Lappa arctium

A robust biennial of the Asteraceæ with large cordate leaves and hooked burs; the root and seeds are rich in inulin, polyacetylenes and bitter principles traditionally classed as “alterative.” The fresh root and seed, or whole young plant, furnish the homœopathic tincture; triturations may be made from the dried root [Hughes], [Clarke]. Empirical herbal use long associated Arctium with chronic cutaneous disorders, glandular swellings and “impurities” of the blood; toxicologic notes are mild—gastric heaviness and looseness in excess—yet the pharmacological direction (sebaceous and lymphatic drainage; diaphoretic/diuretic tendencies) accords with the remedy’s sphere—scalp and facial eruptions (crusta lactea, impetigo), furunculosis, fissured nipples and axillary adenitis, with a general pruriginous unrest [Hughes], [Clarke], [Boericke]. Early homœopathic observations confirmed benefit in “milk-crust” of children, eczema behind ears, acne with greasy skin, and mammary abscess tendency [Hering], [Allen], [Clarke].

Full Hahnemannian provings are scant; the picture rests on fragmentary provings collated by Allen with abundant [Clinical] confirmations in infantile “milk-crust,” impetigo, acne with oily skin, rhagades of nipples, mammary abscess tendency, glandular swellings (axillary), offensive foot-sweat, and pruriginous eczema, especially of scalp and behind ears [Allen], [Hering], [Clarke], [Boericke], [Phatak].

Lappa belongs to the seborrhœic–lymphatic temperament: skin oily yet irritable; scalp and retro-auricular clefts ooze; flexures fissure; acne and boils come in trains when the surface is suppressed. Its essence is the triad of (1) scalp/retro-auricular eczema or milk-crust, (2) greasy, comedoned face with acne, and (3) glandular participation—especially axillary nodes and areolæ/nipples in nursing women [Clarke], [Boericke], [Hering]. The modalities clinch: itching worse at night and from heat of bed; better open air, gentle perspiration and sensible hygiene. When this pattern is respected—no harsh alkali soaps, no occlusive salves, no antiperspirant clamps on axillæ—the skin is allowed to speak; direction of cure is outward: scalp oozes, glands soften, boils ripen and pass, sleep returns. This places Lappa midway between Graphites (fissure-ooze keynote) and Sulphur (burning pruritus and general heat), with a bias to oiliness rather than burning and to glandular accompaniment rather than neuralgic pain, which marks Mezereum [Clarke], [Hering], [Kent].

Psychologically the patient is not dramatic; the mood is borne down by cutaneous shame and lost rest. Children fret and rub; adolescents hide; nursing women dread the next feed for pain at the nipple. In each, improvement parallels a rational regimen: light, plain meals avoiding greasy foods that excite sebaceous outflow; cool air and breathable clothing; looser garments for chest and axilla; gentle cleansing that permits slight oozing but prevents crust congestion. The “alterative” tradition noted by Hughes is clinically echoed: as bowels move and urine frees, the skin clears; as the skin is suppressed, boils and nodes announce the inward displacement [Hughes], [Clarke], [Hering]. Thus Lappa is chosen where a greasy, fissuring eczema–acne diathesis entwines with lymphatic tenderness and mammary areolar soreness, and where the patient is plainly worse at night and heat of bed and plainly better open air and simple care. It is small but decisive when Graphites is too heavy and Sulphur too burning; it minds the sebaceous outlets and the glands that drain them, restoring a healthier exterior economy.

• Skin and Appendages – Scalp and facial eruptions:  milk-crust, impetigo, eczema behind ears; comedones with greasy surface; itching worse at night; scratching excoriates (see Head/Face/Skin). [Clarke], [Boericke], [Phatak]

• Sebaceous system — oily, “unclean” skin with acne and blackheads; seborrhoea and dandruff; hair falls with scurfy scalp (see Head/Skin). [Clarke], [Boericke]

• Lymphatic glands — axillary nodes enlarged and tender with cutaneous flares; tendency to suppurate (see Chest/Skin). [Clarke], [Hering]

• Mammary gland — fissured nipples, sore areolae, disposition to mammary abscess in nursing women (see Female/Chest). [Clarke], [Boericke]

• Furunculosis — recurrent boils and small carbuncles; eruptions travel from scalp to trunk and limbs if suppressed (see Skin/Generalities). [Hering], [Boger]

• Kidneys/Emunctories — mild diuretic and diaphoretic action; clearing eruptions accompanies freer urine and sweat (see Urinary/Generalities). [Hughes], [Clarke]

• Digestive–cutaneous axis — eruptions coupled with sluggish digestion or infantile looseness (see Stomach/Abdomen/Skin). [Clarke], [Allen]

• Feet — offensive foot-sweat with eczematous fissures; interdigital soreness (see Extremities/Perspiration). [Phatak], [Boericke]

• Edges and flexures — raw fissures at commissures (ears, nipples, finger webs), moist eczema of folds (see Face/Female/Extremities). [Clarke]

The mental state is coloured by cutaneous discomfort: children are peevish, sleepless, constantly rubbing head and ears; adults become fretful in the evening as itching mounts, which tallies with the modality (worse heat of bed, night) already noted [Clarke], [Hering]. Self-consciousness about oily, spotty skin and fetor of foot-sweat leads to withdrawal and irritability; better humour appears in the fresh air, mirroring the amelioration by open air. Anxiety is not free-floating but tracks relapses after suppression of eruptions; fear of “it going in” is justified clinically by glandular swellings and boils when salves are applied (Mind ↔ Skin/Generalities) [Hering]. Despondency accompanies long-standing acne in seborrhoeic young adults; they tinker endlessly with soaps and cosmetics, which often aggravate (Mind ↔ Face). In nursing women, tenderness of nipples provokes impatience with feeding schedules; relief and cheerfulness return as fissures heal (Mind ↔ Female). Children wake vexed, rub the scalp, and are only pacified when the head is exposed to cool air or after a warm cleansing that allows slight oozing—this practical observation supports the better-for perspiration and cleanliness already listed [Clarke]. Concentration is otherwise fair; lethargy follows broken sleep from itching.

Disturbed by itching, especially head and behind ears; children rub the head on the pillow; wake cross; sleep returns after cool exposure or warm cleansing that allows oozing (Sleep ↔ Head/Skin/Modalities) [Clarke], [Hering]. Adolescents lie long from shame of face; dreams of being unclean or late to school mark the psychosocial burden; sleep becomes sound when itching abates.

Of washing, combing hair, or being observed; of disagreeable odours (foot-sweat anxiety); dreams cease as skin clears and hygiene routine is settled (Dreams ↔ Skin/Perspiration) [Clarke].

Lappa is a skin–sebaceous–lymph remedy. The picture links greasy, comedoned skin, scalp and retro-auricular eczema (milk-crust in infants), boils/furuncles, fissured nipples, and axillary adenitis, in a constitution sensitive to heat of bed and warm rooms, worse night, better open air, cleanliness and gentle perspiration [Clarke], [Boericke], [Hering]. The digestive and emunctory pattern is psoric-sycotic: richer foods aggravate, while freer urine/sweat and regular stools coincide with clearing eruptions (Generalities ↔ Urinary/Stomach/Skin). Direction of cure is from within outward: suppressions push the disorder to glands and boils; restoration of scalp or skin discharge quiets internal unrest (echoing Hering’s law). Compare Graphites (thick, honey-like oozing, obesity, more fissures; less greasy acne) [Clarke]; Mezereum (crusty scalp with intense neuralgic pains and bone soreness) [Hering]; Viola tricolor (classic milk-crust children with urinous odour, copious urination) [Clarke]; Sulphur (burning itching worse heat of bed, general unwashed state) [Kent]; Hepar (boils and suppuration, stitching pains, chilliness) [Boger]; Dulcamara (worse damp cold; flat, smooth eruptions); Petroleum (deep fissures of hands/heels with winter aggravation); Kali-brom. (pustular acne on face/back; nervous element); and Silicea (recurrent boils with defective suppuration) [Boericke], [Clarke], [Phatak], [Boger].

Little fever; with boils a slight evening heat and thirst for cool water; fever falls as suppuration ripens and discharges (Fever ↔ Skin) [Hering].

Chilliness in damp weather; heat of bed provokes itching and restlessness; sweat—especially feet—may be offensive; gentle perspiration during open-air exertion eases skin (Chill/Heat/Sweat ↔ Skin/Perspiration) [Clarke], [Phatak].

The scalp is the axis: milk-crust in infants—thick, honey-yellow scabs, oozing, itching—worse at night and from bed-heat; scratching makes raw surfaces and mats the hair with exudation; improvement follows gentle cleansing and freedom in cool air (Head ↔ Skin/Modalities) [Clarke], [Allen], [Boericke]. In older children and adults, seborrhœa with abundant dandruff, greasy roots and acneiform lesions at the hairline; hair falls more than usual during flares; glands at occiput/neck may be a little full (Head ↔ Lymph). Eczema behind the ears—moist fissures with crusts; bedding soils; pain smarting after scratching; warm rooms aggravate; this region is a keynote alongside nipples (Head ↔ Face/Female) [Clarke], [Boericke]. Head heat is subjective while the scalp remains moist; cooler air soothes. Suppressing scalp eruption has been followed by axillary node tenderness or a boil on nape—an instructive alternation (Head ↔ Chest/Extremities) [Hering].

Eyelids and canthi may share the eczema, with fine scaliness and itching; rubbing reddens margins and makes a morning gumminess; worse warmth of bed and rooms; better gentle bathing (Eyes ↔ Skin/Modalities) [Clarke]. In acneic youths small styes or marginal blepharitis occur during face flares; bright light bothers when lids are sore; oozing is serous rather than thick.

Retro-auricular grooves are fissured, moist, and excoriated; the child rubs them on the pillow and cries from smarting after scratching; cool air calms, heat excites (Ears ↔ Head/Skin) [Clarke], [Boericke]. Otorrhœa itself is not typical; it is rather the eczematous border and glandular fulness below the ear.

Greasy, comedoned T-zone; blackheads across nose; occasional crusting at alæ with rawness from wiping; seborrhœa of nasal vestibule; worse after greasy meals and in warm rooms (Nose ↔ Face/Food) [Clarke]. Sneezing or coryza is not central.

Acne of forehead, nose and cheeks on a greasy skin; pustules and papules mingle; picking leaves pits; worse at menses and from fats/sweets; better open air and simple cleansing—this tallies with modalities (worse warmth; better air, cleanliness) [Clarke], [Boericke], [Phatak]. Around the ears fissures ooze; at angles of mouth small rhagades may occur with perioral scaliness. The complexion looks “unclean” despite washing; harsh soaps worsen scaliness; mild emollients plus the remedy improve texture.

Lips may crack at commissures in rough weather or with facial eczema; smarting after salty foods; simple emollients and remedy relieve (Mouth ↔ Face/Skin) [Clarke]. Tongue and mucosa are usually clean; no specific ptyalism.

No constant dental picture; teething may coincide with scalp crust and sour stools in infants (Teeth ↔ Abdomen/Head) [Allen], [Clarke]. Gnawing or biting at objects relieves irritability during dentition while scalp erupts.

Sensation of dryness from mouth breathing at night when the child scratches; not a laryngeal remedy; glands under jaw sometimes full with scalp flares (Throat ↔ Lymph/Head) [Clarke].

Mammæ sore to touch when nipples are cracked; danger of small mammary abscess if neglected; axillary glands swollen; better with frequent emptying and air (Chest ↔ Female/Lymph) [Clarke], [Boericke]. Skin over sternum may show follicular pimples in seborrhoeic type.

No primary cardiac pathology; palpitation only from fret at night scratching; subsides with sleep restoration. Pulse soft in anaemic adolescents; skin picture directs selection, not heart signs [Clarke].

Breathing quiet; sighing with weariness from broken sleep; no specific cough. Closed, hot rooms aggravate irritability and itching; open air relieves (Respiration ↔ Modalities) [Clarke].

In seborrhoeic subjects digestion is sluggish after fatty, fried foods; sense of foul taste or coated feeling though tongue is clean; appetite for plain fare; greasy meals aggravate facial oiliness (Stomach ↔ Face/Food) [Clarke]. Infants with milk-crust may vomit curds or show regurgitation when heated and irritable at night—improves as scalp and bowels are managed [Allen].

Infants: sour, greenish stools with colic during scalp eruption (milk-crust nexus); abdomen distends with wind in the evening, the child rubs head more—skin–gut axis apparent (Abdomen ↔ Head/Skin) [Allen], [Clarke]. Adults complain of a heavy epigastrium after rich meals; bowels sluggish; skin clearer when stools regular.

Constipation with hard, knotty stools in sedentary acneic youths; fissures at anus in eczematous diathesis; pruritus ani may alternate with scalp itching (Rectum ↔ Skin) [Clarke].

Urine may be increased when the skin improves (alterative/diuretic trend); cloudiness light; in chronic acne cases, freer morning urine accompanies quieter skin (Urinary ↔ Skin/Generalities) [Hughes], [Clarke]. No fixed dysuria.

Greasy, fried foods and sweets aggravate acne and seborrhœa; the patient thrives on plain, simple diet; cold water preferred; milk may disagree during milk-crust epochs though not causative (Food ↔ Face/Abdomen) [Clarke], [Phatak]. Beer and rich cheeses worsen oiliness.

Eruptions on scrotum or inner thighs—moist eczema with itching worse warmth of bed; better air and loose clothing (Male ↔ Skin/Modalities) [Clarke]. Sexual sphere otherwise neutral.

Fissured nipples with sore areolæ in nursing women; cracks bleed on putting child to breast; axillary glands tender; a thin eczematous border around areola may be present—this is a key sphere (Female ↔ Chest/Skin) [Clarke], [Boericke]. Acne worsens about menses; seborrhœa of scalp and face increases with menstrual delay; better open air and plain diet.

Furuncles at nape and between shoulders; small boils recur after suppression of scalp eruption; improvement follows outward expression (Back ↔ Skin/Generalities) [Hering]. Sweat between scapulæ may itch in warm rooms.

Eczema of hands—backs rough, fissured, worse soaps and damp work; interdigital rawness (Extremities ↔ Skin/Modalities) [Clarke]. Feet: offensive sweat, soreness between toes, fissures at heels; worse in closed shoes, better after airing and foot-baths (Extremities ↔ Perspiration) [Phatak], [Boericke]. Boils on thighs or calves recur in autumn.

The centre: eczema (scalp, retro-auricular, areolar, flexural), impetigo/milk-crust of infants, acne on greasy skin, boils and small carbuncles; itching worse at night and from heat of bed, better open air and after gentle perspiration (Skin axis) [Clarke], [Boericke], [Hering], [Phatak]. Exudations are sero-purulent, honey-yellow; scratching excoriates; borders fissure; suppression of eruption invites glandular tumult or boils (direction inwards). As proper outward expression resumes (scalp again active), glands quiet and the patient rests—confirming the outward-to-within law (Skin ↔ Generalities).

Aetiology — Suppressed eruptions → glands/boils

• Sulphur — dirty heat, burning, sinking at 11 a.m.; broader systemic heat. Lappa is cooler, seborrhoeic, oily. [Kent], [Clarke]

• Hepar-s. — exquisite tenderness, throbbing suppuration; chilliness. Lappa is less painful, more sebaceous. [Boger], [Boericke]

• Silicea — indurated nodes, sluggish pus, chilliness; brittle nails. Lappa shows greasy skin and retro-auricular fissures instead. [Clarke]

Mind / Skin — Children with milk-crust

• Viola-tr. — milk-crust with urinous odour and copious urine; sleepless, fretful. Lappa lacks strong urinary odour keynote. [Clarke], [Allen]

• Mezereum — thick crusts with neuralgic pains; child shrieks on touch. Lappa has itching > pain. [Hering]

Keynotes — Fissured nipples, mammary abscess tendency

• Graphites — fissures with oozing, obesity, constipation; eruptions elsewhere. Lappa has more axillary gland involvement. [Clarke], [Boericke]

• Phytolacca — mastitis with radiating pains and hardness; systemic aching. Lappa is milder, with eczematous areola. [Farrington]

Organ affinity — Seborrhœa / acne on greasy skin

• Kali-brom. — pustular acne on face/back with nervousness; scarring. Lappa emphasises oiliness and glandular concomitants. [Clarke]

• Nat-s. — seborrhœa worse damp; less fissured nipple note. [Boger]

Modalities — Worse heat of bed; better open air

• Sulphur — burning, offensive sweat, hot vertex. Lappa is focused on scalp/flexures with greasy surface. [Kent]

• Petroleum — winter cracking, deep fissures, worse cold. Lappa is worse heat/bed and damp. [Boger]

Feet — Offensive sweat with fissures

• Silicea — sour foot-sweat, chilly, suppurative nodes. Lappa links to seborrhœa/acne. [Clarke]

• Graphites — fissured toe-webs with honey-like oozing. Lappa fits the fissure theme but with greasy overlay. [Clarke]

• Complementary: Sulph. — promotes outward expression; pairs with Lappa in seborrhoeic eczema and boils. [Kent], [Clarke]

• Complementary: Graph. — for fissures (ears, nipples, commissures) when thick oozing remains; Lappa reduces oiliness and adenitis. [Clarke], [Boericke]

• Complementary: Hepar-s. — when boils and small abscesses form after Lappa has brought eruptions out. [Boger], [Boericke]

• Follows well: Viola-tr. — in infants when urinous odour fades and retro-auricular or scalp crusts persist. [Clarke]

• Follows well: Dulcamara — after damp-weather aggravations when seborrhoea dominates. [Boger]

• Precedes well: Silicea — if chronic boils with induration remain after seborrhoea has cleared. [Clarke]

• Related: Kali-brom., Mez., Pet., Nat-s., Sars., Berb-v. (acne/seborrhoea group). [Clarke], [Boericke], [Phatak]

• Antidotes: Remove suppressive ointments/antiperspirants; use simple fats externally; medicinally, Hepar or Sulph. according to stage. [Hering], [Clarke]

• Inimicals: None recorded in the classics.

• Milk-crust (crusta lactea) of infants — retro-auricular fissures, worse warmth of bed, better gentle cleansing/open air. Lappa 6C–30C once or twice daily until sleep returns; space thereafter. [Clarke], [Allen], [Boericke]

• Fissured nipples with sore areolæ — axillary nodes tender. Give Lappa intercurrently between local care; if suppuration threatens, follow with Hepar. [Clarke], [Boericke]

• Acne with greasy skin in adolescents — prescribe alongside dietary simplification (avoid fried/fatty foods). Watch for improvement in stools/urine paralleling clearer skin. [Clarke], [Phatak]

• Recurrent boils after ointment-suppressed eczema — Lappa restores outward direction. Follow with Hepar or Silicea if the pus stage lingers. [Hering], [Boger]

Mind

• Children — peevish at night from itching; rub head on pillow, guiding to scalp focus. [Clarke], [Hering]

• Anxiety — after suppression of eruption; fear it will “strike in”; choose outward-directing remedies. [Hering]

• Aversion to company — from shame of skin; better in open air (psychosocial cue). [Clarke]

• Irritability — evening; itching worse warmth. [Clarke]

• Concentration — difficult after broken sleep, secondary to pruritus. [Clarke]

• Modalities — better open air; worse warm room. [Clarke]

Head

• Scalp — milk-crust; thick honey-yellow scabs; oozing. Cardinal sphere. [Clarke], [Allen]

• Eczema — behind ears; fissured, moist; smarting after scratching. [Clarke], [Boericke]

• Dandruff — abundant; seborrhoea with greasy roots. [Clarke]

• Itching — worse at night, worse heat of bed; child restless. [Clarke]

• Hair — falls during scalp eruptions; mats from exudation. [Clarke]

• Glands — occipital/cervical fulness with scalp flares. [Clarke]

Face

• Acne — greasy skin with comedones; worse sweets/fats. [Clarke], [Phatak]

• Skin — unclean appearance despite washing; sebaceous clue. [Clarke]

• Fissures — at angles of mouth with facial eczema. [Clarke]

• Eruptions — about hairline and ears together. [Clarke]

• Modalities — worse warm rooms; better open air. [Clarke]

• After suppression — boils appear elsewhere (warning). [Hering]

Female / Chest

• Nipples — fissured, bleeding; areolae eczematous (keynote). [Clarke], [Boericke]

• Mammary gland — tendency to abscess; axillary nodes swollen. [Clarke]

• Clothing — tight bras/corsets aggravate soreness/fissures. [Clarke]

• Menses — acne worse at approach; seborrhoea increases. [Clarke]

• Nursing — better frequent brief feeds; air-dry nipples. [Clarke]

• Axillae — sweat irritates nodes; suppression with antiperspirants aggravates. [Clarke]

Extremities / Perspiration

• Feet — offensive sweat; soreness between toes; fissured heels. [Phatak], [Boericke]

• Hands — eczema on dorsum; fissures; worse soaps/damp work. [Clarke]

• Flexures — moist eczema of fossae; raw, itching. [Clarke]

• Boils — thighs, calves; recur in autumn. [Hering]

• Modalities — better airing feet, foot-baths, breathable shoes. [Phatak]

• Modalities — worse closed shoes, synthetic socks, heat. [Phatak]

Skin / Generalities

• Eczema — scalp, retro-auricular, flexural; itching worse night and heat of bed. Signature symptom. [Clarke], [Boericke]

• Impetigo — milk-crust of infants; honey-yellow scabs. [Clarke], [Allen]

• Acne — seborrhoeic, comedones, greasy surface. [Clarke]

• Boils — recurrent; small carbuncles; after suppression. [Hering]

• Glands — axillary swelling with skin flares. [Clarke]

• Modalities — better open air, gentle perspiration; worse suppression and strong soaps. [Clarke], [Hering]

Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–1879): fragments and clinical notes—milk-crust, infant stools, retro-auricular fissures.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879–1891): clinical confirmations—boils after suppression, outward direction, infantile scalp eczema.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): full remedy portrait—seborrhœa/acne, fissured nipples, axillary glands, modalities and regimen.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—scalp eczema, behind ears, fissured nipples, offensive foot-sweat; relationships.
Hughes, R. — A Manual of Pharmacodynamics (late 19th c.): alterative tradition; diuretic/diaphoretic tendencies; skin–emunctory axis.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): generalities—boils, suppression, modalities (night/heat), fall recurrences.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (20th c.): condensed keynotes—greasy acne, offensive foot-sweat, diet aggravations.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): comparisons—Sulph., Graph., Sil., general psoric–sycotic skin doctrine.
Farrington, E. A. — Clinical Materia Medica (1890): mammary therapeutics—Graphites vs. Phytolacca vs. Lappa in nipple/areolar states.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): practical hints—skin suppression cautions; outward direction.
Dewey, W. A. — Practical Homœopathic Therapeutics (early 20th c.): eczema/impetigo management; nursing hygiene.
Tyler, M. L. — Homœopathic Drug Pictures (20th c.): clinical vignettes—seborrhœic youths; infant milk-crust; regimen with simple hygiene.