Nux vomica [Nux-v]
Is a remedy influencing both in glandular secretion and muscular tone of the digestive organs. Among causes of dyspepsia are mental overwork, sedentary occupations, high living and dissipation, and these are all keynote symptoms of **Nux vomica.
This drug will be thought of when the patient is “cranky” and irascible, when he is drowsy and stupid in the evening, feels miserable in the morning and has a dull frontal headache. This headache is a constant element in Nux disease. With **Nux the food and drink taste normal, and the gastric and abdominal disturbances do not commence immediately after eating as under **Lycopodium and Nux moschata, but come on half an hour or so after meals, especially the dinner. There is often nausea, empty retching, scanty, sour or bilious vomiting, water brash, sour, bitter, metallic or putrid taste, and there is vertigo. All these symptoms are aggravated in the morning, and there is also an after dinner aggravation. Headache usually attends the gastric disturbances of **Nux. In the flatulent and pituitous dyspepsia of drunkards **Nux usually precedes **Carbo vegetabilis and Sulphur. **Kali bichromicum is more often indicated in the dyspepsia of beer drinkers. It is well indicated in dyspepsia when there is a feeling as if digestion had stopped after a meal eaten with relish and the food lies like a load; the distress comes sooner than the with **Nux vomica.
The appetite is impaired, the patient does not want even his accustomed stimuli, or there may be an abnormal hunger, and this abnormal hunger usually precedes an attack of dyspepsia, which attack may sometimes be avoided by attention to diet as soon as this symptom of abnormal hunger appears, which it usually does some twenty-four to thirty-six hours previous. This is a symptom of a misused stomach. The eructations of **Nux are painful, bitter or sour. The nausea is especially after a meal. The stomach is sensitive to pressure and to tight clothing, and the patient will say:”If I could only vomit I would feel much better.” In the distress after eating we must compare **Nux with Abies nigra, which has a pain coming on immediately after eating, and with **Kreosote, which has the symptom that three or four hours after eating the patient vomits. **Nux has also gastric irritability with pains radiating in various directions from the epigastrium which are worse in the morning. **Bismuth has burning and lancinating pains of a purely nervous character, a pure gastralgia, with spasmodic vomiting. **Nux has an abnormal thirst, and there is distension even after a light meal and a very characteristic sensation of a lump or a load in the stomach. This oppresses the brain and soon develops flatulence.
**Mercurius has a deathly faintness at the pit of the stomach.
**Calcarea carbonica has a tenderness at the pit of the stomach.
**Lycopodium has a pain in the pit of the stomach when the hypochondria are pressed and a pain in the hypochondria when the pit of the stomach is pressed; there is fullness even after a light meal, but **Lycopodium does not have the intestinal irritability of **Nux.
**Sepia, Sulphur and Natrum carbonicum have an all gone sensation at the pit of the stomach worse at 11 A.M. The pains of **Arsenicum are burning and the dyspepsia of **Pulsatilla is especially after rich and fat food. Waterbrash is more characteristic of **Nux vomica, while heartburn is more characteristic of **Pulsatilla. Atonic dyspepsia with a putrid taste in the mouth in the morning compelling the patient to rinse out the mouth, with a desire for beer and bitters, and an aversion to coffee will strongly indicate **Nux vomica, and when **Nux fails to act perhaps the best remedy is **Carbo vegetabilis. The tongue of **Nux is coated, white usually, and this coating is more on the posterior part; the front half of the tongue may be clean.
Dr. Dyce Brown finds that when the gastric symptoms are prominent the lower dilutions act better, but if constipation be present the higher ones are to be preferred. It acts better when given in the evening.
Carbo vegetabilis. [Carb-v]
This is a putrid remedy, and will be found most useful in the putrid variety of dyspepsia. **Carbo is putrid and **Sulphuric acid is sour. When **carbo is indicated the patient will be below par, the digestion will be slow and imperfect, there will be a weight in the stomach and intestines and a faint, gone sensation in the stomach not relieved by eating, but after a few mouthfuls there is a sense of repletion. There is a ***burning in the stomach extending to the back and along the spine to the interscapular region. There is great distension of the stomach and bowels, which is temporarily relieved by belching. The flatulence of **Carbo vegetabilis is more in the stomach, and that of **Lycopodium more in the intestines. The eructations are rancid, sour or putrid. There is heaviness, fullness and sleepiness after eating, but not so much as in **Nux moschata and Lycopodium. The symptoms are worse from fat, fish, oysters, ice cream, vinegar or cabbage. Coffee disagrees, and milk increases the flatulence. There is violent ***burning in the stomach, chest and abdomen, with paroxysmal and crampy pains which force the patient to bend double; the stomach feels heavy.
**Carbo is a valuable remedy in chronic gastric catarrh and condition based upon degeneration and induration.
Flatulence gives rise to asthmatic breathing and dyspnoea, which is worse by motion and the erect position and from 4 to 6 P.M., just the time of the aggravation of **Lycopodium.
We may find here the symptom that the patient wants to be fanned. There is frontal headache worse in the morning and in a warm room, crossness, irritability. **Carbo, being a putrid remedy, is especially useful for the effects of over-eating, high living or from eating tainted meats, where, digestion being slow, the food putrifies before it digests. There is great craving for salt and other things that always make him sick. Remember that **Carbo has a more upward pressure of gas on the diaphragm, causing distress of breathing, than **China has, and not so much pressure down on the intestines as **Nux vomica has, and that it is more applicable to putrid dyspepsias and the chronic dyspepsia of ***old people. It has more burning and flatulence than **Nux vomica, though, like **Nux vomica, it is suitable for the bad effects of debauchery and high living, and haemorrhoids worse after a spree. It comes in after **Nux. Another distinguishing feature between **Carbo and Lycopodium is, that in Carbo the tendency is more to diarrhoea, while in **Lycopodium it is more to constipation.
China officinalis. [Chin]
**China is useful in cases where, like **Carbo vegetabilis, there is depression o vital power, but here it seems to be especially limited to the loss of animal fluids. Like **Lycopodium and Colchicum it has tympanites, and is still further like the former in the sensation of satiety after a few mouthfuls of food. The distension calling for **China is painful and only momentarily relieved by belching. There are sour or bitter eructations and the flatus is offensive; there is slow digestion and the patients faints easily, as in **Nux moschata, and they are worse after late suppers. There is also a sensation as if the food had lodged in the oesophagus behind the sternum. **Pulsatilla has this, but in a less degree than **China. The boiled-egg sensation of **Abies nigra is lower down. Many times these symptoms of **China are caused by drinking tea to excess. When **China is well indicated there will be a yellow diarrhoea, which is worse at night and after meals. **China does not have the rancid belching with burning, which will distinguish it from Carbo vegetabilis. In cases where the food does not digest, but lies a long time in the stomach, causing eructations and finally is vomited undigested, **China is the remedy.
Is especially suitable for chronic congestion and catarrhal conditions of the stomach in patients with liver and gouty troubles; hypochondriacal patients. A grand characteristic of **Lycopodium is this: the patient goes to meals with a vigorous appetite, but after eating a small quantity of food he feels so full and bloated that he has to force himself to swallow another mouthful, and he leaves the tables with his hunger only momentarily satisfied. Here it is seen that the distress is ***immediately upon eating, not a half hour after, as in **Pulsatilla and **Anacardium. **Nux moschata also has distress immediately upon eating. There is intolerance of pressure about the waist after meals, not all the times as in **Lachesis. Now this sensation of satiety is found under **Arsenicum, Carbo vegetabilis, China, Sepia and **Sulphur, but it is especially characteristic of **Lycopodium, digestion is slow and difficult, and the **Lycopodium patient is almost unconquerable sleepy after eating. There is a great accumulation of flatus in the stomach and intestines- -rather more in the intestines, especially the colon–and this presses upwards and causes difficulty of breathing just as we found under **Carbo vegetabilis. We may also have attacks of ravenous hunger under **Lycopodium, which, if not satisfied, will cause a headache as in **Cactus grandiflorus. The patient is worse after late dinners, the distension lasting into the night, making him restless and wakeful. **Lycopodium is especially useful in the atonic and acid forms of dyspepsia, for it has also sour taste, sour belching, and vomiting when it does occur is sour, which is not common, however; there is also also painful swelling at the pit of the stomach and intolerance of tight clothing; the patient prefers hot drinks. Belching of gas in **Lycopodium does ***not relieve. **Lycopodium is, after all, quite similar to **Nux vomica, but the immediate distress after eating belongs to **Lycopodium. In **Nux vomica, from the flatus presses rather downwards. Both have constipation with ineffectual urging to stool. **Nux from fitful intestinal action, **Lycopodium from contraction of the sphincter ani. **Sepia is also similar in some respects to **Lycopodium, but **Sepia has a sensations of emptiness in the epigastrium while that of **Lycopodium is repletion. The urine is high colored, over acid and loaded with lithates or uric acid crystals and it is not so offensive as that of **Sepia. **Lycopodium has also as an important stomach symptom; desire for sweets, which is similar to **Argentum nitricum. **Lachesis desires oysters.