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 It was severely swollen and it was very hard. This is typical for Conium maculatum. Arnica doesn't have this severe swelling. In an Arnica case the most important symptom is the sensitivity to touch. It hurts by putting something on it, on touch and so on, which is not so strong in Conium maculatum.

 Be careful to give Arnica in an accident with internal hemorrhage, because when Arnica is not indicated everything aggravates. Try to act homoeopathically and not in a routine way.

 Well all right, this patient got Conium maculatum two days later and he reacted very well. The swelling diminished and the pain improved. After a while he came back and said that there still was a kind of nodule. At the place where there was bleeding you could feel a hardening and it also hurt while walking.

 Which homoeopathic examination is now indicated in this situation? There is still a nodule, a local swelling and at night he automatically puts his leg out of the covers?

 If somebody with internal bleeding caused by an accident comes to you always think of comparing the temperature of both sides. Put the back of your hand on the place of the injury and then on the corresponding uninjured place on the other side and try to find out whether there is a difference in temperature. And why?

 Audience: What ameliorates and what aggravates?

 A : No, no, you cannot find this out.

 Audience: ... (not understandable)

 A : And what do you feel in an inflammation?

 Warmth. And which side is warm? The injured or the not injured? Do you mean the injured side?

 No, in 90% of all cases the injured part is cold, colder than the healthy part. Also in this case I could clearly feel coldness of the injured side.

 If you look in the Repertory, where can we find this?

 Look on page 957:

 EXTREMITIES, coldness, painful parts: Led, mez, sil

 There is another rubric on page 1305:

 SKIN, coldness, injured parts:  Led

To feel the temperature of the injured part in an injury must be a reflex just like the examination of the glands in the throat when you are thinking of Tuberculinum bovinum Kent. And when the injured part is cold, the remedy is Ledum palustre.

 Ledum palustre is also a remedy in constitutional effects from injuries.

 Look on page 1422:

GENERALITIES,WOUNDS,constitutional effects of : Arn., carb-v., con., hep., iod., lach., Led., nat-m., nit-ac., phos., puls., rhus-t., staph., sul-ac., zinc.

 GENERALITIES, wounds, constitutional effects of:

 Constitutional effects means that the symptoms after an injury, after an accident indicate a certain remedy and after the remedy constitutional symptoms appear. Or the remedy ameliorates the worst symptoms, but some symptoms always remain.

 That is what happened in this case.

After Ledum palustre the patient got Conium maculatum and a few days later the small nodule disappeared. Such hardening you find as fibrotic reaction to hemorrhage and you can cure this with Ledum palustre.

 So the patient got Ledum palustre and he reacted very well to that and now we will see him again.

 A: The hard swelling on the leg disappeared with Conium maculatum but still a hard nodule remained. Strangely enough this part of the leg felt cold to touch. You started putting your legs out of the covers.

Then you came back, the hard swelling disappeared, but you had pain somewhere else. Where?

 P: In the right arm.

 After Ledum palustre he had pain in the right arm and in the right knee.

 The injury was to the right thigh.

 What is the constitutional remedy of this man?

 Audience: Lycopodium clavatum.

 A: Yes, right, and he always reacted very well to Lycopodium clavatum.

 The only thing which didn't improve was itching on his behind.

 A: Only in the right arm?

 P: As far as I remember it was only the right arm, especially in the right arm. Also in the knee, possibly, I don't argue with that.

 A: It seemed to indicate your constitutional remedy that we gave.

 Do you see, after Ledum palustre the constitutional symptoms appear clearly.

 

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