Hippocastanum vulgaris. Horse chestnut Natural order: Sapindaceae.
Homeopathic preparation: Tincture of the ripe, fresh nut.
The essential features
Aesculus has established a wonderful reputation, and rightly so, for painful and enormously protruding hemorrhoids, purple in colour, that have a reflex action upon the sacral, the lumbo-sacral or the sacro-iliac regions with excruciating pains. These two areas, the rectum and the sacral region, can be affected in sequence, either the sacral area is affected first and then the hemorrhoids appear or the painful hemorrhoids protrude first and then there is a reflex pain in the sacral area. Bleeding is not common but if it occurs it relieves the pain somewhat.
The above is the “keynote syndrome” on which you may prescribe the remedy with a lot of confidence, but Aesculus can cure much more than this.
It has, like every other remedy in our Materia Medica a concrete, definite and singular action upon the constitution that can be expressed by the words venous stasis with venous engorgement. The venous system is in a state of flabbiness, of stagnation, of sluggishness, of laziness that permeates the whole organism. We can say without exaggeration that this remedy is full of “hemorrhoidal” veins that are flabby, full of blood and engorged. The rectum and the portal system are especially sensitive to the effect of this remedy in cases of congestion of the liver, in which the liver feels full and has slowed down in its function, being sluggish and painful.
This sluggishness, this fullness and stagnation affect the functioning of the eyes, stomach, bowels, rectum and heart, as well as that of the mind and emotions. There is a general state of venous stagnation.
It is wonderful to observe how these individuals, after lying down to rest and sleep for several hours, wake up in a dazed state, in total confusion, where they do not know where they are, they cannot recognise the environment, they do not perceive what is going on, unless some considerable time passes and after having moved about quite a lot. They wake up from a dream and are so lost that they do not know whether they are still in the dream or not. They wake up in the middle of the night with a feeling of fear, an indescribable apprehension for no apparent reason. Sleep is an aggravating factor for this lazy vascular system which slows down and stagnates further, and therefore is worse during and after sleep.
This aggravation is observed in acute as well as in chronic conditions. In acute conditions with fever the patient will wake up in a torpor, unable to recognise anyone in the room, with delusions that he is lost, not knowing where he is, and then he may want to escape from the window. The element of disorientation is very strong in Aesculus.
Lying down promotes the venous stasis, the vascular laziness. With Aesculus there is a vicious circle: the more he lies down (something that he desires) the more lazy his body, mind and emotions become. He knows that the best for him is to stimulate his physical body with vigorous exercises and his mind with intense thinking. The more violent the exercise the better he feels. Actually he is at his best when engaged in a vivid conversation in a congenial atmosphere or if stimulated mentally. Then he may find himself having a lot of ideas, his mind becomes lucid and active, he is pleasant with others and feels happy and content. But if the opposite occurs, if he gives in to his “stasis”, to his sluggishness and laziness then his mind becomes more and more dull; he feels stupid, discontent, miserable and cross at the same time. The Aesculus hippo. case is especially cross if he does not agree with something you are doing or something that he does not wants you to do. If he should become cross he can be violent and it will take him a long time to recover.
Eventually he develops a definite aversion to doing any mental or physical work, preferring to remain lazy and inactive, and the more he is in that state the more he sinks into depression. He loses his joy of life and the tranquility which are strong elements within this remedy. Eventually sadness, despondency and depression lead to the confusion of mind which is found in the final state.
Aesculus patients are very difficult people to persuade to do physical excercise, in spite of the fact that they know that if they force themselves to perform such physical exercises they will feel much better in the end. Usually they feel that they cannot be bothered, that it takes too much of an effort to excercise, they know that they are lazy! They are intelligent and nice people with a lot of good humor but if their back starts hurting they give up, they want just to lie down and rest, they feel that they do not want to go to work or attend to their business and the vicious circle starts.
After a disappointment, they easily become indolent, indifferent for their work or even their appearance. They start being absent minded, cannot pay attention, could not care less; their memory weakens rapidly, they become dull and at the same time cross, irritable and miserable because they do not like themselves at these moments. They are in a dazed state and may mistake one locality for another. Difficulty in orientating themselves.
You will have to imagine these plethoric individuals, with vivid mind and ideas, active and engaging, afflicted suddenly with hemorrhoids, with engorged purple huge veins with excruciating pains. It is a stasis where nothing moves. Then the backache starts and they feel miserable, they lose their temper very easily, especially in uncongenial environments, and stay in this cross state for a long time, unable to fix their attention, to think clearly. In this stage they have something like a feeling of death. It is not a fear of dying but a sensation as if death is near, although not at a specific time like Agnus castus or Arg-nitr .
In general, we can say that this remedy has congestion of blood vessels with a feeling of fullness internally and a feeling of heaviness externally.
Symptoms may appear in the afternoon at 4 P. M. and in this respect, will resemble Lyc. as the liver is one of the main seats of trouble for both.
Aesculus is one of those remedies that are aggravated by both warmth and cold, depending on the kind of pains or affections. The superficial pains of Aesculus are aggravated in winter, from cold bathing, cold air, and ameliorated in the summer. But deeper affections are ameliorated by cold and this is in accord with the nature of the remedy.
There is also a general amelioration from violent motion or exercise while slow motion may aggravate the pains on the extremities. Aggravation during and after sleep, while lying, on stooping, after stool.
It is important for the student of homeopathy not to take in a mechanical way certain local or general symptoms like “worse in cold” or “better in warm weather” but rather to pay attention to the nature of the remedy and discover all its hidden sides. I get impatient in my lectures when a student ignores in his analysis of the case a bunch of symptoms peculiar to the remedy and pays attention to a minor detail, especially if it is not written in the books in the same way as the patient expresses it.
Aesculus has flying, shooting pains on the surface to a certain extent.
Pains along the course of the nerves.
Other pains are deep, drawing, lancinating, causing lameness.
Hot perspiration with flushes of heat going downwards.
Clonic convulsions after shock.
Stretching before chill.
Formication all over the body, in different parts, mostly scalp.
Taking into consideration the general nature of the remedy, which is stagnation of blood and engorgement of veins, we can expect a lot of headaches. The headaches are often accompanied by, or alternate with, abdominal, hemorrhoidal, rectal, or sacral symptoms.
In most of its headaches there is a feeling of fullness, a pressure from inside out as if the brain would burst. The pains are felt especially in the back of the head, as if the head is being crushed. Congestion of head with beating of temporal arteries.
Feeling as if he had a board over the head. Dull weight in forehead.
Most of the headaches are centered on forehead and occiput. Heaviness in occiput.
Confused feeling in head with giddiness.
Dull pain in forehead, in occiput. Dull pain in occiput extending to ears.
Dull pain in occiput, with flushes of heat over occiput, neck and shoulders, and lame feeling in small of back. Headache in temples and occiput as if the head is being crushed.
Headache alternating with pain in abdomen. For instance there may be stitching, flying pains from right to left in forehead and once this kind of pain subsides flying pains appear in abdomen. Or headaches which are connected with the liver, or with hemorrhoids, or back pain in sacral area. Dull pressure, in forehead, with slight feeling of nausea in stomach, followed immediately by stitches in the right hypochondrium. Headache as if he had a cold.
Vertigo in the afternoon when sitting or walking. Formication in scalp, in temples and shoulders.
Frequent flying pains through temples and forehead. Pulsating, beating, throbbing headache in right temple; right; frontal eminence of forehead.
Kent writes concerning the action of Aesculus upon the eye: “Aesculus is a wonderful eye remedy, especially when the eyes have “hemorrhoids.” Does that convey any idea to you? By that I mean particularly enlarged blood vessels. Great redness of the eyes, with lacrimation, burning eyeballs and vascular appearance. This increased determination of blood is more or less painful”
This is the kind of symptom we are looking for in a case. This type of symptom belongs to the nature of the remedy and will give you a good hint if you are observant enough and you evaluate correctly what you are seeing. Yet in our texts of Materia Medica you may never find such a symptom as the one Kent gives here. Weight in eyes; they feel heavy and dull.
Sharp shooting in left eyeball, sometimes through left ear. Stinging pain about the eyes.
Fulness in ears.
Pains in the head move from one side to the other, and so it is with the pains in the ears: first one is affected, and then the other. Burning in the ears.
The remedy is suited to mastoiditis with paroxysmal pain behind ear. Ringing in right ear.
Dryness of posterior nares and throat.
Dry feeling and sensation of heat especially on tip of nose.
Burning and rawness in the nose sensitive to inhaling cold air. Feeling of coldness inside the nose on inhaling air.
Severe fluent coryza.
Nose feels raw during inspiration and this brings on a kind of coryza with sneezing. Congestive catarrh. Sense of fullness in root of nose.
Violent formication of the nose.
Drawing pain in right side.
Rawness after blowing, during coryza.
Pain in right nasal bone.
The face has a bewildered and miserable expression.
The face looks congested and red after washing it. Red spots on forehead and swelling after washing.
Face is red on left side.
Lips feel heated.
Viscid yellow mucus, with yellow coating of tongue.
Stitching pain in palate.
Metallic taste. Bitter taste. Sweetish taste. Oily taste of saliva.
Sensation of spasmodic contraction of mouth. Cannot control tongue so as to form words correctly. Unable to articulate long words distinctly.
Difficulty in moving tongue.
Mouth feels burning, as if scalded, raw and smarting, and this sensation is extended to stomach. Tip of tongue sore, as if ulcerated.
Cold water ameliorates toothache.
Here again the key-words are congestion, fullness, distended veins.
Varicose veins of pharynx. Throat looks dark, red. Dark, congested fauces with a full feeling.
The throat and pharynx feel dry and rough as if he had a cold.
All the throat feels excoriated and constricted.
Choking, constricting in esophagus.
Burning and stinging pain in throat when swallowing. A feeling as if something had lodged in fauces that causes constant swallowing. Throat feels sore in the forenoon. Sensation of coldness, as from cold air.
Soreness of cervical glands.
Mucus secreted becomes thinner, watery.
Rawness in larynx.
Pressure in throat-pit.
Dull distressing pains are characteristic.
Constant burning aching distress in the epigastric region with constant dull, aching pains in the right hypochondrium. Dull pain in stomach giving a distress very hard to endure. Constant pain in the stomach with severe pain in lumbar region.
There is a feeling of emptiness, weak feeling, faintness, goneness, in the morning, before breakfast but after eating there are also a lot of problems: eructations, heaviness, heartburn etc . .
Heartburn and gulping up all food after eating. Eructations: frequent, of wind, sour, greasy, bitter. Eructations that taste of the food with nausea. Flying pains in stomach after headache.
Pressure as from a stone in pit of stomach. A great deal of distress in the stomach.
Heartburn and feeling of weight as if from a stone, after eating.
Nausea and also a general aggravation after drinking tea.
Violent retching and vomiting, with burning in the stomach.
Pain in stomach extending downwards.
Trembling of stomach when coughing.
Stomach feels as if will fall down into the intestines.
Distension. Stomach feels dull, as if walls were thickened after eating.
Again, in abdomen symptoms are characterised by fullness, congestion and dull pains. Kent writes: “If we read the symptoms of the right hypochondrium, of the abdomen and of the rectum, we shall see from the study of these that there must be a marked portal stasis.” Abdomen and liver region sensitive to touch.
A great deal of distress in liver and epigastrium due to a dull, aching pain.
There is a reflex dull pain in the whole of the abdomen from hemorrhoids. It has most troublesome hemorrhoids with fullness of the right hypochondrium.
Constant, dull, aching distress in the umbilical region.
Another characteristic is a dull pain in right hypochondrium extending to back or to the scapula or under the scapula, felt also on inspiration. (Farrington says that he has never gone outside of three remedies Aesculus, Chelidonium and Kali-c. in order to cure this syndrome.) Dull pain in region of umbilicus at night.
Dull pain in region of umbilicus after stool.
Throbbing in abdomen during menses.
Throbbing in pelvic cavity and hypogastrium.
Rumbling in hypogastrium.
Swelling of mesenteric glands, liver.
Ulcers about the umbilicus.
It is in the rectum that we have the most prominent symptomatology in Aesculus and the symptoms are in accordance with the nature of the remedy: There is dragging, heaviness, weight in rectum, great fullness especially after stool. Constipation from portal stasis with as a result blind, bluish, external, large hemorrhoids Dry, uncomfortable feeling in rectum, as if it were filled with small sticks. Dryness, the rectum feels raw, the pain of the hemorrhoids is excruciating, sticking, stinging, stitching burning pain extending to the back. Wiping after stool aggravates hemorrhoids. Standing aggravates the hemorrhoids and the pain and there is also an aggravation during straining and after stool. Lying down aggravates the pain. Kneeling ameliorates the pain.
appearance of the hemorrhoids like groundnuts, of a purple colour, very painful, and with sensation of burning. The hemorrhoidal veins are distended and ulcerate. Internal, strangulated hemorrhoids. Hemorrhoids during pregnancy.
Has sensation of prolapsus and actual prolapsus of rectum after stool.
Hemorrhoids that do not bleed are also indicated in certain cases.
Swelling of anus or a sensation of swelling of anus. Fullness after walking.
Impossible to walk because the hemorrhoids are so painful and the back aches tremendously. Walking or standing are very painful.
Another characteristic that you have to remember in this remedy is the fact that hemorrhoids have an effect upon different other parts of the body, like the head, the abdomen, the back but mostly upon the sacral, lumbosacral and sacroiliac regions. Kent says “It is a very common thing for patients suffering from hemorrhoids to have pain in the back of the neck and base of the brain, basilar headaches.” Chilliness during stool.
Formication in anus.
Itching. Itching while walking.
Dark stool followed by white one, showing the liver is involved.
The stool becomes jammed in the rectum.
Diarrhea during hectic fever.
Stool flat, mushy brown, white, milk-like, chyle-like stool.
Desire to pass water but little at a time. Scanty urine in daytime.
Terrible pain in region of kidneys aggravated by motion.
Stitching, stinging, sticking, shooting pain ascending length of ureters.
Pain in urethra during urination.
Urine scanty and of a dark yellow color.
Urine dark and muddy and passed with much pain.
Brown dark sediment in urine.
Urine scanty and of a mahogany color and as it passed through the urethra burned like hot water.
Genitalia – male
Amorous dreams and seminal emissions. Drawing pain in left testes.
Drawing pain in testes extending towards the spermatic cord. Dull and heavy shooting pain through penis.
Genitalia – female
Dark colored leucorrhea aggravated by walking. Walking aggravates an albuminous leucorrhea.
Uterine soreness with throbbing in hypogastrium. Constant pulsation behind pubes. Pulsating uterus.
Leucorrhea with weakness.
Pain in left ovary extending to abdomen and small of back.
Leucorrhea while standing.
Pain in ovaries extending to back.
This remedy is suited also to all kinds of chest complaints, from bronchitis to tuberculosis. We observe a lot of pains across the chest. Tightness of the chest.
Raw feeling in chest. On the right side of chest, when breathing, feels the chest painfully moving up and down. Pain in chest alternating with pain in abdomen.
Pain in sides of chest on respiration. Stitching pain on right side of lower ribs.
Stitching pain in left side extending to right side. Crampy pain in forenoon.
Short cough on deep breathing.
Dry short cough increased from swallowing.
Spitting of blood in the morning on rising.
Twitching over the region of heart.
The heart is affected and again we see fullness in the heart. Cutting pain in heart.
Twitching of muscles in heart region.
Stitching pain in heart on inspiration.
Burning pain in heart region. Frequent stitches in the heart region.
Deep inspiration aggravates stitching pain in heart. Periodic palpitation of heart.
Neuralgic pain so severe as to arrest breathing.
Urination ameliorates stitching pain on lower left side of chest.
As we said before the back, and especially the lumbo-sacral region, is one of the main seats of action of Aesculus. The sacral, the sacroilliac and the lumbo-sacral areas are very sensitive. The pains are excruciating forcing the patient to bend and are mostly apparent when in motion, on rising, from sitting. He cannot raise his body and has to walk bending. Pains on stooping, walking. Feels as if the back would break, as if sacrum is broken.
We may also have pain in these areas at the stage before chill, from suppressed menses and after stool. Pains in sacral area extending to hips.
Lameness on walking, in sacral region.
Pain in cervical region on moving head.
Pain in lumbar region extending to hip. Pain in lumbar region after stool.
Drawing pain in cervical region. Pain between shoulder blades.
Weakness in cervical region and in lumbar region.
Chill extending up and down back; in sacral region.
Flushes of heat in cervical region.
Pain in sacral region after stool.
Rheumatic pain in right scapula; on breathing.
Sensation of paralysis and weakness of upper limbs while writing and lower limbs on walking: foot turns inside. Power of direction is impaired in hands when trying to write.
Strange trembling of muscles of left shoulder, continuing for two hours and followed by a sensation of soreness. Shooting pains from the shoulder extending down the arm into the wrist and thumb.
Arthritic nodosities in finger joints.
Rheumatic pain in upper limbs on left side.
Rheumatic pain in joints of fingers, in forearm.
Wandering pain in lower limbs.
Shooting pain in thigh extending downward; in leg.
Stiffness and swelling in the knee in the morning on rising.
Varicose; blue areolae ulcers in lower limbs.
Hands are blue. Chapped hands. Blue nails.
Hands are cold during menses.
Jerking of upper limbs on right side.
Tingling, prickling in hand after washing.
Numbness and tingling in the forearm and hand on the side lain on.
Affection of anus. Prostate gland affections. Prolapse of uterus.
GASTROINTESTINAL Constipation. Hemorrhoids. Liver affections. Throat affections. MUSCULOSKELETAL
Lumbago. Pain in sacrum. Back affections. RESPIRATORY
Cough. Headache. Hernia. Intermittents.
Compare: Aesculus glabra, Aloe, Collinsonia canadensis, Mercurius vivus, Nux vomica, Polophyllum, Sulphur. Nux vomica antidotes the pile symptoms.
It follows well: Collinsonia canadensis, Nux vomica, Sulphur
Compare also: Kali bichromicum [throat; but Aesculus hippocastanum hasn’t the stringy mucus]; Phytolacca [follicular pharyngitis].
It is antidoted by Nux vomica, coffee.
Foods inimical to it: Tea.
Dosage: From 12c to 10m or higher.