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George Vithoulkas Materia Medica Professional

BISMUTH – Homeopathic Remedy – Materia Medica Viva George Vithoulkas




Hydrated oxide of Bismuth and the precipitated subnitrate of Bismuth are not differentiated.



Bismuth is a remedy which should be thought of in cases where the focus of the problem lies in the stomach region. Severe stomach pains of whatever origin are a strong indicator for this remedy, particularly in cases of pure gastritis, and inflammation of the mucous lining of the stomach. The Bismuth patient’s face is earthy, pale, with blue rings around eyes; there is great thirst for cold drinks in evening, nausea and pressure in stomach after eating with great drowsiness in forenoon. He may experience flushes of heat over head and chest and feel prostrated. Any derangement in the health of the individual has repercussions on the stomach. Thus Bismuth may be classed with the group of remedies whose common factor is a weakness in the stomach region, such as: Nat-carb., Ant-c., Nux v., Robinia, Kali-c. and Kreosotum.

The characteristics of the Bismuth gastritis are the following: severe burning, pinching, cramping or lancinating pains with violent vomiting of enormous quantities of food. The epigastric pains usually extend to the spine. The pains are temporarily relieved by drinking cold water, but as soon as the water becomes warm in the stomach it is ejected by spasmodic vomiting. If this does not happen automatically a heavy load, like a stone, is felt in the stomach which prompts the patient to stick a finger into his throat to induce vomiting.

The patient vomits at intervals when the stomach becomes full and the amount of vomitus is really enormous. It is as if food had been left there for days and is suddenly ejected. Here it is interesting to note another peculiar symptom of Bismuth that has been confirmed: eructations taste of food eaten 24h before. The pains of Bismuth are so severe that the patient is in constant turmoil, writhing about in great distress. The arms and legs, the entire body – all are in constant motion. There is tremendous physical restlessness. The patient goes from one place to another, lies down, gets up, sits now here, now there, but he cannot stay long in one place. The pain is so intense that it provokes great fear in the patient. He keeps repeating, “Am I going to be well? Will I recover? Please hold me! Don’t leave me alone!” These patients, because of the violence of the pain, have a great fear of being left alone and of solitude. They need somebody to be with them constantly, sometimes just to hold their hand. This fear of being alone during the pain is very characteristic of Bismuth.

If such are the symptoms of the case, the attending homeopathic physician will tend to prescribe other remedies first. Arsenicum will come to mind, because of the characteristic restlessness, or Phosphorus, because of the anxiety and fear of being left alone. The selection of Phosphorus may be further justified in a case of Bismuth by the great thirst for cold water, the temporary amelioration from it and more particularly by the fact that the water is ejected soon after reaching the stomach, combined with the tremendous anxiety about health, the need for reassurance and the desire for company during the pain – all symptoms that are as typical for Phosphorus as they are for Bismuth. However, in other areas the two remedies differ totally, as may be seen by the following description of Bismuth’s mental-emotional picture. The Mental-Emotional Picture

The typical Bismuth patient is one who has suffered a great deal in the course of his life, both emotionally and physically. The resulting stress has centred on his stomach which is now inflamed. This patient is nervous, fleshless, irritable and hysterical, and his emotions are hardened. This type of person does not forgive easily, and may pursue a ruthless course of action even with the knowledge that in so doing the other person will be hurt. You will find a combination of excitability, amounting to hysteria, and near cruelty or indifference for the pain of others. The Bismuth patient’s behaviour can be so contradictory that one may get the impression that he is crazy. In the text it says: “want of moral feeling”. In this respect Bismuth is totally different from Phosphorus, whose characteristic emotions are sympathy and compassion.

When in pain Bismuth cases become extremely fearful, worrying that others will not care for them and that they will be deserted at this time of suffering. They develop an obsession with the fear of being left alone.

They dread solitude, especially in times of trial, and they want to cling to persons around. When suffering with a headache they become apathetic and sullen, and their mood becomes one of complaining and peevish dissatisfaction. Actually the Bismuth patient suffers from an alternation of headaches with stomach pains. There are periods when the headaches are in excess and then the stomach problems subside and vice-versa. Headaches appear mostly in winter

These patients do not like to talk, especially during the day when they appear to be irritable and complaining, ill-humored, morose and discontented. This mood is better in the evening when they become more talkative and communicative. Indolence is also better in the evening. Their minds may be unstable, even confused, as if intoxicated. They start on one subject, then change to another, holding but a short time to any one thing. This lack of consistency would seem to indicate a weak will and lack of ability to make a decision. Lastly, the Bismuth patient is easily frightened on waking.


The Children

Bismuth children are slender and irritable, with a tendency to slow chronic diarrhea. This remedy is indicated in infants where a difficult teething period is accompanied by vomiting, offensive eructations, intermittent diarrheic stools, or soft semi-liquid stools of a light color and foul odor, preceded by crampy pains and pinching in the stomach. Children with summer diarrhea, watery offensive stool and great prostration fall into this category if vomiting predominates.

This is one of the main remedies in cholera infantum with a sudden onset of the disease and where the case looks very serious. The stools are watery but excessively offensive and cadaverous smelling, and there is excessive vomiting, especially of cold water as soon as it reaches the stomach. The tongue is thickly coated white, there is rapid exhaustion and dehydration which show the severity of the case. The child is restless and anguished, he wants his mother next to him all the time holding his hand. The case bears a strong resemblance to Arsenicum, with one important difference: the surface of the skin is warm, while in Arsenicum it is cold.


Other Characteristics

Another striking characteristic of Bismuth is that the pain is ameliorated by rubbing or massaging the back. Massaging the region of the solar plexus itself cannot be tolerated, but rubbing the region of the back ameliorates. Such massaging may relieve not only the pain and writhing, but also the tremendous anguish. Here it must be stressed that the Bismuth epigastric pains are felt behind as if they were in the spine; they are not felt on the outside of the back like in belladonna but rather deep in the spine.

While the acute exacerbation of pain is continuous for days at a time, chronically the pain recurs in paroxysms with an irregular periodicity. This periodicity may vary from every fifteen to thirty to forty-five days, and, once the paroxysm begins, its violence, anxiety, and characteristic great thirst for cold drinks (which are vomited) are unmistakable signposts to Bismuth.

It is strange, however, that once the pain abates, these patients can eat and digest virtually anything. During the paroxysm, the body and head may feel as if fever is present. Eventually the extremities become cold, but the torso and head remain warm to the touch, even though there is actually no fever.

Bismuth is indicated in the chronic non-febrile vomiting following an acute gastritis, or indigestion. It is important to remember that in spite of the fact that there is such a strong inflammation of the stomach lining, fever is lacking or very low. This will help you to differentiate it from the belladonna gastritis as both have the intensity of the pain and the extension to the back.


I have used the oxyde of bismuth with success in a number of cases:

for a wearing, nightly cough, (in a hysteric lady, whose strange and odd manners almost amounted to craziness).

  1. in a case of sub-acute cystitis, (after Plumbum), accompanied with violent crampy pains at the bladder, which came on in irregular paroxysms.
  2. in several cases of dysmenorrhea in hysteric females.
  3. and lastly, with brilliant success in a case of phlegmasia alba dolens (phlebitis of the femoral vein). The left lower extremity was the principal seat of the disease.



Restlessness, driven from place to place, driven out of bed.

Faintness from pain in stomach.

Most symptoms are ameliorated from motion.

All muscles of body, particularly those of legs, from toes to thighs, are spasmodically contracted.

Great debility; languor; prostration.

Cold drinks and bathing ameliorate the stomach pain, the headache and the toothache. Vertigo

Vertigo on exercising.

Vertigo; a sensation as if the anterior half of the brain were turning in a circle, several times during the day, lasting several minutes. Confusion of head.



Constriction of head alternating with relaxation.

Heaviness in head on motion, while sitting, on forehead, on occiput, in temples.

Headache alternating with pains in stomach. Violent neuralgic headaches which alternate with gastralgia, the pains in the head involve the face and teeth, worse eating, better from cold water in the mouth.

Headache attended by gastralgia. Headaches in winter.

Boring pain in forehead after eating, while sitting, extending to nose, motion ameliorates.

Burning, cutting and contracting pain from forehead to occiput.

Pressing pain as from a weight in forehead above nose.

Dull cutting pain in the brain, which begins above the right orbit and extends to the occiput.

Dull pressive-drawing in the head, now here, now there.

Pressure and sensation of heaviness in the forehead, more violent on motion. Violent pressive heavy pain in the forehead.



Distended feeling.

Boring, contractive, digging, pressing pain.

Mucus discharged in both canthi. Thickened mucus in both canthi.

Pressure on the right eyeball, from before backward and from below upward. Ear

Tearing pain in ear, pressure of hand ameliorates.



Nosebleed, dark blood.

Heaviness of root.

On attempting to swallow liquids come out through the nose.



Pale, cold face; earthy complexion; blue borders around eyes; features changed, as if he had been very sick during headache. Pain in face alternating with pain in stomach (see also stomach).

Motion aggravates.

Pressing pain in cheek.



Gums swollen.

Pain in gums as if excoriated.

Swelling of mouth, of one side of the tongue.

Taste is bitterish-sour, bloody in the morning.

Taste: sweetish, sour, or metallic on back part of tongue. Copious secretion of brown, thick, metallic-tasting saliva. Mucus bloody.

In the evening, white-coated tongue.

Slight salivation, with marked tumefaction of inner surface of cheek, and side of tongue.

Sensation of looseness of teeth.

Toothache relieved by taking cold water in mouth; worse when water becomes warm.

Pain in teeth, anything cold ameliorates.

Pain from warm food and drinks.

Drawing pain in molars.



Ulcers spreading on uvula.

Inflammation of the throat wakes him at night.

Phagedenic ulceration of uvula, with burning and tearing; difficult swallowing of fluids, which return through nose.



Convulsive vomiting.

Vomiting immediately after drinking the smallest quantity.

Violent retching, followed by fearful vomiting.

Vomiting with oppressive anxiety. Vomiting and diarrhea.

Vomiting and purging with great prostration; warm surface; flatulency; white tongue; cadaverous-smelling stools; patient desires company. Water is vomited as soon as it reaches the stomach.

Vomiting in teething of children.

Nausea in the stomach; he feels as if he would vomit, especially violent after eating, with pressure in stomach. Nausea, ameliorated after cold drinks.

Nausea from warm drinks.

Nausea after operation on abdomen.

Pain alternating with pain in face.

Periodical pain.

Pain in stomach with fainting.

Pain on small spot.

Pain as if something would break inside.

Pain as if pressing food in one spot.

Pressure in the stomach, especially after eating.

Cancer of stomach.

Fetid eructations.

Pains better from cold drinks.

Eructations that taste of the food eaten 24h before.

Rubbing back ameliorates.

Pain in stomach relieved by bending backwards.



Rumbling when standing, right side.

Frequent passage of flatus.

Pinching pressure in the lower abdomen, and rumbling with desire; a sensation as if he must go to stool. Abdomen painful to touch.



Urging in the evening.

Clinical symptoms: Painless diarrhea, with great thirst. Cholera infantum, with tongue thickly coated white, vomiting etc.


Urinary Organs

He is obliged to urinate frequently, every time profusely; the urine is watery.


Genitalia – male

Aching, pressing pain in right testis.

Pollutions without erections, awakens frequently. Chest

Burning, hot constriction.

Pain in lower chest when walking, extending transversely.

Pain in the chest and back, with burning and boring.

Boring pain in right side.

Pinching pain in diaphragm.

Pressing, stitching and tearing pain in nipple, left side of sternum. Tearing pain in lower ribs.



Pain as after prolonged stooping.

Must bend backward from pressure in spine.



Trembling in upper limbs when and after eating.

Blue discoloration of upper limbs, forearm, thighs.

Paralytic weakness and weariness in the right arm.

Paralytic tearing pressure in the right forearm, especially in the bones of the wrist, toward the outer side, at times more in the upper part. Paralytic pressing in upper arm, forearm, touch ameliorates.

Pain in forearm, touch ameliorates.

Cramp-like pain in anterior muscles of upper arm.

Pain in elbow, motion ameliorates.

Motion ameliorates lameness in forearm.

Sore bruised pain in ulna and radius.

Pressing, tearing pain in wrist.

Trembling in hand while eating.

Yellow spots in fingers.

Tearing in the metacarpal bones of the right index and middle fingers.

Fine tearing in the tips of the fingers of the right hand, especially under the nails. Itching of lower limbs and feet, scratching aggravates. Corrosive leg.

Drawing pain in calf, extending downward.

Tearing pain in tendo Achillis.

Pressing pain in bones of ankle.

Boring pain in bones of foot.

Pressing pain in outer side of foot.

Dryness in soles of feet.

Pressing pain in first tip of toe.



Corrosive itching near the tibia and the backs of both feet near the joints, which becomes much worse on scratching; is obliged to scratch himself until it bleeds.



In the morning, a few hours after rising, an excessive sleepiness, but after eating he was unable to take his accustomed nap for several days.

At night, frequent waking in sleep as from fright.

Restless sleep at night on account of voluptuous dreams, without, or frequently with, emission of semen. Starts in sleep; thinks that he is falling; awakes in a fright.



Flushes of heat over the whole body, mostly on head and chest, after rising in morning.

Heat in entire body, with accelerated, contracted pulse; temperature not increased; no perspiration; coated tongue; vertigo; pressure in forehead and reddened conjunctiva.



Painless diarrhea, with great thirst. Cholera infantum, with tongue thickly coated white, vomiting etc.

Gastric catarrh, with terrible gastralgia, the pain extending from the stomach through the body to the spine. The gastric disorders requiring Bismuth vary, but usually are burning, with a feeling of a load or hard lump in stomach (compare with Abies); vomiting of food and of mucus; gastric symptoms ameliorated by cold drinks. Very valuable for inflammation of the stomach occurring during the progress of chronic diseases, for instance scirrhus.

A marked indication for Bismuth is that while taking cold drinks there is relief, yet when the stomach becomes full there is vomiting of enormous quantities.



Antidotes: Nux, Capsic., Calc.


Compare: Antimon., Ars., Bellad., Kreosot.



From 6x to 50m.


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