One of the most common complaints encountered in general practice is facial neuralgia. It is common enough that in view of its apparently easy diagnosis and good prognosis we are apt to consider it lightly.
It is not within the scope of this paper to discuss and differentiate diagnostic points, local therapy, etiology and preventative measures in this condition. However, before selecting a remedy it is needless to say that thorough examinations should be made especially considering causative factors such as sinus and teeth infections, ear discharges, skin eruptions and climatic influences.
If we feel certain that the above factors have been eliminated as far as possible we can look with confidence to our remedies for help. If we are sincerely interested in cure and have confidence and ability we will prescribe only a homoeopathic remedy despite the general trend of resorting to aspirin, bromides, the barbital group and other sedatives. There can be no doubt that we can relieve as quickly, cure more surely, and avoid secondary complications and chronic tendencies with Homoeopathy alone.
No doubt I shall miss a number of remedies useful in facial neuralgia but I limit the number to the commoner ones more frequently indicated. It must always be remembered that the surest way to cure is the totality of the symptoms of the whole economy and only where localized symptoms are the only ones obtainable as in acute cases, are we justified in prescribing for the local condition alone. However, we can often solve our case by some general symptoms which we should try to obtain. These should be considered primarily in remedy selection even with more consideration than a particular distressing symptom such as pain. In this way a similimum is more likely found and the result more satisfactory to both patient and physician.
Here are briefly listed some symptoms of common neuralgia remedies:.
ACONITE is commonly indicated with sharp stitching pains, redness and heat of the face, crawling pains with numbness and the generals: restlessness, anxiety and apprehension, attended with thirst and fever. May be either side, favors the left and has night aggravation.
BELLADONNA. Supraorbital neuralgia, tearing shooting pains, stiffness of neck muscles, pulsating pains, twitching eyelids, heat and redness of the face, convulsive jerking of facial muscles. Belladonna is right-sided, aggravated by pressure and worse with cold.
CAUSTICUM. Drawing pains, tension in facial muscles and bones of face especially zygomatic process, pains accompanied by paralysis, paroxysmal pains. Pains relieved by cold. Tendency to affect right side but may affect the left side.
COLOCYNTH. Especially useful in left-sided neuralgia. Tearing, shooting pains extended to temples, nose, ears and teeth; swollen face. Worse from slightest touch. Pains brought on or aggravated by anger. Relieved by warmth.
HEPAR SULPH. Pains in zygomatic process. Especially aggravated by touch. Pains extended to ears and temples. Aggravated by cold.
LYCOPODIUM. Pains attended with sensation of coldness. Especially a right-sided remedy with evening or night aggravation.
MERCURIUS. Tearing or shooting pains affecting one side from temples to teeth. Aggravated from warmth of bed. Attended with salivation, lachrymation, perspiration on head and face. Right- sided remedy. Worse at night.
MEZEREUM. Radiating spasmodic pains centering in the left side of the zygomatic process. Pains radiate to temple, ear, teeth and eye, even to the neck and shoulder. Worse after eating anything hot or coming into warm room from open air.
NUX VOMICA. Pains usually around nose or mouth, with redness of face or one cheek, swelling of cheek, tingling in face. Aggravated by mental effort and stimulants.
PHOSPHORUS. Especially left-sided; pains attended with itching and tension of skin of face. Pains aggravated by any movement of muscles of face. Worse after eating and chewing. Aggravated by slightest contact. Pains extend from jaws to root of nose or ear. Congestion in head and other Phosphorus symptoms.
PLATINA. Pains tingling or crawling. Spasmodic pains and tensive pressure in zygomatic process. Aggravated at evening and worse from rest. Tendency to be tearful, sensation of coldness on affected side.
SPIGELIA. Burning and pressure in zygomatic process, pains burning and tearing. Violent pains aggravated from slightest touch or motion, accompanied by anguish in the region of the heart.
STAPHISAGRIA. Pains are pressive and pulsating from teeth extending to eye. Pains may be tearing, shooting, burning, accompanied by sensation of swelling of face, cold perspiration of face and hands.
The above outline gives outstanding indications of some of the important remedies in facial neuralgia and it can readily be seen that it is often necessary to differentiate by repertorial study. However, to aid in selection, such lists as the following have proven useful. They are common modalities and include some other remedies in addition to those mentioned above.
RIGHT-SIDED REMEDIES: Bell., Calc., Caust., Chel., Chin. s., Ferr., Kali p., Kalmia, Mag. p., Merc., Plat., Puls., Sep., Spig., Sulph., Verb.
LEFT-SIDED REMEDIES: Acon., Ars., Cedron, Chel., Chin. s., Coloc., Dulc., Guaiac., Kali bi., Lobelia, Mag. c., Phos., spig., Thuja, Verb.
REMEDIES COMMON TO BOTH SIDES: Acon., Carb. v., Caust., Chel., Guaiac., Mag. c., Phos., Spig., Chin. s.
REMEDIES AGGRAVATED BY COLD: Bell., Ferr., Hepar, Mag. p., Phos., Rhod., Rhus t., Sil., Mag. c.
REMEDIES RELIEVED BY COLD: Bry., Caust., Coff., Kali p., Lac c., Puls.
REMEDIES AGGRAVATED BY LYING: Chin. s., Ferr., Mag. c., Puls.
REMEDIES FOR PAIN ACCOMPANIED BY NUMBNESS: Cham., Kalmia, Mez.
REMEDIES HAVING PAIN IN FACE WITH PARALYSIS: Caust., Gels., Nat.
REMEDIES WITH PAROXYSMAL PAIN OF FACE: Caust., Cedron, Cham., Stann.
REMEDIES HAVING PAIN IN FACE AGGRAVATED BY PRESSURE: Bell., Caps., Cina, Coloc.
REMEDIES WITH PAIN IN FACE RELIEVED BY PRESSURE: Bry., Chin. s., Dig., Mag. c., Mag. p.
REMEDIES WITH PAIN IN FACE RELIEVED BY HARD PRESSURE: Bry., Chin.
REMEDIES HAVING PAIN IN FACE RELIEVED BY WARMTH: Ars., Calc. c., Cham., Coloc., Mag. p., Mez., Rhus t.
REMEDIES HAVING PAIN IN FACE AGGRAVATED AT NIGHT: Acon., Caust., Mag. c., Mag. p., Merc., Mez., Sil., Sulph.
REMEDIES HAVING PAIN IN FACE AGGRAVATED IN DAYTIME: Cimic., Spig., Stann.
As stated before, the general symptoms, if available, are very important in treating any neuralgic condition.
DR. SUTHERLAND: I have been troubled by facial neuralgia for the last three years. A patient of mine had it and it bothered me a great deal. This patient was repertorized by myself and was seen by Dr. Roberts and apparently didnt get anywhere. Finally I found out what the trouble was. I was ignoring a symptom that was absolutely characteristic of a remedy she needed, Staphisagria. Her symptoms were unimportant, but the keynote symptom is important, and that was pains going off at night. When she got up in the morning her face began to ache and it ached all day, and when she went to bed at night it stopped. It was an absolute indication. This patient is now perfectly comfortable and she had three years of agony.
DR. PANOS: I would like to ask Dr. Allen if Chamomilla has been used for facial neuralgia. It has been pretty serviceable to me.
DR. H.A. ROBERTS: There is one thing about Staphisagria that is peculiar, and you will overlook if you dont look it up. It has a terrific neuralgia of the face and it is in those patients who are suffering from mortification, chagrin, and things of that kind. It took me quite a while to get on to it in one case that I had, and I found it was due to chagrin over family troubles; so dont overlook the possibilities.
DR. SUTHERLAND: One other thing about Staphisagria is a rather peculiar symptom. That is, they have an aggravation form eating, but especially if a metal instrument comes in contact with the gum or teeth it will surely bring on a paroxysm.
DR. ALLEN, JR.: I dont know what further to say except that it was an oversight that I didnt carry along Chamomilla. It is one of our prominent neuralgia remedies, and when I finish the list and turn it in I will incorporate that remedy.