Symphytum — Homeopathic Remedy Profile

An orthopaedic remedy in the strict sense. Symphytum officinale, the comfrey of European hedgerows, is the preparation practitioners reach for when bone or periosteum has been struck, fractured, or is slow to knit. It is drawn from a tincture of the fresh root-stock, and the older physicians treated it as the single most reliable dynamic preparation for injuries to the hard tissues and to the globe of the eye. Where Arnica leaves off, comfrey begins.

At a Glance

Source and Preparation

The root is dug in autumn or before flowering, and the tincture is prepared from the fresh material. Peter Squire, cited by Clarke, kept an older herbal tradition in view: the black rind of the root scraped away, the mucilaginous inside pulped smooth, spread on cambric and wrapped around an injured limb, where it stiffened into a casing "superior to starch, giving support and strength to the part." The older name consolida, and the derivation of comfrey from confirmare — both preserved in Murphy's entry — point at what the plant is understood to do. Hold together. Make firm.

Croserio was among the first to establish the potentized preparation in fracture work: "Injuries of the bones are healed most promptly with Symph. 30c internally, once a day." Wells reported cures at both 30C and 3C, choosing potency by the sharpness of the local picture rather than by the age of the injury. The topical tincture, as Squire and Brett used it, keeps its own tradition of external application, and carries the ordinary duties of care for a plant dressing on broken skin.

The Essence of Symphytum

Comfrey meets the organism at the boundary where structure has been broken. Where Arnica addresses the shock and the extravasation of blood into soft tissue, Symphytum acts further in, on the periosteum and the bone itself, and later on the callus that must form to reunite what has been separated. The picture is local, structural, and precise. Adolph Lippe reported that Symphytum was the only remedy he had seen efficient in traumatic injuries of bone or periosteum, and cured many cases in which Arnica had been used first without success.

A patient who has been struck by a blunt instrument, who has fallen from a height onto the back, who has broken a limb, or who has taken a cricket ball in the orbit. These are the presentations. So too the elderly bone growing brittle, the fracture that will not consolidate, the old wound that still pricks in cold weather years after the flesh has closed over it. Symphytum answers to a very particular pattern of pain: pricking, sticking, jagging, worse for touch, worse when the healed part is pressed. Better for gentle motion and for warmth.

Clinical Portrait

Bones, Periosteum and Fracture

The great sphere of the remedy. Fractures of every kind, from the simple green-stick of a child to the comminuted break of an adult, respond to Symphytum where the mechanical work of setting and immobilisation has been done but the union is slow, painful, or does not proceed. Deficient callus is one of its indications, and non-union of fractures another. The pain at the point of fracture is described by patients as pricking or jagging, as though rough edges of bone were catching at the flesh. Wounds penetrating to periosteum and bones, with injuries to cartilages, ligaments, joints and tendons involving excessive pain, fall equally within its scope.

Wells recorded a boy of fourteen who had broken his forearm at the junction of the middle and lower thirds, twice re-broken it in slight falls, and whose bone ends were slightly movable on each other two years after the original injury. Three doses of Symphytum 30C completed the union, and the boy grew more robust in general health than he had ever been before.

Injury to the periosteum without visible fracture is equally within its scope. Blows on the shin, on an epicondyle, on the crest of the tibia, that leave a soreness lasting weeks after the bruise has faded. This is the after-Arnica indication that Lippe made canonical. Once the bruised soreness of the soft parts has recovered under Arnica, the remaining pain and soreness of periosteum is met by Symphytum. Tennis elbow of traumatic origin, painful old surgical stumps, post-operative bone pain after amputation or bone puncture, all belong here.

Osteoporosis and brittle bone belong in the same territory. Not as a metabolic entity treated homeopathically at a distance, but as a state of the bone in which every jar produces disproportionate pain and slow repair, and in which Symphytum answers when the picture is otherwise clear. For swellings, nodules and tumors in bones and limbs after an injury, and for bone cancers of the jaw or other bony structures, the nineteenth-century materia medica of the remedy holds a rich clinical history.

Eyes and Orbit

The second great sphere. Injuries to the eyeball from blunt instruments (a fist, a stray branch, a rebounding ball, the corner of a shelf) are Symphytum injuries. Black eye, bleeding inside the eye after injury, retinal bleeding, traumatic conjunctivitis, long-lasting pain or soreness in the eye after an injury has otherwise closed. The eyelids may be spasmodically shut. The patient will describe a curious sensation, as if the upper lid passed over an elevation on closing the eye.

H. C. Allen was categorical on this. "I have long since ceased to use Arn. in injuries of the globe of the eye, Symph. having given such prompt and permanent relief." Where Arnica addresses the soft tissue and the bruising around the socket, Symphytum reaches the sclera and the interior of the globe. Ledum retains its old place for penetrating punctures; comfrey is the remedy of the blunt blow.

Back and Spine

Backache from a fall, from a violent wrenching motion, from lifting beyond capacity, from a blow to the mid-dorsal region. Clarke records the case of F. H. Brett, who cured himself of a spinal after-effect of a fall by applying the tincture to a protuberance that appeared, as if from a slight dislocation, in the mid-dorsal region. Pott's disease traceable to a fall, decay or caries of the vertebrae after injury, low back pain persisting from an old strain, all fall within the compass of the remedy.

A peculiar backache also runs with a sexual causation, preserved in the older herbal literature and carried through into Murphy's entry. Low back pain from excessive sexual indulgence, sometimes with spermatorrhea induced by the excess. It is not a moralised indication; it is a specific pattern of vital exhaustion expressed at the lumbo-sacral junction, and Symphytum meets it.

Head, Face and Teeth

Head injuries with lasting pain in the bone of the skull sit within Symphytum's range, and it is often given after Hypericum has addressed the nerve component or where the injury has involved the frontal or maxillary bones directly. Headache appears in the occiput, at the top of the head, in the forehead, and moves from one place to another. Facial injuries with hard, red, painful swelling of the lower jaw belong here, as do cancers and tumors of the antrum in the older records.

The comfrey history in this territory is unusually rich. Sir William Thomson of Dublin, in Clarke's account, operated on a man in May 1896 for a round-celled sarcoma of the face that had extended to the nose. A month later the growth returned, closed the right eye, became blue, tense, firm, lobulated. Thomson declined a second operation. Early in October the man walked into Thomson's study well, having applied poultices of comfrey root, and Thomson could not identify any trace of the tumor in the face or mouth. Such reports of round-cell sarcoma of the antrum and other bone malignancies recur throughout the nineteenth century materia medica of the remedy. They are historical clinical observations, not therapeutic promises.

Toothache after injury, jaw swollen and painful after dental work, pain worse after tooth extraction, periodontal soreness with receding gums: these are frequent and useful minor indications in day-to-day practice.

Male

Backache from sexual excess has already been named. Testicles that become painful and tender after a blow, so much that walking is prevented, follow the same pattern of blunt injury to a hard structure. Arnica is often given first for the bruising, Symphytum for the persisting soreness once the discolouration has cleared.

Abdomen and Rectum

The lesser but real indications: pain about the navel, worse for sitting; pains crossing the epigastrium from one side to the other when sitting; gastric and duodenal ulceration; inflamed and bleeding hemorrhoids. The tincture as an external dressing for itching of the anus appears in Clarke and in Murphy. Walking causes a pain opposite the spleen. Stooping causes a weight in the forehead.

Modalities

Worse:

• Injuries, particularly from blunt instruments
• Touch, pressure and motion of the injured part
• Sexual excess
• Stooping (weight in the forehead)
• Sitting (pain about the navel)
• Walking (pain opposite the spleen)

Better:

• Gentle motion
• Warmth

Relationships

Complementary and following

Arnica is the primary complementary. In every injury of importance Arnica is given first, and Symphytum follows when the bruised soreness of the soft tissues has resolved but pain in the bone or periosteum remains. Wells's case of the boy of eight with a fractured humerus is the pattern. Arn. 30C for three days arrested the spasmodic jerking of the muscles and settled the traumatic fever; Symph. 3C was then given, one drop in half a tumbler of water, a teaspoonful morning and evening. The splints came off on the ninth day and the bone was found consolidated. The cure, Wells wrote, was entirely without pain.

Hypericum precedes or accompanies where nerves have been involved. Coccyx falls, spinal injuries with radiating pain, crush injuries of the fingers or toes. Calendula belongs to soft-tissue and open-wound repair that runs in parallel with Symphytum's bone work.

Compare

Ruta divides the periosteal territory with Symphytum. Ruta answers where the periosteum is bruised or strained, particularly in the wrists, ankles and long tendons, with the characteristic feeling of soreness deep in the bone and worse for cold and damp. Symphytum comes into its own once fracture, cartilage, or the substance of bone itself is at stake, and the pricking, jagging pain locates the injury precisely. Bellis perennis stands in a similar relation to deep soft-tissue and abdominal injury as Symphytum stands to bone.

Calcarea carbonica and Silica belong to constitutional treatment of slow bone development or defective assimilation of lime, and are the remedies to consider when non-union is a constitutional problem rather than the sequel of a specific injury. Symphytum acts on the injury. The deeper prescription attends to the terrain. Ledum, for penetrating wounds and injuries about the eye of that kind, retains its own indications and does not overlap with Symphytum's blunt-blow territory.

Antidotes

The older materia medica does not fix a formal antidote for Symphytum. Where the remedy has been given inappropriately or in excess, ordinary discontinuation and a return to the totality of symptoms suffice.

Clinical Uses

Fracture, non-union and slow callus formation

The commonest use. Once the fracture has been reduced and immobilised, 30C once a day for a week or two accelerates the formation of callus and shortens the healing time. In non-union of long standing, three doses at intervals of a few days, in the pattern Wells used, may be enough. Where the constitution is at fault, Calcarea carbonica or Silica is added on the deeper level. In compound and comminuted fractures the same principle applies. Symphytum earned its old English name of knit-bone in exactly this work.

Injuries to the eyeball from blunt instruments

Black eye with pain persisting after the discolouration has faded, bleeding inside the eye after a blow, retinal bleeding, traumatic conjunctivitis, long-lasting soreness in the eye after impact. 30C two or three times a day for two or three days, reducing as the eye settles. Serious injury of the eye also warrants immediate specialist assessment; Symphytum runs alongside such assessment, not in place of it.

Periostitis and old bone pain

Blows on the shin, elbow or ankle that leave a soreness lasting weeks or months. Old fractures that still ache in cold weather. Painful surgical stumps and post-operative bone pain after an amputation or a bone puncture. Pricking, stitching pains remaining after the wound is healed, worse for touch, are the guiding quality Allen identified. 30C once or twice a day until the pain quiets, or LM1 for a longer, slower course in chronic cases.

Backache from a fall or from sexual excess

Low back pain that dates from a specific fall, a lift, a wrench, or from a period of over-indulgence, sometimes with spermatorrhea in the second case. The picture is unmistakable when the causation is clear. 30C daily for a week is a common starting course.

Dental and jaw injury

Pain persisting after a tooth extraction, jaw swollen and sore after dental work, periodontal soreness with the pricking quality that Allen made a keynote of the remedy. 30C two or three times on the day of the procedure and the day following generally settles the matter.

A Case from the Older Records

One vignette from the Symphytum literature carries more instruction than a paragraph of theory. Fowler's case of Mrs. J., cited by H. C. Allen, is worth reading in the patient's own words. She stepped on the edge of a scantling, a length of rough sawn timber, which rolled beneath her foot and turned her ankle. Within minutes the joint began to swell, and the pain rose so rapidly that within an hour or two she was in great agony. She was convinced her leg was broken. She could feel, she said, "the rough ends of the broken bones jagging into the flesh." She would not let anyone come near her for fear of being hurt. On inspection there was no discolouration whatever. Symphytum was given, and she went about her usual duties within forty-eight hours.

What is instructive in Fowler's report is the specificity of the sensation and the absence of the ordinary bruise. The remedy is present in the language of the patient, in the words jagging and rough, before it is present in any physical sign. This is the kind of listening the older prescribers meant when they spoke of the remedy meeting the case.

Frequently Asked Questions

When should Symphytum be given after a fracture rather than at once?

Practical convention, following Wells, is Arnica first for the first three or four days while the shock, bruising and traumatic fever settle, then Symphytum from that point onward for as long as callus is forming. Where a fracture has already been set some time ago and pain persists at the site, Symphytum may be given from the outset, since the Arnica window has closed.

Does the modern caution about comfrey alkaloids apply to 30C?

What acts at 30C is the potentized dynamic preparation, prescribed on the totality of the case; the case is chosen on the modalities and the picture, not on a pharmacological dose. Dose-based pharmacology and the regulatory cautions on pyrrolizidine alkaloids in unfractionated comfrey therefore belong to the mother tincture and the low decimals such as D1 to D6, where measurable plant matter is ingested. Practitioners who use the tincture externally as a dressing, in the tradition Squire described, are outside the oral pathway the caution addresses. The distinction between the herbal and the homeopathic register should be stated whenever the question arises.

Can Symphytum be relied upon for injuries to the eye?

For the blunt injury to the globe, the fist, the ball, the falling object, H. C. Allen and Lippe both regarded it as more reliable than Arnica once the initial hour or two had passed. For penetrating wounds of the eye Ledum retains a distinct place, and a serious injury of the eye is a matter for immediate specialist assessment as well as prescribing.

How does Symphytum differ from Ruta in bone and joint injury?

Ruta answers to bruised periosteum in the wrists, ankles and long tendons, and to strain and overuse of the flexors; the pain is a deep, wearied soreness. Symphytum answers when the injury is to bone itself, or to periosteum after a blow, and the pain has the pricking, jagging, catching quality that Allen made a keynote of the remedy.

References

• Murphy R. Nature's Materia Medica. Third edition. Lotus Health Institute, 2006. Entry Symphytum officinale.
• Clarke J. H. A Dictionary of Practical Materia Medica. Homoeopathic Publishing Company, London, 1900. Entry Symphytum officinale, including the Thomson, Squire, Brett, Fowler and Wells cases.
• Boericke W. Pocket Manual of Homoeopathic Materia Medica and Repertory. Ninth edition. Boericke and Runyon, 1927. Entry Symphytum officinale.
• Allen H. C. Keynotes and Characteristics with Comparisons of Some of the Leading Remedies of the Materia Medica. Boericke and Tafel, 1899. Symphytum, with the indications given by Lippe and Fowler's case.
• Lippe A. von. Keynotes and Red Line Symptoms of the Materia Medica. Boericke and Tafel, 1915. Symphytum.
• Hahnemann S. Organon of the Medical Art. Sixth edition, translated by W. B. O'Reilly. Birdcage Books, 1996. §§ 3, 5 and 7 on the totality of the case and the ordering principle of prescription.