The homeopathic method of curing arthritis is an alternative to the already familiar medicinal method.
Homeopathy has been used hundreds of years ago, usually to treat fatal diseases. And now it is no less popular.
Treatment with homeopathy has only 4 principles, such as:
In order to begin treatment with homeopathy, you will need to know the entire list of symptoms that occur with arthritis.
Why do you need to know the symptoms of the disease? Everything is very simple. This is necessary so that you can choose the right set of drugs that cause the same symptoms. To most people, this method of treating arthritis seems pointless, but this is only at first glance.
Traditional medicine methods can be used very often. Today, in terms of their popularity, they are not inferior to conventional methods of treatment.
If you start taking medications on time, then the risk of arthritis spreading is reduced to zero.
The following medications may be helpful in treating rheumatoid arthritis:
This homeopathic salt is used in cases of severe stabbing pain in the joints, and is especially effective in treating pain in the wrist joint. In addition, it can be used in the treatment of pelvic joints.
This drug is prescribed to patients who have large tumors on the joints. In addition, it will be prescribed in the presence of burning or stinging pain.
This homeopathic medicine will be extremely useful in curing people whose stabbing inflammation occurs directly during movement. The inflammation itself in rheumatoid arthritis is painful and subsides when the person lies down or in a warm place. In addition to everything else, a sick person may experience extreme irritability during examination and any type of anxiety.
Belladonna is used in the form of compresses. She copes well with sharp throbbing pains that arise due to touching a sore spot on the body, as well as pressure on it. This drug can also be used with a warm wrap on the diseased area of the body.
This homeopathic remedy will help cope with pain caused by complications from an old disease that has not been completely cured. Rheumatoid arthritis irritation also occurs due to walking and wet, cold weather. It will also help to cope with nodules that sometimes remain in place of the sore spot.
The homeopathic remedy can also be used for joint pain caused by wet and cold weather. It can also be used if joint pain occurs after sleep, that is, when stationary during prolonged movement. Inflammation or tingling usually goes away after walking.
Kalmia will help a sick person cope with pain, which moves throughout the body mainly from top to bottom. It will also help in cases where discomfort occurs suddenly and causes numbness. It also tends to disappear quickly. The pain usually disappears after taking a hot bath, but not for long.
This medicine copes well with the irritation that occurs when bending the joints. As homeopathy practice shows, caulophyllum is most often prescribed to women. This is because in women, arthritis is most often accompanied by menstrual irregularities.
The use of all of the above homeopathic drugs should be under the supervision of a doctor. It is recommended to take medications until the inflammation goes away.
Among foot diseases, arthritis is especially distinguished. The disease causes severe harm to health; disturbances occur in the body, leading to disruption of antibody synthesis. At an advanced stage, cartilage and bones are destroyed.
More often, doctors talk about rheumatoid arthritis, which is the most complex form of the inflammatory process associated with an autoimmune disease. The disease is clinical and acts within the body. Systemic disease - gradually affects other organs of the body. The disease can be treated, the main thing is to choose an effective method.
Many have heard the word homeopathy, but only a few understand the meaning of the word. This is an alternative to traditional methods and techniques.
Scientists find it difficult to say what causes rheumatoid arthritis. The disease affects people of different ages, the risk group is children under sixteen years of age, women up to forty-five or more, and the elderly.
More often, the development of the disease is influenced by infections, viruses, and bacteria. Main versions:
Nicotine and alcohol can affect the body. They cannot name the exact cause of the disease; treatment is based on symptoms. Based on the cause, homeopathic treatment is sometimes the only chance for recovery.
Rheumatoid arthritis is a disease that cannot be completely cured; it develops quickly and has different stages. In the early stages there is a chance to defeat the disease. If the condition is very advanced, muffle the symptoms; it is impossible to get rid of the cause.
Traditional methods and treatment drugs are not always effective; it is better to use homeopathic treatment for arthritis. This is the selection of a suitable course, including traditional medicine, the main thing is that it brings relief and results. Homeopathy is a common method of treating disease. The main principles of homeopathy:
You cannot prescribe treatment yourself; this will be done by a doctor who will monitor your health throughout the treatment. Doctors are called homeopaths, they are not therapists.
Before starting to fight the disease, they undergo diagnostics, make a diagnosis, and determine the symptoms. The doctor will tell you what tests to take and what to diagnose.
Advantages of homeopathy over traditional medicine:
Most medications are aimed at eliminating symptoms and are not a complete cure. Alternative treatment will help overcome the symptoms and make a complete recovery. Symptoms are the main enemy and must be treated.
If the doctor quickly selects a medicine that has a beneficial effect on the body, the patient will begin treatment faster and get rid of the disease. There are homeopathic doctors who are different from ordinary doctors; they have been working in this field for a long time and have considerable experience, which helps them choose the right treatment faster than a regular doctor does.
Homeopathy is beginning to develop as a branch of medicine, scientists are conducting many studies, the results are ambiguous. The method in medicine is the most effective, especially for combating rheumatoid arthritis. Medicine opens the door to the future, the method does not cause harm, is not addictive, has no toxicity, and does not accumulate in the body. The main goal in the fight against arthritis is to reduce the inflammatory process, destruction of joints, stop pain, allowing a person to move joints without becoming disabled.
We will overcome arthritis, with complex treatment, it is worth learning to combine medications with rest, and remembering to exercise. Additionally, faith is required that a cure will occur; homeopathy gives this faith in words and in deeds.
DISEASES OF THE CARDIOVASCULAR SYSTEM, CIRCULATORY SYSTEM AND COLLAGEN DISEASES
Rheumatoid arthritis is a systemic disease of connective tissue, clinically manifested mainly by chronic progressive damage to the joints.
In the development of rheumatoid arthritis, both external (climatic conditions, infection, cooling, allergies, trauma) and internal (heredity, gender, age, metabolism, endocrine disorders) factors are important.
The possibility of a connection between rheumatoid arthritis and a latent viral infection has been suggested. Indirect evidence of the influence of infection on the development of rheumatoid arthritis is the acute onset of the disease in a number of patients, preceding tonsillitis, acute respiratory diseases, and viral infections.
In the pathogenesis of rheumatoid arthritis, immunological and biochemical disorders are closely intertwined, most clearly manifested in the synovium, synovial fluid and articular cartilage. The main link in the pathogenesis of rheumatoid arthritis is considered to be changes in the immune system: redistribution of immunocompetent cells, changes in their functional properties, which determine the formation of rheumatoid factor and other immune complexes.
Rheumatoid factor is an immunological marker of the disease, determining both its diagnosis and prognosis. Rheumatoid factor indicates a more severe prognosis, the threat of faster onset of bone destruction, and the development of systemic manifestations.
I. Rheumatoid arthritis: polyarthritis, oligoarthritis, monoarthritis.
II. Rheumatoid arthritis with systemic manifestations: damage to the reticuloendothelial system, serous membranes, lungs, heart, blood vessels, eyes, kidneys, nervous system, organ amyloidosis.
III. Rheumatoid arthritis in combination with deforming osteoarthritis, rheumatism.
IV. Juvenile rheumatoid arthritis (including Still's disease).
Course of the disease according to clinical data
1. Rapidly progressive.
2. Slowly progressive.
3. Without noticeable progression.
III. High remission.
The course of rheumatoid arthritis is characterized by extreme polymorphism: from mild forms, in which long-term remission is possible, to severe articular-visceral ones. A feature of chronic inflammation in rheumatoid arthritis is a long-term persistent pain syndrome, which does not always correlate with other clinical and laboratory indicators of the severity of polyarthritis or spondylitis.
When joints are damaged, patients develop proliferative changes in the synovial membrane and joint capsule, destruction of articular cartilage and adjacent bone tissue. When the joints of the hand are affected, a “rheumatoid hand” is formed. Characterized by a feeling of morning stiffness, pain, swelling of the joints, hyperthermia of the tissues above them.
Typically, there is a gradual or subacute onset of the disease with wave-like fluctuations in the severity of symptoms, a slow but steady progression of arthritis, and the involvement of more and more joints.
The advanced stage of the disease is characterized by deforming arthritis.
Heart damage in rheumatoid arthritis is usually moderate. Possible pancarditis (damage to all three membranes of the heart), myocardial dystrophy, focal myocarditis, endocarditis.
When the lungs are affected, dry asymptomatic pleurisy is characteristic, followed by the formation of pleural adhesions.
When the kidneys are damaged, amyloidosis most often develops. Amyloid masses are deposited in the walls of arterioles and many capillary loops of the glomeruli of the kidneys. Amyloidosis of the kidneys is most often combined with amyloidosis of the spleen, liver, and adrenal glands.
With rheumatoid vasculitis, vessels of any caliber can be affected, but predominantly small arteries are damaged - the vessels of the fingers and those supplying the nerves. Damage to the arteries of the fingers is accompanied by the development of digital arteritis, and involvement of the vessels supplying the nerves in the process is accompanied by peripheral polyneuropathy. Patients experience paresthesia, a feeling of numbness, burning, and impaired sensitivity in the hands and feet.
Ocular symptoms are uncommon. Scleritis predominates, episcleritis, keratitis and non-granulomatous chronic iridocyclitis are less common.
Therapy for rheumatoid arthritis includes anti-inflammatory, immunomodulatory treatment, as well as surgical and rehabilitation measures. The general principles of treatment include a comprehensive three-stage (hospital - clinic - resort) and individual therapy, differentiated depending on the form of rheumatoid arthritis, the degree of activity of the process, stage, and nature of the course. Complex treatment includes the use of fast-acting anti-inflammatory drugs that have an inhibitory effect on synovitis and inflammatory changes in the body, basic slow but long-acting drugs aimed at normalizing immunological reactivity; impact on the local inflammatory process in the joints (synovitis) through intra-articular administration of medications; improving joint function through physical therapy, muscle massage, physiotherapeutic procedures and rehabilitation measures.
The effectiveness of treatment is judged by the improvement in general condition, the reduction in the duration and intensity of morning stiffness, pain in the joints, the disappearance or reduction of exudative phenomena in them, the dynamics of such indicators as the number of inflamed joints, articular or functional indices, the degree of activity of the process, the radiological stage, and also the number of exacerbations per year and working capacity.
Recognition of the leading importance of immunological disorders in the pathogenesis of rheumatoid arthritis allows us to consider drugs that affect the patient’s immunological reactivity as basic therapy. These are gold salts, D-penicillamine, aminoquinoline drugs and, less commonly, cytostatics. Basic therapy in combination with non-steroidal anti-inflammatory drugs is first-line therapy. If it is ineffective or systemic manifestations of the disease develop, corticosteroid drugs are prescribed (second-line therapy). Third-line therapy is immunosuppressants (leukerac cyclophosphalium and azathioprine in doses of 0.25-2.5 mg per 1 kg). This therapy is used mainly in cases of ineffectiveness of first- and second-line drugs, rapid progression of rheumatoid arthritis, development of vasculitis, neuromyopathies, and “septic” course of the disease.
Treatment of the predominantly articular form of rheumatoid arthritis should begin with non-steroidal anti-inflammatory drugs, which currently constitute a large group of drugs.
Acetylsalicylic acid (aspirin, anopyrin, acesal, novandol)
It has antipyretic, anti-inflammatory and analgesic effects, and also inhibits platelet aggregation. The main mechanism of action of acetylsalicylic acid is the inactivation of the enzyme cyclooxygenase, as a result of which the synthesis of prostaglandins, prostacyclins and thromboxane is disrupted. When used in high doses, the drug can inhibit prothrombin synthesis in the liver and increase prothrombin time. Some dosage forms contain magnesium.
Dosage regimen. The drug is available in tablets. Appointed individually. For adults, a single dose varies from 150 mg to 2 g, daily from 150 mg to 8 g; frequency of use 2-6 times a day. For children, a single dose is 10-15 mg/kg, the frequency of administration is up to 5 times a day.
Side effects may include nausea, anorexia, epigastric pain, and diarrhea. There may be erosive and ulcerative lesions of the gastrointestinal tract, allergic reactions, impaired liver and kidney function, and changes in the peripheral blood pattern.
With prolonged use, dizziness, headache, tinnitus, vomiting, disturbances in rheological properties and blood clotting are possible.
The drug in powder form is recommended to be taken after meals with alkaline mineral water or milk.
Indomethacin (indobene, indovis, indomin, methindol, indotard).
Indomethacin preparations have anti-inflammatory, analgesic and antipyretic effects due to inhibition of prostaglandin synthesis. Suppress platelet aggregation. When administered orally and parenterally, they help relieve pain, especially pain in the joints at rest and during movement, reduce morning stiffness and swelling of the joints, and increase range of motion. The anti-inflammatory effect occurs by the end of the first week of treatment.
With long-term treatment they have a desensitizing effect. When applied topically, they eliminate pain, reduce swelling and erythema, help reduce morning stiffness, and increase range of motion.
Dosage regimen. The drugs are available in tablets, capsules, injection solution, ointment, and gel. Doses are set individually. Adults are prescribed 25-50 mg orally 3 times a day. The maximum daily dose is 200 mg. For long-term treatment, this dose should not exceed 75 mg. The drug should be taken after meals. Intramuscularly prescribed 60 mg 1-2 times a day for 7-14 days. For maintenance treatment, 50-100 mg is prescribed once at night.
The most common side effects are nausea, anorexia, pain and discomfort in the abdomen, bloating, constipation, and diarrhea. In some cases, erosive and ulcerative lesions, bleeding and perforation of the gastrointestinal tract are observed. With prolonged use, dizziness, headache, agitation, sleep disturbance, irritability, fatigue are possible; corneal opacity, conjunctivitis, hearing loss, tinnitus.
Diclofenac (Voltaren, Diclomax, Dicloran, Ortofen, Rumafen).
Diclofenac preparations have anti-inflammatory, analgesic and moderate antipyretic effects due to inhibition of the synthesis of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever.
For rheumatic diseases, these drugs reduce pain in the joints at rest and during movement, as well as morning stiffness and swelling of the joints, and help increase range of motion. Suppress platelet aggregation. With prolonged use they have a desensitizing effect.
Dosage regimen. The drugs are available in tablets, capsules, injection solution, ointment, and gel. Doses are set individually.
Adults are prescribed 25-50 mg orally 2-3 times a day. The maximum daily dose is 150 mg.
75 mg of the drug is administered intramuscularly, further treatment is carried out using tablets.
Side effects include nausea, anorexia, pain and discomfort in the abdomen, flatulence, constipation, and diarrhea. Erosive and ulcerative lesions of the gastrointestinal tract may occur. Possible dizziness, headache, agitation, insomnia, irritability, fatigue. In rare cases - anemia, leukopenia, thrombocytopenia.
Ibuprofen (Brufen, Burana, Marcofen, Motrin).
The drugs are derivatives of phenylpropionic acid and have anti-inflammatory, analgesic and antipyretic effects. This is due to inhibition of prostaglandin synthesis by blocking the enzyme cyclooxygenase.
Dosage regimen. The drugs are available in tablets, capsules, dragees, and suspensions for oral administration. Appointed individually. A single dose is 200-800 mg; maximum daily dose - 2.4 g; Frequency of administration: 3-4 times a day.
The most common side effects are gastrointestinal disorders (nausea, anorexia, vomiting, epigastric discomfort, diarrhea); possible development of erosive and ulcerative lesions of the gastrointestinal tract, as well as headache, dizziness, sleep disturbance, agitation; skin rash, angioedema, blurred vision.
Piroxicam (Movon, Remoxican, Chotemin).
Piroxicam drugs have anti-inflammatory, analgesic and antipyretic effects. The mechanism of action is associated with inhibition of prostaglandin synthesis. Relieves pain of moderate intensity. The analgesic effect occurs 30 minutes after oral administration. The anti-inflammatory effect appears by the end of the first week of treatment. After a single dose of the drug, its effectiveness remains for 24 hours.
Dosage regimen. The drugs are available in tablets, capsules, injection solution, cream, and gel.
Prescribed orally at a dose of 10-30 mg once a day, intramuscularly at a dose of 20-40 mg once a day.
Side effects include nausea, anorexia, pain and discomfort in the abdomen, bloating, constipation, and diarrhea. In some cases, erosive and ulcerative lesions of the gastrointestinal tract. Possible headache, dizziness, sleep disturbance, irritability; changes in peripheral blood.
Ketoprofen (ketonal, profenid, fastum).
The drug has anti-inflammatory, antipyretic and analgesic effects, inhibits platelet aggregation. The mechanism of action is associated with a decrease in the synthesis of prostaglandins. In case of articular syndrome, the drug causes a decrease in pain in the joints at rest and movement, a decrease in morning stiffness and swelling of the joints, and helps to increase the range of movements. The anti-inflammatory effect occurs by the end of the first week of treatment.
Dosage regimen. The drug is available in tablets, capsules, as a dry substance for injection, in an injection solution, suppositories, in the form of a cream, and a gel. The drug is prescribed individually. Adults are prescribed orally at an initial daily dose of 300 mg in 2-3 doses. Maintenance treatment - 50 mg 3 times a day. In the acute period or to relieve an exacerbation of the disease, 100 mg of the drug is administered intramuscularly, further treatment is prescribed in the form of tablets. A gel can be prescribed locally. Side effects: possible nausea, vomiting, constipation or diarrhea, gastralgia, headaches, dizziness, drowsiness, allergic skin reactions, when using the gel - itching, skin rash at the site of application of the drug.
Naproxen (apranax, naprosyn, pronaxen, sanaprox).
The drug has anti-inflammatory, analgesic and antipyretic effects. Suppresses the synthesis of prostaglandins. Reduces pain, including joint pain during movement and at rest, reduces morning stiffness and swelling of joints, and helps increase range of motion. Suppresses platelet aggregation. The anti-inflammatory effect occurs by the end of the first week of treatment.
Dosage regimen. The drug is available in tablets, oral suspension, and suppositories. Appointed individually. Adults are prescribed the drug in a daily dose of 500 mg - 1 g in two doses. The maximum daily dose is 1.75 g. The daily maintenance dose is 500 mg. The preferred dosage form for children is a suspension. Side effects are associated with disorders of the gastrointestinal tract: nausea, vomiting, anorexia, constipation, diarrhea. Allergic skin reactions are possible, and in rare cases, changes in peripheral blood.
The drug has anti-inflammatory, analgesic, antipyretic effects. The mechanism of action is associated with inhibition of cyclooxygenase activity and a decrease in the synthesis of prostaglandins. Suppresses platelet aggregation.
Dosage regimen. The drug is available in tablets, as a dry substance for injection, and in suppositories. It is prescribed in an average dose of 300 mg 2 times a day with meals.
Side effects from the gastrointestinal tract are common: nausea, vomiting, anorexia, gastralgia, erosive and ulcerative lesions. Possible allergic skin rash, tinnitus, dizziness.
The drug has anti-inflammatory, analgesic, antipyretic effects. The mechanism of action is associated with inhibition of prostaglandin synthesis. Reduces platelet aggregation.
Dosage regimen. The drug is available in tablets. The dose is set individually. Prescribed 300-600 mg 3-6 times a day. The daily dose should not exceed 3.2 g. Side effects are manifested by disorders of the gastrointestinal tract, there may be headaches, dizziness, and allergic skin rashes.
The drug has anti-inflammatory, antipyretic, analgesic effects. The mechanism of action is associated with inhibition of prostaglandin synthesis.
Dosage regimen. The drug is available in tablets. The recommended dose for adults is 100-300 mg per day, divided into 2-4 doses. The maintenance dose is selected individually. The maximum maintenance dose per dose is 100 mg. Side effects are observed from the gastrointestinal tract. There may be headaches, dizziness; changes in peripheral blood.
The drug has anti-inflammatory, antipyretic and analgesic effects. The mechanism of action is to inhibit the synthesis of prostaglandins at the level of cyclooxygenase.
Dosage regimen. The drug is available in tablets. Prescribe 1 tablet in the morning and evening. If necessary, increase the evening dose to 2 tablets. The maximum daily dose is 1.2 g. It is recommended to take the drug with meals. Side effects: in rare cases, digestive disorders, dizziness, skin rash, extremely rarely - headache, allergic reactions.
The drug has anti-inflammatory and analgesic effects.
Dosage regimen. The drug is available in capsules. Prescribed 1 capsule 3 times a day, with meals. Maintenance dose - 1-2 capsules per day. Side effects are manifested by disorders of the gastrointestinal tract.
Preparation for external use. It has a local anti-inflammatory and analgesic effect.
Dosage regimen. The drug is available in the form of a gel and is prescribed individually. 5-10 cm of gel column is applied to the painful area and rubbed. Side effects: in rare cases, skin redness and itching are observed, and very rarely - dermatitis.
Along with non-steroidal anti-inflammatory drugs, patients with a predominantly articular form of rheumatoid arthritis use aminoquinoline derivatives from the basic series of drugs - delagil, chloroquine 0.25 g per day or plaquenil 0.2 g per day in order to influence the immunocompetent system. In the first 2 years, 1 tablet daily, and then 1 tablet every other day. The main mechanism of action of quinoline drugs is the effect on vascular permeability, cell membranes, and lysosomal enzymes.
Quinoline drugs are also prescribed for the articular-visceral form of rheumatoid arthritis, especially for rheumatoid kidney damage and septicemia. The best effect is provided by drugs in the early stages of rheumatoid arthritis, providing a slow, gradual decrease in activity and, with sufficiently long treatment, stopping the progression of the process. Side effects are not severe and are observed rarely: slight leukopenia, mild dermatitis, dizziness, weight loss, graying of hair. The most serious complications from the visual organs are retinopathy and keratopathy, partial atrophy of the optic nerve. These complications are not observed often, however, with long-term treatment, systematic examination of patients by an ophthalmologist is necessary, as well as breaks in taking quinoline drugs for 1-2 months a year. Contraindications to the use of these drugs are hepatitis, psychosis, dystrophic changes in the retina and cornea.
To suppress the activity of the local inflammatory process (rheumatoid synovitis), corticosteroids (hydrocortisone, etc.) and immunosuppressants are injected into the joints. Hydrocortisone in large joints 50-125 mg, in medium joints - 25-50 mg and in small joints - 10-25 mg with intervals between repeated injections of 5-7 days. Long-acting corticosteroid drugs (Kenalog, Depo-Medrol, Aristocort) can lengthen the intervals between intra-articular injections to 1-2 months. Cyclophosphamide 100-200 mg is also used intra-articularly, usually together with hydrocortisone.
In case of low effectiveness of the above remedies or in case of a rapidly progressing course of the disease already in the early stages of rheumatoid arthritis, gold salts or D-penicillamine are prescribed as basic therapy. Crysotherapy (treatment with gold preparations) is one of the best methods of treating the articular form of rheumatoid arthritis. Gold preparations include krizanol, sanocrizin, myocrisin, auropan, tauredon, etc., and the use of water-soluble drugs is preferable due to the lower number of side effects. A course of treatment requires 1 g of metallic gold based on intramuscular administration on average of 51 mg per week. Crizanol is used in the form of injections of 17-51 mg of metallic gold intramuscularly once a week, per course - 1-1.5 g, which takes 1.5-2 years.
Auropan is a gold preparation for oral administration. Available in tablet form. Used at 6 mg per day in 1 or 2 doses. If the drug is ineffective, the dose can be increased to 9 mg per day. Side effects: allergic rash, stomatitis, toxic hepatitis, nephropathy, cytopenia, diarrhea. Gold salts have a long-lasting effect and, accumulating in the body, can stop the progression of the disease for a long time and cause long-term remission. It is especially important to pay attention to the early signs of gold intoxication, which are expressed primarily by “golden” dermatitis and ulcerative stomatitis. It is necessary to pay attention to the appearance of itching, especially in the interdigital folds, a decrease in the number of platelets, slight eosinophilia and proteinuria. A decrease in platelet count may be a signal of the development of thrombocytopenic purpura; proteinuria, even small - nephropathy; eosinophilia is a harbinger of a toxic reaction; increased JgE levels - stomatitis. The above complications are indications for immediate discontinuation of cryotherapy. To eliminate developing toxicosis, dimercaptopropanol is used, a drug that neutralizes gold. In order to prevent severe complications of cryotherapy, constant clinical and laboratory monitoring of blood and urine is necessary. Due to the slow action of gold salts, they are combined with corticosteroids, salicylates, and intra-articular administration of various drugs. The combination of gold salts with pyrazolone derivatives and immunosuppressants is undesirable due to the unidirectionality of their side effects. Crisotherapy is started only after a thorough clinical examination of the patient in a hospital, followed by continuation of treatment in an outpatient setting under the supervision of a rheumatologist.
Treatment with gold preparations is contraindicated for diseases of the liver, kidneys, blood system, peptic ulcer, other diseases of the gastrointestinal tract, anemia, leukopenia, general weight loss, as well as for “malignant” or “septic” course of rheumatoid arthritis and its articular-visceral forms, especially with the presence of YE cells.
D-penicillamine has a cumulative effect, the initial effect of which occurs only after 4-8 weeks, and a slowdown in ESR and a decrease in the titer of rheumatoid factor - after 5-6 months. In this regard, treatment with D-penicillamine should be long-term. In hospitals, moderate doses of the drug are used - from 300 to 750 mg per day, in outpatient settings - 150-300 mg, for at least 6-12 months. D-penicillamine can be used for a long time with constant medical supervision of the patient.
Small doses of D-penicillamine (150-300 mg per day) are indicated for patients with rheumatoid arthritis with moderate and minimal activity, resistant to therapy with corticosteroids and antilymphocyte globulin. It is advisable to combine the drug with non-steroidal anti-inflammatory drugs.
It is advisable to prescribe corticosteroids only to patients with a high degree of activity and torpidity of the disease. As a rule, this is prednisolone at a dose of 10-15 mg per day for 3-4 weeks. Corticosteroids taken orally have a rapid anti-inflammatory effect, leading to a significant reduction and sometimes even disappearance of clinical manifestations of arthritis and a decrease in laboratory indicators of inflammatory activity. However, this effect is short-lived; reducing the dose of the drug and its withdrawal usually cause an exacerbation of rheumatoid arthritis.
Cytostatic agents are rarely prescribed as basic therapy in the early stages of rheumatoid arthritis, only when the process is highly active, the disease is progressive and all previous therapy is ineffective. The most commonly used drugs are leukeran, chlorbutin, azathioprine, and cyclophosphamide. Cytostatic therapy requires regular, qualified clinical and laboratory monitoring.
In the treatment of rheumatoid arthritis, the importance of immunostimulating agents - levamisole and the so-called transfer factor - is being assessed.
The age of patients plays a large and sometimes decisive role in the choice of basic therapy for rheumatoid arthritis. In patients of older age groups, due to frequent concomitant diseases (hypertension, ischemic heart disease, severe atherosclerosis, diabetes mellitus, etc.), the possibilities of using adequate doses of corticosteroids, pyrazolone derivatives, and indole group drugs are limited. In elderly patients, sometimes even moderate doses of conventional antirheumatic drugs, well tolerated in middle and young age, cause side effects.
For patients with rheumatoid arthritis that develop in old age, due to the need to quickly suppress the activity of the process, it is advisable to use medium doses of corticosteroids - no more than 15-20 mg per day in combination with small doses of immunosuppressants. When a clinical effect is obtained, patients are transferred to treatment with non-steroidal anti-inflammatory drugs, quinoline derivatives or maintenance doses of immunosuppressants.
When treating adolescents with rheumatoid arthritis, in addition to a number of physiological characteristics, it is necessary to take into account the unique course of the disease, especially the generalized form of rheumatoid arthritis with vasculitis, which occurs in a third of patients. Adolescents should be less likely than adults to include immunosuppressants and gold preparations in their treatment regimen. Quinoline drugs, salicylates, and corticosteroids are prescribed.
Additional treatments
All patients, when the activity of the process decreases, are prescribed physical therapy, massage, and, if indicated, physiotherapy, especially often applications with dimethyl sulfoxide, phonophoresis of hydrocortisone or analgin, electrophoresis of hyaluronidase, novocaine, salicylates, heparin, thermal procedures - mud, paraffin or ozokerite applications.
An effective method of treating rheumatoid arthritis is mud balneotherapy. However, it is not always well tolerated by patients due to its possible effect on the state of the cardiovascular system.
In rheumatoid arthritis, low doses of x-ray irradiation provide a distinct anti-inflammatory and analgesic effect of a local nature. This treatment is indicated for moderate to maximum activity of the process, especially when small joints of the hands and feet are affected.
Spa treatment of rheumatoid arthritis is possible only in the articular form of the disease outside the acute phase at I-II degrees of activity. In case of a benign course of the disease without pronounced changes in the joints, radioactive baths in Tskhaltubo are indicated, in case of a typical progressive course - hydrogen sulfide baths in Sochi, Pyatigorsk, Kemeri, etc., with severe deformation of the joints - mud therapy in Evpatoria, Pyatigorsk, Odessa, etc. The resort continues the previously selected drug therapy.
Along with the further development of conservative methods, surgical treatment of rheumatoid arthritis is increasingly being used, the main principle of which is early synovectomy, which allows eliminating inflammation in the joint, preserving cartilage from inevitable destruction, preserving and restoring joint function. Removal of granulation tissue reduces autoimmunization of the body, has a beneficial effect on the general condition, and ensures stable remission.
Synovectomy is indicated for: 1) stage I mono- or oligoarthritis; 2) lack of effect from chemical or radioisotope synovartesis; 3) failure of complex antirheumatic therapy carried out for 6 months or more.
Synovectomy is most often performed on the knee joint, less often on other joints. At III-IV stage. For rheumatoid arthritis, endoprosthetics are increasingly being used, and arthroplasty and arthrodesis are being used much less frequently.
Acupuncture as a method of treating rheumatoid arthritis. The main conditions that determine the effect of acupuncture are characterized by three factors: the location of irritation, the amount and intensity of irritation, and the patient’s state of health.
The effect of the procedure depends on the correct choice of the point of irritation, on the strength and methods of needle insertion and the nature of the injection.
Acupuncture is based on two opposite reactions of the body to irritation - inhibition and excitation.
The inhibition reaction is caused by the method of strong stimulation, which is applied for a long time with gradually increasing intensity. The patient experiences feelings of heaviness, numbness, fullness, and a feeling of electric current passing through. This method is used for increased motor, sensory and secretory functions of the body. In addition, the inhibition reaction has a sedative, analgesic, hypotensive and desensitizing effect.
There are two ways to induce a braking reaction. One of them is more intense and prolonged irritation. It is indicated for adults, contraindicated for children and elderly patients. The number of needles inserted is no more than 2-3. The needle is inserted with slow rotational movements with a constant increase in the force of irritation, and puncturing is used. The injection depth is 1.5-8 cm, depending on the location of the point; the needles are left in place for 30 minutes to several hours (average 30 to 40 minutes). If the doctor considers it advisable to leave the needle for a long time (a day or more), you need to use gold T-shaped needles.
Acupuncture can be combined with moxibustion for 20 to 60 minutes during or after acupuncture. Indications: spasms, convulsions, pain syndrome.
The second option applies at any age. Number of points 2-4. The sensation from inserting the needle is weaker than in the first option. The needle is inserted with rotational movements. In adults, the needle is left for 10-12 minutes, in children - depending on age (about 5 minutes).
To achieve a stimulating effect, weak stimulation is produced by short, quick stimulations applied sequentially to a number of points. The injection is accompanied by a slight pain sensation. The duration of exposure is short.
An exciting response is also achieved in two ways. In the first case, irritation is caused by simultaneous acupuncture at 5-10 points to a depth of 0.3-0.5 cm. A strong, fast, short irritation lasting 0.5-2 minutes is produced. After inserting the needle, you can make dotted movements, as well as perform juju therapy independently or in combination with acupuncture using the pecking method for 1-3 minutes. In the second case, the stimulating effect is achieved by superficial injections (0.3-1 cm) into a large number of points (10-12), and the stimulation must be fast and strong in order for pain to occur. If the patient does not experience sensations or they are weakly expressed, it is necessary to apply a short strong irritation in the form of continuous rotation or puncturing. If strong sensations immediately arise and the muscle is tense, you need to give a long-term irritation that increases in intensity - slow rotation and then leaving the needle. It has been established that rotation of the needle along the meridian has an exciting effect, while against the direction it has an inhibitory effect.
When treating joint disease, it is recommended to first use the first version of the inhibitory method at local points until painful sensations form in the area of the affected joint, then move on to distant points, using the second version of the inhibitory method until the discomfort previously caused by injections is eliminated. Similar irritation is applied at 2-3 points.
If the joints of the hands are affected, the injection should be done on the lower extremities, and vice versa, using the second version of the inhibitory method. Injections are given with cauterization. Three courses of treatment are carried out for 10 days, a break of 7 days.
Rules for combining points. The most difficult thing in the practice of acupuncture remains the choice of points of influence and their combinations for various diseases.
If you follow the correct method and technique of acupuncture, complications, as a rule, do not occur. In some cases, complications are possible in the form of a pronounced autonomic reaction, needle retention in tissue, hematoma, residual sensation, etc.
In most cases, an autonomic reaction occurs due to too rough manipulation of the needle or excessive fear of the patient being treated for the first time. After insertion of the needle, the patient experiences pale skin, dizziness, and sweating. It is necessary to lay the patient down and remove the needle.
After removing the needle, a drop of blood may be released from the injection hole. The appearance of a hematoma is the result of damage to the vessel. Local application of cold is indicated, followed by a light massage and a warm compress.
Herbalists recommend the use of the following medicinal plants in the treatment of rheumatoid arthritis.
Elm. To prepare flour from elm bark, you need to cut off two-year-old shoots, peel the outer bark and carefully remove the light green shell underneath. Dry. Grind in a coffee grinder. Apply compresses to the affected joints.
You can take the infusion orally, brewing it like tea, 1 glass 3 times a day between meals.
Gentian yellow. 1. Root decoction: 10 g or 1 tbsp. l. pour 1 cup of boiling water. Drink 1 tbsp. l. 3 times a day 30-40 minutes before meals. 2. Root infusion: 1/2 tsp. Infuse the root for 8 hours in 2 glasses of cold boiled water. Strain. Drink 1/2 glass 3-4 times a day 30-60 minutes before meals.
Cranberry. A decoction of the herb is used as a local bath for sore joints.
Oats. 1. A decoction of green oat plants is used as an external remedy in the form of baths and washes. 2. Baths made of fresh oat straw (1-2 kg of straw per 1 bath) are used for inflammation of the joints.
Thistle. Thistle is used internally for inflammatory diseases of the joints as follows:
1) 2 tbsp. l. Boil the chopped herbs for 10 minutes in 500 ml of water. Cool. Strain and drink the resulting infusion daily in equal portions. You can chop the flowers and leave for 1 hour in 2 cups of boiling water. Strain and drink 1/4 cup 4 times a day before meals.
2) Use 1 tsp of juice from fresh leaves. 3 times a day, regardless of meals.
3) Externally: compresses, lotions, washing with infusion - 20 g of herb per 1 glass of boiling water. Instead of decoction, you can moisten the affected areas with fresh juice.
Sprouted wheat. Sprouted grains, especially wheat, are very beneficial for the body. You can also sprout rye, oats, beans, peas, beans, and lentils. Yogi doctors have repeatedly studied the properties of sprouted grains. It has now been revealed that such grains contain a special B vitamin, which is the most important stimulator of the body’s vital functions.
Wheat is sprouted in a plate or enamel tray. First, it is thoroughly washed in a ladle or sieve, then a soaked cloth or gauze is spread on a tray in several layers, wheat is poured in, covered with a cloth and sprinkled with water. It is necessary to ensure that the wheat does not sprout too much; the sprouts should only hatch 1-2 mm. Large and green sprouts are poisonous. Sprouted wheat should be rinsed well again under running cold water, as fungal microorganisms can develop in it. You can eat sprouted wheat raw, only by chewing it thoroughly, or you can mince it and mix it with nuts, honey, raisins, dried apricots, and ground poppy seeds. It is also recommended to add it to various salads. Daily intake - 50-100 g, best eaten for breakfast. It should be borne in mind that “healthy” wheat germinates in about two days. If it does not sprout for a long time, this means that the wheat was excessively pickled and treated with chemicals.
Pine. For rheumatoid arthritis, pine resin is used externally.
Poplar. Preparations from poplar leaves and buds are good for relieving joint pain.
1) 2 tbsp. l. crushed leaves or buds pour 1.5 cups of boiling water. Leave for 15 minutes. Strain. Drink 3-4 times a day, regardless of meals.
2) Externally, leaves and buds are used for sitz baths: 3 tbsp. l. Boil crushed leaves and buds for 5 minutes in 4 glasses of water. Leave for 4 hours. Strain. Pour into the bath. Do the procedure daily. The course of treatment is 11-13 days.
3) Ointment recipe: prepare dry kidney powder (1 part), add fresh butter (4 parts). You can use unsalted lard.
Beans. Dishes made from mature and green beans are useful for lesions of the musculoskeletal system.
Mint. For arthritis, mint is used externally as a rub.
Primrose. An excellent analgesic and anti-inflammatory agent for all types of joint diseases. Infusion of leaves: 1 tsp. dry powder pour 1/2 cup boiling water. Leave for 20-30 minutes in a well-sealed container. Strain. Before use, to improve the therapeutic effect, add table salt to the tip of a knife. Drink immediately, do not store.
Sleep-grass (spring lumbago). A decoction of sleep herb is used as an external remedy for the treatment of arthritis, especially for severe pain. Pour 5 flowers with 1 glass of boiling water. Leave for 10 minutes. Strain. Make a warm compress.
Common Physalis. It has anti-inflammatory and analgesic properties. Infusion of dried fruits: 2 tbsp. l. for 500 ml of boiling water. Cook for 5 minutes over very low heat. Drink 1/2 glass 4 times a day 15-20 minutes before meals.
Walnut. A decoction of green peels is used externally to treat arthritis. 2 tbsp. l. green peels, pour 1 cup of boiling water, leave for 20 minutes. Lubricate sore joints.
Coltsfoot. Compresses made from coltsfoot leaves successfully treat arthritis. Sew “mother” and separately “stepmother” onto the fabric. “Mother” is warm, “stepmother” is cool. Alternate compresses at night, starting with the “mother”.
Borage grass. An infusion of borage flowers is used as an anti-inflammatory agent. 10 g of herb with flowers (2 tbsp) per 2 glasses of water. Leave in a tightly sealed container for 5 hours. Strain and add a little sugar. Take 1 tbsp for several days. l. 5-6 times a day.
Dandelion. Tea made from the herbaceous part and roots of dandelion is used in concomitant therapy for arthritis. There are a lot of dandelions around us, but you can’t collect them within the city limits or near the road: they, like all herbs, accumulate poisons contained in exhaust gases.
Nightshade is bittersweet. An extract from young stems is used to treat arthritis.
Sorrel. A decoction of the roots is used for rheumatic pain.
St. John's wort. To treat arthritis, St. John's wort oil is used externally to lubricate joints or make hot compresses.
Fill a wide-necked jar or bottle with several handfuls of freshly picked flowers, add olive oil or good vegetable oil to completely cover the flowers. Close the jar with a lid. Place on a sunny windowsill for 5-7 weeks. The oil turns a beautiful dark red color. Remove flowers, squeeze and discard. Store the oil in a dark place. Use externally for medicinal purposes. For some diseases, the oil is taken orally.
Cherry. Cherry fruits help with joint diseases. Infusions of fruit pulp are recommended as a refreshing and antipyretic agent.
Healers advised to quickly relieve arthritis pain in the following way: you need to break the cherry pits, remove the seeds, dry them, and grind them into flour. Make compresses with cherry flour.
Noble laurel. There is an old folk recipe for the treatment of rheumatism, gout, and arthritis. Pour 1/2 pack of bay leaves with 1.5 cups of cold boiled water. Bring to a boil and simmer over low heat for 5 minutes. Let cool. Drink while still warm in one go. Drink for 3 days in a row, then a 10-day break and another 3 days of treatment. Take at night. If pain occurs when urinating, do not cancel treatment, but increase (by 1/2-1 glass) the amount of water.
Raspberries. Raspberries contain sugars and acids - citric, malic, salicylic. They have anti-inflammatory and antipyretic properties.
Celery. It relieves pain in arthritis and polyarthritis well.
Cowberry. Leaves (tea, infusion) are used to treat joint diseases. Pour 6 g (2 tablespoons of leaves) into an enamel bowl with 1 cup of boiling water, close with a lid and heat in a water bath for 30 minutes. Cool for 10 minutes, strain, squeeze out the mixture and add to the original volume - 200 ml. Store in the refrigerator for no more than two days. Drink 1/3-1/2 glass 2-3 times a day 20-30 minutes after meals.
Tansy. Perfectly soothes headaches, joint pain due to rheumatism, arthritis. For these purposes, prepare a decoction: 5 g of flowers per 1 cup of boiling water. Bring to a boil over low heat and simmer over the same low heat for 1 minute. Strain. Drink in 4-5 doses throughout the day in between meals. You can also apply warm compresses.
Sunflower. In villages, a tincture is prepared from sunflower heads to treat rheumatic and arthritic pain. Heads with flowers are collected when they are not yet strong; the color should be juicy and golden. The tincture is prepared as follows: pour 9 tbsp into a bottle. l. 96-degree alcohol, add 5 spools (1 spool - 4.266 g) of finely chopped flower heads. Close the bottle carefully. After 5-6 days, strain through several layers of gauze. Adults take 25-30 drops, children, depending on age, from 5 to 15 drops. Drop the tincture into cold boiled water. Take 2-3 times a day between meals.
Horsetail. Perfectly treats all diseases of the musculoskeletal system. It is used in the form of infusions and decoctions.
Ledum. To reduce joint pain you need 2 tbsp. l. Brew 700 ml of boiling water. Brew as tea, drink during the day, and make a compress at night.
Verbena. Antipyretic, anti-inflammatory agent. For arthritis, the leaves are used as a poultice.
Heather. For patients suffering from polyarthritis, prepare a decoction: 2 tbsp. l. heather to 1/2 cup boiling water. Leave for 10-12 minutes and apply compresses. Course of treatment: every other day for two weeks.
Chestnut. For arthritis, chestnut tincture is used:
1) For 2 parts of flowers, take 1 part of vodka. Leave for 15 days. Strain. Keep refrigerated. Take 3-5 drops 2-3 times a day between meals.
2) To rub sore joints, prepare a tincture of green peel with thorns: 40 g of peel per 1 liter of vodka. Infuse for 21-25 days.
Burdock. For external use, use burdock roots: 3-4 tbsp. l. chopped burdock root in a bucket of water. Boil for 5-7 minutes. Cool to medium temperature. Fold the sheet into the broth, fold it in four, then wring it out and wrap the body so that it is covered from the armpits to the ankles. Wrap tightly, legs should be wrapped separately and should not touch. Also wrap yourself in a dry sheet and a thin woolen blanket. Lay in bed for 2-3 hours; if you fall asleep, that’s great, don’t allow yourself to be woken up. The course of treatment is 2-3 weeks. To preserve all the healing properties of the root, you do not need to wash it, but just wipe it several times with a damp cloth, dry it a little, chop it thinly and dry it. The root must be harvested in autumn or early spring, before the leaves appear. It is better to dry the root in a stove or oven, not in the air!
Cabbage. Raw cabbage leaves applied to sore spots relieve arthritis pain.
Other folk remedies
Ancient folk recipes for the treatment of rheumatoid arthritis are still used today.
Salt. For aching joints, rub the sore spots with salt dissolved in honey or vodka.
Clay. Special varieties of clay, found in certain areas, are used for clay therapy - by applying medallions and applications. For clay therapy, fatty, plastic clay is used, which is sifted through a metal sieve, diluted with water to the consistency of thick sour cream and thoroughly stirred until a homogeneous mass is obtained. Clay heated to 60 o C is mixed with cold clay until a solution of the desired temperature is obtained. The clay temperature for general applications is 39-40 o C, waist (half) - 39-43 o C, local - 40-46 and up to 48 o C. The thickness of the clay application (cake) is 4-5 cm, the duration of the procedure is 15-25 , less than 30 minutes. The course consists of 12-20 procedures, carried out every other day or 2-3 days in a row, followed by a day of rest.
Paraffin. Paraffin is a wax-like substance with a melting point of 40-65 o C, obtained from oil synthetically. Paraffin has a coarse-crystalline lattice. In appearance it is a white translucent solid mass, odorless and tasteless.
Paraffin began to be used for heating in 1909. Special experiments have established that human skin can withstand water with a temperature of 45 o C, dirt - 50 o C, and paraffin - 60 o C, and in some experiments - up to 70 o C without being burned. In addition, paraffin cools down more than three times slower than, for example, sand.
When paraffin hardens, it decreases in volume by about 10% and contracts, covering the body tissues on which it was applied, slightly squeezing them. Paraffin, depending on the type, contains 0.6-5% oil fraction, and it also softens the skin.
Paraffin for the procedure is usually first melted in a water bath and then cooled to the required temperature, depending on the method of its application. The duration of the paraffin treatment procedure is usually 30-60 minutes, they should be carried out every other day. Rest after the procedure for at least an hour.
Below are 4 main methods of paraffin treatment.
1. Melted paraffin at a temperature of 60-65 o C is applied with a flat brush or cotton swab to the desired area of the body in repeated layers until a layer 1 cm thick or more is obtained. Then this area is covered with a piece of plastic film and wrapped in a wool or cotton blanket.
2. This method can be used at home only for the treatment of hands and feet and requires much larger quantities of paraffin. It consists in the fact that the hand or foot is first coated with paraffin according to the first method, and then immersed in a bucket or other container into which molten paraffin is poured at a temperature of 60-65 o C.
3. Put on medical or household rubber gloves and prepare napkins by quilting 8-10 layers of fabric. The napkins are immersed in molten paraffin at a temperature of 60-65 o C, squeezed between two boards (this can only be done with gloves) and applied to the desired area of the body after first applying a thin layer of paraffin to it according to the first method. Then, as in the first method, the body area is covered with film and wrapped in a blanket.
4. The most convenient way to treat at home. Melted paraffin is poured into a plate, photo cuvette or mold for pouring jellied meat, depending on the size of the paraffin cake - application - in a layer 1-2 cm thick. The frozen but still soft cake (usually this corresponds to a paraffin temperature of 50-54 o C) is removed from the mold, having previously trimmed it on that edge, and applied it to the required area of the body. Then, in the same way as in the previous methods, it is thermally insulated.
The course of treatment for arthritis is 10-30 procedures; in one procedure, no more than 2-3 joints are treated simultaneously, alternating them.
Copper. Copper applications - thin plates of annealed copper - are attached with a bandage or plaster to the sore spot for a period of 6 hours to 2 days. Then the plates are removed and the skin under them is washed with water. If the plates seem to “stick” to the body when removed, and the color of the skin under the plate turns out to be greenish, this is a sign of the effectiveness of the treatment. And as long as this connection exists, treatment should be continued.
For arthritis, a course of treatment with copper applications for up to 30 days is recommended.
Mineral water. For patients who are contraindicated for bath treatment, compresses and lotions made from iodine-bromine waters, sometimes prepared artificially, can be applied to the affected joints. A pad moistened with iodine-bromine water is placed on the affected joint, plastic film or compress paper is applied on top, then cotton wool. The compress is fixed by bandaging it to the joint. Compresses are applied daily in the evening and left overnight. The course of treatment is 8-10 procedures.
Healing mud. Mud therapy involves applying therapeutic mud of a certain temperature to various, depending on the specific disease, parts of the patient’s body or to the entire body for 10-30 minutes. There are several types of mud found in our country.
Silt mud is a plastic-oily viscous mass of black color, bitter-salty taste, with the smell of hydrogen sulfide, formed in salt reservoirs (estuaries), for example in Lake Saki in Crimea.
Sapropelic muds are brownish-brown, olive or gray in color. Sapropel is silt formed in freshwater lakes, swamps and ponds as a result of decay of plant and animal microorganisms.
Peat mud is a more or less densely compacted rock of yellowish-brown or black color. Peat formation occurs in freshwater swamps as a result of decomposition and rotting of plants: shrubs, trees, grasses, mosses.
Clay silts are silt deposits of fresh lakes.
Medicinal mud has been used to treat arthritis since ancient times.
Honey. A mixture of honey with aloe juice and vodka in a ratio of 2:1:3 is a good compress that has an anti-inflammatory effect for arthritis.
Bee venom. The literature provides data on the successful treatment of rheumatoid arthritis with bee venom. Only a doctor can make the correct choice of sting location and quantity.
As a result of treatment, joint pain is reduced, inflammation is reduced, and joint mobility is restored. The analgesic effect occurs immediately after the sting or after 5-15 minutes and lasts from several hours to 2-3 days. To consolidate the effect, bee stinging courses must be systematically repeated.
Royal jelly. For rheumatoid arthritis, complex treatment with royal jelly and bee venom is recommended according to the scheme and in doses usually used for treatment. In this case, the effect of both substances is significantly enhanced. In addition, there is a pronounced stimulation of the immune system.
Bile. Pharmacies sell medical canned bile obtained from cattle and pigs, containing stabilizers and antiseptics (alcohol, formalin, furatsilin). It is used externally in the form of compresses on joints as an analgesic, anti-inflammatory and absorbable agent.
Snakes. Some pharmaceutical injection preparations made on the basis of snake venom are vipraxin, a 0.06% solution of dry viper venom; vyperalgin, sand viper venom; cobrotoxin, cobra venom; epilorctine, rattlesnake venom - used to treat arthritis.
Ointments based on snake venom for external use: viprotox (viprakutan), contains the venoms of various snakes, viprasal, containing the venom of the viper; vipletox, contains viper poison; viprazide, contains sand viper venom.