Nux Juglans

[NUX REGIA, EUROPEAN WALNUT.]

We prepare an infusion or a dark -green alcoholic tiucture of the outer envelop.

This drug acts upon the digestive canal, and is particularly indicated in scrofulosis, fever and ague, and leucorrhcea.

Dr. Clotar Mueller, who has furnished some provings of this agent, shows that it has been successfully employed in some forms of intermittent fever. According to the same authority, it has effected a permanent cure in a case of lingering mucous and bloody leucor- rhcea by being used as an injection.

Professor Negrier recommends it for scrofulosis. Of fifty-six patients affected with goitre, ophthalmia, glandular swellings and swelling of bones, he cured thirty-one completely, relieved eighteen, and four died, two of phthisis tuberculosa, one of encephalitis, and one of compound pneumonia.

This agent acts upon the digestive canal ; it causes an inflation of the stomach, liquid stool, increased secretion of urine. It like- wise causes a variety of scrofulous eruptions, such as : toils, red pimples on the back and face ; eczema in the axilla, with burning and itching, secretion of a greenish-yellow pus, soreness, redness, and chapping of the skin ; lichen, little blotches with hard scurfs on the instep ; also a hard and inflamed sioelling of the face, boils on the shoulders, hip, arm.

Among medicines obtained from the vegetable kingdom — which, as far as my experience goes, act decidedly better in low dilutions or in undiluted tinctures, especially on young subjects — is mix juglans. The results of the provings of this medicine show that its action is almost exclusively on the chylopoesis, the first and deepest link in the hcematosis. It deranges the digestion and blood-formation; hence crude products are given out, and then occurs functional derangement of the glands in the mucous membrane of the intestinal canal.

Catarrh and chronic irrita- tion of the mucous membrane of the stomach and intestines and their glandular apparatus are the proximate cause of the divers derangements of the organic opera- tions, whence, in consequence of the blood dyscrasia thence arising, the skin becomes also affected. Thus we find papular, vesicular, and pustular forms of exanthema, with their various forms of modifications, among the morbid symptoms particularly in the sphere of action of nux juglans. * * * I had an opportunity of observing a severe case of acne pustulosa in a girl of eighteen years, in whom the forehead, cheeks and chin were affected.

The disease had lasted over two years, in spite of constant treatment. Calcarea carbonica removed some prominent constitu- tional symptoms of the case, but had no effect on the acne. I now resorted to nux juglans. Beginning with two drops night and morning, I gradually increased the dose to five drops ; and in the first fortnight the flesh eruptions became much rarer, dried up more rapidly and never attained their former size.

Four weeks later there were no fresh spots, and all traces of pustules were gone ; but still many bluish-red

458 JsTUX JUGLANS.

spots remained, giving the appearance of a recent attack of small-pox. It was from two to three months, before these traces of the eruption finally disappeared. (Dr. Hirsch, "On the Dose," in the British Jour, of Horn., Jnly, 1867.)

Dr. Mueller, the prover of this drug, offers the following lucid and philosophical comments on the physiological-therapeutic action of this agent:

"The sphere of action of juglans appears on the whole to be rather limited, the digestive organs being particularly and directly affected by this drug. In these it causes derangement and irritation, which simultaneously call forth abnormal symptoms in other organs and systems, especially in the head. Gradually, after the continued action of nux juglans, the digestive apparatus (a term to be taken in the broadest sense, because it embraces not only the stomach and intestines, but includes the liver, spleen, kidneys, glands, etc.,) undergoes an entire change of action, its functions appear altered, and the product of its action, the lymph and the blood, are changed dyscrasically in their composition ; the signs and consequences of this impression are the various exanthematous symptoms and mate- rial changes in the organic structures.

For this reason these latter symptoms appear late and run a very chronic course, whereas the symptoms of the prima? via?, which are mostly of a gastric nature, appear early and run a rapid course. But since the impression made by juglans affects principally or exclusively the reproductive life of the organism, the symptoms caused consist, to a small degree only, of pains and subjective sensations, but chiefly of disturbances or alterations of the functions and secretions, and of organic changes of matter.

The forms of pain are only itching and burning (skin), aching (head, stomach, belly), stitches (belly, chest, back, anus), drawing (belly, extremities), tearing (teeth), and pinching (belly).

" The symptoms of general fatigue and lassitude in the body are evidently of no great importance, and dependent only on the gastric affections and those of the head.

"I am of opinion that the symptoms which may be traced to the influence of the time of day, of evacuations of the bowels, or of meals, on the aggravation or alleviation of previously-existing symp- toms, do not possess much characteristic value, and should not determine us in our selection of this drug as a remedy. Thus, for instance, an inflation and tension of the abdomen and stomach will, of course, be relieved by the discharge of wind and feces ; affections of the head, caused by congestion, be aggravated toward eveuing,

NUX JUGLANS. 459

whereas they will hardly be perceptible in the morning, after a few hours' sleep, etc.

"Without intending to detract from the importance of the subjective symptoms, since they are of characteristic and decided significance of those remedies particularly which exercise their chief influence on the sensitive nervous parts, we cannot but make them very inferior to the objective symptoms ; these will unquestionably furnish the best criterion for the employment of juglans."

This drug is probably one of those which it is not safe to administer in an attenuated form. Sauberbielle, Funke, Professor Negrier, and others who have made extensive clinical experiments with the green envelope of the walnut, and with the leaves of the tree, have administered it in the following quantities and prepara- tions.

In jaundice, for which Dr. Souberbielle recommends the leaves of the walnut tree as a specific, he macerates over night a drachm of the dried and powdered leaves in a sufficient quantity of white wine, and on the following morning the patient swallows this quantity before breakfast.

In a case of quartan-fever and ague for which every imaginable preparation of china and other remedies had been used in vain, Dr. Funke effected a cure by means of two drachms of the green envelope which the patient had to swallow in six ounces of mint- water. The remedy was continued for a fortnight longer.

In the extensive experiments instituted by Professor JSTegrier in the treatment of scrofulosis with walnut, he administered the drug in. the following manner : After having used a decoction of the drug externally for cleansing scrofulous sores and as a fomentation to white swelling of joints, he commenced in 1837 to give it internally in his hospital for scrofulous children, each child drink- ing from twTo to three cups a day of an infusion of the fresh leaves sweetened with syrup or honey.

At the same time he gave to each child a pill composed of the extract of the leaves and weighing a little more than one grain. The sores were washed with a decoction of the leaves, or else dressed with a compress or with lint moistened with the decoction, or, in some cases, a cataplasm of flaxseed and walnut leaves was applied. Seven boys and ten girls were thus treated. One of these patients was afflicted with strumous swellings which had not changed to abscesses, seven had suppurating gang- lionic swelling, and nine were afflicted with diseases of bones and

460 J5UX MOSCHATA.

fistulous ulcers. Some of these children had been sick two years, others six, eight and even ten years. After two months' treatment three of these children were cured, ten much improved and four had remained unchanged. At the end of another six months four more were cured, and after a treatment of eighteen months ten of thess children were cured, two were nearly well, and two did not exhibit any change.

An infusion is prepared by boiling a handful of the cut leaves in half a pint of water. From two to three and even five cups of this decoction are drank every day. For external use a decoction is prepared by boiling a handful of leaves for ten or fifteen minutes in two pounds of water. This decoction may be used for fomentations, cleansing the sores, fistulous ulcers, etc. The dried leaves may be obtained at all seasons.

IUX MOSOHATA.

[mYRISTICA MOSCHATA, NUTMEG. NATURAL ORDER, MTRISTACE^E.]

This is the fruit of the myristica fragrans, a tree growing on the Molucca Islands. It consists of an outer envelope, and of a reddish shell known as mace, which is closely adhering to the nut, and leaves depressions upon it when removed. The nut itself is dipped in lime-water by the Dutch before it is shipped off as an article of trade. The lime-water, traces of which may be seen on the nut, protects it against the ravages of worms which are apt to perforate its interior.

Cullen relates that two drachms of the powdered nut were swal- lowed, by mistake, and caused a warmth in the stomach ; an hour after, drowsiness supervened, gradually increasing to stupor and insensibility. The person was found on the floor; after being put to bed, delirium set in, which lasted for some hours.

One morning Purkinje swallowed a whole nut in little pieces, mixed with sugar. The whole day he experienced a sort of dullness in the outer senses and in the motor organs, without the mental operations or any of the other functions being interfered with ; he found, however, that a small glass of wine after dinner affected him a good deal.

One afternoon he swallowed three nuts ; soon after, he was attacked with drowsiness, and he laid the whole afternoon on his sofa in a state of somnolence and his mind absorbed in pleasant reverie. At half past five in the evening he went out ; although he

NUX MOSCHATA. 461

was perfectly able to control his movements, yet he lost himself continually in reveries ; at times he lost even his recollection, and the road appeared to him very long. Arrived at the theatre, the struggle between dream and reality continued for a long time until the external senses finally obtained the mastery. He had a good night's rest. There were no unpleasant after-symptoms, except that he felt the effects of wine more vividly for some days longer.

A woman, sixty years old, in order to check a too profuse menstruation, grated two nutmegs into half a pint of boiling water, and began taking the "tea" at 8 a. m. She sipped it after stirring, so that particles of the nutmeg might be taken with each sip. She continued this during the morning, being unusually lively, laughing and bright, but about 1 p. m. she began to feel giddy and light in her head, chilly and cold all over. She discontinued the use of the infusion at 2 o'clock, while these symptoms gradually increased, with loss of memory ; thought uncontrollable ; objects would vanish for an instant ; total loss of consciousness, seemingly to her of an half-hour's duration, but really only momentary.

Sickness at the stomach, but no vomiting. About 4 p. m., feeling as if the blood were rushing to the heart ; from thence to the head, and then all over the body ; again to the heart, with a repetition of the former ; at the same time the extreme coldness and the other symptoms given were present. The alternate paleness and redness of the sur- face, indicating this varied and increased action of the circulation, was distinctly visible. About 5 o'clock she complained of a sensa- tion as if the heart were grasped, with sharp, cutting pain in the cardiac region.

At 4:30 p. m. I found her sitting up in bed, tossing from side to side. Surface cold and blue ; deep-blue semi-circles under the eyes. Hippocratic countenance and pulse almost imper- ceptible ; skin cold over the whole body.

She complained of feeling faint, with lightness, giddiness and emptiness of the head. She answered promptly and correctly all questions put to her, but had great fear of death. Ten drops of the concentrated tincture of gelsemium in one and a half ounce of whisky were given at a single dose, with a hot mustard pedaluvium. She recovered promptly.

(Dr. K. K. Koberts in the Halm.

Monthly, June, 1868.)

Mrs. B. S., aged about thirty years, at 11 a. m. grated a large nutmeg upon an egg and some sugar, and ate the whole of it between then and 5 p. M.

During the evening she had dullness of senses and loss of control. She could have been led anywhere with- out resistance. Loss of will power. The upper eyelids were swollen and red around the borders, and drooping.

She looked as though she had been weeping. Her hand, to her, looked red, too large, and as if covered with red spots. Vision was indistinct; everything looked red. She now has a sensation as if everything had fallen back against the rectum, accompanied with violent straining and urging to stool.

Crampy, forcing-down pain in the bowels and

462 lifUX MOSCHATA.

NUX MOSCHATA. 463,

The above accidental provings show that nux moschata affects principally the nervous system. Hence its value, as a remedy, in various derangements which are either wholly of a nervous origin or are accompanied by serious and characteristic disturbances of the nervous system. The narcotic effect of the nut is slight; it creates a well-marked disturbance in the generative organs of women and is a remedy of the utmost importance in many diseases peculiar to women.

SPASMS, arising from nervous excitement, accompanied Tb^ vertigo ; fainting spells, followed by stupor and other characteristic symptoms of nux moschata, may call for its exhibition.

464 NUX MOSCHATA.

This case teaches an important lesson and is Avorthy of careful note, as an illustration of those distant drug-effects, which, in an isolated form, are easily overlooked ; while they are of supreme im- portance, if taken as a part of the entire drug picture.

HEADACHE of a throbbing, pressing pain, confined to small spots, worse in the left supra-orbital region ; spasmodic pains in the head and forehead ; the brain feels loose in the skull ; upon shaking the head, it seems as if the brain were beating against the skulk Vertigo, as if drunk, with staggering and weakness in the limbs. Great distention and hardness of the stomach and abdomen; fre- quent and sudden changes of mood. Is especially applicable to hysterical and gastric headaches of people of a highly sensitive nervous organization ; after suppression of some eruption.

APHONIA, when it occurs as a symptom of hysteria; sudden loss of voice when walking against the wind.

TOOTHACHE of nervous people, of pregnant women, of persons

.NUX MOSCHATA. 465

who have a dry, cool skin and do not perspire easily ; the ache is aggravated from inhaling cold air or drinking cold water; it is relieved by heat; there is a feeling as if the teeth were being wrenched out.

COUGH in nervous persons or pregnant women, with hoarseness, especially from walking against the wind; the sputum is dark, slimy, saltish ; tickling, scratching in the trachea ; increased by exercise, warmth of bed and by getting heated ; great dryness in the mouth and throat, but no thirst. In

NERVOUS AFFECTIONS OF THE HEART mix moschata is a most important remedy. It is of particular value in hysterical subjects. The action of the heart may be very violent, with fre- quent and long-continued intermission, creating a fear of immediate death ; it may consist in a feeble fluttering, hardly less distressing. There may be present much pain in the cardiac region, with a feel- ing of fulness, and a well-marked, even enormous bloating of the stomach and abdomen after every meal, and severe headache, ten- dency to faint, and many symptoms described under hysteria.

Nux moschata may come into play whenever we find serious disturbances of the nervous system which are characterized by intense nervous excitement, trembling of the limbs, spasmodic movement of the muscles of the face, hands or legs; fitful moods of the patient ; a muddled condition of the perceptive faculties ; general excitement, followed by faintuess and profound sleep. There may be present many other symptoms mentioned, such as the peculiar heart-symptoms of the remedy; the bloating of the stomach and abdomen ; irritation of the intestinal track ; dryness of the lips and mouth without thirst. Such symptoms are frequently found in persons who have received a severe shock of the nervous system from fright or from an injury, and in patients who have ruined their nervous system by a continuous and excessive rise of alcoholic drinks.

•vox., n. — 29.

466 NUX MOSCHATA.

stomach, as from colic ; uncomfortable and tired feel ng after eating ; scratching eructations, as from rancid oil ; heat in the stomach, rising upward with oppression ; cutting, pinching around the navel, relieved by pressure.

DYSPEPSIA, with similar symptoms; enormous distention of the stomach and abdomen soon after each meal; vomiting of digested food and mucus of a bitter or sour taste ; sensation of warmth in the stomach; the appetite seems good, but a small amount of food satisfies the patient. Nervous excitement; hys- terical symptoms.

DIAERHCBA of undigested food, like chopped eggs, with loss of appetite and great sleepiness ; the stools are offensive ; cutting in the bowels during stool, with slight tenesmus; tendency to faint; stupor ; after taking cold ; from nervous excitement. Very useful in diarrhoja of children.

NUX MOSCHATA. 467

Nux moscbata is a remedy of great importance in the treatment of diseases of women. This is not due to any direct effect of the drag upon the generative organs of woman, hut depends upon the near relationship of the nervous system to the generative organs. It would be almost impossible to find a well marked lesion of the generative apparatus without serious nervous disturbances; neither can a serious disease of the nervous system exist, without destroying, sooner or later, the harmony and vigor of the generative functions. The observing practitioner, then, will often be able to administer this drug, with the best of success, in the following diseases of women:

MENSTRUAL SUPPRESSION, followed by hysteria, gastric and other constitutional derangements, with the characteristic symp- toms already given.

MENSTRUAL DERANGEMENTS. — Irregular menstruation, with discharge of thick, black blood ; pain and weakness in the - limbs ; severe, hard ache in the back ; profuse leucorrhceal discharge during the menses ; distention of the stomach and abdomen after each meal ; flatulent distention of the uterus ; weariness ; faintness ; drowsiness; peevishness; hysteria; dryness of the throat, mouth and tongue, without thirst ; pain in the sacrum when riding in a carriage.

LEUCORRHCEA with well-marked hysterical and other symp- toms characteristic of the remedy; leucorrhoea in place of the menses.

UTERINE HAEMORRHAGE of thick, dark blood, with chilli- ness, fainting spells and hysterical symptoms. A good remedy in miscarriage.

UTERINE DISPLACEMENT, especially anteversion, with hysterical symptoms, irregular menstruation, leucorrhoea, etc. Also : faintness, distention of the abdomen and uterus ; pain in the sacrum when riding in a carriage ; relaxed condition of the sexual organs ; sterility.

Your attention has been called to a peculiar sleejjiness, a drowsi- ness which completely overcomes the patient, which has been produced by nux moscbata. This symptom has been cured under the exhibition of the remedy,

A woman, aged forty-two years, mother of two children, formerly perfectly well,

468 nux vomica.

I^UX VOMICA.

[STKYCHNOS NUX VOMICA. NATURAL 0KDEK, APOCYNEZE.]

Seed of the fruit of strychnos nux vomica, a middling-sized tree \ leaves spear-shaped ; berry round and smooth, covered by a shell containing a pulp which is eaten by birds ; seed button-shaped. The bark termed "angnstura spuria" was at first believed to be the bark , of the brucea antidysenterica, a native of Abyssinia ; but it was afterward found to be the bark of the strychnos nux vomica.

This tree is a native of East Indies. The bark is poisonous to animals and men.

Emmert reports a case of poisoning by this bark where a boy, five years and a half old, was given three tablespoonf nls of a decoction of five ounces of the bark boiled down to five fluid ounces. The prin- cipal symptoms in this case of poisoning were : tremor which soon increased to spasms ; the least touch brought on tetanic spasm ; lock- jaw with protrusion and immobility of the eyes ; the breathing, after the paroxysm, was excessively labored, stertorous ; face and forehead covered with sweat ; blueness of the lips and cheeks ; the spasms were excited by drinking a little lukewarm water, by the least noise or contact ; previous to death, the whole body became relaxed and the eyes extinct, with a few convulsive inspirations at long intervals; death took place one hour after taking the poison, and half an hour after death the body was quite rigid.

A post-mortem examination showed that the blood was cherry brown and fluid. The right lung was externally pale and bloated, internally gorged with blood ; the left lung was externally blue, aud when cut into, it looked blackish and was gorged with blood.

The action of nux vomica on man is so graphically described by Pereira that I beg the privilege of quoting his remarks on this point, with some slight but necessary comments.

According to Pereira, three degrees of the operation of nux vomica on man may be admitted.

NUX VOMICA. 469

Pereira, educated in the old mental habits of the school, assigns to small doses of nux the power of producing tonic or strengthening effects in the healthy stomach. No intelligent homoeopathic phy- sician, no homoeopathic practitioner who has habituated his mind to reflection and philosophical reasoning, will ever be guilty of perpetu- ating the superficialities of old-school therapeutics. Drugs are poisons. It is in their very nature to be poisonous to the organism.

They are poisonous whether taken in small or large doses. Wherein then does this' pretended tonic effect of nux consist? As soon as the poison comes in contact with the stomach, and begins to exercise its deleterious action, the brain, in its capacity of chief supervisor of the functional activities of the organism, comes to the support of the threatened organ, administering to it, lending to it from its own abundance an additional power to manifest the vital phenomena inherent in its organic destiny.

The brain is no reasoniug manager. It obeys an instinctive law of order. If the organic power of the stomach is threatened, the brain seeks to restore the equilibrium of the functions by supplying additional power to the invaded viseus. Is this increase of power real or only apparent ?

Common sense at once informs us that it is only apparent. It is power borroioed from the brain. As long as the brain has any power left to lend to the stomach, it will do it ; it will impoverish itself ; but when the period for restitution has arrived, as it assuredly will, when the brain shall be obliged to call in all its outstanding funds for its own preserva- tion and support, then the funds will be found exhausted ; the organs cannot repay what they had borrowed from the brain, their common reservoir of vitality ; the brain is drained of its resources, the organs will soon find themselves reduced to the condition of empty pouches and worn-out tissues, and universal prostration and decay will be the consequence.

470 iOJX VOMICA.

the limbs, and increased sensibility to external impressions (of light, sound, touch, and variations of temperature,) with depression of spirits and anxiety, are usually the precursory symptoms. The limbs tremble, and a slight rigidity or stiffness is experienced when an attempt is made to put the muscles into action. The patient ex- periences a difficulty in keeping the erect posture, and, in walking, frequently staggers. If, when this effect is beginning to be observed, he be tapped suddenly on the ham while standing, a slight con- vulsive paroxysm is frequently brought on, so that he will have some difficulty to prevent himself from falling.

I have often in this way been able to recognize the effect of nux vomica on the muscular system before the patient had experienced any particular symptoms.

If the use of the medicine be still persevered in, these effects in- crease in intensity, and the voluntary muscles are thrown into a convulsed state by very slight causes. Thus, when the patient inspires more deeply than usual, or attempts to walk, or even to turn in bed, a convulsive paroxysm is brought on. The sudden contact of external bodies also acts like an electric shock on him. The further employment of nux vomica increases the severity of the symptoms ; the paroxysms now occur without the agency of any evident exciting cause, and affect him even when lying perfectly quiet and still in bed.

The muscular fibres of the pharynx, larynx, oesophagus and bladder also become affected, and Trousseau and Pidoux say those of the penis are likewise inflamed, and the nocturnal and diurnal erections become inconvenient even in those who, for some time before, had lost somewhat of their virility. I am acquainted with two cases o£ paralysis, in which the use of nux vomica caused almost constant nocturnal erections. Women also, say Trousseau and Pidoux, experience more energetic venereal desires ; and we have received confidential information on this point which cannot be doubted.

"The pulse does not appear to be uniformly affected; for the most part it is slightly increased in frequency between the convulsive attacks, but Trousseau says he has found it calm even when the dose of the medicine was sufficient to cause general muscular rigidity. Previous to the production of the affection of the muscles, various painful sensations are oftentimes experienced in the skin, which patients have compared to the creeping of insects (formication,) or to the passage of an electric shock ; occasionally an eruption makes its appearance.

NUX VOMICA, 471

472 NUX VOMICA.

Nux vomica affects primarily the spinal column, motor and sentient nerves ; it also affects the brain ; we infer this from the injurious action of nux vomica upon the brain in patients who are attacked with apoplexy attended with softening of the brain, and from the fact that it has caused stupor, vertigo, buzzing in the ears, sleeplessness and turgescence of the capillaries of the face.

According to Flourens, nux vomica acts upon the medulla oblongata; this fact is disproved by Orfila, who never found the medulla altered, contrary to Flourens, who teaches that the specific or exclusive action of every poison on some special organ always leaves, after death, traces of its action sufficient to distinguish the affected from other organs. It would seem that nux affects the cerebrum as well as the cerebellum, for both, more particularly the cerebellum, have been found softened after death.

In the nineteenth volume of the London Medical Kejjository a case is reported where a young woman swallowed purposely a drachm of nux vomica mixed in a glass of wine. In fifteen minutes she was seized with heat and pain in the stomach, burning in the gullet, a sense of weariness in the limbs, succeeded by stiffness in the joints, convulsive tremors, tottering in her gait, and at length violent and

NUX VOMICA. 473

Orfila states that a person swallowed, in the morning, a scruple of nux vomica in powder, and drank afterward a few glasses of cold water, in order to diminish the bitterness occasioned by this sub- stance. Half an hour after, he appeared to be drunk; his limbs, especially his knees, were tense and stiff ; his walk was staggering and he was afraid of falling. He took some food, and the symp- toms soon afterward disappeared.

As regards the quantity sufficient to produce a fatal effect, Dr. Basedow mentions the case of a young lady who swallowed, by mis- take, a table-spoonful of the powder ; she was almost instantly deprived of the power of walking, and fell down, but did not lose her recollection ; she recovered.

A case occurred in London, in 1839, where fifty grains of the ptowder of nux, equal to one-quarter grain of strychnine, proved fatal ; in another case, fifteen grains destroyed life ; this is the smallest fatal dose on record.

The provings which we possess of this drug have been obtained by means of large doses, and constitute one of the most brilliant pages in Hahnemann's Materia Medica.

The physiological action of nux upon the organism shows that this agent is an excellent remedy for various typical and intermit- tent disorders ; for tonic spasms, and more particularly for tetanus and opisthotonos ; for gastric and bilious derangements ; for consti- pation arising from torpor or paralysis of the peristaltic motion ; for strangulated hernia with or without fecal vomiting ; for acute and chronic diseases of the spinal marrow. You will find it stated in the books that it is more adapted to the male than to the female sex ; I doubt the correctness of this statement, which I accept only in so far as the disease to which nux is homoeopathic occur more frequently among men than they do among women. For the same reason it is more suitable to the bilious nervous than to the phleg- matic temperament, and more to those who are subject to piles and

474 nux vomica.

CEPHALIC GEO UP.

CATARRHAL HEADACHE ; the brain feels heavy and aching, as if bruised.

NUX VOMICA. 475

EHEUMATIO HEADACHE ; a tearing pain after eating, with sensation of heat in the cheeks, and a chilly feeling over the body, or only in the hands ; also with throbbing in the forehead ; or a crampy pain in the head, with soreness and sensitiveness of the scalp.

GASTRIC HEADACHE ; from overloading the stomach, worse after eating, with nausea, sour vomiting, also darting pains in one side of the head.

BILIOUS HEADACHE, similar to gastric headache, with sen- sation as if the head would split, tearing and burning pain in the head and forehead, vomiting of bitter and sour phlegm.

HYSTERIC HEADACHE with pressing in the head as if the brain would be pressed asunder ; accompanied with heat in the brain ; the headache is relieved by compressing the head with the hands.

CONGESTIVE HEADACHE with violent throbbing and aching pain, as if the head would split ; the headache may be excited by abuse of wine, coffee, by a violent mental excitement, suppression of haemorrhoids.

PERIODICAL HEMICRANIA, with sticking, sore pain in one side of the head ; also drawing pain in one side, or pain as if one side of the brain would be rent asunder.

A woman, aged twenty-seven years, of sanguine temperament, passionate, choleric, sensitive, suffered from : sensation of wavy motion in the brain ; sensation in the head as if she had been on a spree ; pressive pain in the occiput, early in the morn- ing; pressive, beating headache upon the slightest attempt to do a problem in arith- metic; increased by coffee and wine; after eating, drawing pain in the teeth and temples ; looseness of the teeth; bitter taste in the mouth. Nux vom.24 cured in six days. (Schreter in Annul., i., 73.)

476 NUX VOMICA.

VEKTTGrO. — !Nux having such a powerful specific action upon the cerebrum and cerebellum, it will be found available in some very important and dangerous conditions of the brain. We shall find it useful in vertigo, especially when arising from excessive use of alco- holic liquors, coffee, or when the brain is overtasked and there is danger of softening ; the pulse during the attack is small, irregular ; or the patient vomits, is troubled with dyspepsia ; the vertigo seems to be in some sort of sympathetic connection with the gastric irritation.

APOPLEXY of a peculiar type comes within the therapeutic range of nux. It is doubtful whether nux will ever be found avail- able in apoplexy which is not connected with, or depending upon, some primary derangement of the stomach, especially inflammation of the mucous coat.

The whole of the right side was of a blue-red color, the abdomen horridly distended, the hands convulsively closed, face pale and col- lapsed, the mouth tightly closed, with blue lips and traces of blood oozing from the mouth ; stomach inflamed throughout and almost gangrenous in the region of the pylorus ; the inflammation spread even to the middle of the ileum. The larger bowels were in a nor- mal condition.

Another woman took six grains of the powdered nux at one dose. She was attacked with extreme weakness of the limbs, so that she was unable to stand ; general trembling, vertigo, stupefaction of the head, anxiety, small and intermittent pulse.

xux vomica. 477

ENCEPHALOMACIA this agent will prove very useful, especially if the disease results from the excessive enjoyment of wine, rich food or even from excessive mental labor.

CEREBRAL CONGESTIONS.— We shall find nux admirably adapted to the consequences resulting from the excessive use of spirits, among which we may range cerebral congestions, with vio- lent throbbing and aching pains in the head, dizziness, stupefaction, protrusion and redness of the eyeballs, stuttering or inarticulate speech, paralytic weakness of the extremities, full and bounding pulse, or feeble and rather accelerated pulse, with coldness of the extremities.

Nux will likewise be found indicated under these circumstances if the patient's brain is clear, but the sensibility seems to be almost extinct; the skin feels dead ; he is apprehensive of having a paralytic stroke ; the pulse is rather feeble and compressible, inclining to be irregular.

NEBVOUS GROUP.

In some of the cases of poisoning which I have related, nux caused a sudden falling, as if the patient were struck down ; it produces this effect by its primary action upon the cerebro-spinal axis, and more particularly upon the ganglionic system of nerves.

478 NUX VOMICA.

A girl of thirteen years, of feeble but otherwise sound constitution, had been com- plaining of frontal headache, and more particularly of a painful pressure in the epigastric region, after which she was attacked with convulsions. In the first two days the convulsions returned three or five times daily, and were preceded by anxiety and extension of the limbs in a recumbent posture ; these symptoms were followed by an almost complete vanishing of the senses, and by shocks which forced the body out, jerking the head upward, with the arms crossed on the breast, the legs stretched downward, and the abdomen, which was somewhat drawn in, jerked up.

These jerking shocks recurred as many as fifty times in one minute; with every jerk the patient uttered an anxious moaning sound. The least, movement, the slightest contact, was followed by several jerks. She took one-twentieth of a grain of pulver- ized nux every two hours ; in three days she was entirely restored. The last attack had been the most formidable.

TETANUS. — These symptoms demonstrate the homoeopathicity of nux vomica to tetanus and to chorea; it is not necessary to repeat the indications which call for its exhibition.

2JTUX VOMICA. 479

Itching and crawling in the face seems to be characteristic of nux. We find this symptom recorded among Hahnemann's provings : " Itching and crawling in the face, as if ants were crawling over it."

PAKALYSIS, not accompanied by inflammatory or congestive symptoms, nux vomica may prove an invaluable remedy. Accord- ing to Magendie, a paralysis to which nux vomica is homoeopathic is more or less accompanied by, or resulting from, softening of that portion of the cerebro-spinal axis which sends off nerves to the paralyzed limb. The temperature of the part is moreover dimin- ished, it may be liable to perspire, and the pulse is reduced in volume, quicker, and more or less irregular. In paralysis accom- panied by engorgement of the nervous centres, where the limb feels heavy, full, enlarged, hot, the pulse is heavy and irregular, or small, quick and irregular, the sensibility is altered, the patient complains of a pricking and formicating sensation in the part, aconite is the

480 NUX VOMICA.

RHEUMATIC PARALYSIS of the extremities, without much fever, nux may effect a complete cure.

TIC DOULEUREUX.— Nux is a valuable remedy in tic douleu- reux, with "tearing pain in the course of the infra-orbital and middle branch of the trigeminus, with redness and watering of the eye ; flow of clear water from the nostril, and numbness of the affected side ; the patient is morose, irritable, belches a great deal, and is constipated ; after the abuse of coffee, liquor, quinine, etc. ; also intermittent prosopalgia." (Eaue.)

INFLAMMATORY GROUP.

Nux cannot be said to cause inflammation of a phlegmonous character with full, bounding and rapid pulse. Nux has caused inflammation of the stomach and small intestines, but this sort of inflammation seems to be incidental to a complete disorganization of the nervous life of the organ rather than the result of a tem- porary depression of the nervous energy. Inflammations of this kind are apt to be attended with convulsive paroxysms.

CHILBLAINS — By our provings we know that nux causes a burning and itching in the finger and toe-joints, such as patients

NUX VOMICA. 481

experience from chilblains. Hence in chilblains this agent may prove serviceable, if they itch and burn a great deal, especially when entering a warm room or getting into bed.

Among the provings of nux we find a number of symptoms re- corded, pointing to arthritic and rheumatic affections, such as: swelling of joints, drawing, tearing, laming pains, and pains as if bruised, in the muscles of the nape of the- neck, abdomen, extremi- ties ; crampy pains, and contractive pains as if the tendons were too short in the joints, are likewise complained of by the provers. The parts may feel numb and heavy, but there are scarcely any outward symptoms of inflammation.

PALE ARTHRITIC SWELLINGS of the toes, balls of the toes, arthritic-rheumatic swelling of the knee-joint, of the abdominal muscles, with gastric symptoms without, and even with, moderate fever, have yielded to nux.

MUSCULAR PALS' S, aching, boring and twitching pains may find a remedy in nux.

ORBITAL GROUP.

SORE EYES, when the weakness is of an arthritic or scrofulous character. If this weakness or soreness of the eyes is accompanied by weak digestion, for which nux seems indicated, we shall find this agent so much more efficient in the treatment of the former affection.

If this weakness arises from abuse of alcoholic stimulants, over- feeding, excessive use of coffee, straining of the eyes by nightly mental labor, nux may prove a useful agent.

DENTAL GROUP.

ODONTALGIA. — Nux cures various kinds of pains in the teeth ;

482 NUX VOMICA.

the most characteristic pains to which nux is specifically adapted are : sticking, drawing, tearing, digging, burning and jerking pains. The stitching pains seem to be particularly indicative of nux. We shall find this kind of odontalgia prevailing in the case of arthritic individuals; persons addicted to the use of strong drinks, coffee; men and women of sanguine-bilious temperament, with impaired digestion ; scrofulous and arthritic individuals who are frequently exposed to the night air, to damp weather, draughts of air.

Nux may be indicated if the pain affects several teeth at once, or if the precise tooth cannot be pointed out. For the toothache of pregnant women nux is highly recommended.

PHARYNGEAL GROUP.

Nux seems to cause a feeling of soreness and fulness in the throat, as if a lump were lodged there. Some homoeopathic physicians pro- fess to have used nux in

ANGINA, or chronic sore throat. Very little reliance can be placed upon nux in this affection, unless it should happen to be in rapport with a peculiar state of gastric derangement to which nux is homoeopathic.

SPASMODIC SINGULTUS.— Nux has caused spasmodic twitch- ings of the pharynx; hence in spasmodic singultus it may prove useful ; likewise in

DYSPHAGIA of a spasmodic character.

CHYLO-POIETIC GROUP.

Taste and Appetite. — Nux causes a sou?' tase ; food leaves a sour taste in the mouth ; afoul, musty and bitter taste in the mouth, not of the food ; loss of appetite, an aversion to the food of which the pi over is usually fond; a sensation of hunger, but the appetite is immedi- ately satisfied after eating ever so little, or it may cause a sensation of hunger, and yet the patient may experience an aversion to food.

Secretions. — Nux causes a copious flow of saliva; spitting up of a hlachish almost coagulated blood at two in the morning and two in the

nux vomica. 483

afternoon ; heartburn, as after eating rancid grease ; scraping sensa- tion in the pharynx as after heartburn ; rising of a sour and bitter fluid' off the stomach.

Sensations experienced, during and after Eating. — After eating the prover experiences an oppression of the stomach and epigastric region, with metallic taste in the mouth ; chilliness and heat of the face ; the heat seems to come from the abdomen ; qualmishness, nausea and fainting spell ; depression of spirits and ill-humor.

Eructations, Nausea, and Vomiting.— Nut causes nausea, even early in the morning, vomiting of sour mucus and blood.

Pain. — Nux causes continual and violent distress in the stomach ; pressure as from a stone in the epigastric region ; tension in the epigastrium, followed by pain in the abdomen as if the inside were sore and raw ; contractive, crampy pain in the bowels, sometimes followed by watery diarrhoea ; distention of the epigastrium which is painful when touched ; throbbing in the epigastric region as if an abscess were forming; burning distress in the epigastrium; flatulent distention after eating or drinking ; painful prickings in the abdo- men ; cutting pain, as if a cutting instrument were pressing upon the bladder, neck of the bladder, perineum, rectum and anus ; a sensation as if cutting flatulence had become incarcerated in these parts ; cutting, also burning-cutting distress, with nausea ; pinching in the bowels as if diarrhoea would set in; pressing, bearing-down pain in the bowels; feeling of weakness in the inguinal ring as if a hernial sack would protrude ; the abdominal muscles feel sore and bruised, especially during motion.

Before considering the alvine evacuations, let us examine these physiological effects of nux with reference to their corresponding pathological conditions. Agreeably to these effects we shall find nux indicated in the following affections :

HEARTBURN, or pyrosis, characterized by the gulping-up of a sour, acrid or bitter fluid.

CHRONIC VOMITING and retching, especially after eating, with oppression and distention of the bowels, swelling of the epigastrium, soreness and throbbing of the epigastric region.

VOMITING- OF BLOOD, or hsematemesis ; the blood looks and tastes foul, is mixed with food and mucus.

A woman, thirty-six years of age, who has just menstruated profusely, has suffered for a week from nausea and vomiting of undigested food after each meal. Symp- toms : Lassitude in the morning, feeling of heaviness in the head; vertigo; sleepi- ness; does not want to get out of bed; violent, pressive pains in the epigastric region,

484 NUX VOMICA.

A man, aged sixty years, tall, sanguine temperament, a sufferer from piles and pains in the lower abdomen, dating back to an attack of intermittent fever, has noticed for some weeks a dull, stitching pain in the region of the spleen. Symptoms : In the night of October 10th a pressive, tensive pain in the lower abdomen, with anxious restlessness; after midnight, vomiting of bright arterial and coagulated ve- nous blood, which was repeated once or twice within the next hour, accompanied with general coldness and eructations.

The patient is exhausted ; eyes closed; countenance pale ; expression of suffering ; nausea relieved by eructations ; fulness and pressure in the epigastric region; tearing pain in the left hypochondriac region, increased by touch, urine dark, pulse slow, not feeble. Skin cool. Prescribed tincture of nux vomica, one drop in three ounces of water, one spoonful every hour, followed by vio- lent thirst, hourly increased pressure with aching in the stomach and vomiting of mucus, profuse flow of saliva, tearing pain in "the left side." No more vomiting.

During the following days, decrease of all the symptoms under the continued use of nux. Discharged cured on October 14th. (Holecyek in Hygea, xv., p. 197.)

SPASMODIC VOMITING and retching after a fit of indiges- tion, in consequence of over-eating or of eating indigestible food.

DYSPEPSIA, with burning distress in the region of the pylorus, with oppression after eating, sudden feeling of repletion after swal- lowing a small quantity of food, in spite of a previous sensation of hunger.

CARDIALGIA, GASTRODYNIA. — The cardialgia to which nux is homoeopathic may correspond with an inflammatory patho- logical process in the stomach and small intestines, and likewise with a pathological process going on in the hepatic system. We mean by this, that in the one case the cardialgia is, sensually speak- ing, an inflammatory irritation of the stomach and duodenum, or of parts thereof ; and in the other case, a pathological process going on in the stomach and duodenum, but developed out of certain primary disturbances of the hepatic system. In either case, nux may be applicable, though the symptoms may differ very greatly.

NUX VOMICA. 483

Iii a case of poisoning, reported by Orfila, the patient experienced an intense pain and throbbing in the epigastric region, with dryness and heat of the skin, frequent pulse, redness of the edges of the tongue, extreme depression of spirits, prostration, alteration of the features. In this case, an examination after death revealed inflam- mation of the stomach, duodenum and upper portion of the ileum.

48G NUX VOMICA.

In the chronic form of this affection, with burning distress in the epigastrium, redness and soreness of the tongue, constipation, or small mucous stools with frequent urging, sallow complexion, loss of appetite, distention and pain after eating, we shall find nux indicated. For the dyspepsia and cardialgia of drunkards, or of inveterate coffee-drinkers, nux has been found a great remedy.

HEPATIC COLIC, hepatalgia, a colic characterized by the sud- den invasion of a most excruciating pain in the epigastrium and right hypochondrium, nausea and vomiting, spasmodic contractions of the abdominal muscles, coldness of the extremities, profuse cold perspiration. Jaundice may be present, although this is not neces- sarily a pathognomonic sign.

HEMORRHOIDAL COLIC, with horrid tearing, pressing pains in the small of the back and lower bowels, attended with flushes in the face, and consensual symptoms, such as sickness at the stomach, vomiting, rush of blood to the head, dizziness, headache.

SXJX VOMICA. 48?

MENSTRUAL COLIC, with contractive crampy pains in the lower bowels, followed by the occasional passages of bloody coagula from the vagina.

COLIC OF PREGNANT WOMEN, with griping, crampy sick- ening pain in the bowels, nausea, headache.

FLATULENT COLIC, as if the bowels, bladder, rectum were pressed upon with a cutting instrument.

SPASMODIC COLIC, the bowels feeling as if twisted together, sore, with obstinate constipation.

A man of fifty-eight years who had to lead a sedentary life, was attacked with the following symptoms in consequence of this change in his habits : bad digestion, cos- tiveness, flatulent distention, palpitation of the heart, dullness of the head, irritable temper. The attenuated nux afforded relief, but not entirely ; one drop of the strong tincture every night at bedtime, continued for a number of days, achieved a perfect cure.

Another man of fifty-one years who had to lead a sedentary life, had been com- plaining for a long time of uneasiness and irritability in the bowels. Nux18 and 24 was of no use ; a drop of the tincture every few hours afforded him marked relief.

A worker in metal, fifty-six years old, complained of a violent, painful pressure in the head, with distress in the stomach and bowels, coated tongue, anorexia, consti- pation. Repeated doses of the first attenuation of nux had no effect ; drop doses of the tincture every few hours cured him speedily and radically.

A man who had formerly been addicted to drinking, and was troubled with vomit- ing, pains in the bowels, arthritic pains in the joints, was speedily cured by taking one-twelfth of a grain of the powdered nux every two hours, without experiencing any sign of homoeopathic aggravation.

A carpenter, sixty years old, who had been addicted to abuse of brandy and cider, was attacked by weak eyes and vomiting. _ Nux12 and 18 stopped the vomiting, except when he ate meat ; the tongue remained coated and the other derangements of the digestive organs continued. He now took four times a day half a grain of pulverized nux, and was perfectly relieved without experiencing any medicinal symptom.

A lady who was affected with oppression of the stomach, costiveness and headache, took nux24 without any relief ; one-fourth of a grain of pulverized nux morning and night cured her perfectly.

Kopp states that he has cured hundreds of such cases of derange- ment of the digestive organs, whether resulting from piles, lead- poisoning or other causes, by means of the spirituous extract of nux, in doses of one-sixteenth, one-fourth, and even one-half of a grain, two or three times a day.

STRANGULATED HERNIA we give nux, if there is no inflam- mation, or very little of it; simple strangulation, nausea or even vomiting; if inflammation is present we give aconite or belladonna.

488 nux vomica.

DYSENTERIC DIARRHCEA.— Nux causes small discharges of mucus, with pressing, or even some tenesmus ; hence in dysenteric diarrhoea, where characteristic evacuations prevail, nux will be found a curative agent.

srux vomica. 489

Nux has cured diarrhoea with cutting pain in the lower bowels, shooting down the thighs. CHRONIC DIARRHCEA

CONSTIPATION. — Moderate doses of nux cause a torpor of the bowels ; hence homoeopathic physicians employ nux in constipation, when this condition is characterized by the following symptoms: Constipation as if the bowels were not sufficiently active ; — as if the bowels were constricted ; — with rush of blood to the head ; — with insufficient passage of feces — sensation as if more had to be expelled, which had been retained on account of the constriction of the rectum ; — connected with derangement of the liver, deficient secretion of bile through the ductus choledochus, (hence deficiency of peristaltic action, lumpy agglomeration and pale color of the fecal mass) ; — attended with a good deal of ineffectual and frequently repeated straining ; or caused by abuse of coffee, spirits, or arising from sedentary habits ; — arising from spinal irritation.

In the case of pregnant women who suffer from constipation, but are otherwise well, and in small children who labor under the latter difficulty without any breaking down of the general health, nux voni.3 and 6 acts curatively. (Schoven, Hygea, v., 201.)

When constipation exists as an independent disease, nux vomica is quite often indicated, especially so after the abuse of coffee.

A school-teacher, aged forty years, always inclined to constipation, has suffered from it so severely during the last six years, that he had constant resort to laxatives. Symptoms: appetite poor; the tongue is coated slightly; he eats very little at a meal; eructations of gas after each meal; sensation of fulness in the pit of the stomach, with painful pressure. About one hour after his meals, he experiences a shivering, followed by a flash of heat, which does not last long. In the afternoon he feels depressed, sometimes with light giddiness and heat of the head, indisposition to mental labor, a peculiar sensation of heaviness in lower abdomen diverting his atten- tion from his occupation.

The bowels move every five or six days, the use of an

490 NUX VOMICA.

PROCTALGIA. — We find that nux causes a sharp and painful pressure in the rectum after stool, or in the night, or at other periods ; hence in proctalgia, nux may be found useful.

FLUENT PILES. — Nux causes haemorrhage from the anus, pressing in the rectum, burning, stitching, and other symptoms such as are frequently present during an attack of piles ; hence in fluent piles, with pressing in the bowels, rigidity in the small of the back, headache, rush of blood to the head, nux may prove very useful.

In conclusion, let us not forget that nux affects the abdominal integuments and the liver. In. the abdominal muscles it causes a twitching, soreness, numbness and tingling, a sort of rheumatism of these integuments.

In the region of the liver nux causes the following symptoms : Throbbing pain in the region of the liver as from an ulcer ; fine, stinging pain in region of the liver ; creeping chills in the region of the liver.

NUX A'OMICA. •A'.JL

These symptoms justify the use of uux in liver-complaint, chronic hepatitis, induration of the liver, where similar symptoms exist.

CHRONIC JAUNDICE.— Nux has also this symptom: "Jaun- dice, with aversion to food and short fainting-turns ; afterward he feels weak and sick." This symptom tells us that in chronic jaun- dice mix may be available ; also in liver-complaint, if jaundice is a characteristic symptom.

URINARY GROUP.

In the case of poisoning related by Oilier, and quoted by Pereira, Ave were told that the urine had passed off involuntarily. For

INCONTINENCE OF URINE, mix has been administered with the best effect by eminent practitioners of both schools ; it may depend upon paralysis of the sphincters. For the

NOCTURNAL ENURESIS of children, nux has likewise been used with good effect.

DIABETES MELLITUS.— Another symptom which nux causes may, perhaps, lead to the use of nux in diabetes mellitus ; it is this symptom : " A pale-colored urine is emitted, followed by the dis- charge of a thick, whitish, puriform matter, attended with burning pain." Unfortunately, this secretion has not been subjected by Hahnemann to the action of appropriate reagents ; we are therefore unable to decide concerning the presence of saccharine matter in this secretion ; but in view of the remarkable action which nux has upon the functions of the liver, we may certainly feel justified in recommending nux in diabetes mellitus. In

PARALYTIC RETENTION OF URINE nux will be found available, more particularly if the torpor of the muscular fibres can be traced to irritation of the lower portions of the spine.

492 NUX VOMICA.

SEXUAL GKOUP.

Nux vomica acts very powerfully upon the sexual organs of both sexes.

On the other hand, the proviugs of nux distinctly show that it depresses the sexual energies ; for it causes, according to the record : " Nocturnal emissions without erections, followed by weakness and relaxation of the parts." It also causes : " Sudden relaxation of the parts during sexual intercourse, a state of impotence." It would seem therefore that nux may prove useful in

IMPOTENCE, where Trousseau and Pidoux have employed strychnia with success. Nux, or its alkaloid, is particularly useful in impotence caused by self-abuse, or abuse of spirits, coffee, or by sedentary habits and mental exertion.

SELF -ABUSE, involuntary emissions, impotence, involuntary discharge of prostatic fluid, perhaps with retraction and swelling of the testicle, may require nux vomica.

The action of nux upon the female organs of generation is like- wise indicative of its use in several abnormal conditions. We find that nux causes premature menstruation ; the menses are generally more scanty than usual and attended with cramps in the bowels.

The appearance of the menses is accompanied with other charac- teristic symptoms, such as : nausea, chilliness and fainting turns ; the chilliness may be succeeded by internal heat, dryness of the lips ; it is attended with a most distressing headache as though the eyes would be pressed out of their sockets.

NUX VOMICA. 493

rhcea. where the appearance of the menstrual blood is ushered in by such pains, and where the blood is expelled in the form of coagula, nux may be of eminent use.

These distresses, attendant upon premature menstruation, may likewise exist if the menses appear after the regular period. Nux may be of use even in this case ; for we see it stated that mix has actually retarded the appearance of the menstrual discharge.

MENORRHAGIA. — Again, the menstrual discharge may seem scanty, but it may be of too long duration, weakening, sickening : nux may correct this condition of things, which we might designate as a peculiar form of menorrhagia, a continual dribbling of the menses.

AMENORRHCEA. — Nux may prove of service in amenorrhoea, when depending upon irritation of the lower portion of the spine, or when accompanied by spasmodic rigidity of the uterine fibres. In such cases, the consensual symptoms of congestion of the gastric organs, of the head, nausea, violent frontal or general headache, with burning and swelling of the eyeballs, chilliness, and perhaps disten- tion of the abdomen, and dragging, bearing-down pains in the small of the back, may afford us important indications.

PROLAPSUS OF THE WOMB AND VAGINA.— Nux has also been used by homoeopathic physicians for prolapsus of the womb and vagina; it removes the sense of weight and bearing-down, which often gives rise to the suspicion- that prolapsus exists ; it is particularly efficacious if these symptoms occur among a group of uterine disorders to which nux is generally homoeopathic. It may, undoubtedly, be possessed of a power to restore the contractility of the relaxed ligaments.

LEUCORRHCEA. — -Nux has caused : " Swelling of the internal pudendum, with burning pain which rendered contact unpleasant." And likewise: "Discharge of yellow mucus from the vagina which sometimes has a bad smell." In accordance with these indications, we may recommend nux for leucorrhcea, a discharge of yellowish mucus from the vagina, with swelling and soreness of the internal lining membrane. A leucorrhoea of this kind may set in very copiously in place of the menses, or as a continuation of the men- strual discharge.

494 NUX VOMICA.

CATAEBHAL GEOUP.

CATARRHAL IRRITATION.— This drug has been employed by homoeopathic physicians in catarrhal irritation of the Schneide- rian membrane, with or without discharge from the nose ; or, with discharge of blood, tingling and. itching in the nose; also in

CHRONIC CATARRH, with discharge of foul blood and mucus, bad smell in the nose.

The provers of nux have recorded, as one of the effects of this drug, cough of a spasmodic nature, dry and hacking, causing a soreness in the throat-pit, or in the pit of the stomach ; also a cough as if the head would split, or a cough exciting vomiting.

Some homoeopathic physicians profess to have seen good effects from nux in the treatment of cough which seemed to be in sympa- thetic relation with certain gastric derangements. I have not been so fortunate ; nevertheless it is well not to overlook this statement.

We may, perhaps, be able, in some cases, to trace a catarrhal irri- tation of the lining membrane of. the lungs to some lingering derangement of the liver. Under these circumstances, the peculiar sallow or jaundiced appearance of the patient, and the soreness in the epigastrium and region of the liver, which may not be experi- enced by the patient until hard pressure is made in those parts, will undoubtedly determine our diagnosis.

In Bernhardt 's Journal a case is reported, illustrating in a very characteristic manner the connection between the lungs and liver, or, if you please, the dependence of a catarrhal irritation of the pulmonary lining membrane upon liver-complaint.

NUX VOMICA. 495

THOEACIC GROUP.

SPASMODIC ASTHMA— These effects of nux show most con- clusively that it must be useful in spasmodic asthma, if the muscles of the chest become rigid and hard during the attack, the patient is oppressed with anxiety as if he should suffocate, wheezing breath- ing, a cold sweat starting out upon his brow. The attack may seem to proceed from a deep-seated aching pain under the sternum, and, after the attack, the patient may complain of soreness under the sternum ; the soreness may be only felt along the breast-bone, or it may extend from the breast-bone laterally toward the shoulder. Copious vomiting of phlegm eases the paroxysm.

A young man, twenty years of age, the son of an oil manufacturer, thin and weak- ly, had been from his childhood subject to a spasmodic asthma, which used always to increase from the commencement of autumn until the depth of winter, and gradu- ally decline from that period until the mild weather in spring. Every year he had grown worse, and this autumn he hoped might be his last. Already the attack com- menced more violently than the last year at this time. The probable issue was evi- dent.

Last year, and for years past, every fall of the barometer, every south-west, and more particularly north wind, every approaching fall of snow, every gale of wind, had brought on an asthmatic paroxysm lasting hours and days; he would not unfre- quently pass the night with both hands grasping the table, exerting all his strength to draw the smallest quantity of breath, and every moment in dread of suffocation. The intervals between such fits were occupied by slighter attacks, brought on by a draught of air, the vapor from the heated oil-cakes, dust, a cold room, or smoke.

He told me of these symptoms with the utmost difficulty of utterance, elevating his shoulders to •draw a scanty breath, and this at a season of the year when his condition was as yet pretty tolerable. This case occurred in Hahnemann's practice at the beginning of his professional career as a homoeopathic reformer. The remedies which are usually recommended for asthma in allceopathic practice had been tried in vain, a medicine was procured which could produce anxiety and diminish the easy action of the bowels.

The choice fell on nux vomica. Four grains, given twice daily, removed gradually, but perceptibly, the constriction of the chest ; he remained free from the spasmodic asthmatic attacks, even in the worst autumn weather, even in winter, in all winds, all storms, all states of the barometer, all humidity of the atmosphere, during his now increased domestic, manufacturing and traveling business, in the midst of the oil vapor, and that without any important change in his diet, or any change in his place of abode.

He now slept comfortably at night, whereas formerly he had passed the whole night in an arm-chair, bent forward, or leaning against the wall, or coughing without intermission. During this season, which had threatened to be so dangerous to him, he gained strenght, agility, cheerfulness, and capacity of Tesisting inclement weather. He was eventually cured.

SPASM OF THE HEART.— Nux causes shocks and palpitation

496 NUX VOMICA.

of the heart. These symptoms may occur during a paroxysm of asthma, or in consequence of a peculiar idiopathic irritability of the heart, a sort of spasm of the heart, which may be excited by some sudden, violent, irritating emotion, anger, disappointment

FEVER GROUP.

INTERMITTENT FEVER mix may prove very efficient, es- pecially if the paroxysms set in every day, with chilliness followed by heat all over, flushed face, coated tongue, loss of appetite, weariness, dark urine, depositing a whitish cloud ; the thirst is only felt during the heat. During the fever the patient may complain of oppression on the chest, anxiety, palpitation of the heart, all of which symptoms are relieved as soon as the sweat breaks out; the sweat may have a strong and even fetid smell. In fevers of a typhoid character, nux is not indicated by its known effects. In

RHEUMATIC OR ARTHRITIC FEVERS of a chronic type, with gastric symptoms, loss of appetite, soreness of the flesh, costive- ness, weakness of the joints, oppression, chilly feeling at night, followed by heat and sweat, weakness and aching, laming pains in the back, nux may be a good remedy. The prevailing type or genius of disease, although assuming a variety of forms in different cases, may find in nux its most universal representative. The doctrine of a typical genius of disease may be of great use to us in practice.

In one epidemic it may be arsenic; in another nux, in another aconite or mercury. In epidemics of a rheumatic or arthritic character, nux may undoubtedly be one of the typical rep- resentatives or correspondences of the disease.

PUERPERAL FEVER, — Lilienthal advises the use of nux vomica when the following symptoms are present : Bruised sensation in the neck of the uterus; frequent desire to urinate, with pain; scalding and burning ; suppression or too profuse discharge of offensive lochia, with violent pains in the small of the back ; eonstipation ; nausea ; desire to vomit, or actual vomiting ; spasmodic pains in the

XUX VOMICA. 497

thighs and legs, with going to sleep in these parts ; red face ; dull headache and vertigo, dimness of vision, ringing in the ears, and fainting turns. We may add: Bruised sensation in the bowels upon being touched and from a jar ; bitter taste in the mouth : dry lips ; dry tongue, coated with a slimy, yellow coating ; burning heat and feeling of weight in the genitals ; constipation with burning- stitching pains in the rectum ; dry, parchment-like condition of the skin, with great desire for cold drinks ; especially suitable for ple- thoric women, with aggravation of all the symptoms in the morning.

EXAXTHEMATOUS GROUP.

PRURIGO, attended with irritation of the gastric organs to which nux seems homoeopathic, we may find this agent eminently useful. Pathologically the prurigo may be represented by a rash, fine, red little stigmata; we find this itching and burning rash described by some provers.

In Dierbach's work on materia medica and therapeutics the fol- lowing interesting case is described, where, under the action of nux, a remarkable eruption made its appearance.

A young man, aged twenty years, whose left arm was completely, and whose right arm was partially paralyzed, was put on the use of pills composed of equal parts of the extract and powder of nux, and weighing two grains each. Gradually increasing the dose, he finally took six pills morning and evening. On the twelfth day he was attacked with a raging pain and shuddering of the right arm, with violent redness and swelling of the limb, and breaking out of pushdes which seemed to form an almost confluent eruption, and gradually spread over the whole body.

The paralysis improved in proportion. Six days after the eruption had appeared, it dried up and fell off in large whitish scales. The patient continued his pills, and the eruption broke out a second time, preceded by rigidity of the limb. From sixteen pills daily he now came down to eight ; the sixteen pills had caused shocks and tetanic rigidity ; the eight pills caused heaviness of the tongue and a hurriedness in all his motions.

Gradually he only took one pill a day ; the eruption broke out twice more, but only in the shape of small vesicles, which dried up and left the patient perfectly cured.