrhea that drives the patient from bed at dawn, and both worsen from ointments applied to the anus. Sulphur is the deeper constitutional; Aloe has, in addition, the sense of insecurity of the sphincter, the hemorrhoids like a bunch of grapes better from cold water, and the alternation of head with bowel. Where Sulphur is the ground, Aloe often finishes what Sulphur begins; the two are complementary, and either may prepare the other's action.

Which potency and how often?

Boericke gives "trituration, tincture and all potencies," meaning no restriction. In practice, for acute diarrhea 30C is used and repeated after each loose stool until the urging settles. For chronic hemorrhoidal and portal states 200C or higher, given less often, with intervals set by the response and not by a schedule. As with any dynamic preparation the case, not the calendar, determines the interval.

References

• Allen, T. F. The Encyclopedia of Pure Materia Medica. Aloe socotrina.
• Boericke, W. Pocket Manual of Homœopathic Materia Medica. Aloe socotrina.
• Clarke, J. H. A Dictionary of Practical Materia Medica. Aloe socotrina.
• Hering, C. The Guiding Symptoms of Our Materia Medica. Aloe socotrina.
• Murphy, R. Nature's Materia Medica. Aloe socotrina.
• Phatak, S. R. Materia Medica of Homoeopathic Medicines. Aloe socotrina.
• Nash, E. B. Leaders in Homoeopathic Therapeutics. (Aloe, constipated child cured with 200C.)
• Dunham, C. Lectures on Materia Medica. (Aloe, winter-headache / summer-diarrhea alternation; incontinence in the aged with enlarged prostate.)