While in Hering’s Guiding Symptoms over seventy remedies are mentioned as applicable in various neuralgias, yet there are a few that come to mind and use much more frequently than others. **Aconite is one of these. It is almost a specific for facial neuralgias of congestive form. It seems to have an elective action on the trigeminus nerve, producing painful sensations. It corresponds to recent cases in young subjects traceable to cold drafts, exposure to dry, cold winds, etc. The special features are the ***continuous pain not only in the nerve, but in the surroundings parts; the red, swollen face, ***tingling, great excitement and intolerance of the pain; patient declares that something must be done. According to Baehr and other observers, it acts better in the higher potencies in neuralgia. It is also applicable to rheumatic prosopalgia, with swelling of the face. The zygoma, cheek and articulation of the jaw are favorite seats of the pain.
**Plantago major is especially applicable to sharp neuralgic pains plying between the teeth and ears. Otalgia finds a valuable remedy in **Plantago.
**Chamomilla. Neuralgia with great nervousness; pains utterly intolerable, worse at night and from warmth, accompanied with heat of face, thirst, redness, hot sweat, very impatient, can hardly answer a civil question. Of little use in the lower potencies.
This is also a remedy for recent cases traceable to emotions, catarrh, or exposure, the characteristic being tearing pressive pains worse from motion and touch and relieved by rest and external warmth. The attacks are paroxysmal, mostly on left side, though the sciatica is right-sided. Abdominal neuralgias of a pure nervous type, not inflammatory. Ovarian neuralgias are often greatly benefited by **colocynth. The pains of **Colocynth are better from rest and pressure, but return as soon as pressure is removed.
**Nux vomica has also proved useful in many cases. Jousset places great reliance on it in high dilutions. Neuralgias about the abdomen, worse on left side.
**Stannum pains gradually increase and gradually decrease. “Sun neuralgias.” Of great use in neuralgias of the supraorbital nerve following intermittent fever and abuse of quinine.
**Rhus. Neuralgia from eating, worse in damp weather.
Baehr claims first place for this remedy in the treatment of prosopalgia. The pains are rheumatic, jerking, tearing, worse from dampness, contact, motion, touch sending a shudder through the frame, are periodical and attended with anxiety at the heart and restlessness or preceded by palpitation. The location of the pain is in the nerves of the forehead, orbit and teeth of upper jaw. There is often a sensation as if the eye were too large. Ciliary neuralgias or leftsided prosopalgias where the pain comes up over the head from the occiput; burning, sticking pains, worse from change of weather, call for the remedy. It is not so often indicated in chronic cases.
**Colchicum also has left-sided pains, a kind of paralytic weakness, lacking the severity of **Spigelia.
**Cimicifuga has supra-orbital neuralgia, but it is usually reflex, dependent upon uterine disturbances. This remedy produces a picture of myalgia, worse at night;prosopalgia in nervous women, coming on afternoons and going off at night. Left infra-mammary pains, which often indicate ovarian troubles, will suggest **Cimicifuga.
Hartmann lays special emphasis on **Belladonna for infra- orbital neuralgic, accompanied with increase of tears and saliva. There are violent cutting pains coming on towards evening, most violent about midnight; the paroxysms are of long duration and there are symptoms of vascular excitement; the pains radiate to temples, ears and nape; are worse from noise, motion, jar, chewing, cold air, etc., and are relieved by absolute rest and warmth. In prosopalgia the face is swollen, bright red and the pain is particularly severe; the pains come and go suddenly and hyperaesthesia marks the remedy.
**Atropine sulphuricum 3 is recommended by Kafka in case **Belladonna fails. Hale also speaks highly of **Atropine in neuralgias. The indications seem to be intermittency of the pains, appearing and disappearing suddenly. Jerking and twitching of the muscles mark the remedy.
**China has neuralgic pains which are ***aggravated by touching the parts, or by a draft of cold air. A malarial basis or complication is an additional indications. Most neuralgias that are recurrent are on an anaemic basis and here **China often finds its indications. **Belladonna has a plethoric habit which strongly contrasts with **China.
The more purely nervous the affection the more effective is **Arsenicum. It has the well-known intermitting burning, stinging, hot needle-pain, the distressed countenance, the restlessness and the periodicity. It holds the first place in miasmatic neuralgias, especially of malarial origin, neuralgias from influenza or simple debility with great aggravation at approach of night, and relief from external heat. The pain are severe and drive the patient from place to place. It suits especially infra-orbital forms with a Hippocratic countenance during the attack. Its effect is rapid, and sometimes rivals a powerful dose of **Opium. Among other remedies for malarial neuralgias are:
**Natrum muriaticum. Neuralgias worse at seashore; ciliary neuralgias worse at midday, affections from abuse of quinine.
**Cedron. Periodicity, appearing every evening with clock-like regularity. Supra-orbital pains worse on left side with burning in eyes. It especially suits the trigeminal form due to malarial poisoning.
**Sulphur, China and Chininum sulphuricum are also useful remedies in malarial neuralgias.
**Capsicum has fine, acute, penetrating, burning neuralgic pains in the right malar bone, worse by contact and by draft of air, and is especially severe just as the patient is about to go to sleep.
In prescribing **Arsenicum in neuralgia one must be careful not to give too low a potency, even the 6th will often aggravate, as the nerves are apt to be specially irritated. Baehr says Arsenicum quiets nervous pain better than any other medicine.
A useful remedy where there is a constrictive pain, numbness, profuse lachrymation, worse at night and at rest. The pains are cramping, causing numbness and tingling; pain at the root of the nose or in the other part of the body as if squeezed in a vise. The pains also increase gradually and decrease gradually, as in **Stannum.
**Mercurius. Neuralgias from amalgam feelings in teeth, worse at night.
**Staphisagria. Neuralgias from hollow teeth, especially suitable to old people with a mouth full of hollow stumps, which pain violently at times.
**Platinum suits especially hysterical subjects who have profuse, thick, black exhausting menses.
This remedy is indicated by the spreading character of the pains, and the aggravation from warmth; they are accompanied with chilliness and sensitiveness. There is a stupefying pressure and the pains are worse at the midnight hours. Especially useful in mercurial and syphilitic subjects. After the attack there is a numbness remaining. It is a chief remedy in intercostal neuralgia setting in with zona or shingles.
**Ranunculus bulbosus is the remedy for intercostal neuralgia with sharp stitching pains following the course of the nerves; stitches in chest on every change of weather, sore spot in chest. Among other remedies having chest pains are: **Gaultheria, pains in anterior mediastinum; **arnica, sore, bruised feeling; **Rhus radicans, pains shoot to shoulder blade; Senega, pain and soreness; **Cimicifuga, etc. a psoric or arthritic soil will demand as a systemic remedy an antipsoric such as **Sulphur or Lycopodium, and if of syphilitic origin high dilutions of **Syphilinum will clear the field.
**Mezereum is most useful in ciliary neuralgia when there is a cold feeling in the eye, and it is one of the best remedies for neuralgias which are reflex from decayed teeth.
Pressure, tensive pain in the zygomatic bones worse from pressure, mastication and cold air. The parts feel crushed, as if squeezed between tongs; aggravated by talking and sneezing.
**Kalmia has a neuralgia brought on by exposure to cold, involving the teeth of the upper jaw, rending pains, worse from worry or mental excitement, worse on right side. It has cured some of the most severe and long lasting cases. The tincture is recommended by Cowperthwaite, but other observes find the higher potencies quite as useful. The neuralgia is not confined to the facial nerve, but extends to the sides of the neck and shoulders.
Magnesia phosphorica. [Mag-p]
This remedy has an excellent clinical record in neuralgias. It is curative in a typical facial neuralgia where the pains are intermitting, darting and are relieved by warmth, this relief from warmth being the guiding symptom; neuralgias involving whole of side of head and neck.