Ratanhia — Homeopathic Remedy Profile

Ratanhia (Krameria triandra) is the small Peruvian shrub whose blood-red root gives the remedy its name and its reputation. Its prescribing center is the rectum: fissures that burn like fire long after the stool has passed, hemorrhoids that protrude with straining and burn like fire, briefly eased by cold water, pinworms with unbearable itching, and a bursting pain in the middle of the forehead when straining. The classical range runs from tincture through the highest potencies, and the older writers used it in both registers.

At a Glance

Source and Preparation

The remedy is prepared from the dried root of Krameria triandra, an intensely astringent shrub of the Peruvian Andes assigned by Boericke to the Polygalaceae. All the species of Krameria known to commerce are strongly astringent, and the infusion of the root is blood-red — Clarke records that it has been used both as a gargle and as an adulterant of port wine. Boericke lists "tincture and all potencies," and adds that a cerate made from the root has proved invaluable locally in rectal complaints.

The distinction between the two registers matters wherever a claim about Rhatany root is imported into the discussion. At Ø and low decimals the astringency of the crude drug is real, and the herbal writers used it as a tonic for muscular debility and passive discharges. At 30C and above no astringent principle is present, and what acts is the dynamic preparation, prescribed on the totality of the case. Cushing, whose proving is one of the fullest we possess, once treated an old and feeble woman with 3X internally alongside a Rhatany suppository at night — the two registers combined deliberately, one at each end, in a case severe enough to warrant both.

The Essence of Ratanhia

Something in Ratanhia is wound tight and cannot let go. Constriction runs through the whole remedy: throat that cannot form a loud word, chest gripped as by a stone, eyes held as if in a vice, rectum feeling as though the person were sitting on splinters of broken glass, anus that seems to protrude and then suddenly jerk back inside. The pains do not move steadily; they jerk, they twitch, they shoot. Persons who need it are often dark, thin and scrawny, chilly even in a warm room, subject to weakness and prostration with anxiety and sweat over the whole body, worse from the smallest exertion, quarrelsome when disturbed and afraid to be alone.

The rectum carries the load. A patient with a chronic anal fissure who needs this remedy will typically describe the same course of complaint: a burning that begins as the stool comes, sharpens into knife-stabs as it passes, and persists for hours afterwards, easing only when they sit in a bath as hot as they can bear. Hartlaub and Trinks proved the whole picture in a single phrase — "straining, stool so hard she cried out with great protrusion of hemorrhoids, followed for a long time by burning in anus." Nothing needs to be added to it.

Clinical Portrait

Mind and Temperament

Peevish, quarrelsome, easily made irritable, and then depressed as soon as they are alone. Clarke and Murphy both record the polarity: depression when alone, better in company; a fear that something will happen if left by themselves; anxiety on waking at night; a starting from sleep. During the worst pains the person may express a wish to die. The mind is changeable, and a firm decision is difficult while the pains are on.

The dreams are heavy — battles, sick people, funerals, the death of friends, earthquakes. A woman with a chronic fissure who dreams of catastrophe, wakes at one in the morning with sweat, thirst and a dry mouth, and cannot bear her husband to leave the house the next day, is showing more of the remedy than her rectum alone would tell.

Rectum and Anus

The rectum is the seat of Ratanhia. Constriction is the leading sensation: as of sharp splinters of broken glass, as if the whole passage were twisted, as if the anus were protruding and then went back with a jerk. Dry heat sits at the anus and is broken by sudden knife-like stitches. The stool is forced with great straining and followed by prolonged aching and burning, temporarily relieved only by hot water. Fissure of anus with great constriction, burning like a fire, is the keynote each source repeats.

Hemorrhoids burn in the same way and, characteristically, protrude with straining. Cold water gives a short-lived relief for the piles — a small but useful reversal from the fissure picture, which prefers heat. Bleeding may be marked. Oozing at the anus is a Ratanhia signature. So is a dry, itching anus without visible eruption, and, particularly in children, pinworms; Cushing wrote that after making his proving he had cured "nearly every case of pin-worms in his practice" with it. The itching is fierce and is not settled by scratching. Ascarides belong to the same picture.

Diarrhea, when it comes, is fetid and thin, and the burning holds whether the stool is loose or hard. Blood may drop from the rectum with or without stools. Clarke's account of Cushing's old and feeble woman — almost continuous discharge of mucus, blood and pus, night and day, with pain and burning so severe that sleep was almost impossible — records the collapse the remedy can meet even at the end of a long illness.

Head

The head belongs to the same picture as the rectum. At the height of straining the person feels the brain would burst out of the middle of the forehead, and the bursting eases with the stool but does not go away entirely. Long-lasting headache as if the head were screwed in a vice; dullness as if intoxicated; a sensation as though the scalp from nose to vertex were being stretched — all appear in the proving. Sitting with the head bent forward brings the bursting on, and stooping generally aggravates. Silica and Puls. share the ground of headache from straining at stool; the constrictive vice-like quality belongs particularly here.

Eyes

Ratanhia has a small but definite ophthalmic sphere. Inflammation of the sclera, pterygium — the fleshy triangular growth encroaching on the cornea — twitching of the lids, and a stiffness of the upper lids with soreness along the tarsal edges are all recorded. There is agglutination at night and lachrymation in the morning. A servant girl whose right upper lid twitched so rapidly and continuously that she could not see, described in the case Clarke preserves from Rummel, was not helped by Belladonna or by Calcarea Carb.; Ratanhia 12C relieved her quickly. A white speck seems to sit before the eye and gives a constant urge to wipe it away. Vision is dim for distant objects.

Nose and Mouth

Itching on the tip of the nose, better only by rubbing, is a Ratanhia signature that has drawn many prescriptions in children. Nostrils are scabby and burn; the nose is dry with frequent sneezing; a dry coryza stops the nose completely. Nosebleeds are violent — Murphy records one that recurred three times a day for five days in succession. Breath is offensive. A tasteless watery saliva collects. Gums bleed on sucking. The tip of the tongue burns as if scalded. A peculiar sensation as of a cobweb hanging about the right side of the mouth appears in several provers.

Teeth

Toothache is worse in the evening, worse on lying down, and drives the patient out of bed to walk about. The pain is tearing or jerking, with a digging quality; the incisors are painful to touch. A particular Ratanhia sensation is that of coldness rushing out of the molars, as if a cold draft blew from the tooth into the mouth. Toothache during pregnancy that compels the woman to leave her bed at night is a well-marked indication and, alongside Raph., Mag-c. and Chamomilla, belongs among the small remedies that meet this obstinate complaint.

Female

Menses may be suppressed with a swelling of the abdomen and breasts that simulates a pregnancy of several months, with profuse leucorrhea and kidney pain. Or they come too early, too long, too copious, with pains in the abdomen and loins. Metrorrhagia is passive rather than active — an ooze rather than a flood. Leucorrhea is discharged with itching in the rectum and streaks of bloody mucus. The rectal keynote extends into the female pelvis and often draws the prescription there.

Miscarriage is an old indication. The herbal writers used Ratanhia to prevent it in delicate and nervous women who had never carried to term; a French practitioner named Tournel, whose case is preserved by Teste, prescribed it as a tonic in incipient miscarriage without suspecting the abortifacient action recorded elsewhere, and by that route seems to have saved several pregnancies. Cracked nipples in nursing women are a leading indication. Graphites and Silica share this ground, and the choice turns on the concomitants: Silica for the retiring, chilly, foot-sweating mother whose skin suppurates readily; Graphites for the sluggish, plump woman with honey-oozing cracks; Ratanhia when the cracks burn like fire in the manner of its anal fissures.

Chest and Cough

Painful constriction in both sides of the chest. A stone-like pressure with short breath on slight exertion. Burning and sticking pains; a burning stitch in the last ribs near the back on stepping; an ulcerative pain during and after coughing. Malaise with frequent yawning and labored attempts to draw a long breath belongs here also. Dry cough with tickling in the larynx. In pleurisy and hydrothorax the older writers prefer Seneg., but Ratanhia should not be forgotten when the constrictive quality dominates.

Stomach and Abdomen

Violent, long-continued hiccough that causes pain in the stomach — one of the strongest markers of the remedy after the anal picture — with long hiccough after dinner as its most familiar form. Sudden bursting pain in the pit of the stomach. Pains as from ulceration. Empty belching with the taste of food; cutting like knives, better by belching. Nausea and disgust with retching, worse in the open air. In the abdomen: griping in the lower half, pinchings, a coldness at the umbilicus, and a peculiar movement in the sides "as of something alive."

Limbs and Skin

Tearing and shooting pains as from excoriation are the leading limb sensations — tearing in shoulders, arms, forearms and wrists; jerking and stitches in the thumbs; drawing and tearing in thighs, knees, legs and feet; tearing from the left Achilles tendon up the leg; sticking and burning tearing in the left big toe. Voluptuous itching in the left sole. Contractions of the flexor muscles. Pain in the bend of the elbow when flexed, better on extending it.

The skin has a sickly cast. Small red and white pimples that do not suppurate, especially between the shoulders and on the loins; the pimples itch and burn after scratching. Formication and itching on the back. Itching in the nape, between the scapulae, on the scrotum, at the front of the thigh, in the bends of the knees. Chronic edema of the skin. Scurvy is an older indication that belongs to the herbal register.

Modalities

Worse:

• Straining at stool
• Sitting bent over, stooping
• Touch, exertion
• Anxiety, uneasiness of mind
• Night, especially on waking
• Eating

Better:

• Hot water applications, hot bath (rectal complaints)
• Cool bathing
• Walking in open air, exercise
• Pressure (for chest pain)
• Emission of flatus

The bath detail is important. A patient with a fissure who describes putting on a kettle to top up the sitz-bath in the middle of the night, and who says the relief lasts only as long as they stay in the water, is telling the story Ratanhia was written for. Such a case is preserved in Teste's account of an earlier French cure.

Relationships

Teste placed Ratanhia in his Sulphur group, and Sulphur antidotes and complements it in many chronic anal states. In uterine affections it follows Bov. and Sepia well. For anal symptoms the wider comparison runs through Cantharis, Iris-v. and Peon.

For fissures the great comparison is Nitric Acid, which shares the splinter-like pain and the burning after stool but lacks the extreme constrictive quality. Graphites is similar in the rectal picture and in cracked nipples but does not have the same constriction. Silica shares the fissure and the cracked nipple ground and is preferred when the patient is chilly, retiring, and prone to suppuration.

For the sensation of splinters of glass in the rectum, Thuja is the classical parallel; Stict. and Aesc. carry the sensation elsewhere. In hiccough the comparison is Cycl. For burning on the tip of the tongue, Raph., Ran-s. and Sang. For the sensation of something alive in the abdomen: Croc. and Thuja. For the cobweb sensation about the mouth: Ran-s. and Bar-c.

Clinical Uses

Anal Fissure

This is the remedy's home ground and its most reliable indication. A crack in the anus with intense constriction; burning that comes on before, during and — most characteristically — after the stool, and does not settle for hours; temporary relief only from hot water. The stool may be hard or loose; the burning holds either way. Straining brings a bursting pain in the middle of the forehead. Oozing at the anus is common. The anal fissure monograph gives Ratanhia a section of its own, and this remedy is what is meant there by "the fissure that burns like fire."

Typical potency is 30C two or three times daily until the burning after stool begins to shorten. Cushing's combination of 3X internally with a Rhatany suppository nightly belongs to an older combined practice and is cited here as historical record rather than current recommendation.

Hemorrhoids

Hemorrhoids that burn like fire, protrude with straining, and are only relieved by cold water — the reverse polarity from the fissure, and clinically important. Bleeding may be marked. Where the burning after stool persists as in the fissure picture, the same remedy answers whether the primary lesion is a fissure or a pile. The hemorrhoids hub carries the full differential.

Pinworms

Ratanhia is one of the first remedies for pinworms with severe itching that keeps the child awake, drives them to scratch at the anus, and is not settled by scratching. Cushing's clinical record — nearly every case in his practice cured after the proving — is the primary evidence, and no subsequent writer has reduced its standing. Cina, Teucr. and Sant. are the other primary comparisons.

Cracked Nipples

Nipples cracked during nursing that burn as the fissures do at the other end of the body. Given as 30C internally, and a calendula preparation externally does not conflict.

Toothache in Pregnancy

The tearing, jerking toothache that keeps the pregnant woman out of bed at night, worse lying down, better walking about. Not a large sphere for the remedy, but distinctive when it appears.

Violent Hiccough

Long-continued hiccough after dinner, painful in the stomach, is a small but characteristic prescribing niche that Boericke and Clarke both underline.

Frequently Asked Questions

What is Ratanhia homeopathic medicine used for?

Ratanhia is prescribed primarily for anal fissures, hemorrhoids and pinworms — three conditions unified by burning pain, constriction and itching around the rectum. It is also used for cracked nipples in nursing women, violent hiccough after dinner, toothache in pregnancy, and a bursting frontal headache that comes on when straining at stool.

What is the typical potency for Ratanhia in a fissure?

30C is the usual starting point, two to three times a day, until the burning that follows the stool begins to shorten. Higher potencies (200C) may be used once the picture is clearly matched. Boericke notes that all potencies from tincture upward have been used; the older herbal cerate belongs to a separate register and is not part of classical prescribing.

How does Ratanhia differ from Nitric Acid in anal fissures?

Both remedies share the splinter-like pain and the long-lasting burning after stool. Ratanhia's leading sensation is constriction — as if the rectum were twisted or seated on broken glass — with hot water bringing marked relief. Nitric Acid patients are usually more chilled in a fixed way and often show a lean, dry constitution with a longer history of ill-health; the pains are compared to splinters but the constrictive vice-like quality belongs particularly to Ratanhia.

Is Ratanhia safe in pregnancy?

At 30C and above, the classical potencies contain no molecule of the crude root and the pharmacological cautions attached to the herbal drug do not apply. The herbal preparation itself carries a more complicated history: it has been used both to prevent miscarriage in delicate women and, at other doses, to precipitate it. Any use of Ratanhia in pregnancy belongs to a qualified prescriber who has taken the case in full.

References

• Boericke, W. Pocket Manual of Homoeopathic Materia Medica. Entry on Ratanhia (Krameria triandra).
• Clarke, J. H. A Dictionary of Practical Materia Medica. Ratanhia; case histories from Rummel and Cushing preserved therein.
• Murphy, R. Nature's Materia Medica. Ratanhia Peruviana.
• Phatak, S. R. A Concise Repertory of Homoeopathic Medicines.
• Teste, A. Systematic and Alphabetical Repertory of the Homoeopathic Materia Medica. Sulphur group; French cases (Tournel; Bretonneau via Trousseau and Pidoux) cited in the Ratanhia entry.
• Hartlaub, C. G. F., and Trinks, C. F. Reine Arzneimittellehre. Proving of Ratanhia, as cited in Clarke and Murphy.
• Cushing, D. Proving and clinical observations on Ratanhia, as preserved in Clarke.