An evacuation is followed by little or no relief to the desire for stool. Such a dysenteric condition is said to be associated with uterine conditions and vesical symptoms which come naturally under consideration at this stage.
Genito-urinary Sphere.-There is frequent urging to urinate, day and night, not relieved by lying down, and followed by a sensation of oppression in the chest if the call is not responded to-this occurs in both sexes. Dysuria-burning and smarting-is often present, described as “like passing boiling oil”; or the pain may be chiefly after the flow of urine has ceased. The kidneys are not noticeably affected. The remedy has been recommended for mild cystitis.
The pelvic sexual organs in women have hitherto occupied the most prominent place in the pathogenesy and therapeutics of lilium. It is quite open to question whether they deserve it, and it seems probable that the symptoms have, at any rate, been misinterpreted.
“Bearing down,” the feeling that the pelvic and, in this case, the abdominal viscera would protrude at the vulva, is a marked symptom, and with it aching in the sacrum, up the back to the neck and through to the pubes may be present. It has been described (or interpreted) as a state of relaxation, a passive condition. In reality it is a forcing and it is not constant. Like the rectal tenesmus it is intermittent. The patient intermittently experiences the feeling that the abdominopelvic contents (“all her inside”) are being forcibly expelled right down to the vulval orifice, and that she must sit down and support herself with her hand or a bandage. It may not be relieved by lying down, as a passive prolapse would be. The feeling occurs with or quite independently of real prolapse or retropositions of the uterus, and with or without pelvic inflammation. One medical woman prover reported severe pain, interpreted as in her uterus, occurring in paroxysms of about an hour and passing off “without leaving any lameness.”
While the pain was present the prover could not bear to move or to be touched, or bear the weight of the bedclothes. the “anteversion” made so much of by old observers is the normal position of the uterus, so that the symptoms (quite real) were not due to mal-position of the uterus. The bearing down is not seldom associated with rectal tenesmus and is really a spasmodic (involuntary) muscular effort, described in one case as “like light labour pains.”
A sensation as of a foreign body in the rectum may be experienced, and if the fundus uteri retroposed and felt per rectum the sensation is put down to this.
the abdomen is distended, may be pendulous and there is a dragging feeling, relieved by support or by passing water. In addition to the bearing down, there are sharp pains, especially in the ovarian regions, or either side separately. The suprapubic region may be very sensitive to touch.
There is also a feeling of heat and fulness in the vagina with voluptuous itching, creating desire for intercourse and, if frequent, bringing sexual thoughts into undue prominence. Leucorrhoea, yellow or brownish and excoriating may be present or follow the irritation. A hyperaemic condition may accompany these symptoms, but in lilium cases they are more reflex and nervous than mechanical or inflammatory. Menstruation under lilium may be too early and accompanied by pain in the loins and small of back. The flow is usually dark, scanty, premature and offensive, and ceases on lying down.
The urinary symptoms are of the same type as the rectal, urging to micturate and to defecate, pyknuria, during the daytime, constant desire to pass urine with small result, burning in the urethra after.
These genito-urinary symptoms are mostly associated with palpitation, vertigo, pain about the heart, and are conspicuous about the menopause, but may occur during pregnancy or after parturition. In support of the view that they are not chiefly mechanical or inflammatory (though these states may co-exist) is the fact that the abdomino-pelvic bearing down, though worse at first on walking, returns more severely when the patient is at rest and compels walking again. Also it may alternate with the mental symptoms.
The sharp pains differentiate the case from a sepia condition. Most often they appear to be uterine and may be relieved by pressure of the hand on the hypogastrium. Sometimes the pains are located in the ovarian regions, if unilateral they are usually left-sided.
Ocular symptoms.-These symptoms have been utilized clinically in cases attributed to ciliary spasm or fatigue, aching pains from sewing or other close work, gradually increasing until the aching becomes constant. It is worse from light, especially if artificial, and is relieved by closing the eyes and gently pressing on the eyeballs. the lids look irritable and the edges are scurfy and they smart; lachrymation is inconvenient.
LEADING INDICATIONS.
(1) Hurried feeling, to accomplish duties to which the patient feels totally unequal; aimless hurry.
(2) Irritability if disturbed; hypercriticalness.
(3) Loss of memory; errors in speaking.
(4) Religious melancholy; indifference; weeping.
(5) Fears: Of being alone, of losing his or her reason, of having a mortal disease or of some other calamity.
(6) Intense sexual excitement, amounting almost to nymphomania.
(7) Forcible “bearing down,” as if body contents would be forced through the vaginal orifice, not relieved by lying down; associated with rectal and vesical straining.
(8) Similar rectal and vesical tenesmus in men.
(9) Palpitation, irregularity of heart’s action, with missed beats; spasms of pain about heart, like angina, as if heart were grasped.
(10) Pains in small spots, moving from place to place; pains chiefly left-side.
(11) Vaginismus, prolapsus, ovaritis, tenesmus.
(12) Diarrhoea (early morning); dysentery; dysuria, burning on micturition.
(13) Asthenopia, ocular pain relieved by pressure and closing eyes; photophobia.
AGGRAVATION:
In a warm room (faintness), at night (chest); after 5 p.m.; motion, especially in the evening (neuralgic pain in the head); lying on right side (weight in left side of chest), moving, on rising (diarrhoea, sacral pain, bearing down), after eating (chest).
AMELIORATION:
From fresh open air (headaches), sitting, or supporting vulva with hand (bearing down or prolapsus), lying left side, rubbing and pressure (angina).
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,