Pain killers are a little difficult to systematize, and I thought probably the most helpful way would be to consider the cases of acute pain which one meets with in general practice, and these I think one can classify to a certain extent. One gets acute neuralgias, acute inflammation of one of the serous membranes, and acute colic. I think that more or less covers the ordinary conditions one meets with in general practice.

The next problem I want to touch on is the patient suffering from acute pain.

Pain killers are a little difficult to systematize, and I thought probably the most helpful way would be to consider the cases of acute pain which one meets with in general practice, and these I think one can classify to a certain extent. One gets acute neuralgias, acute inflammation of one of the serous membranes, and acute colic. I think that more or less covers the ordinary conditions one meets with in general practice.

To tackle these from the homoeopathic standpoint is not very difficult. If one considers the acute neuralgias from the prescribing point of view one takes the character of the pain and the circumstances which make it better or worse, and to a lesser extent its situation. It is on these that one mainly prescribes: in other words on the character of the pain and the modalities.

It is exactly the same as regards serous inflammations; again it is partly on the situation but much more on the character of the pain and the circumstances which modify it that one prescribes. With colic equally; and it does not matter whether it be gallstone, intestinal or renal colic, one pays a little attention to the situation but very much more to the character of the pain and what modifies it.

Working on these lines it is possible to take up the three groups and give the indications for the leading drugs which you must have at your finger ends.

But before taking these up in detail I should like to touch on another very painful condition commonly met with in general practice, namely, ACUTE EARACHE.


If you go to a patient who is suffering from violent earache, acute stabbing pain 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 you relief astonishingly quickly, and often a case which a you except would require incision of the membrane, within the next few hours quickly subsides and the patient is comfortable when you to back in the evening. This is the sort of thing you should be able to do in these 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 staring will have entirely disappeared. That it 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 be present, but where the pain is even more intense and where the patient is practically beside 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 the 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 one not infrequently sees as case giving indications for Mercury or Hepar sulph., but these I have no time to do more than mention.

Then to go on to typical acute neuralgias, facial neuralgias, or acute sciaticas, or things of that 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 these conditions. It does not really matter which branch of the nerve is involved, you take a case a 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 effected nerve, which is much more comfortable from warmth, applied warmth, and also from firm supporting pressure.

That case, particularly when it involves involves the right side, almost always responds to MAG. PHOS – nine out of ten will so respond. Incidentally this dose not apply to dental neuralgia, these are much more difficult 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 determines 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 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 three 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 the pain for the time being, for ten minutes or so, and thus unnecessary suffering, so in these cases with acute pain I seldom go higher than a 30th potency. POST-HERPETIC NEURALGIAS

There is another group of condition of the same type, the post- herpetic neuralgias, which are sometimes very troublesome. You know the ordinary shingles neuralgia where the patient comes with acute burning pain along the course of the intercostal nerve and gives a history that he has had a small crop of shingles, very often so slight that he paid little or no attention to it. Well, if you can get the same modalities as you got in the facial neuralgias under Mag. phos. that remedy with often relive. Much more commonly you find that these post-herpetic cases respond to RANUNCULUS. The particular features for this drugs are the history of herpes, the very sharp shooting pains extending along the course of the intercostal nerve, that the painful area is very sensitive to touch, that the pain is induced or aggravated by it, and you may get the statement that the patients is extremely conscious of any weather change because it will cause a return of the neuralgia again. Well, that type of case responds in almost every instance to Ranunculus.

You will get a few of these cases which have not responded to Ranunculus, with much the same distributions of pain, and the same modalities, but without the marked aggravation in wet weather. where the affected area is extremely sensitive to any cold draught, particularly sensitive to any bathing with cold water, and where the pain are likely to be very troublesome at night, and with a marked hyperaesthesia over the affected area. And these cases usually respond to MEZEREUM.


Then you get another type of neuralgia-the sciaticas. And there again you can get helpful leads. In cases of sciatica, pure sciatica, in which I can get no indications at all but the ordinary classical symptoms of sciatica, that is to say, acute pain down the sciatic nerve, which is aggravated by any movement, is very sensitive to cold, more comfortable if kept quite and warm, then it depends which leg is involved what drug I give. If it is a right sided sciatica I give MAG. PHOS., but if it is a left sided I give COLOCYNTH. And you would be astonished how often one gets almost immediate relief from either Mag. phos. or Colocynth.

Some sciatica patients are frightfully uncomfortable the longer they keep still, they have got to start moving, and there are two drugs which seem to cover the majority of these cases. If the patient is warm-blooded, and the sciatic pains tend to be more troublesome when warm, particularly warmth of bed, and rather better when moving about, in the majority of instances one gets relief from KALI IOD.

Douglas Borland
Douglas Borland M.D. was a leading British homeopath in the early 1900s. In 1908, he studied with Kent in Chicago, and was known to be one of those from England who brought Kentian homeopathy back to his motherland.
He wrote a number of books: Children's Types, Digestive Drugs, Pneumonias
Douglas Borland died November 29, 1960.