PULSATILLA is neglected in Neurasthenia of men. It causes sensation in the back as if, it was tightly bandaged a very characteristic symptom, which may be mistaken for the girdle of Myelitis. It means simply an irritation of the posterior nerves, not inflammation. There is, too, in the Pulsatilla case, a peculiar sensation, aptly compared to a sense of sub- cutaneous ulceration. It is a sort of smarting.
Accompanying the backache is a general fatigue with heavy, tired aching, not relieved by repose. The patient feels weary in the morning, vying with Nux. Such a condition of the nervous system may be produced by dyspepsia, or by excess in venery.
The general condition of the patient is one of relaxation, with poor blood, defective animal heat and diminished motility. Pulsatilla, in large doses, at first excites the heart and circulation and then weakens the cardiac walls and relaxes the veins. Engorgements and varicosities follow; and hence the patient, despite his chilliness, is oppressed in a warm room. Autopsies on poisoned animals showed hyperaemia of the spinal meninges not an active congestion but a passive fullness of lax vessels. Hence arise numbness, crawling, going to sleep of the limbs, feeble heart’s action, etc.
As a “venous remedy”, Pulsatilla is nearly related to Hamamelis -is a drug much abused by the laity and much neglected by the profession. It causes dull backache, weakness of the limbs, with going to sleep of various parts of the body., and great languor. Seminal emissions give rise to dull pains in the loins and increase the weariness. If there are present, enlarged veins or soreness in the course of the blood-vessels, the choice of Hamamelis is certain.
SEPIA is another drug resembling Pulsatilla. It relaxes the tissues and favours stasis. The patient complains of aching in the lumbar region. Sense of sub-cutaneous ulceration. Soreness and pain in the sacral region. Dull heavy aching from sacrum to thighs. Weakness in the small of the back. Limbs go to sleep. Numbness after manual labour (like Phosphorus). Sensation as if, drops came from the bladder after urinating. Atony of rectum or bladder, urging even for papescent stool; urine is tardy on beginning to flow.
And here we may mention Sulphur, which has caused Paraplegia from spinal congestion. It produces violent bruised pain in the small of the back, down to the coccyx; weakness; formication; legs weak, numb, paralytic. Sudden violent jerks of the limbs as the patient falls of to sleep-a symptom of organic spinal affections, but also present in so-called functional disease. Abdominal plethora, Haemorrhoids, etc., very much like Nux and Sepia.
But in pure nervous weakness, we may expect good results from such remedies as the following:-
DIOSCOREA, excellent when weak back and weak knees follows seminal loss. Calcarea follows well. And Cobalt is a good substitute if the backache is markedly worse while the patient is sitting.
NYMPHAEA ODORATA claims attention for weak lumbar region, with weak bladder and weak legs.
ZINC has backache worse when sitting and from long walks. Legs weak, trembling; hungry at 11 A.M. with increase of spinal weakness. Small of the back weak, while walking. Muscular twitchings. Wine increases the pains and the nervous weakness. Violent pain in the small of the back when walking, steadily relieved by continuing to walk. Drawing in the back.
Aesculus Glabra and Aesculus Hippocastanum,, both cause paralytic weakness. The latter induces hyperaemia, with numbness, Pricking, tingling, great sacro-lumbar pain; and especially a paralytic weakness of the symphyses, making locomotion difficult or impossible. It may be that the Aesculus patient must display also irritation of the mucous membranes, catarrh, gastric disturbances and symptoms of Piles. But nervous symptoms, in Dr. Burt’s provings at least, were the first to appear.
This symptom of the symphysis calls to mind a much profounder remedy that Aesculus. We refer to Argentum Nit. Silver Nitrate impresses the nervous system most profoundly. At first, it irritates the sensory nerves and increase reflex excitability somewhat like Strychnia; but soon paretic symptoms appear, characterized by vertigo, unsteady gait, trembling, headache, etc. His legs feel weak, as after a long journey. The legs jerk during sleep. Pains in the small of the back, relieved when standing or walking. The lumbar region feels rigid, as if, put on the stretch; paralytic heaviness. Sacral region so painful that blowing or sneezing makes him start. Backache or rising, but not on walking. Symphyses weak, loose, as if, they would give way.
Inco-ordination is present, even in non-tabetic cases. In a restless, nervous state, he fails to judge of distances, and dodges projecting signs. etc. This is due in part also to the dizziness, which is constant. He staggers in the dark or when the eyes are closed. He is depressed in mind, gloomy, even to thoughts of suicide. He suffers from dull frontal headache, with nausea, irritations and burning in the stomach, with great prostration and restlessness. The heart beats irregularly with a faint feeling in the praecordia. Emotions increase the palpitation.
In other cases, somewhat akin to those suggesting Silver, Arsenic is the remedy. We must not neglect Arsenic in neuroses. Its irritating effects are noticed in nervous, as well as in other tissues. There are loss of strength in the small of the back; pain, as if, bruised; aching. Starting of the limbs when falling asleep. Legs uneasy, he cannot lie still, reminding us of the fidgetiness of Zincum met. Legs weak. Feet feel fuzzy, numb and cold; distressing general weakness disproportionately severe. Arsenic affects especially the lower portion of the spine.
This fuzziness suggests another drug. Alumina. pain through the lower vertebra as from the thrust of a hot iron. Bruised pain. Legs heavy, he can scarcely drag them; when walking he staggers. Nates go to sleep while sitting. Tension in legs Numbness of the heel on stepping upon the foot. Heaviness of the feet. Soles pain, when stepping upon them as though they were soft and swollen.
Rectum inactive, as if, paralyzed. Urine passes when urging to stool a very unphysiological condition, but very characteristic of the remedy.
Boenninghausen cured several cases of undoubted Locomotor Ataxia with Aluminium. But the drug is also applicable to Neurasthenia. Dr. T.F. Allen records cures with Alumina, His patients were tired, drowsy, unconquerable disposition to lie down. Impaired co-ordination. Loss of contractile power of the bowel, with lack of secretion and tendency to rupture of the haemorrhoidal vessels. Weak bladder. Fulminatory pains. Sudden jerks and starts from sleep.
Cocculus Indicus causes paralytic pain in the small of the back, with spasmodic drawing across the hips, preventing walking. Knees sink under him from weakness. The soles of the feet go to sleep while he sits, with sticking as from pains. Attacks of paralytic weakness, with pains in the back.
There is in Cocculus a peculiar combination of convulsive irritability with paralytic weakness, eminently qualifying the remedy for Neurasthenia. Like Strychnine its active principle Picrotoxine, causes tetanic spasms. But respiration is accelerated by the latter, not from spasm of the respiratory muscles only, but by spasm of the glottis and there is not the same over-susceptibility to touch in the two poisons. In the Cocculus, spasms tend more directly to Paralysis than in Strychnine; and we observe a speedily developed relaxation of tissues as shown in the empty, gone feeling in all the splanchnic cavities.
We find Cocculus needed, then, when any loss of sleep, any drain on the mental powers, or any loss of fluids, leads to speedy nervous exhaustion, combined with irritability. Thus, though sleepy, he is so nervous and weak that he cannot calm his brain. Though very tired, he is too restless to keep still.
Gelsemium is a priceless boon, the introduction of which is mainly due to the provings made by Dr. J.C.Morgan.
It causes dull pain in the lumbar and sacral regions. Weak back. Loss of muscular control, ending, in complete motor Paralysis. Every little exertion causes fatigue of the legs, with muscular soreness. The patient is languid, listless and drowsy.
In protracted sleeplessness from nervous exhaustion, it disputes the honors with Cocculus.
The various preparations of Peruvian Bark, though almost universally abused, nevertheless, are of inestimable value in anaemia with spinal irritation or exhaustion. No remedy equals China in weak back from loss of animals fluids, especially in rapid or excessive loss. With the weakness are usually evidences of over-sensitiveness; excessive tenderness of the surfaces, making the least touch unendurable; senses morbidly acute; restless and fidgety despite the tiredness and exhaustion.
CHININUM ARSENICOSUM caused a pressure in the “solar plexus” (usually felt only after eating tough meat or hard nuts, of which, however, the prover had not eaten) extending to the back, where it changed to a pinching sensation: spine painfully sensitive to touch at this point. Heart as if, it had stopped; no perception of its beating. Legs weary.
