ON NEURALGIA, iTS CAUSES AND ITS REMEDIES BY BURNETT
IN Germany, a number of years ago, I was one morning standing at the side of a celebrated professor of medicine, surrounded by a crowd of patients, watching his procedure, listening to his words of wisdom, and taking mental notes. One of the poor folk had pleurodynia, and seemed very particularly anxious to impress upon the professor the important fact that the pain was a neuralgia, and this he did so volubly and persistently that the professor finally retorted rather testily, “Of course your pain is a neuralgia; did you ever know a pain that was not a neuralgia? every pain is a neuralgia.”
And, equally of course, the professor was right in so far as pain is necessarily nerve pain. For the practical purposes of this little treatise I shall understand by neuralgia any sharp paroxysmal pain that, apparently, constitutes in itself the entire case, i.e., where there is no demonstrable pathological change or anatomical cause. I do not maintain that neuralgia is a strictly scientific term, in as much as I hold that every neuralgia has a positive pathology if we only knew it, for our not knowing the materies morbi does not get rid of its presence.
But what the word neuralgia lacks in scientific accuracy it fully makes up in practical utility, for nearly everybody knows what neuralgia is or is held to be. This being so, I will tarry no longer over the word, but plunge at once into my subject.
The authority I propose to follow is that of homoeopathic literature as well as my own experience where it has run on newer lines, and I will begin with the statement that Aconitum napellus is, probably, the most frequently indicated remedy in the scientific treatment of neuralgia.
This is as well known in homoeopathic practice as the fact that woollen socks tend to keep one’s feet warm. But some people who wear woollen socks have nevertheless cold feet, and in like manner a good many persons with neuralgia have taken Aconite and still kept their neuralgia. There is no such a thing as a panacea or specific for all sorts of neuralgia, a sure proof that there is neuralgia and neuralgia, or, in other words, every neuralgia has a pathology of its own. Aconite is most frequently indicated when the pain comes from a cold, rheumatism, or active congestion. Acidum hippuricum, however, runs it very close, and quite outs it when the neuralgia is primarily arthritic.
I am not sure but Sulphur comes next in rank to Aconite, and Dr. Cooper praises it very warmly in ague and malarial neuralgia.*(Sulphur as a Remedy for Neuralgia and Intermittent Fever, by Robert T. Cooper, M.D., 1869.) It is Hahnemann’s great antipsoric, and is also as such very frequently indicated.
A very reliable indication for Sulphur is, further, where the pain comes from the suppression of a psoric or diathesic eruption. A very striking case of neuralgia of the heart-angina pectoris neuralgica-was once cured by me with it. I am almost ashamed to use it again, as it has already served me more than once in print, but my excuse must be that I cannot afford to lose the lesson it teaches in the antipsoric treatment of neuralgia.
So I will trot it out once again :-
NEURALGIA OF THE HEART CURED BY SULPHUR.
In connection herewith one may remember the known neurotic origin of certain cutaneous affections.
One Sunday morning, some ten or twelve years ago, a gentleman ushered his wife into my consulting room because she had been taken with an attack of angina pectoris in the street, on her way to church. Though only a little over thirty years of age, if so much, she had been subject to these attacks of breast- pang of several years : they would take he suddenly in the street, nailing her, as it were, to the spot, and hence she no longer went out of doors alone, lest she should faint away or fall down dead, as was apprehended.
An examination of the heart revealed no organic lesion, or even functional derangement, and I could not quite see why a comparatively young lady should get such anginal attacks. She had been under able men for her angina, but it got no better, and no one could apparently understand it. I prescribed for her, and saw her subsequently at her home, to try and elucidate the mater. I let her tell me her whole health-history from her earliest childhood.
She said she was getting to the end of her teens, and was preparing to come out, but she had some cracks in the bends of her arms that were very unsightly; these cracks had troubled her from her earliest childhood. Erasmus Wilson was consulted; he gave her an ointment which very soon cured her skin, and the patient came out socially, made a hit right off, and got married in due course. She had always been very grateful to Erasmus Wilson for curing her arms, for otherwise, “How could I have appeared in short sleeves?”
But there soon followed dyspepsia, flatulence, dyspnoea, and palpitation, and finally the before described attacks of angina pectoris threatened to wreck her life. More over, she had borne one dead child. As I have already said, there was no discoverable cardiac lesion, and from the lady’s health-history I gathered that this cure of her skin (though to me the one important point) was of no causal importance.
I gave my opinion that her skin disease had never been really cured, only driven in by Wilson’s ointment, and that her angina was in reality its internal expression or metastasis. No one believed it, however. I began to treat her antipsorically, and very soon-I think it was less than a month from the Sunday morning visit-the old cracks reappeared in the bends of the elbows, and from that time on she had no further attacks of angina at all, and thenceforth she bore living children.
There is a small work on cutaneous affections written by me, entitled Diseases of the Skin from the Organismic Standpoint, in which I use this case to illustrate the constitutional nature of skin disease. And now, from the standpoint of neuralgia, the rapid cure of the pain stamps it fairly, I think, as neuralgic. In the language of the biopathology of Hahnemann, it speaks eloquently for the truth of psora, or at least for the practical clinical value of the general conceptior, call it a diathesis if you will.
It also aids me in teaching my readers this cardinal doctrine, viz., that we need a number of different remedies to cure the various species and genera (kinds) of neuralgia, and in the choice of the right remedies lies the art of its medicinal cure.
I should like, before we go any further, to point out the very important difference between curing a neuralgia from the bottom, which is the task of homoeopathy as shown in this small book, and stopping, deadening, lulling, or killing a neuralgia by means of allopathic medication, which is what nearly all the world believe in, and certainly nine doctors out of every ten practise it, fundamentally bad and harmful though it be.
The pain of neuralgia is not in itself the disease, but it is the voice of man’s sentients calling out for help; it is a telegraphic message from the within of the body sent along the nerves, and speaking at the outside at a spot, dolorously demanding assistance, perhaps telling of an approaching danger in the inward parts from the presence of an enemy lurking within; this pain-expressing voice which we call neuralgia is a telegram with painful news.
What does allopathy do with neuralgia? How does allopathy treat the faithful truth-telling neuralgic nerves?
Let us see. I will not be my own authority on the doings of my allopathic brother chips, but will rather go to their highest authorities, and see what their authoritative statements, as to the proper treatment of neuralgia, are; for instance for hemicrania (Eulenburg: Cyclopaedia of the Practice of Medicine, by Von Ziemssen, vol. xiv. p. 23), “Among the great number of remedies administered empirically, the preparations of iron, quinia, and caffein are by far the most popular, and certainly not without reason, although the universal (? Burnett) agreement in praising them seems to show that they have usually been adopted without clear views, or even with quite wrong views of their action.
The preparations of iron, especially the carbonate, so much praised by Hutchinson, Stokes, and others, are hardly specifics against migraine, but may serve to improve the constitution of anaemic and weakly persons who are victims of migraine as of other forms of neuralgia. In recommending quinia, as also such analogous remedies as quinoidin and berberin, the anti-periodic effects of the remedy have been chiefly regarded; and the tolerably regular recurrence of the attack leads one to hope for corresponding success with the remedy. But experience shows that the use of quinia, no matter in what form, does not ordinarily affect the regular periodicity of the attacks, especially when they occur at wide intervals, but that a considerable dose of quinia (from seven and a half to eighteen grains), given once or more often, may sometimes shorten an attack, or arrest it at once.”
Eulenburg then discusses caffein in a similar strain, mentions guarana, declaring it to be needless, because the guaranin is perfectly identical with caffein. He praises the efficacy of the aqueous extract of ergot, because it produces contractions of the bloodvessels, which it certainly does, but it also produces mortification and other direly diseased states. Nine to fourteen grains of ergotin a day is our author’s dose, which, in my judgment, is dangerous. He merely mentions strychnia, arsenic, nitrate of silver, sulphate of nickel, bromide of potassium, chloride of ammonium, oil of turpentine, and lupulin.
Finally, he speaks approvingly of the nitrite of amyl, and affirms that “the indication for its use depends on the fact that it possesses the powder of dilating the blood vessels,” which sounds rather oddly when one has just read on the previous page that the good effects of ergotin depend upon its powder to produce contractions of the blood-vessels. And we are asked to believe that this is scientific treatment of disease. That ergotin does contract the blood-vessels, and that the nitrite of amyl does dilate them, may indeed be granted.
That the use of these two therapeutic agents for the superficial symptomatic allopathic (palliative) treatment of pain is relatively to be considered I will not deny, but a really curative therapeusis it is not. If we add electricity, we have about exhausted the ordinary treatment of neuralgia and hence we cannot marvel that Eulenburg should, indeed, himself declare that he had never seen anything more than a palliation of the trouble.
Summed up, the entire treatment by the ordinary means is just palliative symptomatic treatment, and nothing else; and no directly and positively curative treatment is believed in at all, and is therefore not even attempted. We in homoeopathy can do very much better than that. We can often quite cure neuralgia, as I will show.
I ask again, What does the allopathic treatment amount to? I have already said that this pain-expressing voice of the organism, which we call neuralgia, is a telegram from the within with painful news. The allopathic treatment of neuralgia, as we have just shown by quotations from he highest allopathic authorities, amounts merely to this:- They either stun, stifle, maim, mutilate, or cut the telegraphic wires (the nerves), so that the painful news may not arrive, i.e., in true Oriental fashion, they kill the messenger because of the disagreeable message he brings. And what then?
The morbid process that was going on within goes on still, which the numerous sequential complaints often clearly demonstrate. It is irrational, shallow, harmful, damnable to deaden, lull, kill, or otherwise to silence a neuralgia by nerve sedatives, local pain-killers, lotions, hypodermic injections, or whatsoever else, and that indifferently, whether the medicos who do so swear by one pathy or another. The boast of orthodox medicine of the great benefits of their powerful sedatives is the philosophy of the silly bird, that hides its little head when its body is in danger. The only proper right and rational treatment of neuralgia is to go to work aetiologically and cure causally.
But is this possible? Yes, hypothetically it is, as my just cited case of neuralgia of the heart clearly proves; and when I say hypothetically,
I mean not problematically but actually, only the aetiology is based upon a sound working biopathological hypothesis, and not a palpable fact as gross and evident as a haystack.
The causes of neuralgia are very various and sometimes complex, and hence the remedies which we have to use will be correspondingly various, and for the complex cases several remedies will be needed. Of course, it is much more difficult really to cure a neuralgia in the way I am trying to make plain, than it is to whip out your little hypodermic syringe and inject morphia, or to take some pain-killing pills or drops of opium, laudanum, or chlorodyne.
A remedy very frequently required in the (hypothetically) causal treatment of neuralgia is Natrum muriaticum. There is published a small monograph written by me on this powerful remedy, entitled Natrum Muriaticum as Test of the Doctrine of Drug Dynamization, and from it I transcribe the following case of
Mrs -, at. 24, came under treatment in 1876, in the early months of pregnancy, with very severe neuralgia of the face. The case proved itself very obstinate, and many drugs were fruitlessly tried, but eventually it yielded to China given in the form of pilules saturated with the matrix tincture, which drug was chosen because of perspiration breaking out when the pain became very bad. The neuralgia constantly reappeared, and finally China ceased to have any effect. Then Populus tremuloides was given simply because of its being a congener of China, and did good-in fact, quite cured for the time.
This pregnancy passed, and my patient consulted me again, being again enceinte early in 1877, for the same kind of neuralgia, and this time its obstinacy nearly reduced her and her physician to despair.
The Case was treated in the old Hahnemannian fashion according to the totality of the symptoms, which were very few and apathognomonic, the neuralgia being always bad and always worse, and apparently not ameliorated by anything.
After many weeks of fruitless endeavours to cure this neuralgia with medicines chosen from the repertory, I turned to Guernsey’s Obstetrics (2nd edition), and found I had already tired all those given in his list at pp. 372, 373, 374, except two; these two I then fairly tried, and again failed. So my patient had received Aconite, Belladonna, Bryonia, Calcarea c., Cocculus, Cimicifuga, Coffea, Gelsemium, Gloninum, Ignat. mag. c., Nux v., Pulsatilla, Sepia, Spigelia, Sulphur, Veratrum a., China, Populus, and some others. Besides which she had applied, often in almost frantic despair, nearly every known anodyne, so that the soft parts of the face seemed almost macerated.
Here I suggested change of air (what should we poor practical physicians do without this ultimum refugium), but circumstances prevented her from leaving the place for more than a day or two; so she took little outings to sea-side places and inland, when it was observed that the neuralgia was worse at the sea-side and better inland.
A happy thought struck me, that this mighty be due to the salt in the air at the sea-side, and being, moreover, absolutely at the end of my tether, I acted on it, and gave Nat. mur. 30, one pilule very frequently.
The neuralgia at once began to get better, and in a day or two was quite well. It subsequently returned at intervals much less severely, but promptly yielded to the same remedy in the same dose. The 30th dilution was chosen simply because some pilules of this strength were in patient’s chest.
The patient was quite satisfied that the Nat. mur. 30 effected the cure, and so was I, and so will many others be; but, in a general way, the case will not carry conviction to unprepared minds, and still less so to prejudiced ones.
Hitherto I had had no great respect for Natrum muriaticum as a remedy; in fact, none whatever, having but rarely, if ever, prescribed it. Indeed, how can a sensible man believe that the common condiment salt, which we ingest almost at every meal, can possibly be of any curative value, especially as some are known to eat salt in considerable quantities every day, and that without any apparent deleterious effect.
Dr. Hughes, in his Pharmaco-dynamics, 2nd, ed., p. 411, says, “I really know nothing myself of the virtues of salt.” We find him now, however, a riper homoeopathic scholar, for in the 3rd edition of the same admirable work, p. 561, he gives an interesting case of defective nutrition, showing itself especially in emaciation, with dry and ill-coloured skin, accompanied with depression of spirits and suspected abdominal disease. Here a few occasional doses of Nat. mur. 30 changed the whole condition, and initiated a complete recovery.
This testimony is very valuable and especially gratifying to me, and, moreover, carries conviction to my mind. It is evident that Dr. Hughes unwillingly yielded to a belief in the doctrine of drug dynamization, and would have continued to “know nothing of the virtues of salt.
To believe in salt as a remedy is almost synonymous with believing in the doctrine of drug dynamization and a belief in this doctrine is extremely repulsive to one’s common sense. Perhaps the proper spirit would be gratitude to a beneficent Creator.
Worse at the sea-side has since proved itself a valuable indication for Natrum muriaticum with me.
In my little work called Fifty Reasons for being a Homoeopath, p. 53-4, may be found the following case of
and which is based on that just given.
Not many years ago, the daughter of a London alderman was suffering from fearful neuralgia of the face; at intervals she had it for years, and no trouble or expense had been spared in endeavouring to cure it.
Their ordinary family adviser was a homoeopath, but he had not managed to cure this neuralgia, notwithstanding several consultations with colleagues, and other men of eminence had been consulted, but to no avail.
I found that the pain was worse in cold weather; worse at the seaside; better away from the sea-inland, i.e., not so frequent or severe; and when the pain came on the eyes watered. A pinch of the sixth trituration of Natrum muriaticum, in water three times a day, cured my young patient in about three weeks. This anti-neuralgic action of Nat. mur. had the great advantage of being permanently curative, as the pain did not return, and patient herself continued otherwise well.
It may, nay it must, strike those whose practice is to give quinine and iron, or pain-lulling drugs, injections, or lotions, that this individualizing treatment of neuralgia is very tedious and laborious for the physician, and this I shall not deny, but I believe it to be by far the best and most rational.
Not a few cases of neuralgia that one meets with were originally caused by quinine, and then Sulphur, followed by Natrum muriaticum, will very frequently effect a cure.
QUININE has scored many successes in neuralgia, to which it, in not a few cases, is undoubtedly homoeopathic when very moderate doses are harmless as well as curative. To try to QUELL (quelling is not curing) all neuralgias with big doses of quinine is useless, harmful, and unscientific.
Ferrum-iron-besides being unquestionably a great blood medicine, is also useful in neuralgia, and in those cases of great debility where the urine is alkaline (Rademacher), the acetate in small material doses is facile princeps.
Probably few practitioners of experience will deny that we are living in an age of neurosin, where neuralgia is becoming more and more prevalent, and I am strongly of opinion that tea, coffee, tobacco, alcohol, wear and tear and worry, are essential causal factors. Some have advanced good grounds for believing that migraine, or hemicranial neuralgia, is mainly due to coffee.
Enteralgia, I know, is very frequently due to tea, and I have some grounds for believing that pig-meat (notably roast pork), shell-fish, and potatoes also contingently cause neuralgia.
In neuralgia of the walls of the chest, Ranunculus sceleratus renders good service, and in neuralgia of the heart, made worse by walking, Arsenicum, Juglans cinerea, Arnica, Bellis perennis, and Aurum are to be thought of.
Arsenicum has a wide and well deserved reputation in neuralgia, and is a great favourite with some practitioners. A patient of mine once went to the sea-side, where then practised Dr. Harmar Smith, now of Guildford. I had in vain treated the lady’s fearful ovarian neuralgia, bur Dr. Smith cured it very quickly with Arsenicum. This very day I saw in the Homoeopathic World that the same gentleman still cures neuralgia with this faithful antiperiodic. I will not quote the whole case, although it tallies with my own views, that neuralgias yield best to higher dilutions, but will just say that Dr. Harmar Smith was treating a case of acute gastrodynia that yielded to Arsenicum 12x trit. after the Liquor arsenicalis (F.), the 3rd trituration of Arsenicum, Trisnitrate of Bismuth 1x, and Apomorphia 3x, had all more or less failed. The one weak point in this case is that the after-history of the case is only of a few days’ duration. But neuralgia of all parts with arsenical symptoms has been so often cured dynamically by Arsenicum, that its antineuralgic reputation is firm, and needs no prop.