In women there is pressure towards the genitals, especially in the morning; the breathing down may be so severe as to cause prolapse, from spasm, not from relaxation, as with sepia. Menses are too early and profuse, the flow is dark, there are cramping pains with discharge of clots, the patient is over-sensitive to nervous impressions, and faints easily. Metrorrhagia may occur at the climaxis or as the result of too high living; also thick yellow leucorrhoea. Labour pains are spasmodic, and are accompanied by urging to stool or to urinate, they are felt mostly in the back and may be so violent as to cause fainting, but are at the same time inefficient. After-pains are violent and protracted, and the lochia are scanty and offensive.
The headaches of nux vomica are usually associated with digestive troubles, and are brought on by the same causes, viz., over-eating, alcohol, mental over-work and anxiety, and lack of sufficient exercise. The whole head feels full, congested, as if intoxicated, with dizziness, which occurs especially in the morning and after dinner. Headache occurs in the morning in bed, even before the eyes are opened, it may be felt in the forehead or in the occiput, and is a sore, bruised pain, as if the head had been beaten. This morning headache gradually disappears after rising. Another headache is a pressure on the vertex, as if the skull were being pressed as under, or as if something heavy were being pressed down into the head. The brain seems to shake when the patient walks in the open air. Constipation usually accompanies headache, and may be the cause of it. Head symptoms are worse from mental exertion, exercising in the open air, after food, from wine and coffee, better after rising in the morning in a warm room, lying down or sitting quietly. Headaches are accompanied with heat and redness of the face, which appears puffed, and nausea or vomiting (sick headache) are frequent concomitants. The scalp is sensitive to touch and to wind, and the patient likes to be warmly covered (sil.).
Eyes.-The margins of the eyelids itch and burn, the canthi are reddened and itch, rubbing relieves the itching, movements of the lids are hindered by stiffness of the muscles. Ecchymoses occur in the sclerotics. The retina is hyperaesthetic, giving rise to photophobia, and vision is cloudy and impaired. There may be paresis of the ocular muscles.
Ears.-Sounds reverberate in the ears, which are hypersensitive to noises, and there is itching in the ears and through the Eustachian tubes, which compels the patient to swallow.
Nose.-The sense of smell is too acute, and odours may even cause the patient to faint. There is an acrid discharge, while the nose feels obstructed. Coryza is dry at night and fluid by day, is worse in a warm room and better in cold air; there is frequent sneezing in the morning in bed.
Face.-The face, when there is headache or fever, feels hot, as if sitting before a hot fire; at other times it is pale, yellow, or florid, with a yellow ground, and yellow around the mouth, eyes and nose; this will be most apparent when there are liver or digestive troubles. Neuralgic pain in the infra-orbital branch of the trifacial nerve is typical of nux. The facial muscles twitch, and when the dose is large trismus occurs.
Respiration.-In the respiratory sphere nux vomica causes hoarseness and roughness in the larynx, which provokes a fatiguing dry cough that is worse after midnight and in the morning. Each cough excites a bruised pain in the abdominal walls and a shattering pain in the head, as if the skull would burst. The cough is worse from mental effort and physical exertion, after eating and drinking, lying on the back, cold, on awakening, from tobacco and alcohol, and is relieved by warm drinks. The chest feels oppressed, as by a heavy load, and breathing is tight, from spasmodic constriction of the lower part of the thorax.
Back and limbs.-In addition to the reflex spasms and the paralysis of muscles already mentioned, there is a bruised feeling in the limbs and joints, worse during motion, and various drawing and darting pains are experienced. The arms go to sleep, the legs become numb and dead, cramps occur in the calves and soles at night, the legs tremble when walking, and the fingers and toes become red, burn and itch, as if frozen. Drawing pains are felt in the back in bed, and are such that the patient cannot turn over without first lifting himself up with his hands to a sitting posture.
Sleep.-The patient is sleepy in the evening, goes to sleep till 3 or 4 a.m., when he wakes up full of ideas that keep him awake for some hours till he at last falls asleep again, and when aroused at the proper time feels headachy, cross and tired.
Chill, Fever, &c.-The nux vomica patient is a chilly person, dislikes cold, and wants to be in a warm room and well covered, he has difficulty in getting warm in bed night. He takes cold from the slightest draught of air, and exposure to cold winds will give him colic or neuralgia. With the nux fevers the chill begins in the back or extremities, the limbs ache, the nails finger tips and hands are blue, the patient yawns a great deal. To this stage succeeds long-lasting fever, in which, however hot the patient may be, he cannot bear to be uncovered, he cannot move or uncover in the least degree without shivering; there is a tendency to jaundice with fever. The sweat that follows is light, it relieves the pains in the limbs. A sour, offensive sweat occurs after midnight or in the morning. Heat and sweat are often intermingled. During the apyrexia there are gastric and bilious symptoms, and marked weakness, and the patient sweats easily at all times, on the slightest provocation.
Skin.-There are no marked skin symptoms caused by nux, but there may be burning itching all over the body, especially if there is jaundice, and ecchymoses and small boils may occur.
The mental symptoms of nux are a counterpart of the physical hypersensitiveness. The patient is extremely irritable, every harmless word offends; he can bear no opposition or interference; noise, smells, light and music are unbearable, and he is intolerant of the slightest pain or bodily ailment. With these mental states there is great disinclination to work and an inclination to hypochondriasis. Sometimes homicidal or suicidal impulses are present, but they are rarely put into effect, as the patient has no illusions, and is able to exercise self-control when he rouses himself.
THERAPEUTICS.
Nux vomica is one of the most frequently used medicines, not so much on account of its having a very wide range of action, but because the complaints for which it is indicated are so common. These are mainly disorders of the digestive system caused by improper food and faulty modes of living. The patients requiring nux are usually those of sedentary occupation-business men who have anxious and important matters to attend to and who do not take sufficient exercise or relaxation, men who are zealous and energetic, easily excited, nervous and unable to take things calmly. They become constipated and resort to purgatives, lose their appetite and try to stimulate it with strong-tasting rich foods or resort to alcohol. Indigestion, sleeplessness and headache are the result. Too great indulgence in wine and rich food, and also debauchery, will of themselves bring about the same condition. His ill-health affects the morale of the patient, and he may become hypochondriacal, unfit for work, even spiteful and malicious.
Digestion.-The indigestion takes the form of nausea, which is yet accompanied with a craving for food that when taken causes fulness and weight in the stomach, or a cramping pain there, with heartburn and sour eructations, and may end in vomiting, which will relieve. The tongue is covered with a white fur or has a dirty coating at the base, and there is a sour or bitter taste. The patient is often very hungry twenty-four hours or so before an attack of dyspepsia. Nux is a good remedy for the vomiting of drunkards and that of pregnancy. It is useful for gastralgia that is worse in the morning before breakfast, worse from food and better from warm drinks. It checks the excessive peristalsis and the vomiting resulting from obstruction of the pylorus. It is useful also in gastro-duodenal catarrh with the usual gastric symptoms and pain over the liver, which is enlarged and tender, and is associated with a yellowish hue of the skin and scanty high-coloured urine containing bile and depositing a brick-dust sediment. Nux has been of service in gall-stone colic, in flatulent colic of the intestines, in colic whether due to exposure to cold, indigestion or suppressed haemorrhoidal flow.
Constipation is nearly always present in the gastric disorders requiring nux, and is of the kind where there is frequent urging, which proves to be ineffectual, or a small motion is passed leaving behind a sensation that there is more to come. It is useful in dysentery when there are nausea, backache and much ineffectual straining with finally the passage of faeces, mucus and blood, which immediately relieves the tenesmus. Painful, blind haemorrhoids, accompanied with constipation, should be treated with nux. Hernia, especially on the left side, and when occurring in babies, is an indication for this remedy.
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,