If you to a patients who is suffering from violent earache acute stabbing pains in the ear, and tenderness over the mastoid region when you first look at it from the homoeopathic standpoint you are completely lost. After a little experience you find that these cases are very satisfactory you get your relief astonishingly quickly and often a case which you expect would require incision of the membrane within the next few hours quickly subsides and the patient is comfortable when you go back in the evening.
That is the sort of thing you should be able to do in the acute conditions.
In cases of acute otitis with violent pains all round the mastoid region there are three or four drugs I want to consider
Supposing you take the case which has come on very suddenly with a history of the patient having been out in a very cold north-east wind, he is intensely restless, the pains are very violent usually burning in character. He is irritable a bit scared with all the signs of a rising temperature, and extreme tenderness to touch. with that history after a few doses of Aconite the acute inflammatory process which is just starting will have entirely disappeared. That is the type that one hopes for, and which one sees very often in winter.
You will get another case usually in children where there is not the same definite history of chill although that may present but where the pain is even more intense and where the patient is practically besides himself with pain will not stay still is as cross and as irritable as can be again with extreme tenderness, and you get the impression that nothing that the friends do satisfies him. You give him a few doses of Chamomilla and again the whole inflammatory process will rapidly subside.
The next case has gone a little further; there is much more tenderness over the mastoid region possibly a little bulging and the ear begins to look a little more prominent on the affected side. The external ear is very red, often much redder than on the opposite side. There are very acute stabbing pains running into the ear the condition is a little comforted by hot applications and the patient is extremely sorry for himself miserable, wanting to be comforted probably a little tearful but without the irritability of Chamomilla, and Capsicum almost always clears it up.
In addition to the three drugs which I have considered, one always has in mind the possibility of a pulsatilla child requiring a dose of pulsatilla for the condition. And also me not infrequently sees a case giving indication for Mercury or Hepar Sulph but these I have no time do more than mention.
Then to go to typical acute neuralgias, facial neuralgias, or acute sciaticas, or things of the sort where you want to get immediate relief. Again you can use pretty well routine methods for relieving these cases.
Let us consider the acute facial neuralgias for instance acute trigeminal neuralgia there are two outstanding drugs for these conditions. It does not really matter which branch of the nerve is involved you take a case like that, with violent pain coming in sharp stabs or twinges of pain running up the course of the nerve, coming on from any movement of the muscles of the face, very much aggravated by any draught of air with extreme superficial tenderness over the affected nerve, which is much more comfortable for warmth applied warmth, and also from firm supporting pressure. That case, particularly when it involves the right side, almost always responds to Mag. phos nine out of ten will so respond. Incidentally this does not apply to dental neuralgia these are much more different and they run to quite a number of different drugs.
If you have the same condition with practically the same symptoms the same modalities, affecting the left side, it generally responds to colocynth.
The side usually determine the choice, but occasionally either drug may relieve neuralgias involving the opposite side.
Where you get an orbital neuralgia with much more sharp stinging pains, “as if a red hot needle were stuck into it is a very common description in these cases, and the pains tending to radiate out over the course of the nerve in the majority of cases you get relief from Spigelia.
There is one very useful point about spigelia; and that is that you sometimes get the statement that in spite of the burning character of the pain after it has been touched there is a strange cold sensation in the affected area. That is spigelia and spigelia alone.
These are the tree drugs which I find much the most useful in a routine way for facial neuralgias.
As a rule I use high potencies, but I do not like to go too high because sometimes in these very painful conditions the very high potency aggravates in the pain for the time being for ten minutes or so and thus causes unnecessary suffering so in these cases with acute pain I seldom go higher than a 30th potency.