ALTHOUGH this drug has only been imperfectly proved, it is a very useful one. Our use of Ornithogalum is restricted entirely to pyloric ulcers and gastric or pyloric carcinomas.
There are certain characteristic symptoms which help one to prescribe it. Unless these are present the drug has very little effect. I have seen it prescribed in a haphazard way for pyloric carcinoma with no benefit at all, and I have seen it prescribed with very great benefit. On the one hand it was prescribed simply on the pathology of the case, and on the other it was prescribed on the pathology plus the distinguishing symptoms.
There are certain symptoms connected with this drug which are purely pathological. For instance, a feeling of extreme pressure, distension in the epigastrium described as a horrible feeling as if the whole upper abdomen or lower part of the chest were completely full up; very often a foul taste in the mouth, and severe constipation. On examination, you often find that the abdomen is definitely enlarged, frequently with obvious enlargement of the superficial veins, and a very much enlarged liver.
The individualising symptoms of Ornithogalum are several. There are very characteristic pains, described as a feeling as if an attempt were being made to force something through a narrow passage in the stomach, the pyloric region or the chest. These pains seem to spread all over the body : they spread right down into the hands, into the arms and through to the back, particularly just between the shoulders. The pains tend to be very much worse at night. They are slightly relieved by warm foods, and are aggravated by cold drinks.
In the early stages, where the lesion is pyloric, the patients are relieved by food. Unfortunately the indications for Ornithogalum in these early cases are apt to be missed, or the patients do not seek advice until this early stage is passed. So far as I know, there is no record of any definite food likes or dislikes.
There is a horrid feeling of restlessness-the patients say they cannot keep still-and this feeling is associated with a very unpleasant, creepy feeling in the legs. There is also a marked tendency in Ornithogalum cases towards the early development of oedema of the lower limbs.
They get another peculiar sensation, as if the stomach were full of water-just as if there were a loose bag of water which tended to drag to either side when they turned over. Mechanically, it is the kind of symptom you would expect from their pyloric obstruction and resultant dilated stomach. It is a very marked symptom in Ornithogalum, and is sometimes very useful.
These patients are always bringing up a quantity of offensive gas, but this dose not appreciably relieve their feeling of distension.
With the sensation that something is being forced through in the pyloric region, the patients often complain that they feel as if they swell up into little hard lumps in various parts of the epigastrium or throughout the abdomen; and they very often feel as if, after a gurgle, this little lump begins to subside again.
Not infrequently they feel extremely chilly before the attacks of pain develop, or just as the pain is beginning to become acute.
Not unnaturally in this state, the patients are usually extremely depressed and may be actually suicidal. They have much the same restlessness as Arsenicum, but without the Arsenicum fear.
There are two further points. One is that Ornithogalum patients, with their carcinomatous lesion, tend to have a very clean red tongue with a coated base, The other is that, with their feeling of abdominal distension, they get a strange sensation of pressure throughout the whole body, which is described as feeling as if all their nerves were in a state of tension.
It is allied to the tingling, distressing sensation they get in their legs associated with oedema, but they get it in areas where there is no oedema at all; it is very much the feeling of fullness that they may get anywhere. As the condition progresses they get nausea and vomiting. The vomit will be typical of gastric or pyloric carcinoma, either mucus or mucus and blood.
One should look critically at the mode of administration of Ornithogalum. Those who have used it most are insistent that it should be given in unit doses of the tincture. In the majority of cases which I have seen treated by Ornithogalum, unit doses of the tincture have been employed. However, I have seen two cases of undoubted carcinoma which responded rather better to single doses of a 200 potency than any case that I have seen on unit doses of the tincture.
These two cases had very obvious Ornithogalum general symptoms as well as the local ones. The unit dose of the tincture has been so strongly recommended because the medicine has been given mainly on pathological grounds, without much attention being paid to the general symptoms; and Ornithogalum does seem to have a specific effect on pyloric growths.
Ornithogalum is a very useful drug and one which we cannot afford to forget. At worst, the e most hopeless, inoperable cases can be made comfortable under its action, even though it may not prove curative. But there are numerous records of its curative action and I have myself seen several cases make a complete recovery after its administration where the outlook appeared to be absolutely hopeless.