IT is very difficult to give a coherent story of the uses of Plumbum because it seems to fit such different conditions.
Plumbum is occasionally indicated in infancy. The child is wasted and shrivelled-looking, with a very large abdomen and obstinate constipation, and a history of violent attacks of abdominal colic which make him double up. The infant has a very offensive odour, sweaty skin, cold hands and feet, a very coated tongue and, in addition to the abdominal colic, is liable to attacks of cramp or generalised spasms. He has no appetite at all, and refuses any food or drink.
There is another-Plumbum type at the other end of life: a patient who has had a cerebral haemorrhage, a flaccid paralysis of one or other side and is suffering from the most obstinate constipation-particularly if the constipation is associated with abdominal colic. In these cases, there is the slow mentality of the post-apoplectic, a general mild depression and faulty memory.
Instead of the general abdominal distension of the infant, there is much more likely to be a somewhat retracted abdomen; and the complaint of feeling as if the abdomen were being pulled in. They get sudden attacks of violent colic, in which the pains are rather better from pressure and eructation of wind.
It is not only at the two extremes of life that one gets indications for Plumbum. There may be indications for Plumbum in the chlorosis of late adolescence where it is associated with obstinate constipation, a generalised milk anaemia, a very sallow, somewhat greasy skin and complete loss of appetite.
There will be, in addition, the peculiar Plumbum mental picture of sluggish mentality, with poor memory, frightfully slow mental reaction and-in spite of the general mental sluggishness- history that the patients find difficulty in sleeping.
In these cases, the patients may suffer from a somewhat chronic gastric catarrh. There is a feeling of nausea, a complaint that everything seems to turn sour; and the vomiting of quantities of sour material. In spite of everything turning sour, they sometimes complain of a very troublesome sweetish taste in the mouth. They are liable to violent attacks of hiccough. Frequently they have a very dry, red, glazed-looking tongue.
These cases suffer from obstinate constipation, often accompanied by an acute spasms about the anus on any attempt at defecation and a feeling as if the anus were being pulled right up into the rectum. Associated with the constipation, they often complain of very severe pain in cecal region. They are liable to suffer from acute headaches with the constipation; and complain that the effort to get the bowels to act is so extreme that they are completely exhausted by it.
With the constipation and chlorosis, these patients very frequently suffer from crops of boils.
Plumbum chlorotic adolescents are always neurasthenics and they are very liable to sham all sorts of illnesses which they have not got, particularly ailments associated with some kind of paretic symptoms. They say they feel almost paralysed, or they cannot use an arm or a leg-and they sham beautifully until they think there is no one watching them.
These neurotic patients often give a history of attacks of difficulty in swallowing, as if there were a spasm of oesophagus which made them choke.
These patients are very often troubled with cold, sweaty, very offensive feet. They complain that the skin of the feet, particularly between the toes, is almost as if it had bee steeped in water and looks half macerated.
Plumbum patients are intensely chilly, particularly sensitive to damp and upsets by any exertion. They have one very peculiar symptom : the more they walk in the open air, the colder their legs and feet become. It is a symptom I have come across several times in these abdominal neurasthenics.
There are two other conditions which give indications for Plumbum. One is acute jaundice, in which there is a very dry, shrivelled appearance with the typical jaundiced skin; very constant, very marked, acute nausea and persistent vomiting. There is acute constipation and pretty acute pain in the liver which is very tender, to pressure; and the pain extends right through to the back, sometimes right over to the left side. The vomit is a green, bilious, mucous vomit.
These cases of jaundice have a heavily coated tongue, and there is liable to be generalised muscular cramps. For Plumbum to be indicated, there must also be the Plumbum mentality, the general sluggishness, depression and complete loathing of food or drink of any kind.
The other condition which may give indications for Plumbum is intestinal obstruction. As you would expect in these cases, the patients get most violent abdominal colic, a feeling as if everything were churning up and an acute spasm were trying to force it past the obstructions.
But the characteristic Plumbum sensation is a feeling as if everything were being drawn backwards up against the posterior abdominal wall, or a feeling as if there were acute retraction of the umbilicus, as if it were being tugged in.
There is complete obstruction-no action of the bowel at all- extreme nausea, the vomit first consisting of food-ordinary gastric contents-then becoming sour, bilious and, finally, faecal. All this is accompanied by very persistent hiccough, extreme sensitiveness of the abdomen to pressure-the slightest contact with the abdominal wall being painful-general cold, offensive sweat and typical loathing of anything taken by mouth.
Plumbum may be indicated in intestinal obstruction at any age. I have seen it indicated in children with strangulated hernia, in intussusception in infants and in intestinal obstruction from intestinal carcinoma. I remember one patient who had a carcinoma at the splenic flexure; she had typical indications for Plumbum, which stopped her spasms for months on end. She had no morphia at all, though before having Plumbum she had been having pretty heavy doses of morphia without any benefit-it was merely making her sick.
The strange thing was that at the post mortem she was found to have an almost complete obstruction even though, after Plumbum she had started to pass some faecal material; how it got through was a mystery but the obstruction was up in her splenic flexure where the contents are still pretty liquid.
With these inoperable conditions one can give enormous relief with homoeopathy by prescribing accurately on their symptoms. A very small dose of morphia will keep the patients quite comfortable if they are having homoeopathic treatment whereas, without it, they would be requiring half grains of morphia four hourly.
I remember a child in the children’s ward whom everyone believed had an intussusception. While he was waiting for the operation and to get him into a fit state, as he was very shocked, he was given three doses of Plumbum, and all his symptoms disappeared. He had had all the symptoms of intussusception and yet, after Plumbum, they simply disappeared. It may be that the Plumbum, relieving the spasm, allowed the intussusception to correct itself.
The boy was about two years old, and had been ill for three days. He was in a very collapsed condition, and was really only left to recover sufficiently to be fit for operation-instead of which he recovered altogether.