Arsenicum Album (ars.) is a classic remedy known in its basic outlines to all homoeopaths. Originally proven by Hahnemann himself, Ars. has been exhaustively described in every Materia Medica since. The classic description in Kent’s Materia Medica covers all the essentials in both the acute and chronic states: Anxiety, Restlessness, Aggravated by Cold, Worse 1 – 2 p.m. and 1 – 2 a.m. , Thirsty for Sips, Periodicity, Alternations of Symptoms, Ulcerations, Burning PAINS. A mere cataloguing of symptoms can be misleading in actual prescribing. However, unless the image is rounded out by a understanding of the essential dynamic process and stages of development of the remedy, particularly in comparison with other similar remedies.
The essential process underlying the Arsenicum pathology is a deep-seated INSECURITY. From this insecurity springs most of the key manifestations known in Arsenicum. This insecurity is not a mere social dynamic, but more essentially a sense of being vulnerable and defenceless in a seemingly hostile universe. This insecurity dominates the Arsenicum personality even from the earliest stages.
Arising from the insecurity is the Arsenicum DEPENDENCY on other people. Of course, Arsenicum is a prominent remedy listed under the rubric “Desires Company”. In reality, the Arsenicum person has more than a mere desire for company – it is an actual need for someone to be present, near him. Arsenicum surrounds himself with people because of his insecure sense concerning his health, his unaccountable fear of being alone. The need for company is not necessarily a need for interaction with people, such as in Phosphorus. Arsenicum needs people nearby, more for reassurance and support than anything else.
The Arsenicum person is very POSSESSIVE – possessive about objects, of money, and especially of people. The Arsenicum person does not easily share a relationship with a give and take dynamic. He is much more selfish, a “taker”. In a relationship, he will give support to another person, but primarily with the expectation of receiving support in return.
It is in this sense that Arsenicum is a selfish remedy. Automatically, he perceives events in the world from a purely personal standpoint. If something happens to someone else, the Arsenicum person will think first of what it means to him. For example, if a car accident occurs, the Phosphorus patient’s heart will automatically go out to the victim, putting himself in the place of the victim. The Arsenicum patient will instantly think to himself, “Oh, Oh! If that can happen to him, it could happen to me”. He may not think at all of the other person, but only of the implications to himself.
The possessive quality of Arsenicum extends to physical possessions, as well as people. He is miserly, avaricious. He is conscious of saving money and things, always calculating what the returns to him will be. It can occur that he may be generous with his money or possessions, but he is still giving with the expectation of receiving in return, and he will be upset if the returns do not come back to him. The same possessiveness leads to a compulsive collecting nature, if there is anything that he believes might be of some value even some insignificant little item, he will carefully store it somewhere where he will be able to find it easily later.
Next we come to the well known Arsenicum trait of FASTIDIOUSNESS. Here, it is important first to reiterate that in homoeopathy we do not prescribe on the basis of beneficial traits, but only on pathological qualities. Thus, if someone is neat and orderly as a manifestation of an orderly approach to life, this would not be a limitation in constructing the image of the remedy for that person. The same could be said about the perfectionistic quality, which derives in the same manner as the fastidiousness. On the other hand, we see people who are compulsively fastidious, obsessed by the need for order and cleanliness to the point of expending inordinate energy constantly cleaning and straightening. This is the Arsenicum fastidiousness. It is an obsessive attempt to assuage the anxious insecurity felt inside by creating order and cleanliness in the external world. The fastidiousness in Arsenicum arises out of anxiety and insecurity, whereas in Nux vomica it arises more from an excessive compulsion for work, for overly conscientious attention to details, and to an exaggerated sense of the need for efficiency. The Natrum Mur. fastidiousness is similar to this, but is more concerned with scheduling of time.
In studying remedies, it is crucially important to have an appreciation of the stages of development of the pathology. Otherwise, if we see a patient at a given stage, we may miss the remedy simply because we are looking for symptoms that are characteristically found at a different stage. Also, an understanding of the stages of the remedy and to differentiate it from other similar remedies.
In the early stages of Arsenicum, we see a relative preponderance of physical level symptoms with less emphasis on the mental disturbances. Particular physical complaints, burning pains, chilliness and aggravation from cold, frequent colds periodicity, thirst for sips, and time aggravations of 1 – 2 p.m. or 1 – 2 a.m. may be the primary symptoms to work with. Upon enquiry, one will probably see the fastidiousness, miserliness, and a certain degree of insecurity also. At this stage, particularly if the complaints are more functional and not involving much physical decay, it may be difficult to separate Arsenicum from Nux vomica. One must the search carefully for the psychological tendencies: Arsenicum will tend to be more insecure, needing the support of people, whereas Nux vomica will be more self-reliant and impulsive.
As the illness penetrates deeper, the Arsenicum patient will manifest more anxiety, particularly ANXIETY ABOUT HELTH, for he is afraid that he will die. At first, this anxiety may be most noticeable upon awakening in the morning, but it gradually occupies his attention throughout the day and night. It is also at this stage that the Fear of Being Alone becomes a prominent factor. He will have a constant need for company, particularly at night. The fears of Arsenicum are raised tremendously while alone.
The Arsenicum anxiety causes great anguish internally, and out of this arises the tremendous restlessness known to this remedy. The restlessness is not a physical process; it is a mental restlessness, an anguished attempt to allay the deep-seated anxiety. He will move from place to place, from chair to chair, from bed to bed. He will go from person to person, constantly seeking reassurance and support. It is interesting for the homoeopathic prescriber to note the difference between an Arsenicum and Phosphorus patient in relation to the prescriber. While both have great anxiety about their health, the Phosphorus type will plead for help to the homoeopath, while the Arsenicum type will demand it. The homoeopath is bound to feel the weight with which the Arsenicum patient will cling to him. Once they have reached that stage of development, no patients in our Materia Medica are so clinging and demanding of relief from their anxiety as are Arsenicum and Nitric acid. It is important to be able to distinguish the peculiar characteristics of the Arsenicum anxiety about health, as there are many other remedies having this characteristic also. The Repertory lists these thoroughly and in relative strengths but it is unable to describe the particular distinguishing qualities which are so important in separating one remedy from anther. If one only knows the fact that a particular remedy has the “anxiety about Health” without knowing how to differentiate it from the others, one will find great difficulty in selecting the precise remedy that fits the patient. This cannot be done by a simple process of repertorisation; it requires a minutely detailed knowledge of Materia Medica.
The anxiety about health in Arsenicum is really, deep down inside, a fear of dying. The idea of his own death causes intolerable anguish to the Arsenicum patient. It is not so much the fear of the consequences of a degenerating condition of health, but the fear of the ultimate state of insecurity – death. For this reason the Arsenicum patient will exaggerate many symptoms, blow them out of all proportion. He will come to the conclusion that he has cancer, and will go from doctor to doctor seeking someone who will confirm his fear. Even if all the tests are negative, he will not be consoled; his anguished fear and restlessness will continue to lead him to more and more doctors. He will fear that he has cancer, because that is the symbol of fatal disease in our day and age. It is not really the possibility of cancer, but the prospect of death that causes him such anguish. It is not a fear that he will get cancer sometime in the future; he hears that he has it now.
Other remedies have a strong anxiety about health also, but in different ways. Calc. carb. has a strong anxiety about health, but more focused on the possibility of infectious diseases, or particularly of insanity. Calcarea fears the insanity or the infectious disease itself, not so much the possibility of death; Calcarea can accept death with relative equanimity, but is more likely to be caught in a despair over being incurable and not being able to recover.
Kali carb. has anxiety that he will get a disease in the future, whereas Arsenicum fears he has cancer now. Kali ars. has a particular anxiety about heart disease, but does not fear death as much as Arsenicum does. The Kali ars. patient will say. “If I must die, it is O.K. “, but if you begin talking about his heart he will begin to express anxiety.
Phosphorus feels anxiety about his health, but primarily when the subject is raised to him. Many Phosphorus fears revolve around health, his own or his relatives, but the Phosphorus anxieties are not as obsessive. The Phosphorus patient is suggestible. He hears of someone who has died from a bleeding ulcer and then he imagines to have a bleeding ulcer. He does not hold his anxiety within himself but he will grab the nearest person and animatedly express his concern. He will immediately go to the doctor, who reassures him that he does not have an ulcer; the anxiety then disappears as quickly and easily s it came, to return again on the first provocation. He leaves the doctor’s office very relieved, saying to himself, “How silly I am”. By contrast Arsenicum, Kali arsenicum and Nitric. acid are not so easily pacified. They are inconsolable in their anxieties. The Nitric acid patient, unlike Phosphorus, always has anxiety about his health – an anxiety about any possible ailment, not only cancer, infectious disease, insanity, or heart diseases. He may read in a magazine about someone with multiple sclerosis, and he will say to himself. “Oh, Oh! That explains it! That must be what I have”. Then, instead of expressing his anxiety, he carries it around inside. Eventually he may very secretively make an appointment with a doctor, but the doctor’s assurances fall on deaf ears. He is convince of what he has and cannot be consoled. Later, he may read another article, and the process begins again. The Nitric acid anxiety about health is not so much the fear of death that we see in Arsenicum, it is more a fear of all the consequences of a long-term degeneration, with the expense, dependency on others, immobility etc.
Lycopodium has a marked anxiety about heath. The Lycopodium anxiety can be about any type of illness, like Nitric acid, but it is an anxiety that springs from a basic cowardice. It is not a fear of death, but a fear of the pain and torture of illness. He has a fear that he won’t be able to cope with a serious illness, that he will fall apart and reveal a lack of courage to others.
So it is clear that the simple rubric “Anxiety About Health” is actually full of wide varieties of shades and subtleties which are crucial to the precise choice of a correct remedy. This is true of every rubric, as a matter of fact, in the Repertory.
The same is true of another rubric describing a prominent Arsenicum anxiety – Anxiety for Others. As one would expect from what has already been said, Arsenicum does not have so much of a concern for others per se, but rather a fear of losing someone close to him. Again his anxiety is based on concern for himself. Consequently, he will show little concern over someone who is a stranger to him. It is a fear of loss of someone upon whom he is dependent.
Phosphorus, on the other hand, is so sympathetic and suggestible that he can lose all senses of himself in his concern over someone else, whether a close friend or a stranger. If an Arsenicum person were to meet someone new to the area he would welcome the company but would make conversation merely for the sake of the company; if the person were to mention, say, difficulties in finding a hotel, the Arsenicum patient would courteously express consolation and perhaps make a few suggestions, but his attitude would basically be, “Well, you have your problems but what about the problems I have”? The Phosphorus patient, on the other hand, would become excited and say, “You have no hotel? Oh, my goodness we must do something about that! Here, we’ll go right now to the directory and try calling a few”!
Sulphur also has an anxiety about others. In his instance, it is his active imagination which leads to the anxiety. A Sulphur father, for example, might lose sleep worrying about his daughter coming home two hours late from a date. It is not the Arsenicum anxiety over losing his daughter, or the Phosphorus sympathetic anxiety. The Sulphur type will lie awake inventing endless possibilities about what might have happened. He will allow his imagination to blow the whole incident out of proportion to the reality.
Let us return to the stages involved in Arsenicum. The first stage emphasizes the physical symptoms, the fastidiousness, and the stinginess. Then we see an increasing emphasis on the insecurities, dependency, anxiety about health, anxiety over losing others, the fear of being alone, and the fear of death. Gradually the fear of death becomes an obsessive, anguishing fear, the central issue of the person’s life.
As the illness progresses, we see the emergence of a paranoid, delusionary state. Suspicion dominates the picture. Once the paranoid state develops in a case, we frequently see the fastidiousness disappear. Eventually, the anxiety and fear diminish as a deep state of depression sets in – a despair of recovery, a loss of interest in life, and the suicidal thoughts, suspicion of others and the fear of killing people upon whom he depends. In this stage, the person may even avoid talking to people, becomes obstinate, inward. It is in this stage of insanity that one may find the most difficulty prescribing Arsenicum without a knowledge of its stages. Many of the usual symptoms of Arsenicum may be missing – anxiety, desire for company, fear of death, restlessness, fastidiousness. It may be difficult to separate Arsenicum from Nux vomica, or other remedies, at this stage. But if the case is taken carefully, the full dynamic process will become clear. The stage described herein illustrates nicely the progression of pathology steadily into deeper layers of the organism. It begins on the physical level, progressing to a state of anxiety and insecurity, then to fear of death, and finally despair, a loss of interest in life, suicidal disposition and a delusionary state on the mental plane. Consequently, under correct prescribing of Arsenicum in such a case, we can except a reversal of this sequence. As the paranoia and delusions lift and the fears and anxieties return, the homoeopath with a true knowledge of health and disease will recognize progress in the direction toward health.