THE typical Bryonia influenza develops, like the Gelsemium case, over a period of six to twelve hours. And the appearance of Bryonia patients is not unlike that of Gelsemium patients. They give the impression of being rather dull, heavy, slightly congested, with a rather puffy face.
Although they are definitely heavy-looking, they do not have the sleepy appearance that you find in Gelsemium, nor yet the besotted look of the Baptisia patient-something between the two.
Mentally, as stated, Gelsemium patients are dull, sleepy, heavy and do not want to be disturbed. Bryonia patients are also definitely dull and do not want to be disturbed-but if they are disturbed-but if they are disturbed they are irritable. Irritability is always cropping up in Bryonia patients. They do not want to speak, and do not want to be spoken to. They do not want to answer because speaking annoys them, not because they are too tired to do so.
As a rule, Bryonia influenzas are very depressed; they are despondent and not a little anxious as to what is happening to them they feel they are ill and are worried about their condition.
To their worry about their impending illness they add a very definite anxiety about their business. They talk about it; if they become more toxic, they are apt to dream about it, and it is an underlying throughout in the back of their minds thought their illness.
It is also typical of Bryonia influenzas that the patients are difficult to please. They are very liable to ask for something and refuse it when it comes. They want a drink and, when it comes, do not want it. Or, they may ask for a fruit juice drink and, when that comes, say they would much rather have had a drink of plain cold water they are very difficult to satisfy.
Typically, they have a good deal of generalised, aching pain. They will tell you that it hurts them to move, and yet, very often, Bryonia patients are constantly on the move. They are restless and uncomfortable, and move about in spite of the fact that the movement increases their pain.
Get hold of this fact very clearly, because it is so definitely laid down in text-books that Bryonia patients are aggravated by motion. Apparently it does hurt them, but they get into this restless state when they will not keep still.
When the patients are restless, find out whether it eases them or not. If it does not, they are probably Bryonia cases. If it does ease them, consider one of the other drugs-possibly Baptisia or one of the restless drugs, such as Rhus tox. It is a point that needs early clarification.
Bryonia patients feel hot, and are uncomfortable in a hot stuffy atmosphere; they like cool air about them. This can be linked with their thirst. They are always thirsty, and their desire is for cold drinks-large quantities of cold water-though, as mentioned above, they may ask for cold, sour things and then refuse them when they are brought.
As a rule, Bryonia patients sweat a fair amount, sometimes profusely, with a damp, hot sweat.
Although these patients are sensitive to a hot room, you occasionally find a Bryonia influenza with definite rheumatic pains-one or other joint becoming very painful-and who claims that the joint is relieved by hot applications. This is a local contradiction to the general heat aggravation.
There are one or two points which help in differentiation, in connection with local conditions.
There is a very typical Bryonia tongue. It is usually a thickly coated white tongue. The white coating is liable to become dirty in appearance, and may become brown if the disease condition has lasted long, particularly if there is much respiratory embarrassment and the patient is breathing through the mouth.
With that dry tongue, the patients complain, not unexpectedly, of an unpleasant taste in their mouths, very often of a bitter taste, accompanied by fairly intense thirst. As a rule, these patients have rather swollen, puffy, dry lips which tend to crack and may bleed very easily.
In the typical Bryonia throat there is the same sensation of extreme dryness, heat and burning. On examination, the tonsillar region and the back of the throat are usually found to be pretty deeply congested; the tonsils are liable to have small, usually white, spots. The throat also is unduly painful on swallowing, which is, of course, the ordinary Bryonia aggravation from movement.
All Bryonia influenzas have very intense headaches. Usually, the headache is intense, congestive and throbbing; the most common situation for it is in the forehead.
Patients often say they feel as if they have a lump in their foreheads, which is settling right down over their eyes. The pain modality or the headache is that it is very much relieved by pressure-firm pressure against the painful forehead affords great relief to the bryonia headache.
As one would expect, the headache is very much worse from any exertion-talking, stooping or movement or movement of any kind. It is worse if the patient is lying with the head low;the most comfortable position is semi-sitting up in bed, just half- propped up.
Definite neuralgic headaches are found sometimes in Bryonia influenzas: general neuralgic pains about the head, with extreme sensitiveness to touch. The whole surface of the the scalp seems to be irritated; and it may spread down into the face, on to the malar bones, again with extreme hyperaesthesia.
All Bryonia influenzas tend to more or less congestion of the eyes, which may go on to a definite conjunctivitis. The eyeballs themselves are sensitive to pressure; patients sometimes say that it hurts even to screw their eyes up-not an uncommon influenzal symptom.
As a rule, Bryonia patients do not have a very profuse nasal discharge. More commonly, they complain of feelings of intense burning and heat in the nose, or of fullness and congestion.
There is liable to be a very early extension of the catarrhal condition into the larynx, with a very irritating, tickling, burning sensation and very definite hoarseness- sometimes actual loss of voice. Also a feeling of rawness, and a very suffocative tight sensation rather lower than the larynx, with a very irritating bursting, explosive cough.
I have not observed much tendency to acute ear involvement in Bryonia cases. There is much more a feeling of blockage and stuffing-up of the ears, possibly a certain dullness of hearing, but little more than that.
Bryonia influenzas do not show any very marked tendency to extend into the digestive tract. There are, of course, Bryonia abdominal symptoms in other conditions, but I have never seen Bryonia indicated in an influenza with definite abdominal symptoms.
There is nearly always troublesome constipation, and a definite lack of appetite which, considering the state of the Bryonia mouth, is not surprising. There may be a certain amount of general abdominal discomfort, a feeling of heaviness-almost of solidity- in the epigastrium.
The patients do not want any food and, if pressed to eat, are very often more uncomfortable after it. But as a rule, I have not seen acute gastric disturbances associated with Bryonia influenzas. They are much more likely to have a chest disturbance, even a definite pneumonic attack, than a gastric attack.
Of course, if the patient does have a pneumonic attack, it will be the typical Bryonia pneumonia, with violent stabbing pains in the chest, a feeling of acute oppression, extreme pain on coughing, pain in the chest on movement with the desire to keep it as still as possible. But this is rather going beyond the uncomplicated influenzas.