PULSATILLA is one of the typical flatulent dyspeptics. The patients get a feeling of general abdominal distention, they suffer from flatulence and very often have complete loss of appetite. They complain of a very dry mouth, sometimes with a bitter taste, and yet there is a complete absence of thirst.
They often say that they can taste their food hours after it is eaten -it seems not to digest at all-and when eating it feels as if the food stuck in the throat. This regurgitation, or taste, of food comes on about an hour or an hour and a half after a meal, and patients frequently say the food comes about halfway up the throat, sticks there and then goes back again.
In attacks of nausea and vomiting, they often complain of feeling horribly chilly. And yet, in any warm atmosphere, they get flushed and develop an acute sweat about the face and, in spite of their general chilliness, their nausea is made very much worse.
The eructation of Pulsatilla, when not tasting of food, is very often bitter or sour, and sometimes definitely fatty. The patients complain of the mouth feeling horribly slimy in the morning; and they suffer from acute heartburn, very often with a raw, scraped sensation in the throat and a burning sensation in the stomach. The burning sensation is very much aggravated by taking any warm food, and is temporarily relieved by cold fluids or cold food.
They tell you that when they are feeling most bloated, full up, they very often get relief from walking about gently in the open air. This also seems to relieve their sense of nausea.
These digestive upsets are always made worse by any rich food, particularly by any fat; and they are liable to get digestive upsets if they have been living too well. They not infrequently get a digestive upset-either in the way of abdominal cramp, sickness or diarrhoea-from taking very cold food, such as cream, particularly if they are overheated.
They develop a definite aversion to any fatty or greasy food; to meat, milk, bread, pastry and pork. And they very often have the oddest desires for all sorts of indigestible foods with a definite taste; for sour foods, highly-seasoned things or very juicy fruits.
They often have a longing for cakes and pastry, in spite of being upset by them. Although they have no thirst, they often have an acute craving for acid fluids. This tends to be particularly marked in association with the unpleasant slimy condition of the mouth in the morning.
The condition from which they are most likely to suffer is a definite gastric or gastro-intestinal catarrh. Occasionally with the intestinal catarrh, they get a mild attack of jaundice and attacks of acute diarrhoea. There is acute abdominal colic, which tends to centre about the umbilicus, and is associated with intense chilliness and a sensation of nausea.
Sometimes they actually vomit, but more commonly they get a very violent diarrhoea with a burning sensation in the bowel and the passage of a quantity of mucus in the stool. The stools are very loose and watery, the diarrhoea tends to be much worse at night, and it is always accompanied by a good deal of flatus. In colour, the stools tend to be greenish, but the mucous character is the constant factor. In appearance, the stools vary very much from one action to another.
These attacks are liable to be brought on from exposure to cold, from iced food or drinks, from too much fruit.
When the catarrh extends to the liver, these patients complain of a good deal of pain-heavy dragging pain-in the region of the liver; and the pain extends right through to the back, between the shoulders. There may be a mild degree of jaundice, in which case there is usually a heavily furred, white tongue.
With liver attacks, Pulsatilla patients often complain of acute giddiness on first rising.
With the digestive upsets, you have, of course, the Pulsatilla make-up-general sensitiveness to a stuffy atmosphere, intolerance of heat, generally mild depression, slight nervousness of being left alone, a tendency to get worse in the latter part of the day (as evening comes on, the patient may becomes rather terrified), wanting to have somebody about, and craving for sympathy.
You get indications for Pulsatilla with alternation of gouty pains-particularly, gouty attacks which seem to wander from one joint to another-with digestive upsets. That is to say, when the digestion is fairly good, the gout returns, and when the gouty pains are better their digestion is worse.
The gouty pains are rather better from moving about gently, much worse from heat, and wander from joint to joint. These, alternating with digestive upsets of the above character, quite frequently respond to Pulsatilla. The tendency is to give Kali bic. to most of them but very often Pulsatilla would be better.
In Pulsatilla you will come across cases of constipation which exhibit all the local symptoms which one associates with Nux vomica-the ineffectual urging to stool with the feeling that they never get properly cleared. When these symptoms occur in a warm-blooded, gentle, yielding, Pulsatilla type of patient, you will fail entirely to get a response from Nux vom; but, they will respond beautifully to Pulsatilla.