Ears.- Stitches in the meatus affected by change of temperature a blocked sensation tenderness of cartilage of ear, cracking noises at every step and in cold air, roaring singing and other noises in head and intolerance of noise are the chief aural effects.
Vertigo occurs in the same provings as these ear symptoms, but not necessarily in closer connection with one another than with other symptoms. They are recorded at this point, however, for clinical reasons.
The giddiness is worse on rising from sitting or lying -even on raising the head with faintness on suddenly rising. The patient feels as if falling backwards or as if moving in a circle, or as though the object were reeling around him.
Glands.- The parotid glands share the effects of bryonia, becoming painful and tender and the breasts are still more markedly involved they may become tender, swollen and red, threatening abscess; the pain is worse on movement and deep breathing. The flow of milk may become diminished or suppressed.
The kidneys only appear top feel the effects of bryonia secondarily to febrile and other affections due to the drug.
Skin.- The same is to some extent true of the skin its yellow colour is probably of hepatic origin. Perspiration is easily excited by exertion, even in cold air; it may have a sour, oily odour; the contiguous folds of skin perspire and become irritated.
Fever without local inflammations may occur, beginning with chilliness of extremities, great thirst (lasting through all the stages of the attack) followed by dry, burning heat in face and generally, and towards morning,
The patients is drowsy, looks heavy, with dusky, “besotted” face, and objects to talking or being roused. In a few cases a persistent “lateral motion of the lower jaw” is noted as a characteristic-it is not chewing (Kent).
Sleep.-The bryonia patient tends to be restless and wakeful or wide-awake before midnight and (perhaps as a consequence) drowsy and yawning all day. His dreams are chiefly about his daily business or about domestic affairs.
THERAPEUTICS.
BRYONIA has a very wide clinical sphere and its used have been fairly outlined in the foregoing statement of its pathogenic powers. Reference based thereon will now be made to its employment in various named diseases or diseased conditions following the order already adopted.
(1) MUSCULAR AND FIBROUS TISSUES.-In the first place are general pains commonly described as rheumatic or gouty. even acute rheumatism is well within the sphere of influence of bryonia, and this condition is not only paralleled by the drug in its local features, it has the bryonia modalities concerning movement and heat in a most pronounced degree. These modalities will be referred to later. The fibro-muscular pains in chest, neck, and back have the same modalities and a similar origin; it may be a chill after being over heated, it may be an outbreak of acute symptoms on a chronic “rheumatic” or gouty condition, due perhaps to a gastro-intestinal disturbance or to influenza, or it may be due to an injury or overstrain.
The right side is more conspicuously affected than the left. When the lower extremities are involved weakness and unsteadiness are added to the pains. When the fibrous tissues are more involved than the muscular, going downstairs may be more trying than going up (as in rhus cases); when inflammation in the joints calls for bryonia, going up is more difficult.
Any of these symptoms may come on when the weather suddenly changes to hot after a spell of cold. After “taking cold” the symptoms take some hours to develop.
(2) THE DIGESTIVE SYSTEM.-Bryonia is useful in “dyspepsia,” due to gastric catarrh : in congestion of the liver and hepatitis, in gastralgia, in gastro-enteritis and diarrhoea, even with dysenteric symptoms, and in constipation. Heartburn, nausea, vomiting, eructations or hiccough are common bryonia symptoms. The stomachic discomfort is compared to a weight or a lump or stone in the epigastric region. Nux vomica and pulsatilla both have a similar symptom. A bad taste in the mouth is another symptom common to the three remedies. In bryonia cases the taste is mostly flat and insipid or sour; or it may be perverted and things taste different from their real flavour; with these again thirst for large quantities which give relief is experienced. In pulsatilla cases the disposition is less irritable, though the patient is sensitive to pain even if it may not be severe, and thirst is not conspicuous, even if there be a rise of temperature. Nux vomica and bryonia patients are worse in the mornings (though sometimes at 9 p.m. aggravation is found in a bryonia case) and pulsatilla cases are worse in the evenings. The state of the bowels also will often help in choosing between these there allied medicines.
Gastro-intestinal conditions brought on by eating oysters, vegetable salads dressed with vinegar, sour, unripe fruits, new bread, coffee, and by a chill after amenable to bryonia. The likes and dislikes as regards diet must receive attention as indications for the remedy; in such cases they are perverted in the sense that the patient is liable to crave for things which disagree and which he knows disagree and still craves, ex. gr., he may desire cold drinks, while warm fluids relieve and cold ones aggravate; or he craves acids which disagree. His desires are liable to change suddenly, and he may refuse things he thought he fancied.
In general, want of appetite and aggravation of symptoms from eating at all, from greasy dishes and rich foods, are bryonia characteristics, any of which may influence its choice.
When a gastro-duodenal catarrh extends up the common bile- duct, as after a so-called “bilious attack,” blocking the duct and causing temporary jaundice, with its usual accompaniments, no remedy is more useful than bryonia.
The liver may be more definitely involved by infection from the gall-bladder-cholecystitis and mild cholangitis with hepatic enlargement and tenderness, jaundice, pyrexia, headaches, sweats an delirium; all these conditions call for bryonia.
In this connection the constipation and diarrhoea caused by the drug should be mentioned. The usual habit of a bryonia patient is that of constipation with large, dry, hard stools, tending to be pale in colour, requiring an effort at expulsion, for which there is little spontaneous desire, and causing some degree of pain in passing, on account of hardness and size. If mucus is present it is passed separately after the solid evacuation.
The diarrhoea is only an occasional feature in bryonia cases (while the constipation is habitual); it is brought on by some irritant or by a chill; is liable to be urgent, especially in the morning; it may be a large, exhausting, loose stool, possibly with bile, mucus or even blood. In the latter event there may be colicky pain and straining, or the stool may be soft, unformed and very offensive; or with undigested portions of food. Here again the modalities must be carefully considered in choosing the remedy.
Headache.-Headache is present in so many bryonia patients that it deserves a special paragraph to describe its varieties and modalities.
(a) An intense headache with sharp, shooting pain, extending to the eyes, which are tender on moving them, is common with indigestion or hepatic cases. The scalp is tender to touch, to brushing the hair or pulling it; is greasy and has sour sweat during sleep. The pain is worse in a hot room and from movement, but is relieved by support or uniform tight bandaging and by cold bathing.
(b) a neuralgic headache, often unilateral, affecting chiefly the left side, is another variety. The pain is superficial, runs in lines, possibly following nerve distribution, and is relieved by warm applications.
(c) a dull, throbbing headache, more or less general, increasing to a bursting feeling, as if the head would burst- especially frontal, the whole head feels hot, the face is flushed and heavy, the patient is drowsy and resents disturbance. This variety is commoner at the onset of a febrile illness.
Any of the varieties is worse from stooping, movement aggravates the first and third kinds, and so does heat.
(3) RESPIRATORY SYSTEM.- The area affected by bryonia has been dealt with under the section of Pathogenesis. Therapeutically it is useful in the results of a common cold “travelling down” into the trachea and bronchi. The raw, tearing pain in the windpipe, felt on coughing, when it may amount to severe pain reflexly bringing tears to the eyes, which is experienced in some of these chest colds, is an indication for bryonia, which quickly brings relief.
Muscular pains in the chest wall-pleurodynia-are removed by the drug, whether they are part of a “cold on the chest” or occurring independently.
True pleurisy also finds its appropriate remedy in bryonia, both in the early stage, when the shallow breathing and sharp pains relieved by lying on the affected side are conspicuous, or later, when effusion (serous) has taken place. It is not likely to be a chief remedy in empyema unless the characteristic modalities of the drug are present. Bryonia is a sheet anchor in lobar pneumonia, especially for the typical pneumococcal variety. The power of the drug to inflame lung tissue is clearly manifest in the poisonings. Its irritating effects on the liver, serous membranes and synovial membranes have been utilized in the therapeutics of the liver, of pleurisy, and of peritonitis its symptomatology justifies the use of bryonia, as do the clinical results. Here, as would be expected, aggravation from pressure is conspicuous. It has also been a prominent drug in the medicinal treatment of appendicitis where operation did not seem called for or where it was not easy to obtain.
Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,