Kernel of Myristica officinalis. Nutmeg. N.O. Myristicaceae. Tincture made from the ground nuts with rectified spirit.
PATHOGENESIS.
THE symptoms of nux moschata, as collated from the provings and cases of poisoning, are purely of nervous origin and do not show any change in organic structure. The parts affected are chiefly the brain and the digestive and generative systems and these only as they are functionally disordered.
Mind.-There is a peculiar state produced, in which the mind is abnormal. There is a tendency to dual personality. For instance, in one case of poisoning from eating a nutmeg, a young man seemed afterwards, when playing the violin, to be two persons: one his real conscious self, who was watching his other self playing. Another prover felt as if he had two heads. In another “everything seemed too large, my hands double their size.” Thoughts cannot be controlled without a great effort, memory for recent events is in abeyance. Appreciation of time and distance is impaired so that minutes seem hours and near objects a long way off; “voices sounded far away, words spoken seemed as if spoken a long time before.” Dreams and reality contend in the patient`s mind and before answering a question he has to think a while laboriously to collect his thoughts. Or the power of thinking may be lost and the patient fall into a peculiar state of hallucination in which the dreams are mostly of an agreeable kind, he is inclined to be merry, to laugh and joke and to indulge in silly gesticulations. With these states of mind the head feels confused and heavy, as if intoxicated, and there is irresistible drowsiness, in which the eyes close but from which the patient can be easily roused, but only immediately to fall back into the same condition. He may lie with his eyes closed, conscious of everything that is going on but remembering nothing. Sometimes there is a sensation as if floating in the air.
Head.-Sensation of fulness in the head is accompanied with throbbing or shooting pains, felt especially in the temples; heat rises to the vertex with a feeling of pressure; pressing-out pains occur in the forehead, which seems to be twice its normal size. A prickling sensation, like an electric stream, flows through the head. When the head is shaken there is a sensation as if “the brain” struck against the skull. A throbbing pressing pain in a small spot above the left eye was felt by some provers. There is pain in the nape, which comes on when damp wind blows upon the patient; a related symptom is “head dropped forward with the chin resting on the breast, could be raised with difficulty, was obliged to support it with the hands because it seemed to be too bulky and to be rolling about.”
The throbbings and pulsations noticed in the head are not confined to that part, but are felt all over the body and often as a throbbing pain localized in a blood-vessel.
The eyes feel full and dry and as if stuck together so that they can hardly be opened. Sometimes there is lachrymation and in poisoning cases the pupils are widely dilated. There are deep blue semi-circles under the eyes. Paroxysms of momentary blindness occur. Objects seem to diminish in a size (a variant of appearing to be a long way off) while looking at them. In one prover objects in the left half of the field of vision appeared to be of a chocolate-brown colour.
Ears.-Hearing is too acute and stitching pains are felt in the left ear.
Face.-Contractive or pressive pains are felt in the cheeks in the neighbourhood of the maxillary joints, and on the chin are pustules with broad, red margins and stitching pains.
Digestion.-The symptoms of the alimentary tract are of nervous origin. The mouth feels sticky and full of thick saliva, which causes the teeth to feel blunted as if covered with lime. There is a taste of chalk. The lips and the whole oral cavity appear dry and the tongue seems to be like leather and to cleave to the roof of the mouth. The teeth aches as if cold air is drawn into the mouth, and a shock to the body generally will cause pain in the teeth. Notwithstanding the sensation of dryness of mouth and tongue there is rarely any thirst, though this is sometimes present. It is difficult to move the dry, stiff tongue and speech is embarrassed. The throat also is dry, and swallowing may be impossible from paresis of the muscles of deglutition. There is pain along the Eustachian tube, as from a foreign body lodged there, worse before a shower. Appetite is usually increased, nausea, waterbrash and hiccough occur with burning and cramps in the stomach and a fulness which presses on the diaphragm and impedes breathing. Inspiration causes pain along the attachments of the diaphragm with the accompanying sensation that the lungs cannot be filled. There is a feel in of weight and swelling in the liver region and stitches in the spleen. The abdomen is often enormously distended with flatus, cutting and pinching pains are felt in the umbilical region and are worse after eating and drinking. Diarrhoea may follow, but the characteristics symptom is much forcing down towards the rectum and a sensation that a stool will come, but its passage is long delayed and when, finally, after great pressing and straining it is evacuated, it is soft, undigested, slimy and in some cases putrid and bloody. Stools are exhausting, associated with sleepiness and often with fainting. There is a sensation after stool that some portion of it remains behind in the rectum.
Urine.-There is frequent micturition of pale, clear urine in small quantities, with urging similar to that felt in the rectum which it often accompanies.
Sexual.-There is an inclination to coitus though the genitals are relaxed. In women the pelvic viscera are very irritable, especially during menstruation, when the ovaries and uterus feel swollen and are sensitive to touch or pressure. The menses are irregular in time and quantity but usually are too late, scanty, dark and thick, with bearing-down in the abdomen and an aching pain in the small of the back which extends down to the thighs. The lumbo-sacral pain has been described “as if a piece of wood were lying crosswise and being pushed out.” Hysterical laughter and fainting are common concomitants of the menses.
Respiration.-The larynx feels dry and rough, causing hoarseness, and there is a sensation as if something constricted the throat and prevented speech. The chest feels oppressed over the front, especially over the sternum, and there is a sensation of pressure and weight round the attachments of the diaphragm; dyspnoea accompanies this sensation; also there are jerking and shooting pains in the chest, which take away the breath. Dark coagulated blood may be expectorated.
Circulation.-The pulse is quickened and intermittent or it may be slowed with extraordinary long intervals between the pulsations. The blood seems to rush to the heart, then to the head, then all over the body, and back to the heart again. The heart feels quiver to, palpitates violently, or there is a sensation as if it were grasped, associated with sharp, cutting pain; or there is a numb, cold feeling as if it dripped cold drops of water. The blood-vessels all over the body seem to throb.
Sleep.-There is great sleepiness day and night, but at night sleep may be restless and disturbed by dreams of sexual excitement, of being pursed or of falling from high places.
Back and Limbs.-Intermittent, wandering, digging or pressive pains, which come always on small areas as, ex.gr., in the bones, on the forehead, eyebrows, upper arms and tibiae, are characteristics of nux moschata. Shooting and tearing pains in the limbs are common. The sacrum is painful, as if broken, worse at rest, and the shin bone feels as if smashed. The legs are restless though weary. Numbness occur in the limbs, especially the hands, or the hands feel frozen and there is a sensation of thrill in the finger tips and under the nails. The patient feels very weak and fatigued, staggers in walking and feels he must lie down after the least exertion.
Chill and Fever.-He is usually chilly, the skin is cold and dry and very sensitive to cold air. He is easily chilled by cold and damp. Occasionally there are slight rigors followed by heat; rigors start especially in the sacrum when it is exposed to cold air. Sensations of coldness and faintness, with a fear that ability to breathe was being lost, were felt for a whole year afterwards by one of those poisoned by nux moschata. Sensations like electric shocks are sometimes felt all over on movement.
Skin.-Nux moschata has long been a popular remedy for boils, and many of the recorded cases of poisoning by it were the result of taking too much of the nut. Neither poisonings nor provings show that it produces show that it produces boils but only blue spots or a bluish mottling of the skin, but it has a reputation for these troubles where the constitutional symptoms are present.
THERAPEUTICS.
Mental.-It will be seen from the above symptoms, which are nervous in origin and occur without any organic lesion, how suitable a medicine nux moschata is for the protean manifestations that go by the name of hysteria, but in this case, as in all others where homoeopathic treatment is concerned, the symptoms of drug and disease must correspond, the name itself is of no value and, indeed, is of doubtful import and often used to conceal our ignorance of the true nature of the disease. However, the name hysteria is serviceable in presenting to the mind and body that is fairly well understood and is used here in this rather vague way.
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,