throat

Phytolacca vs Lachesis on Throat

Phytolacca decandra

Phytolacca affects glandular structures and is well-indicated in sore throat with pain shooting to the ears on swallowing (1). The throat feels hot, rough, and burning, and the tonsils appear dark red or bluish-red, often with pseudo-membranous exudate (2). The tongue is coated at the back with a red tip, and the patient experiences aching in bones and limbs along with the throat complaint (1,3). Hot drinks aggravate, while cold drinks may soothe; there is a marked tendency for suppuration of glands (4). It is useful in tonsillitis, diphtheria, scarlatina, and phthisical subjects (2,5).

Lachesis mutus

Lachesis is the great left-sided remedy; throat symptoms begin on the left and travel to the right (6). There is a sensation of a splinter, constriction, or choking in the throat, and the patient cannot bear anything tight around the neck — collars, scarves, or even touch (1,7). Pain is often worse from warm drinks and after sleep; the throat looks purplish, swollen, and bluish (6,8). Concomitants include loquacity, jealousy, hot flashes, and aggravation during the climacteric or in patients with a hot, intense temperament (1,7,9). It is also indicated when throat complaints follow suppressed discharges, jealousy, or grief (9).

Key Differentiation

1. Side: Right, or left → right (less marked) (Phytolacca)| Left → right (strong) (Lachesis)
2. Sensation: Burning, aching, hot ball (Phytolacca)| Splinter, constriction, choking (Lachesis)
3. Swallowing: Pain shoots to ears (Phytolacca)| Liquids may hurt more than solids (Lachesis)
4. Throat colour: Dark red, bluish-red (Phytolacca)| Purplish, bluish (Lachesis)
5. Worse: Hot drinks, night (Phytolacca)| Warm drinks, after sleep, tight clothing (Lachesis)
6. Concomitants: Bone pains, glandular swelling, breast involvement (Phytolacca)| Jealousy, loquacity, climacteric, intolerance of touch (Lachesis)
7. Constitution: Phthisical, lean, glandular (Phytolacca)| Hot, dark, intense, left-sided (Lachesis)

Clinical clue: Pain radiating to the ear on swallowing points to Phytolacca; an inability to tolerate a closed collar or tight neck points to Lachesis (1,6,9).

Reference List (Vancouver Style)

1. Boericke W. *Pocket Manual of Homœopathic Materia Medica*. 9th ed. Philadelphia: Boericke & Runyon; 1927. p. 511–4 (Phytolacca), 369–73 (Lachesis).
2. Clarke JH. *A Dictionary of Practical Materia Medica*. Vol. 3. London: Homœopathic Publishing Co.; 1900. p. 704–8.
3. Allen HC. *Keynotes and Characteristics with Comparisons of Some of the Leading Remedies of the Materia Medica*. 4th ed. Philadelphia: Hahnemann Publishing Co.; 1916. p. 208–10.
4. Kent JT. *Lectures on Homœopathic Materia Medica*. 2nd ed. Philadelphia: Boericke & Tafel; 1911. p. 660–6.
5. Farrington EA. *Clinical Materia Medica*. 4th ed. Philadelphia: Lea Brothers & Co.; 1897. p. 357–61.
6. Clarke JH. *A Dictionary of Practical Materia Medica*. Vol. 2. London: Homœopathic Publishing Co.; 1900. p. 199–208.
7. Vithoulkas G. *The Essence of Materia Medica*. 2nd ed. New Delhi: B. Jain Publishers; 1990. p. 110–3.
8. Lippe A von. *Keynotes of the Homœopathic Materia Medica*. Philadelphia: A.J. Tafel; 1900. p. 184.
9. Murphy R. *Lotus Materia Medica*. 3rd ed. Blacksburg: Lotus Health Institute; 2010. p. 1142–9.