Winter First Aid Homeopathic Care for Hypothermia and Frostbite

Stocking the First-Aid Kit with Remedies for Winter Exposure

Winter weather can vary dramatically, day by day. It is not uncommon for one day to be warm and unseasonably sunny, so that everyone goes out with the lightest clothing; only to be followed by an extreme swing of temperature to the coldest, below-zero depths. Where I live, this kind of fluctuation can take place within the span of a few hours: its only natural that many people are caught off guard.

Sudden temperature changes in such extremes can create the conditions for all the enjoyable outdoor activities that so many people love: skiing, snowboarding, skating, or simply taking walks in the freshly fallen snow. But these quickly changing conditions can also create opportunities for injury and misery, which can be easily addressed or avoided with good planning. If avoidance can’t be managed, first aid care is the next best thing.

Some of the most common and dangerous winter complaints are frostbite and hypothermia: while everyone knows that dressing warmly is a priority in cold temperatures, there are instances where we don’t often dress as we should, particularly if the weather is prone to sudden changes. Outdoor winter activities such as skiing, snowboarding, tobogganing, and skating involve a lot of exertion, enough movement to keep the body feeling deceptively warm despite the freezing temperatures around us. Kids and outdoor enthusiasts will always over do it: I have a few memories from my childhood where I simply refused to come inside, and spent much more time skating or tobogganing with my friends even though I knew I was starting to feel cold and tired. Those days always ended the same way: with painful, cramping hands and feet that hurt for what seemed like hours, frostbitten from too much exposure.

Children aren’t the only ones who suffer from the risks of frostbite and hypothermia—those whose livelihoods depend on working outdoors, such as construction workers or farmers, also run the risk. Smokers, babies, and the elderly are most vulnerable, as their circulation will be less than ideal as a result of the habit or age, or simply because they may lack the ability to keep moving. The best precautions always involve dressing appropriately, in a number of layers of clothing that can be removed and replaced depending on how warm or cold one feels. Choose appropriate fabrics which insulate the body and wick moisture away from the skin so that the body does not become chilled—wool layers, for example, will insulate the body even if the fibres become wet. If you can’t move for any reason, or if you fall into icy cold waters while skating, ice fishing, or ski-dooing, then the risks of hypothermia and severe frostbite increase dramatically; so it is only reasonable to prepare for any contingency while outdoors. Rule out layering fabrics that simply can't provide you with some level of insulation even though they're completely wet (jeans, for example, are never a good choice of clothing in cold weather activities involving water or snow).

Hypothermia is the condition of having an abnormally low body temperature. It can come on very slowly, making it difficult to notice that its happening. When the body becomes extraordinarily cold, all the systems begin to slow down - eventually to the point where death can result. Sometimes, hypothermia can actually save lives, especially where the body shuts down heart and brain function in order to limit the oxygen the body needs so that it can stay alive; in some of these cases, children have been successfully revived because of the limitations the hypothermia placed on their bodies.

Frostbite, or "chilblains", as our old books refer to it, happens when a part of the body actually freezes. Mild frostbite doesn't leave lasting damage, but severe frostbite can cause permanent damage and may even lead to amputation.

Symptoms of Hypothermia: What to Look For

When the body is cold, it tries to generate heat by shivering - it's trying to warm itself. When hypothermia sets in, the shivering stops, as the body is now trying to conserve all the energy it can. This is one of the first warning signs of hypothermia. Other signs to look out for: disorientation and clumsiness, which take place as body temperature drops; and an irregular heartbeat which takes place when breathing slows down. Frostbite and hypothermia can set in in minutes, if the temperature is extremely cold.

Mild frostbite or "frostnip" makes the skin look pale or waxy, but the colour returns once the skin is warm again. Severe frostbite begins with white or waxy looking skin, but as the damage progresses the colour becomes bluish, or grey. The cold feeling is replaced with numbness, and blisters often form on the surface of the extremity. when things progress to this degree, even more tissue damage can be caused. Trauma injuries can result: a frozen finger can easily break in a fall; a frozen foot can suffer broken bones if walked on. Blisters can burst if they are placed under the pressure of a step, or inadvertently made to rub against the inside of a boot.

Frostbitten skin will burn if it is not warmed up properly, so this is a good time to remember the Law of Similars: warm the frostbitten skin with cold water or snow until circulation is restored to the area—do not try to use hot water for this purpose as permanent tissue damage will result. Keep in mind that as the body part warms up, the affected area may swell, itch, burn, or cramp painfully (this is what I remember to be my experience with this ailment). In cases of extreme frostbite, the skin will turn black: there is a risk that gangrene may set in, and amputation may be necessary.

Materia Medica

Agaricus Muscarius is the first remedy that comes to mind for chilblains, as it produces the stinging and itchy sensations in the toes and feet that are characteristic of frostbite. If no other remedy is specifically indicated, use Agaricus.

Agaricus features the swelling, burning, redness, cramping, and skin eruptions that itch and burn. Some patients experience lasting redness after frostbite and symptoms which look like the puffy, raised skin in rosacea; some experience swollen veins with the cold skin. It is good to keep in mind that the more serious effects of hypothermia are addressed by Agaricus, namely the irregular, tumultuous palpitation of the heart, which can take place when hypothermia has progressed. In general, look for these markers: these patients’ symptoms are all worse for open, cold air; worse after eating, worse after coitus, and worse before a thunderstorm. Slow movement brings about amelioration.

If the patient’s complaints worsen with exposure to heat, or more specifically from being in a warm room, think of Pulsatilla, which always suffers from stuffy heated interiors; think of Pulsatills especially if the affected part feels hot and itchy long after being thawed with cold water. If the thawed skin produces dark, red, itchy inflammations that are worse for cold and damp, think of Rhus Toxicodendron. Some other good remedies for the itching and coldness in skin or in fingers and feet include Abrotanum, Tamus, and Plantago. Abrotanum’s modalities are better for movement, worse for cold air and for suppression of any secretions. Tamus can be applied in a topical cream to soothe the itching; as can Calendula, if the surface blisters break and the skin needs to be sterilized and encouraged to heal.

Nux Vomica is a good remedy to consider if there is superficial inflammation with bright red swelling and burning itch. We can recognize the need for this remedy when the skin begins to crack and bleed as it warms, as well as if we see the typical Nux Vomica emotional state: extreme irritation, anger, and a kind of denial/denouncement of the situation. Where there is bleeding, cracked skin or inflamed, swollen, painful red heels bathed in unpleasant-smelling moisture, we should think about Petroleum as a good remedy. The physical symptoms appear to be similar to Nux Vomica’s, but the mental state in Petroleum will be far more concerned with the approach of death and the need to settle affairs than it will be with anger and irritable frustration.

The patient who needs Arsenicum Album has suffered a more severe frostbite, where the tendency in the frozen skin leans towards gangrene. Blackish vesicles may be present on the affected parts. Don’t forget to look for the characteristic fussy anxiety and restlessness of this patient, to confirm the choice for Arsenicum as the remedy.

Consider Sulphur as a treatment if the chilblain has a tendency to suppurate, and if its burning itchiness only gets worse once the part warms up as it thaws (particularly once the body warms up again in bed). In cases where the swelling and itching is violent, think about Zinc—and look for the characteristic fidgety feet.

Hypothermia

Hypothermia sets in when the core body temperature falls below 35°C (95'F); if the body has been cooled to less than 25°C (77°F) recovery is unlikely. As body temperature dips, the person becomes dreamy, unresponsive, and reluctant to move; the hands, feet, and abdomen feel icy cold to the touch. There may also be cramping, numbness, or paralysis, causing falls and accidents if the person tries to walk or move.

First, check breathing and pulse, and if necessary give artificial respiration. If you are certain that there is no heartbeat, use cardiac resuscitation. Once the person is revived, warming them becomes the next priority.

The best way to look after someone who is hypothermic is to bring the person into the warm, and give them sips of hot, sweet, non-alcoholic drinks. Warm the person up gently, so as to avoid overstraining the heart. Place warm-to-cool (not hot) water bottles, well wrapped, against the person's body, not against the extremities. Resist the urge to “restore” circulation by massaging the limbs, or encouraging the person to do “warm-up” exercises. Cover the body well with blankets. Though it sounds like it may be a good idea, submerging your patient in a bath should not be done.

A hypothermic baby will be unusually limp and drowsy and refuse to feed, even though the baby’s face, hands, and feet may appear to be normal. The most effective way of warming a baby is to hold him or her against your skin in a warm bed. In the elderly, it is sometimes difficult to distinguish hypothermia from a stroke or heart attack, particularly if the hypothermia results not from a winter accident or outdoor exposure, but from something as every-day as not being able to heat the home properly for lack of funds, or for difficulty in repairing faulty heating equipment. These situations are an unfortunate reality for many elderly people, especially if they are used to living alone.

Materia Medica

If the remedy Antimonium Tartaricum is indicated, the patient will experience a sensation of coldness running through the blood vessels. The face will be cold to the touch, and appear blue and pale, covered with cold sweat. The chin and lower jaw will be shivering; and in general the patient will experience chills, trembling, and muscular pains all over the body. Drowsiness, debility and sweat are big symptoms for this remedy. You will also hear lots of rattling mucus in the chest, as if it were filled and congested…but very little mucus is expectorated.

Arsenicum Album features faintness, icy coldness, and great exhaustion made worse after the slightest exertion. Pale coldness is everywhere: the face, which has a death-like colour with a bluish nose and open mouth; coldness felt in the stomach, coldness felt in the chest. Anxiety and agony are the facial expressions which indicate this remedy.

Camphora is indicated when the whole body feels icy cold, the blood pressure is very low, and the pulse is small and weak. These patients experience a sudden sinking of strength. The coldness in this remedy will pervade through to the tongue, and breath—yet the patient will not allow himself to be covered. There is also great numbness, tingling, coldness and cramping, especially in the calves. Everything will feel cold to the touch.

Secale Cornutum is another remedy which refuses to be covered: even though the body feels cold to the touch, the patient feels the sensation of heat and refuses to bear the added warmth of blankets. In this remedy, the extremities will feel icy and cold, and appear blue, shriveled, bent backwards or splayed apart, and numb.

If the patient is icy cold and blue but the head is hot and the breathing is laboured, quickened, and cold, think of “the corpse reviver”, Carbo Vegetabilis. These patients will have such difficulty breathing that they need to be fanned; the pulse is almost imperceptible as the blood stagnates in the capillaries.

If tremendous cramping is the major complaint, and convulsions or spasmodic affections which begin in the fingers and toes present themselves, consider the use of . Look for the characteristic blueness in the face, lips and nails.

The Veratrum Album patient will present with a stuporous, blank, dazed and seemingly indifferent appearance—what they used to describe as “a stupid manner, noticing nothing”. The collapse state in this remedy is extreme, along with the coldness and blueness felt and presented by the patient. The face will be pale, with a sweaty forehead; the pulse will be feeble, but rapid. There is a sensation of a lump of ice, on the vertex--pay attention to the patient's complaints about feeling cold to determine if this is what he or she feels; all of the skin is blue and inelastic, clammy feeling to the touch.

The Question of Potency

Well selected remedies work best if the potency of the remedy matches the case as well as the actual medicine itself. For first aid treatment, I find that carrying a kit with a number of remedies in the same potency can simplify things, and I try to select potencies in the lower rather than higher dilutions because they will give me an opportunity to repeat the dose more easily if they work successfully. A 30c potency in these remedies will allow you to start with treatment using a moderate potency, which can be repeated as indicated by your patient's responses; it can also be a good potency to use dissolved in water, for "plussing" the dose--extending the one dose by simply putting a pellet in a container of water (glass is prefered, and use about 8 ounces or so), which will allow you to give doses in sips. Then, your patient can sip the medicated water as needed without fear of using too much of the remedy. The best thing about the 30c potency remedies is that they can be easily located in health food stores or homeopathic pharmacies without too much travel or trouble; it's usually the most commonly carried potency on the shelves, which makes stocking and restocking the necessary remedies easy. Without too much effort, your kit will always be ready when you need it.