Catalepsy, etc.- Nux. and Ipecac. in alternation; later Aranea diadema.
A woman, 29, of healthy parents still living (the father 89, mother 75), has suffered from her youth according to her statement, on the slightest bodily exertion or mental emotion from palpitation of the heart. The only cause she could think of was that in her youth she was ascribed to hearing children’s tales. Physical examination revealed neither valvular nor other defects except rapid action ever during complete bodily rest; the pulse was 80.
Of children’s diseases she had whooping-cough and nothing else. The colour of her skin is brilliant white, the skin clear, having never presented any eruptions, hair dark brown, eyes blue, figure slender, form metrical. She had already given birth to three children without difficulty, but has suffered with an incessant headache since her last confinement, which was quite normal, and after
* The cases are given in v. Grauvogl’s own words which she nursed her child for two months, when she weaned it for lack of milk. All this happened six years before she came to see me. The headache occupied no definite place but extended from the forehead over to the occiput, only sometimes it was most severe on the vertex. This headache did not permit her to visit or receive visits from her most intimate friends even, because it was so greatly (<) by talking or hearing others talk that vomiting ensued; and to make the pain at all endurable she had to take to her bed, where she remained three or four days motionless and lying on her back.
Not unfrequently pain in the stomach set in which ceased of itself after the discharge of sour water rising in the throat with nausea, and also the eructations of tasteless gas, which was more frequently induced by the ingestion of vegetable acids or vegetables. Her appetite was good but not ravenous; she refused to eat meat, even the smell of it was repugnant to her. The menses, as indeed was indicated by the pain in the vertex, were irregular, scanty and pale, and were generally six to eight days too early. In the interval there was more or less leucorrhoea which was debilitating, and the accession of the menses was debiliting, and the accession of the menses was announced by a violent colic.
The respiration was unrestrained, but in the apex of the right lung there was dull respiratory murmur, in a small portion without any change of sound on percussion. She never had any cough and the digestion was regular.
To the above symptoms were added, since her last confinement also, cataleptic attacks, almost every morning, after waking from an uninterrupted, good, but not refreshing sleep. Thus, if her husband did not notice in the morning that she closed her eyes again shortly after waking, and at the same time sighed once deeply, and at this very moment did not at once shake her shoulders with both hands and call to her aloud, then nothing would arouse her from the motionless insensible condition lasting from one to two hours, in which one could raise her arms and legs in any direction without them returning to their former position. These attacks had come and still came and went without any known cause, but they left behind them no further ailment.
As regards the concomitant circumstances of these pains, I learned that they were much more violent in damp weather than in dry and, in fact, her general condition was(<) at such times, so that this woman, who was previously lively and joyful became more more melancholic. The many physicians who had been consulted, the many cures which had been tried for her, and especially, even aside from considering the influence of the weather, was most violent in the afternoon and evening; that consequently it increased in severity irregularly though periodically, which also pointed to an affection of the nervous system; that she constantly suffered from chilliness, hence the whole winter through was obliged to keep her room very warm, and even in summer she had cold hands and feet, not withstanding all her clothing and other means for keeping warm.
Whoever has read the foregoing will have no doubt that here we have before us a disease in a hydrogenoid constitution, which latter must be extirpated first of all, without regard to the organs affected or the other parts of the organism; for as long as the general conditions of a disease are not removed no thought can ever be logically entertained of the cure or improvement of its special form.
I often read in the Homoeopathic journals clinical cases of physicians whose treatment, contravening this logical principle, was followed by little good results, or less than that which really was obtainable; while, by virtue of the Law of Similarity other physicians again were led to the right indication, though this principle was unknown to them. This is, then, an involuntary logic of the Homoeopaths, as a counterpart to the involuntary Homoeopathy of the physiological school.
I know full well that, unhappily, few Homoeopathists trouble themselves about the physiological significance of remedies, but in the choice of these remedies they are all the more uncertain in as much as our drug-provings still require complements.
In brief, among all the remedies which might be indicated according to the law of similarity for the case, which certainly was not easily to be cured, there were mainly two of which I knew at once from many years practice, that they not only produce a more active interchange of substance, and hence would occasion more warmth in the body, and would occasion more warmth in the body, and would not only restore the lost power of resistance against the influences of cold and moisture, but would also have an enlivening effect on the nerves system. These two are Nux vomica and Ipecac. I have also observed that each of these remedies had far less effect in these directions when given by itself, alone, than whey they were permitted to operate on the organism in succession.
I therefore ordered Nux 3 to be taken at 7 or 8 a.m. and 6 p.m., and three or four drops of Ipecac. 3, every two hours during the day, although it was the fervent desire of this patient to be delivered as soon as possible, first of all and at any price, from the headache which tormented her without ceasing, for this was the most annoying of all her sufferings and hindered her in most of her duties.
Had I sought to confirm to this wish I should surely have had to select quite other remedies, and probably a long series of them in succession, and most probably too with no favourable result – or no result at all.
Hence I told the patient that I could not meet her wishes at once but on the other hand promised her with all assurance the complete restoration of her health and, within the space of a year at furthest, a deliverance from all her sufferings; adding that before her headache could be relieved she would first have to notice a greater sensation of warmth in her body.
Besides, I forbade her to take any baths for more than five minutes, and for the time being her accustomed washing in cold water; and also her remaining near water, especially standing water. I forbade her also coffee and, of course, vinegar, fruit and fish.
This was on the 1st of May. I visited the patient every eight days, having told her to take the remedies as directed for eight days, and so on.
On the 4th of June she stated that she really thought she was not so cold now even sit in the shade in the garden, a thing which had hither to been impossible to her. At the same time the cataleptic attacks had so diminished in intensity that she had often only a mere intimation of them. But headache and palpitation of the heart still unfitted her for all occupation.
The cataleptic attacks now happily had returned but seldom for several weeks (except the merest indication of them), and even the headaches were no longer aggravated in the evening, when, at the end of July, her children got measles one after the other. She would not entrust the care of them to anybody but was unspeakably happy that she could sustain the bodily exertions and mental excitements thereupon attendant, which a month before would have been utterly impracticable.
During the whole course of her children’s sickness I naturally intermitted the use of the Ipecac. and Nux vomica, and only gave her Aconite occasionally, as she was very much alarmed at the condition of one of the children whose disease had become very severe.
After this had all passed off without injury for the children as well as for the mother, the whole family went for eight days into the mountains of Bavaria. This agreed very well with all except the mother; for she took a sail upon a lake, which I had expressly forbidden, and after this day felt chilly and cold again, the headache also being notably aggravated.
As I had found in my practice that Aranea diadema even more than Nux. and I Ipec diminishes the influence of hydrogen upon the system, and since it was also indicated her to take four or five drops every two hours.