For very particular, careful, zealous persons, inclined to get excited or angry, spiteful, malicious disposition, mental workers or those having sedentary occupations.
Over-sensitiveness, easily offended; very little noise frightens, cannot bear the least even suitable medicine; faints easily from odors, etc.
Twitchings, spasms, convulsion, < slightest touch.
Chilliness, even during high fever; least uncovering brings on chilliness. Very red face.
Persons addicted to stimulants, narcotics, patent medicines, nostrums, debauchees, etc.
Frequent and ineffectual desire for stool or passes little at a time, > after stool.
Modalities: < uncovering, mental work, after eating, cold air, dry weather, stimulants, 9 A. M.; > wet weather, warm room, on covering, after stool.
Spasm (from simple twitchings to the clonic form); sensitiveness, nervous and chilliness are three general characteristics of this remedy.
Anxiety with irritability and inclination to commit suicide, but is afraid to die.
Sleepy in the evening, hours before bedtime; lies aware for an hour or two, at 3 or 4 A. M., then wants to sleep late in morning.
Awakens tired and weak and generally worse, with many complaints.
Stomach: Pressure an hour or two after eating as from a stone (immediately after, Kali bi., Nux m.).
Convulsions with consciousness (Strych.); < anger, emotion, touch, moving, alternate constipation and diarrhea (Ant. crud.).
Menses: Too early, profuse and lasting too long, with aggravation of all other complaints during their continuance.
Nux vomica acts better when gived at night, during repose of mind and body; Sulph. in the morning.
* * * * *
Among the symptoms called characteristic, as given by Constantine Hering, are these:
"After aromatics in food or as medicine, particularly ginger, pepper, etc., and after almost any kind of so-called 'hot' medicines (Goullon)." Also, "will also benefit persons who have been drugged by mixtures, bitters, herbs and so-called vegetable pills, etc. -(B.)"
This is putting it in too wholesale a fashion. It would be true if said that Nux vomica will often benefit such cases. The fact is that it will benefit those cases in which the use of such drugs, aromatics, pills, etc. has brought about a condition that simulates the symptoms produced in the provings of Nux vomica, or in cases to which it is homoeopathic and no others. Another fact is that things often do produce such a condition, and that is one reason why so many physicians are invariably prescribing Nux vomica the first thing, in cases coming from allopathic hands, without even examining the case, but it is unscientific. We have a law of cure and there are cases in which the Nux vomica condition is not present but another more similar remedy must be given. It does not alter the case to say, "Well, I did not know what had been given," for Nux vomica will neither antidote the effects of the drug poison nor cure the disease condition unless it is homoeopathically indicated, especially given in the dynamic form.
Here are two more of Hering's card symptoms, in which are given the temperaments that are most susceptible to the action of Nux:
"Oversensitiveness, every harmless word offends, every little noise frightens, anxious and beside themselves, they cannot bear the least even suitable medicines - (B)." And, "For very particular, careful, zealous persons, inclined to get excited and angry, or of a spiteful, malicious disposition."
This is a graphic picture of what is called the "Nervous temperament," and practice corroborates the truth of the value of these temparametic indications for this remedy; but there are a number of remedies that have as markedly this so called nervous temperament, such as Chamomilla, Ignatia, Staphysagria, and others.
So no physician would be justified in prescribing Nux vomica on temperament alone, be the indication ever so clear. The whole case must come in. There seems to be another kind of condition belonging to this nervous group of Nux vomica that has not so much of excitability in it. "Hypochondriasis, with studious men, sitting too much at home, with abdominal complaints and costiveness."
Now if you take a second look at these cases, you will find that a very little irritation will arouse their kind of their hypohondriac gloom and make them angry or irritable similar to the first condition, so that on the whole the first proves to be the predominant one.
If the gloomy or hypochondriac condition of mind persist, we will more likely have to look to such remedies as Aurum, Nat. mur., etc., to find the true similimum. These nervous symptoms of mind and body are wonderful leaders to the selection of the right remedy.
"Frequent and ineffectual desire to defecate or passing but small quantities of fæces at each attempt."
This symptom is pure gold. There are a few other remedies that have it, but none so positively and persistently.
It is the guiding symptom in the constipation to which Nux vomica is homopathic, and in my experience will then, and then only, cure. Carroll Dunham wrote over twenty-five years ago on this symptom. He said, in effect -while Nux vomica or Bryonia are equal remedies for constipation there was never any reason for confounding them, or alternating them, as they were so different. The Nux vomica constipation was caused by irregular peristaltic action of the intestines, hence the frequent ineffectual desire; but the Bryonia constipation was caused by lack of secretion in the intestines. There was with Bryonia absolutely no desire, and the stools were dry and hard as if burnt.
And the above symptom is found not in constipation alone. It is always present in dysentry. The stools, though very frequently consisting of slimy mucus and blood, are very small and unsatisfactory. Dr.P.P. Wells pointed out the very reliable additional symptom for Nux vomica in dysentry -that the pains were very greatly relieved for a short time after every stool. This is not so with Mercury, but the pain and tenesmus continue after the stool, as it is sometimes well expressed as "a never-get-done" feeling. But it makes little difference whether the patient is afflicted with constipation, dysentry, diarrhoea or other diseases, if we have this frequent ineffectual desire for stool present we always think of Nux vomica first, and give it unless other symptoms contra-indicate it.
"Catamenia a few days before time, and rather too copious, or keeping on several days longer with complaints at the onset, which remain until after it is over."
This is also an oft verified symptom of Nux vomica. Of course there are many other remedies for too early or too copious menstruation. Calcarea Ostrearum is not at all like Nux vomica. I have found that patients that required Nux vomica., for this condition could hardly ever take Pulsatilla for anything. For instance, if the patients had green, bland, thick discharge and you gave them Pulsatilla it would often bring down too early and profuse menses. In such cases I had to give Sepia which would act like a charm on the catarrh and not aggravate the menses.
These cases calling for Nux vomica. often occur in young girls or women at the climacteric. We often have the characteristic rectal troubles also present (Lilium tig.). The pains are pressing down and extend to the rectum and sometimes also to the neck of bladder. Inefficient labour pains, extending to the rectum, with desire for stool or frequent urination, are quickly relieved, and become efficient, after the administration of a dose of Nux vomica 200.
If, in addition, your menorrhagic patient is costive, has gastric troubles, and especially if generally < in the morning, we have an almost sure remedy in Nux vomica.
"Feels worse in the morning soon after awaking (Lach. and Nat. mur.), also after mental exertion (Nat carb., vertigo; Calc. ost., Sil., occipital); after eating (Anac. card., reverse) and in cold air (Puls., reverse)" If Bnninghausen had never done anything but given us his incomparable chapter on aggravations and ameliorations, this alone would have immortalised him.
It seems to me, after profiting them in a practice of over thirty years, it is impossible to over estimate them. But some one will say perhaps -there are twenty-eight remedies in Allen's Bnninghausen., in large caps, that are worse in the morning. That does not seem like coming very close to the choice of the remedy.
But when we look at those that are worse in the evening, we find thirty-eight remedies, and only eight of them occurring under both morning and evening, and these eight are worse not generally, but rather in some especial symptoms. For instance, in Rhus the loose cough is worse in the morning, the tight dry one in the evening.
So you see we are quite on the way to making a choice after all. But now take all the aggravations of Nux vomica as regards time, mind, gastric (symptoms), temperature etc., where can you find the combination so prominently under any remedy? Of course those physicians who are not able to appreciate anything but pathological symptoms have not much use for these modalities. But one thing is certain, they cannot do as good homopathic work without as with them.
"Great heat, whole body burning hot, especially face red and hot, yet the patient cannot move or uncover in the least without feeling chilly." This condition of feverishness is of common occurrence and yields to Nux vomica with a promptness that would delight the heart of a Lippe. It makes no difference what the name of the fever, whether inflammatory, remittent or fever accompanying sore throat, rheumatism, or any other local trouble, if we have these indications, we may confidently give this remedy and will not be often disappointed with the result. It took me years to learn the value of this symptom, because I was a routinist and thought that Aconite, Belladonna, or both in alteration, must be given in all cases where high fever was present. So I have some sympathy for young physicians now, who from false teachings have been led to the same error. But let me say here, for the benefit of all such, that there is a much better way: namely -to closely individualize, which is not always difficult; give the single remedy in the potentised form, giving it time to act, and wait for reaction before repeating.
Of course low potencies will often cure, and that in spite of alternation, over dosing and frequent repetition. But they will often fail, and in the great majority of cases will not accomplish anything like the satisfactory results of the true similimum, the single remedy and the single dose.
"After eating: (Kali bich., Nux moschata) sour taste pressure in the stomach an hour or two afterward, with hypochondriacal mood, pyrosis tightness about the waist; must loosen clothing (Lachesis, Calcarea, and Lycopodium), confused cannot use mind two or three hours after meal, epigastrium bloated, with pressure as from a stone in the stomach."
This is a group of symptoms as given in "Guiding Symptoms." There are so many symptoms given under the digestive organs that it shows that Nux vomica has really very wide range of action in gastric troubles. And there are no really characteristic and peculiar symptoms to mention, unless it be the peculiar aggravation of the stomach symptoms "an hour or two after eating," instead of immediately after as is the case with Nux moschata and Kali bichromicum. The pressure as from a stone occurs also in Bryonia and Pulsatilla.
More stress may be placed upon the cause of the stomach, liver and abdominal complaints for which Nux vomica is the remedy. For instance, coffee, alcoholic drinks, debauchery, abuse of drugs, business anxiety, sedentary habits, broken rest from long night watching (Cocc., Cup. met., Nit. ac.), too high living etc. So we find that Nux vomica is adapted to complaints arising from these causes, which is abundantly verified in practice.
One thing is very apt to be present in these cases: namely -the very characteristic rectal symptoms already noticed.
We ought not to leave Nux vomica without speaking of its great efficiency in headaches and backaches.
The headache often occurs in conjunction with gastric, hepatic, abdominal and hæmorrhoidal affections. Here also the modalities, more than the character of the pain, decide the choice. The aggravations are: from mental exertion, chagrin or anger; in open air (opposite Pulsatilla), on waking in the morning, after eating, from abuse of coffee or spirits, sour stomach, in the sunshine, on stooping, from light and noise, when moving or opening the eyes (Bryonia), from coughing high living or highly seasoned food, in stormy weather, after drugging, from masturbation, from constipation or haemmorhoids.
These headaches may or may not localize in any part of the head.
The patient is just as apt to say in one part of the head as another, and will often say, in no particular part, "it feels badly and aches all over."
The pains in the back are more peculiar. The patient is apt to have backache in bed, and must sit up to turn over; as turning or twisting the body, aggravates when standing (Sulphur) (worse when sitting, Kobalt, Pulsatilla, Rhus toxicod., Zincum) or sitting is especially painful. The pain is mostly located in the lumbar region, though it may be in the dorsa, and is often in connection (like Æsculus hipp.) with hæmmorhoids. Æsculus is especially < from walking or stooping. Backache caused by masturbation (Kobalt, < sitting; Staphysagria, lying at night) finds one of its best remedies in Nux vomica. We might here launch out into a description of the general action of Nux vomica upon the spinal cord, including the motor and sensory centers, etc. but that can all be found in other works. So now we will leave Nux, except as we refer to it in comparison while writing of other remedies. In reviewing of what we have written, we are impressed that some may be led to think that we have narrowed down the sphere of this truly great remedy too much. Let us say here, that it is not our aim in this work to write exhaustively upon any remedy, but to point out a few of the chief virtues and the characteristic symptoms, around which all the rest revolve.
To write exhaustively would be to write a complete materia medica.
practice there are two kinds of cases that come to every physician. One is the
case that may be prescribed for with great certainty of success on the symptoms
that are styled characteristic and
peculiar (Organon § 153.) The other is
where in all the case there are no such symptoms appearing; then there is only
one way, viz, to hunt for the remedy that, in its pathogenesis, contains what is
called the "tout ensemble" of the case.
The majority of the cases, however, do have, standing out like beacon lights.
Some characteristic or key note symptoms which guide to the study of the remedy
that has the whole case in its pathogenesis.
Mild, gentle, yielding disposition; sad and despondent, weeps easily, sandy hair, blue eyes, pale face, muscles soft and flabby.Changeable remedy, pains travel from one joint to another; hæmorrhages flow and stop and flow again, no two stools alike, no two chills alike, no head nor tail to the case-mixed.
Bad taste in the mouth, < mornings, with great dryness, but no thirst.
Stomach easily disturbed, especially by cakes, pastry or rich fat foods.
Thick bland discharges from all mucous membranes.
Catamenia too late, scanty or suppressed, particularly by wetting the feet.
Modalities: < in warm room, warm applications, abuse of Iron; chilliness with the pains, > by cool open air, walking slowly around, cold food or drink, tying up tightly > the headache.
Pains accompanied with constant chilliness, and the more severe the pain the harder the chill (with profuse sweating, Cham.; with fainting, Hepar sulph.; with frequent micturition, Thuja; with delirium, Verat. alb.).
* * * * *
The mental picture of Pulsatilla is almost the opposite of that of Nux vomica. Nux vomica is called the man's remedy and Pulsatilla the woman's remedy. This means simply that the complaints of one are found oftener with men, while those of the other are found oftener with women.
Now to call attention to another of Hering's characteristics, and I know of no one who has expressed them better, we have -"Mild, gentle and yielding disposition; cries et everything; is sad and desponding; creeps about everything; can hardly give her symptoms on account of weeping.") And again: "Sandy hair, blue eyes, pale face, inclined to silent grief with submissiveness." (Silicea is its chronic). Here we have a description of the Pulsatilla temperament as near as words can express it, and it is a fact that when you find it in a patient, no matter what the pathological condition, Pulsatilla will almost surely help. There are few exceptions. So we learn not to put too much stress on pathological states to the neglect of symptomatological conditions.
Pulsatilla is a remedy of wide range of action. Farrington mentioned its use in seventy-three different affections, and has not by any means exhausted them all; and if you study Pulsatilla in Hughes' Pharmacodynamics you will notice that, although he recommends it in many diseases, he does not, and evidently is not able to, talk as much from a pathological standpoint especially from the provings of the drug as he does of many other remedies. It seems to me like folly to undertake to pose as either an exclusive pathologist or symptomatologist. Both pathology and symptomatology are valuable and inseparable; neither can be excluded. Pathology is what the doctor can tell (sometimes); symptomatology is what the patient can tell.
There is another condition of Pulsatilla which may be considered Characteristic, and which Hering does not mention in his cards, viz., changeableness of symptoms (Ignat., Nux mosch.). All that Hering said was "wandering pains shift rapidly from one part to another, also with swelling and redness of the joints." Now if this occurs in rheumatism (Manganum acet., Lac caninum, Kali bichrom., Kalmia lat.), and especially if in the Pulsatilla temperament we may perform a miracle of curing with this remedy. But this shifting or changeableness is not confined to the pains, which may be either rheumatic or neuralgic, but is found in the disposition. The patient is now irritable, then tearful again, or mild and pleasant; but, even with the irritableness, is easily made to cry. The hæmorrhages flow, and stop, and flow again; continually changing. The stools in diarrha Constantly change in color; they are green, yellow, white, watery or slimy; as Guernsey expresses it -"no two stools alike." (Sanicula). This is often found in the so-called cholera-infantum or entero-colitis of children in hot weather.
We sometimes have patients come into the office, and find, in trying to take their case, no "head to tail" to it. It is mixed. The suffering and pain is now here, now there. The symptoms are contradictory, as we term them. This condition should always call attention to Pulsatilla and it will often clear up and cure the case. Ignatia also has these ever-changing, hysterical and contradictory symptoms, both pre-eminently woman remedies.
Pulsatilla like Nux vomica is a great remedy for disorders. of digestion. Symptoms -"Bad taste in the mouth, especially early in the morning, or nothing tastes good, or no taste at all." (Bryonia, bad taste with coated tongue and thirst; Pulsat., no thirst).
"Great dryness of the mouth in the morning, without thirst. Stomach disordered from cakes, pastry, rich food; particularly fat pork." (I would say -fat meats generally). These are reliable symptoms, as given in Hering's cards, and are not very much like the symptoms of Nux vomica, which is not disturbed by fats, but on the contrary likes them and they agree. With Nux vomica warm food agrees best; with Pulsatilla, cold things.
The bad taste in the mouth is persistent and the loss of taste is frequent, as is also the loss of smell. How peculiar that Pulsatilla should have dry mouth and no thirst, while Mercurius should have characteristically moist mouth with intense thirst. There is no accounting for taste, as the man said when he saw a fellow kiss his mother-in-law.
I do not know that I could give a satisfactory pathological reason for this. Is it not a good thing that we do not have to give the pathological explanation for such a symptom before we can use it to cure our patients? To be sure there is always a reason for these things, but we do not need to know what it is before we can utilize the symptom.
The merest tyro in prescribing could hardly mistake the symptoms of Pulsatilla for those of Nux vomica and yet I have found physicians prescribing these remedies in alternation, at intervals of two or three hours.
Having called attention to the action of Pulsatilla on the digestive organs, which are lined with mucous membranes, we now wish to notice that it has a peculiar action on mucous surfaces generally. This peculiarity consists in the character of the discharges from them. They are thick, bland and yellowish green. These are found in nasal catarrh; leucorrha; expectoration; gonorrha; in ulcers; from the ears and eyes; in short, from every mucous outlet of the body.
The expectoration of pulsatilla, which is thick, green and bland, tastes bitter, while that of Stannum is sweet and that of Kali hydroiodicum and Sepia salty. One of Schuessler's tissue remedies (Kali sulphuricum) greatly resembles Pulsatilla in the character of its discharges, and not only that, but also in its wandering pains, evening aggravations and ameliorations in cool, open air. Kali hydroiodicum is also ameliorated in open air and worse in a warm room. Now that we are on the subject of greenish discharges, especially the expectoration, we will mention also Carbo veg. Lycopodium, Paris, Phosphorus and Sulphur. Of course, the other symptoms must decide the choice between several remedies having one symptom in common.
A certain physician in Albany, N. Y., was called in consultation on a so-called case of phthisis pulmonalis. The case was in allopathic hands. After carefully examining the case, he was asked: "What is your diagnosis, doctor?" "Stannum," said the doctor. "What!" "Stannum," replied the doctor. Stannum was the diagnosis of the remedy, not the disease. It was given and cured the patient.
Now we come to the curative action of Pulsatilla in affections of the female genital organs. The fact that it has such a decided action upon these, added to the womanish disposition of this remedy, is additional reason why it is called the woman's remedy, as we said when writing upon the disposition and temperament. "Catamenia too late and scanty, or suppressed, particularly by getting feet wet," and "Painful menstruation with great restlessness, tossing in every possible direction," and we have already mentioned the changeable characteristics in the flow of the menses, viz., they stop, and flow, stop and flow again, etc. So, also, the menorrhagia.
In these menstrual troubles of Pulsatilla the wetting or chilling of the feet is of prime importance and, acting upon it, you may save your patient from consumption as a result of such exposure and suppression. Now don't pour down mother tincture of Pulsatilla by the ten-drop doses, as is the manner of those who do not believe in potentized remedies. You may give Pulsatilla in the high, higher, and highest potencies, and confidently expect the best results. I have often seen the delayed menses of young girls of Pulsatilla temperament appear promptly and naturally under the M. M. of Swan and C. M. of Fincke (also with Kali carbonicum, Tuberculinum, and others). so also have I seen them restored after suppression, by the same. Now if you should try one of these very high potencies in a case of menstrual difficulty, and it should not succeed, don't jump to the conclusion that I have been mistaken, for Pulsatilla is not the only remedy for such cases. Homopathy is too often blamed when the blame lies in the stupidity and malpractice of the prescriber. Magnesia phos. will relieve more cases of painful menstruation than Pulsatilla, and that is not a cure-all, either. Study up your case.
But after all, the prime characteristic of this wonderful remedy lies in its modality. "Better in cold air and from cold applications." The patient is not only better generally in the open, cool air and worse in a warm, closed room, but local affections also, as, for instance, the vertigo; pain in head, eyes, ears; itching of eyelids; roaring; coryza; pain in face; toothache; colic; labor pains; sciatica; ulcers, are all better in open air. These affections that are > in cold air are also especially > while walking or moving slowly about (Ferrum) in open or cool air. Remember that Pulsatilla as well as Rhus toxicodendron is ameliorated by motion, but Pulsatilla in cold or cool open air, while Rhus tox. wants motion in warm dry air.
With Pulsatilla warm applications aggravate, warm room oppresses, heat of bed aggravates itching (Mercurius) and chilblains; cold drinks retained, warm vomited.
Other remedies have aggravations from heat; but Pulsatilla leads them all. The relief from cold and cool, open air is as positive as that of warmth or heat is for Arsenicum.
Now to close our remarks on Pulsatilla we will give a few choice symptoms without any particular comments upon them.
"Affections consequent on the abuse of Iron." "Chronic affections following cases of badly managed measles." "Pressure, or tying up tightly, relieves the headaches." (Argentum nit., Apis mellifica). "Increased inclination to micturate, < when lying." "Metastasis of gonorrha to testicles." "Chilliness, with pains, yet wants cool room." "One-sided sweats." "Inflamed parts bluish," (Lachesis, Tarantula Cub.) "Pulsations through the whole body." "Metastasis of mumps to mammæ or testicles." In any of these local affections we should expect to find the mind and modality of this remedy present or not be very confident of a brillant cure.
complaints < on motion.
Dryness of mucous membranes generally (lips, mouth, stomach, wants drink in large quantities, at long intervals; intestines, dry hard stools as if burnt).
Effusions in serous membranes (meninges, pleura, peritoneum, etc.).
Constipation (no desire) or diarrha, < mornings on beginning to move.
Stitching pains, especially in serous membranes and joints.
Sitting up causes nausea and faintness.
Modalities: < from motions, warm weather after cold. > from quiet, lying on painful side.
Suitable to dry, spare, nervous, slender persons, of irritable disposition; rheumatic tendency. Complaints in hot weather, or exposure to dry, cold air, in wet weather (Rhus tox).
Cough, dry, hard, racking, with scanty expectoration; with splitting headache; delirium, about the business of the day; (typhoid) headache; < stooping; ironing; hot weather; coughing; motion, vertigo; with nausea, and faintness; < from sitting up after lying down. Pressure, as from a stone, at pit of stomach relieved by eructation.
Vicarious menstruation; nose bleeds when menses should appear (Phos.).
Mammæ heavy, of a stony hardness; pale, but hard; hot and painful.
Rheumatism of joints, with pale swelling, great paint worse on touch or least motion.
* * * * *
As in Pulsatilla, so in Bryonia, the leading characteristic lies in its "modality." Three words express it -aggravation from motion.
What is aggravated on motion? Sufferings of almost any and every kind. We will not undertake to enumerate them. All that Hering says in his cards on that line is -"Joints red, swelling, stiff with stitching win from slightest motion," and this so far as it goes is genuine, but it is only the beginning of all the ailments that are < on motion.
Look in "Guiding Symptoms," under "Motion," and see the long list of symptoms aggravated by motion, and even these do not cover all. Now we begin to realize the value of this modality.
It makes no difference what the name of the disease, if the patient feels greatly > by lying still and suffers greatly on the slightest motion, and the more and longer he moves the more he suffers, Bryonia is the first remedy to be thought of, and there must be very strong counter-indications along other lines that will rule it out.
Nor does it make much difference what organ or tissue is the seat of the disease, mucous, serous or muscular, the same rule applies.
very valuable modality of Bryonia is
again expressed in three words -amelioration from
pressure. This is the reason the patient, much to the astonishment of
the nurse, wants to lie on the paintful
side or part. (Opposite
Belladonna, Kali carbonicum).
No one can realize the value of these two modalities until he has often met them at the sick bed and witnessed the prompt relief from the use of Bryonia.
When writing upon Pulsatilla, we noticed the characteristic action of that remedy upon the mucous surfaces. Here Bryonia acts just as characteristically, but it is so different. With Bryonia it is excessive dryness or lack of secretion in them. It begins in the lips, which are parched, dry and cracked, and only ends with the rectum and stools, which are hard and dry as if burnt. The same condition is undoubtedly present in the stomach. which is evidenced by the excessive thirst; which can only be satisfied by large draughts of water; a little does not satisfy.
The same condition obtains in the lungs and bronchia, which causes hard, dry cough with little or no expectoration, and with soreness and pain in the chest when the patient coughs. (Natrum sulphuricum has loose cough with soreness). The urine is scanty and only exceptionally (or as I would express it reactionally) copious. We must remember that every remedy has a dual action. These two actions are termed primary and secondary. I think that the so-called secondary action is only the reaction of the organism against the first or primary (so-called) action of the drug. For instance -the real action of Opium is to produce sleep or stupor, the reaction is wakefulness; of Podophyllum, Aloes, etc., catharsis; the reaction constipation, and I think that the truly homopathic curative must be in accord with the primary (so-called) effects of every drug in order to get the best and most radical cure, but if given for the secondary (so-called) symptoms, the primary ones having passed by, we should carefully inquire for all the symptoms which have preceded those which are present; and taking both past and present, let them all enter into the picture whose counterpart is to be found in the drug which is to cure. Any other method is only palliative and not curative.
Bryonia has also a very decided effect upon the serous membranes. It is very useful in the second stage of inflammation, after the stage of serous effusion has set in. In most of these cases the first stage has been attended by symptoms calling for the exhibition of such remedies as Aconite, Belladonna, Ferrum phos., etc., but not always; and right here let me call attention to the most characteristic pains of this remedy. They are stitching pains. Now observe, the characteristic pains of inflammatory affections of the serous membranes are stitching pains; this is the reason why Bryonia comes to be such a regal remedy in pleuritis, meningitis, peritonitis, pericarditis, etc. The subjective symptoms corresponding to the remedy must go down before it, and the objectives must as surely follow. Only one remedy can equal Bryonia for stitching pains, viz, Kali carbonicum. (Stitching pains in chest are particularly found under Bryonia, Kali carb., Natrum mar., Squilla and Mercur. viv.). And there is this difference between them: The Bryonia stitches come on or are aggravated by the least motion, while those of Kali carbonicum will occur whether the patient moves or not, (Bryonia > by pressure, Kali carb., not). But in both remedies they cry out sharply with the pains. Apis has pains which cause the patient to cry out sharply, but they are stinging pains -like a bee sting. All these three are great remedies for effusions into serous cavities, and Sulphur precedes and follows equally well anyone of them.
A word right here in regard to interpolating Sulphur, when, as we express it, "the seemingly indicated remedy does not act." Some would stumble over that, and ask -as they would have a right to do- how about your similia, etc., in such a use of Sulphur? I answer -Sulphur is a remedy of wide range of action, and covers more perfectly those conditions and symptoms which are the outgrowth of psora than any other remedy; so it does meet the case complicated by psora very often, and either cures it or removes the complication so that the other remedies may act. But remember it will not always do it, and other antipsoric remedies must be chosen. It must be the simillimum for the psoric condition.
Bryonia stands alongside of Nux vomica and Pulsatilla for disorders of alimentation. All three remedies have a sensation as of a stone in the stomach, Bryonia and Nux vomica more so than Pulsatilla. Bryonia leads in thirst, Nux vomica less, and Pulsatilla little or none. All have bad taste in the mouth; Bryonia and Pulsatilla bitter and Nux vomica sour. All have nausea and vomiting; Bryonia worse on motion, as rising up, Nux vomica in the A. M. and after eating, Pulsatilla in the evening and also after eating.
The gastric derangements of Bryonia often occur as a result of dietetic errors, especially when warm weather sets in after cold. Those of Nux vomica more from continued over-eating and inactivity, the abuse of drugs, coffee, tobacco or alcoholics; Pulsatilla from too rich foods, pastries, fat foods and ice cream (in excess); a little ice cream feels good in the Pulsatilla stomach, but much overdose the matter, because it is too rich.
All three remedies have attacks of diarrha, although constipation is most characteristic of Bryonia and Nux vomica, and is only exceptionally found under Pulsatilla.
Bryonia diarrha is worse in the morning, on movement, and open occurs as an effect of over-eating in the heat of summer. Nux vomica diarrha is also apt to be worse in the morning, is mostly caused by over-eating and is apt to put on the dysenteric type. The Pulsatilla diarrha is more apt to occur in the night, from causes above mentioned, and is attended with great rumbling of the bowels.
All have white, sometimes very thickly-coated tongue, but taking into account the causes of these gastric and bowel troubles, temperament and modalities there should not be much difficulty in choosing the right remedy for any case.
So far as temperament is concerned, Bryonia is like Nux vomica, but Bryonia has much more of the "rheumatic diathesis." Both are easily irritated or angered, and are oftenest found indicated in spare, dark-complexioned subjects. Both are aggravated generally on motion, by Bryonia very much the more so, while Pulsatilla is sometimes like Rhus toxicodendron relieved by motion.
Now a few special indications for Bryonia and we will have it:
"Bursting headache, as if it would split the head open, aggravated by stooping; coughing; ironing; opening or moving the eyes; moving any way; in hot weather. Nausea and faintness when rising up, relieved when lying still."
"Epistaxis instead of menses (vicarious menstruation), also blood spitting."
"Mastitis; breasts pale, hot, hard, heavy and painful."
"Suppression of lochia with bursting headache."
"Suppression of milk, menses, measles or rash of scarlatina, or where all these are slow in appearing; of course the other Bryonia symptoms must be present."
"Frequent desire to take long breath; must expand the lungs. (Cactus, Ignatia, Nat sulph.)."
"Cough dry, < after eating, sometimes math vomiting; < moving; < coming from open air into warm room. (Nat. carb)."
"Cough hurts head and chest, holds them with hands." (Eupatorium perf., Natrum sulph.).
These are some of the peculiar symptoms which cannot be ranged under any general head, and are excellent leaders to the consideration of Bryonia, all and each of which will be found associated with the more general characteristics already noticed.
The dominant school do not know what they have lost in not being acquainted with the virtues of this remedy, as developed in our provings and clinical use, but we know what we have gained.
Thick, milky white coating on tongue (in many complaints).
Derangements from overloading the stomach, especially fat food; nausea.
Crushed finger-nails: grow in splits like warts and with horny spots.
Corns and callosities on soles, with excessive tenderness; can only walk with pain and suffering.
Alternate constipation and diarrha in old people, especially with the characteristic tongue.
Child cannot bear to be touched or looked at, fretful, cross.
Feverish conditions at night.
Headache; after river bathing; from taking cold; alcoholic drinks; deranged digestion; acids, fat, fruit; suppressed eruptions. Mucus; from anus, ichorous, oozing, staining yellow; mucous piles. Cannot bear heat of sun; < from exertion in sun; exhausted in warm weather.
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This remedy, like the three of which we have been writing, has a strong affinity for the alimentary canal. Its leading characteristic is in its thickly-coated, white, very white, white as milk, tongue.
Many remedies have white tongue, but this one leads them all. It is also a great stomach remedy, and in disorders of this organ arising from over-eating, where there is much nausea, distress, and especially the characteristic tongue, it is to be thought of before any of the three of which we have written. It is especially to be considered if the gastric derangement is of recent date. The process of digestion is hardly under way; the eructations taste of the food as he ate it, and the sufferer feels as if he must "throw up" before there will be any relief. In such a case a few pellets of Antimonium crudum on the tongue will often settle the business, save the loss of a meal, and all further suffering.
Diarrha may often follow these dietetic errors, especially during the heat of the summer season, and then the stools are peculiar in that they are partly solid and partly fluid, showing that digestion has been only partially performed in the whole length of the canal Antimonium crudum and Bryonia sometimes present about equal claims in a case of summer complaint; but the case in its entirety must decide the choice between them.
There is a form of diarrha which alternates with constipation, oftenest found with old people, where Antimonium crudum is the only remedy. Then it is also one of the best remedies for mucous piles; there is a continuous oozing of mucus staining the linen, very disagreeable to the patient.
There are some mind symptoms that are very peculiar, "the greatest sadness and woeful mood with intermittent fever"; again, "sentimental mood in moonlight, ecstatic love," and again, "child cannot bear to he touched or looked at."
Of the first two symptoms I can say nothing from experience or observation, but of the last, that it is a gem. Many times in cases of gastric or remittent fever, for which Antimonium crudum is a very excellent remedy, I have been led to its use by this very condition of the mind: the child is cross, but not like Chamomilla wants to be carried and soothed, but will scream and cry, and show temper at every little attention. Another thing that I have noticed in many of these cases is, that the fever runs higher at night and is accompanied with great thirst; the white tongue is almost always present. Such children are quite apt, even when around the house, to have "sore, cracked and crusty nostrils, and corners of the mouth," and so this may appear when sick.
There is a peculiar constitutional condition found in some people which calls for this remedy. It is found in the extremities ; finger-nails grow in splits, like warts, with horny spots (Silicea nails crippled, on fingers and toes; Graphites nails become thick, crippled; Thuja nails brittle, crumbling, distorted), and if by accident one becomes injured or split, it does not repair as it should, but grows out of shape. Then the toe-nails are brittle and grow out of shape also, or shrivel up and do not grow at all. The feet are covered on the soles with corns and callosities which are VERY TENDER, can hardly walk on them on account of this tenderness.
Some of the worst cases of chronic rheumatism have been cured by this remedy, guided by the excessive tenderness of the soles of the feet. (Baryta soles get sore from foot sweat; Pulsatilla soles pain and are tender; Ledum heels and soles tender when walking; Medorrhinum couldn't walk except on knees; Lycopod. soles swollen and painful). Horny excrescences anywhere on the skin make one think of Antimonium crudum. The remedy is oftenest found indicated in the extremes of life, in children and old people.
Now the peculiar modalities which deserve particular mention are: First, the troubles are often caused or aggravated by heat, and especially by the heat of the sun. (Bryonia, Glonoine, Gelsem., Nat. carb). The patient feels exhausted during warm weather; the gastric troubles come on, or are worse; such as nausea, vomiting and diarrha. The cough is worse, and, like Bryonia, is worse on coming into a warm room from cold air. These affections are particularly worse in sunshine, but also from radiate heat of the fire, so that Antimonium crudum takes a high rank as a not weather remedy. Second, cold bathing aggravates or causes trouble. (Rhus tox., Sulphur) "Child cries when washed or bathed in cold water." Cold bathing causes headache, cold in the head, gastric catarrh, diarrha, suppressed menses, toothache, etc. When any case of long standing comes to us, and the patient dates the beginning of the trouble to going in swimming or falling into the water, we think of Antimonium crudum and examine for further indications for the drug.
Now a few scattering symptoms that have found their remedy in Antimonium crudum: "Copious hæmorrhage from the bowels, mixed with solid fæces; chronic redness of the eyelids; toothache in decayed teeth, worse at night; gastric trouble after acids, sour wine, vinegar," etc.
Swollen, flabby tongue, taking imprint of the teeth; gums also swollen, spongy or bleeding; breath very offensive.
Sweats day and night without relief in many complaints.
Creeping chilliness in the beginning of a cold, or threatened suppuration.
Sliminess of mucous membranes.
Moist tongue, with intense thirst.
Glandular swellings, cold, inclined to suppurate; ulcers with lardaceous base.
Modalities: < at night in warmth of bed, while sweating, lying on right side.
Bone diseases; pains worse at night.
Dysentery: stools slimy, bloody, colic, fainting; great tenesmus during and after, followed by chilliness, and a "cannot finish sensation." The more blood and pain the better indicated.
Affects lower lobe of right lung; stitches through to back (Chel., Kali c.).
Intense thirst, although the tongue looks moist and the saliva is profuse.
In low potencies, hastens suppuration; in high, aborts suppuration, as in quinsy.
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As in Antimonium crudum, so in Mercurius, the leading characteristic is found in the mouth, or, I might rather say, characteristics, for the gums are swollen, spongy, sometimes bleeding; the tongue is also swollen, flabby, taking the imprint of the teeth (Arsenicum, Chelidonium, Podophyllum, Rhus tox. and Stramonium), generally moist, yet with intense thirst; the whole mouth is moist with salivation which is soapy or stringy, and the odor from the mouth is very offensive; you can smell it all over the room. No remedy has this condition of mouth in any degree equal to Mercury. It is found in very many complaints, and if anything corroborative of the truth of "similia," etc., were desired the curative power of Mercury, when indicated by these symptoms, ought to be satisfactory. Many a time have I given great relief to my patient, and great credit to Homopathy, by brilliant cures of that painful affection, quinsy, guided by these symptoms. Of course, in addition to the above symptoms the tonsils were greatly swollen and often apparently on the verge of suppuration. Right here let me warn against giving Mercurius too low, for if you do, it will hasten suppuration instead of aborting it. If anyone is skeptical as to the efficiency of the very high potencies, I invite him to a test in just such a case. Give a single dose, dry upon the tongue, or if you must seem to do more, dissolve a powder in four tablespoonfuls of water and give in half-hourly doses. Then Wait. I have done in many times and am convinced. If the patient has that other strong characteristic of Mercurius, viz., profuse perspiration, without relief of the suffering, success is doubly sure. (Sweat relieves, Arsenicum, Natrum mur., Psorinum.) I wish right here, as perhaps the most appropriate place, to disclaim being an exclusive high-potentist. The questions of dose is, and I believe must remain, an open one as long as different degrees of susceptibility are found in different diseases and persons. I have experimented along the whole line and know that both the high and the low are efficacious in certain cases. The preponderance of evidence, however, is greatly in favour of the high and the highest. This is my opinion. You may differ, and are welcome to do so.
The fever symptoms of Mercurius are notable, especially in the sweats. The chill also is peculiar as I have observed it. It is not a shaking chill, but is simply creeping chilliness. Often when this creeping chilliness is felt it is the first symptom of a cold that has been taken, and, if left alone, the coryza, sore throat, bronchitis of even pneumonia may follow; but, if taken early, a dose of Mercurius may prevent all such troubles. The chilliness is felt most generally in the evening and increases into the night if not removed by Mercury. It also alternates with flashes of heat; first chilly, then hot, then chilly, etc., like Arsenicum. It is often felt in single parts. Then again it is felt in abscesses and is the harbinger of pus formation. If pus has already formed, especially much of it, the only thing Mercury can do is to hasten its discharge; but if little or none is actually formed a dose of Mercury high will often check the formation and a profuse sweat often follows with a subsidence of the swelling and a rapid cure of the disease.
Now the sweats. They are very profuse and do not relieve like the sweats of inflammatory diseases generally do, but no the contrary the complaints increase with the sweat. (Tilia.). In what diseases is this condition found? It may be found in almost every disease: In sore throat, bronchitis, pneumonia, pleuritis, peritonitis, abscesses, rheumatism, etc., to the end of a long list. In short in any disease in which this profuse and persistent sweating without relief is present Mercurius is the first remedy to be thought of. Worse at night, and especially in the warmth of the bed, is another strong characteristic of Mercurius. (Ledum pal.) There is a long list of remedies that have aggravations at night, but not so many from warmth of the bed. I have cured many skin diseases of various names guided by this modality.
The glands and bones also come strongly under the influence of this remedy. The glandular swellings are cold, inclined to suppurate, having these chilly creepings aforementioned. These with the bone-pains in the exostoses and caries are all aggravated at night in the warmth of the bed.
The mucous membranes are everywhere affected; the discharges from them are at first thin and excoriating, even from the catarrh of the nose to the diarrhic, or dysenteric, discharges. Afterwards they become thicker or more bland, like the Pulsatilla discharges. Where are worse at night also, even the leucorrha.
Hahnemann ranked Mercury (first) for syphilis, as he did Sulphur for psora and Thuja for sycosis, and no doubt justly so, for Mercury in its various forms symptomologically covers more cases of that disease than any other remedy. but it must be remembered that Mercury is no more a panacea for syphilis than is Sulphur for psora or Thuja for sycosis, else there would be no truth in similia similibus. The case in hand must simulate Mercury, or that remedy is not "in it," but some other remedy is. Experience abundantly corroborates this and proves the truth of the law, Similia Similibus Curantur.
Most persistent and terrible tenesmus before, during and after stool; stool scanty, mucus tinged with blood.
Tenesmus of the bladder and rectum at the same time; urine passed in drops with much pain.
Throat intensely inflamed, swollen, burning, with swollen gums, which bleed easily.
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While we are on the subject of mercury we may as well notice the various combinations of the drug. Mercurius solubilis and vivus are so nearly alike that with the same indications some use one and some the other preparation. It is claimed by some that the vivus is better adapted to men and solubilis to women. I have not observed it, but do think that the solubilis works better in skin troubles. Of Mercurius corrosivus we have to say that it leads all other remedies for tenesmus of the rectum. This tenesmus is incessant. Stool does not relieve it, and this is what decides between it and Nux vomica in dysentery. It has also severe tenesmus of the bladder, and may here vie with Cantharis, Capsicum and Nux vomica, especially in dysentery.
Other symptoms must decide the choice.
This severe tenesmus may begin in the rectum and extend to the bladder or vice versa.
It is a very efficient remedy in gonorrha, in the second stage, when the greenish discharge has set in and the burning and tenesmus continues. It seems to have gained some reputation in Bright's disease. I have no experience with it here, but would expect it to do good if it were indicated.
It seems, according to the testimony of others, to be a useful remedy for catarrhal affections of the eyes and nose. Here also I have no testimony to offer, but would not cast doubt upon it for that reason. I do not desire to place my own experience ahead of that of others. We are co-laborers. Let each add to the general store of medical knowledge, that all may draw freely from it as occasion demands.
Dr. Beck, of Monthey, in Switzerland (I think it was), first brought this remedy to notice as of great value in that much-dreaded disease, diphtheria. Von Villiers claimed to have had astonishing success with it in Germany, losing only two per cent. (if I remember correctly) of the cases treated With it. He recommended the 30th potency, but others have used the 6th and claim equally good results. There are, so far as I can find, no very marked characteristic symptoms by which to choose it. It seems to spread its action all over the buccal cavity. Dr. T. F. Allen published a good cure with it, and then claimed that he chose this preparation of Mercury on account of the remarkable prostration, which he attributed to the cyanogen element in it. This looks reasonable. But I think we must investigate further to bring out its true characteristics. There is a chronic condition of the throat in which I have found it very efficacious. It is in the so-called cases of public speakers. The throat feels raw and sore, and examination reveals a broken down appearance of the mucous membrane bordering on ulceration. It is nor granulated, but looks raw in spots, as if denuded of membrane. I have helped this kind of throat, so that the patient wanted me to remember what it was I gave him so that I could repeat the prescription if the trouble returned. I forgot to state that it hurt the patient to speak, and there was also hoarseness. This is all I know of this remedy, but I believe it well worth proving and study.
Tongue coated thickly yellow at the base; tip and edges red or pale; takes the imprint of the teeth.
Swelling of the throat; begins on the right side (diphtheria) (left, Lachesis).
Genuine Hunterian chancre (l,000th clinical.).
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It is a preparation that has a every reliable and prominent characteristic. It is "Tongue coated thickly, yellow at the base." The tip and edges may be red or pale and take the imprint of the teeth, like the other Mercuries. Of course, other remedies have a yellow-coated base of the tongue like Kali bichromicum, Natrum phos. and Chelidonium, so that this symptom would not indicate Mercurius Protoiodide to the exclusion of all others, but I think I am safe in saying that this remedy has it in the greatest degree.
In diphtheria the swelling of the throat and the formation of membrane begins on the right side, like Lycopodium, and the ftid breath and flabby tongue, showing imprint of teeth, are generally present. Now if you have the thick yellow coating at the base of the tongue you need not hesitate to give this remedy. In regard to dose, I have seen good results from the 3d trituration to the C. M. potency. For myself I prefer the high, and have had abundant opportunity to test all the different potencies. If you are so prejudiced that you cannot give anything above the 12th because you cannot discover the drug with the microscope, don't give it too long; withdraw it after a few doses and give the powers of reaction a chance.
But diphtheria is not the only disease in which the yellow base of the tongue is an indication for the use of this remedy. Stomach and liver troubles often produce this appearance of the tongue. It is also a good remedy for Hunterian chancre, and no secondary symptoms follow its proper use. Here it must be given high.
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