A Supplement to Clarke's Dictionary of Practical Materia Medica

by Peter David Fraser



Bitis arietans

Bitis arietans

Clotho arietans (old name)

Puff Adder, Common Puff Adder, African Puff Adder

Common throughout Africa except for deserts and rain forests. Also found in the Arabian peninsular and the Middle East.


Dilution and succusion of the venom.

Kingdom: Animalia

Phylum: Chordata

Class: Reptilia

Order: Squamata

Suborder: Serpentes

Family: Viperidae

Subfamily: Viperinae










Varicose veins



The Puff Adder is one of the commonest snakes in Africa and is certainly the continent's most dangerous snake. The result of a combination of factors including the quantity and toxicity of its venom, its unwillingness to run away and its willingness to bite.

The average size is about 1 metre but it is exceedingly stout with a girth much greater than that of any other snake of the same length. It is a sluggish snake and usually moves slowly by rectilinear motion, up and down like a caterpillar. It can, however, move at surprising speed with a serpentine motion. It can swim and climb trees and its strike is extremely fast and powerful, driving its long fangs deep into its prey. It is nocturnal, waiting camouflaged for rodents, reptiles, amphibians and birds that come close. It strikes quickly and then withdrawing and follows its fatally wounded prey until it can safely consume it.

The Puff adder is a solitary animal it lives in a single den and hunts close to home. It is not found in groups. When the female is ready to mate she produces a pheromone that attracts the males. Several males will follow a female and engage in a neck wrestling fight or dance to win her.

The Puff Adder is ovoviviparous with the eggs developing within the mother and being delivered just after, or sometimes before, hatching. The litter is large, 50 or 60 is not unusual and 156 young have been recorded, the largest litter for any species of snake. The neonates are already 12-20 cms at birth and already venomous. The are sexually mature in about two years.

They can be kept in captivity though they are often very bad tempered. They are gluttonous and can eat themselves to death if given the chance.

Lying in wait or sheltering from the heat of the day they do not retreat at the approach of humans and are easily stumbled upon. When threatened they adopt a tightly coiled defensive pose and inflate themselves with air which is expelled with a loud hissing sound. They strike very fast, to the side as well as in front of them.

The venom is cytotoxic and one of the most toxic of any of the vipers. It is produced in large quantities and injected deep in the flesh. 100mg is sufficient to kill a man and they can yield more than 350mg. The bite causes immediate tenderness, swelling and severe pain. The venom is slow acting and it can be twelve hours after the bite that the worst symptoms occur. There can be serious necrosis which may develop into secondary infections, sepsis or gangrene. There is often internal haemorrhage, bruising and bleeding of watery blood. Blood blisters may appear suddenly. Oedema and swelling affect the muscles and painful swelling of the lymph nodes often occurs. Nausea and vomiting, hypotension, weakness, dizziness and semi-consciousness have all been reported.

The remedy was proved by Craig Wright in South Africa with 6 male and 9 female provers. It was also proved by Farouk Master in India in 2003 with 2 male and 3 female provers. There is a good synergy between the two provings.

The overwhelming feature of the remedy is an unreasonable and over the top anger. They become angry at the least trifle and will often express that anger in a wild and offensive manner. The provers were afraid that their anger would get out of control and that they would become insane. The need to control anger was more from this fear that it could get out of control than a need to behave in a civilised manner. Bitis lacks much of the manipulative charm of the other venomous snakes and just as the snake itself is aggressive and thuggish, so the remedy is rude and abusive and definitely lacking in charm. They are intolerant of contradictions and take offence at the least thing. They feel driven to pick quarrels. Like all the snakes they are very suspicious and believe that people are talking about them and conspiring against them. The anger rises very quickly but it is also short lived and tends to subside as quickly. The snake unlike most others would rather strike than run away and the remedy wants to hit someone who has offended them. There is a corresponding fear of being hit, of being hurt or murdered and violent dreams of being pursued and attacked. There is a fear that something will happen with many types of anxiety: sudden anxiety and panic attacks, anticipatory anxiety and a fear of reprimands. The anxiety is accompanied by shakiness and heart palpitations. There is a nervousness and lack of confidence.

They are irritable and snappish. There is some desire for company but they are intolerant and likely to quarrel and not good at social interactions. They tend to end up isolated and estranged from society. There is a desire to be alone and especially in nature. They can show another side of being sentimental and wanting consolation.

They are generally better for activity but it exhausts them quickly. They find physical activity, that does not require thinking easier than that which involves mental effort.

Again like the Puff Adder the remedy is lethargic and lazy. They do not want to do much and postpone their chores. Their surroundings become messy and untidy. They become disinterested, morbid and joyless. The end state of this is a complete apathy and despair. They cannot rouse themselves to do anything.

There is a foggy or lightheaded state, which is often described as if intoxicated or drunk. This ties in with one of the major physical symptoms that is a vertigo which takes many forms and is aggravated in many ways. It can be a giddiness or a feeling of turning, but is most often a feeling of falling or that she will fall, particularly to the left. This can be while standing, sitting or walking and can be worse for closing the eyes, turning the body or head, stooping and particularly for concentrating. They are forgetful and have difficulty concentrating. They easily distracted They are also clumsy and awkward. They drop things and make mistakes in speaking, reading and writing. Interestingly the clumsiness is less pronounced during their anger.

They are materialistic and fear being robbed or poor. The envy and jealousy common to snake remedies in Bitis is particularly about money. They want to have money and in the dreams it is money that comes easily, they win it rather than earn it, and often by cheating.

There is a strong sense of division in the remedy. This can be between heart and mind but is best expressed as a division between left and right. This is also a gender division with the female left side and the male right side both pulled together and in conflict. There was also some gender ambiguity in the dreams particularly one where the female sexual partner turned into a male. Generally there is a lack or complete loss of libido, but there were times when there was increased sexual desire. It seems likely that this follows the same pattern as the anger with short bursts from a background of apathy.

Libido like almost everything is better in the afternoon and night than it is in the morning. Like all the snakes, Bitis is worse on waking and gets better as the day progresses. However, it is a nocturnal animal and the drowsiness during the day and increased activity at night is characteristic. Like other snakes there is a periodicity but is particularly a weekly periodicity and follows the pattern of the day: worse on Monday and then improving as the week progresses.

The main physical symptoms come from some form of swelling or bloating. The venom causes swelling and oedema and this is found in the remedy, as is painful swelling of the lymph glands. The Puff Adder puffs itself up by inflating itself with air and in the remedy there is bloating of the abdomen with painful cramping. There are also eructations and flatus and stool with much offensive wind. There are many stool symptoms with ineffectual urging and straining to produce stools that are incomplete. There are similar urinary symptoms with straining and urging that is often ineffectual. There was a tendency to try and control these urges but they then became painful.

Again like most snake remedies there are feelings of restriction, an aversion to tight clothing around the abdomen and constriction of the lungs and throat. There is asthma and tightness of the chest. There was also the sensation of a lump in the throat and rawness with difficulty swallowing.

The remedy is generally dry, particularly the mouth and lips. Sometimes this was accompanied by thirst but often it was not.

The venom of the Puff Adder cause a watery haemorrhage and this is present in the remedy as is epistaxis. Menses were generally very heavy but were most notable for not being preceded by the usual symptoms and so took the provers unawares.

Appetite was usually greatly increased though in some cases it was diminished. There was a desire for many things, the most extreme being for cheese, and an aversion to cooked food.

There were pulling sensations particularly in the chest and heart. The heartbeat and pulse are slow but strong.

There is a particular vulnerability in the wrists and ankles which many provers strained.

Artistic correspondences

Peculiar sensations

As if seeing the world only through right eye.

As if intoxicated.

Feel bloated and fat.

Mouth is disconnected from brain.

Sensation of turning.

Buzzing sensation.

Feeling of falling to the left.

Head feels as though it were full of cotton wool.

Head feels as heavy as a concrete block.

Sensation eyes are moving slower than the head.

Sensation of a foreign body in the nose.

Sensation as if the throat is closed.

Sensation of a lump in throat.

Sensation of coldness in lungs and airways.

As if someone were squeezing her lungs.

Heaviness as of a weight on left side of chest.

Uneasiness in the chest.

Constricted feeling in the heart.

Sensation that someone is pulling her heart.


< left side

< morning

< heat

> exertion, activity

< after eating

> outside in nature.

< alone (anxiety, vertigo, heart symptoms)

< on waking (palpitations, anxiety)

< turning body or head (vertigo)

< for bending forward (neck pain)

< sitting (vertigo)

< stooping or leaning forwards (vertigo)

< on closing eyes (vertigo)

< concentrating (vertigo, heaviness of eyes)

< cold food or drink (headache)

> making faces (headache)

> anger (clumsiness)



All snake remedies. Lycopodium (anticipatory anxiety, bloating)

Follows well



Stool & Anus
Neck & Back
Upper Limbs
Lower Limbs


Angry at trifles. Anger that is out of control. Must keep busy to keep anger under control. Anger comes quickly and goes quickly. Fear of his own aggressive impulses. Will do something crazy because of the anger. Desire to hit someone without any reason. Anger at people who treat her unjustly. Driven to pick quarrels. Easily offended. Anger is expressed in a nasty way. Angry but walks away from the person who has angered them. Awkwardness is less when angry. Craving company but intolerant.

Intolerant of contradiction. Nothing seems to please her. Abusive. Rude. Abusive when alone because she cannot be in front of others. Shouting loudly without cause.

Irritable. Irritated when disturbed. Irritated at trifles. Irrational irritability. Impatient

Activity of mind. Talkative.

Tearful and upset. Wants to cry and be comforted. Desire consolation and hugs. Sentimental.

Wants to be left alone. Hard to make social contact. Claustrophobic when around people. Better outside in nature. Cynical, isolated and estranged. Feels left out.

Envious, especially about money. Want to have lots of money.

Suspicious. Suspicious that people are talking about her. Afraid that people would hit and hurt him. Fear of being robbed. Fear of death.

Insecurity and lack of confidence. Nervous and apprehensive. Anticipatory anxiety. Fear of reprimands. Sudden anxiety. Anxiety when driving, visualised horrible accident. Feeling shaky. Nervousness and palpitations on waking and when alone. Anxiety and palpitations on thinking of past disputes. Fear that something bad was going to happen.

Lightheaded, as if intoxicated. Laziness and lethargy. Morbid and apathetic. Untidy. Joyless. Disinterested. Everything seems boring. Despair. Brooding over past incidents. Postponing things. Lack of concentration, easily distracted. Mind foggy. More comfortable with manual tasks that require no thinking.

Mistakes when speaking, when reading and when writing. Mouth is disconnected from brain. Forgetful.

Divided. Heart says one thing; mind another. Body is split, left half female, right half male, there is a pull between them and they are in conflict.

As if seeing the world only through right eye. Noises seem strange. Image of a reptile coiled at the base of my skull.


Vertigo if looking constantly at an object. Vertigo < alone, < sitting, < turning body or head, < stooping or leaning forwards. Feels she will fall to the left. When sitting feels as if she is moving and could fall down. Unbalanced on closing eyes. Feeling she is swaying. Unsteadiness while walking. Giddiness as if she would fall down < concentrating on something. Giddy and lethargic. Sensation of turning.

Head pain < cold food or drink. Burning pain. Throbbing headache in temples. Headache oscillating between temples, < shaking head. Throbbing headache behind eyes. Headache in band across forehead. Headache luck pressure on inside of skull, > pressure, > making faces. Pain in forehead, extending from left to right. Heaviness. Head feels as heavy as a concrete block. Congestion of head. Sinuses congested. Head feels as though it were full of cotton wool. Sensation of heat.

Three bald spots appeared.


Burning. Heaviness. Heaviness when concentrating. Dryness. Itchiness < left side. Itchy and sore, > cold bathing. Deep ache. Eyes tired and sore. Watering. Sensation eyes are moving slower than the head. Vision blurred. Difficulty focussing. Sensitive to light.


Blocked. Blocked with difficulty hearing on waking. Difficult to equalise pressure in ears. Noises in ears: buzzing, ringing, rushing, shuddering. Sounds echo and seem distant.


Blocked with crusts and scabs. Congestion. Sinuses full and congested. Dryness. Irritation and itching. Epistaxis. Sneezing. Sensation of a foreign body.


Face feels hot and flushed. Jaw tight, from clenching teeth. Pain in eyebrow. Blister-like eruption on forehead. Skin feels tight. Complexion appears darker.


Clenching. Throbbing. Ache in lower left wisdom tooth.


Apthae, white centre and red outer, on inside of lower lip. Lips dry and itchy. Lips and mouth are dry but without thirst < morning. Mouth dry with thirst. Mouth tastes stale. Saliva yellow and sticky on waking. Tip of tongue as if burnt. Tongue swollen and flabby. Impression of teeth on tongue.


Constriction. Sensation as if the throat is closed. Sensation of a lump. Lump in throat with choking feeling. Pain < empty swallowing. Pain < swallowing. Scraping sensation. Rawness on waking.


Uncontrollable hunger. Appetite increased, having to eat at short intervals. Hunger but no desire for anything in particular. Loss of appetite. Hunger without desire to eat. Aversion to cooked food. Aversion to fried food. Desire for cheese which aggravates constipation and bloating. Eating cheese to the point of vomiting. Desires bread. Bread < sleeplessness. Desires potatoes. Desire for peanut butter. Desires sweets. Desires Ice cream. Desire for milk. Desire for meat. Desire spicy food and salty food. Thirst increases later in day. Lack of thirst. Thirst for cold water. Desire for coffee and warms drinks.


Nausea. Violent eructations that scrape the oesophagus


Bloating and heaviness. Bloating after eating. Bloating on an empty stomach. Abdomen stony hard on waking. Aching pain with desire to pass wind and stool which does not ameliorate, < pressure and stretching. Indigestion with pain on right side of abdomen, sensitive to touch. Borborygmus. Pain after eating. Heaviness immediately after eating. Constricting cramp. Cramping pain after eating. Pain in epigastrium during stool. Cannot bear tight clothing around abdomen.

Stool and Anus

Burning stools. Sudden urge to pass stool. Frequent urging. Ineffectual urge to stool. Urge to stool with bearing down sensation. Straining. Unsatisfactory stools after great straining. Stools incomplete. Constipation. Hard stools. Soft, offensive stools with offensive flatus. Sticky stools with mucus. Explosive stools. Dark stools.

Urinary Organs

Pain before and during urination. Burning pain during urination and at the tip of the urethra. Uncontrollable urge to urinate. Pain in lower abdomen from resisting urge to urinate. Incomplete sensation after urinating. Ineffectual bearing down. Frequent urination. Urine profuse and greater than fluid taken in.

Male Sexual Organs

Libido increased. Erotic thoughts in the evening. Sexual desire absent.

Female Sexual Organs

Dysmenorrhoea, as if entire contents of abdomen were falling out. No pain before menses. Menses appears without warning. Menses heavy, feels as if it will come gushing out, < morning. Menses 4 days late. Menses early. Leucorrhoea before menses. Thin, watery, brown discharge after menses. Raw, burning sensation around vagina. Libido increased with sensitivity of genitals. Absence of sexual desire.

Respiratory Organs

Asthma. Breathing difficulty with need to sit up and for fresh air. Tightness and wheezing. As if someone were squeezing her lungs. Breathing difficult as if a weight on the chest. Chest congested, cannot expand to inhale. Lungs congested better for coughing. Coldness in lungs and airways.


Sudden electric shock like pain and drawing of the body to the left. Heaviness as of a weight on left side of chest. Uneasiness in the chest. Prickly heat under breast. Stitching pain in left breast.


Sensation of strong slow heartbeat. Heart beat slower and more deliberate. Palpitations. Constricted feeling in the heart. Sensation that someone is pulling her heart, < alone.

Neck and Back

Unbearable pain in neck, worse for bending forward. Stiffness in neck and in back. Tension, tightness and aching in neck. Pain in lower back, < sitting, < lying on back, < on waking.

Limbs in general

Sprains of wrists and ankles. Muscles stiff and sore. Extremities very cold.

Upper Limbs

Pain in axilla from swollen lymph glands. Hands sweaty with anxiety.

Lower Limbs

Sharp pain in ankle. Aching or stitching pains in knee. Muscular pains in buttocks and hips, with stiffness, < movement. Heaviness in lower limbs. Oedema. Pins and needles in right leg.


Tired and lethargic. Weariness. Overtired after exercise. Lack of stamina. Anaemia. Drowsy during the day, more energetic at night. Stiff and aching. Can't tolerate heat. As if a layer of heat around her body. Chilliness, cannot get warm. Haemorrhage. Bruising. Necrosis. Swollen and painful lymph glands. General swelling and bloatedness. Clumsy. Uncoordinated and dropping things. Buzzing sensation. Static shocks from touching objects. Periodicity. Weekly periodicity, worse every Monday, better as the week progresses.




Sleepiness. Sleeplessness. Cannot fall asleep. Calling and talking in sleep. Frequent yawning. Dullness in morning with sense of having slept very heavily. Deep sleep without dreams.


Of being very angry and violent. Of being hit and hitting back. Pursuit. Of being pursued by men brandishing swords. Of fighting a gang of toughs. Of fire, arson and riots. Of being shot at. Of impending danger. Dead bodies and injured people scattered across the road. Burying loved ones. Examinations. Lovers are forced to appear naked and are beaten and humiliated. Of getting married. Of wearing clothes that are transparent. Sexual ambiguity. Of gambling, cheating and winning. Of mothers hitting daughters and daughters hitting mothers. Of babies. Of snakes and of snakes biting people. Of water, waves and floods. Battling enormous waves. Urination. Unremembered dreams.



Master, F.J., Bitis arietans

Wright, Craig, Bitis arietans