Neuritis is defined as inflammation of a nerve. Pathological symptoms include pain, tenderness, more or less impairment of function, sensory disturbances and in severe cases areas of anesthesia and even paralysis.
Neuralgia, on the other hand, simply means nerve pain. A typical neuralgic pain is defined as severe, darting or throbbing in character, intermittent, with sensitiveness of the skin. Generally there is relief from warmth and pressure.
Back of both neuritis and neuralgia there is always some form of nerve irritation. Some cases are traumatic in origin, others toxic, still others are caused by nutritional deficiencies. Alcoholism and emotional stress are predisposing factors of considerable importance.
When the cause is traumatic such local treatment must be instituted as the case may require. Fixation and rest of the affected part may be indicated. There is always more or less damage to nerve tissue in any injury but the homoeopathic remedy by matching the symptoms of motor and sensory disturbance will afford the maximum of relief and restore function to the fullest extent possible.
Cases of nerve injury associated with a bone or periosteal bruise or where there are strained or over stretched tendons will respond to Ruta. Direct injury to nerves in which the tactile sense is highly developed will generally require Hypericum. This remedy is nearly always indicated following injury to the coccyx, also for bad effects following chilling of the buttocks and lower part of the back as from sitting for a long time on a cold, damp bench or on the cold ground.
This form of chilling in which there is a damp, penetrating cold extending up the spine is one of the important predisposing causes of poliomyelitis. It is regrettable that the “March of Dimes” fails to provide enough pennies to inform the public of this fact and thereby prevent many cases of infantile paralysis. What are they waiting for, a new wonder drug or a polio-antitoxin?.
Punctured wounds of the extremities are best treated by cleansing the wound with Calendula solution and by giving Ledum internally in the thirtieth or two hundredth centesimal potency. This is a more effective prophylaxis against tetanus than the antitoxin and no risk of an unfavorable serum reaction is incurred. Hypericum may be required in the extremely few cases in which lymphangitis develops with red lines or streaks extending up the arm or leg.
Neuralgic pains in the stump of an amputated limb will generally be relieved by Allium cepa when the pains are fine, thread-like and shooting in character. Ammonium mur. is often indicated after amputation of the foot when there are tearing, stitching pains, worse in bed at night and better from massage. Arnica is the remedy following amputation through the fleshy parts of the arm or leg when there is the sore, bruised feeling and the history of considerable trauma to the muscular structure.
Hypericum may be the remedy after amputation of the distal phalanx of any of the fingers following an accident in which the tip of the finger has been chopped or cut off. Sharp, shooting pains will extend up the arm, the pain being almost intolerable and associated, perhaps, with a degree of shock apparently out of proportion to the severity of the injury.
Phosphorus is indicated after amputation in nervous, sensitive subjects when there was excessive bleeding during or following the operation and a weak, all-gone feeling with thirst for ice cold drinks. Staphisagria has sometimes been used on a routine basis after amputation but the indications are what might be called “clean cut” cases with little or no contusion and when the sensation as of a knife cutting persists long after the surgery.
A contusion causes local shock to the nerves in the involved area. A temporary paralysis results in an extravasation of blood from the capillaries into the surroundings tissues, then we have ecchymosis, bruise marks or a black nail if the injury is to the end of the finger.
These effects can nearly always be prevented by giving immediate and adequate mechanical support to the contused tissue until the local efferent nerves recover from shock. A severe hammer blow will not cause a black nail if very forceful pressure is instantly applied and maintained until the pain subsides, then ever so gradually relax the pressure.
Arnica is the remedy for bruises of the soft tissues and their nerves of supply. Painful soreness is characteristic with a bruised sensation which often extends beyond the area of trauma. Worse from light touch and better from hard pressure, worse from motion and better lying down. Arnica is often indicated following contusions to the abdomen.
Bellis perennis is especially suited to injuries to the blood vessels and following trauma to the coccyx, as in Hypericum. Often called for in gastralgia from ice cold drinks taken when overheated, also for neuralgia after exposure to cold and wet when overheated. As in Arnica, there is the sensation of bruised soreness. There is aggravation from cold and cold applications, amelioration from continued motion, as in Rhus tox.
Ledum is indicated following contusion of the eye with extensive ecchymosis and when there is marked relief from ice compresses.
Ruta for periosteal and bone bruises and for eye-strain from over-use of the eyes. Other remedies for eye-strain include Apis in which there is aggravation from heat and relief from cold applications; Natrum mur. when there are zigzags in front of the eyes and marked aggravation from sun-light and other bright lights; Senega when a certain object has been held in the field of vision for a long time and the eyeballs feel distended.
In the case of sprains as from over-lifting, over-exertion or trauma the most frequently indicated remedy is probably Rhus tox. with its aching, restlessness, aggravation when quiet and relief from continued motion. Often worse on beginning to move. Better from heat and worse from cold. Neuritis involving the left shoulder and arm after straining the heart from over-lifting or over-exertion. Involvement of the sciatic nerve, especially on the left side. Aggravation in wet weather, from getting wet and from dampness in general.
Calcarea carb., the chronic of Rhus tox. in the traumatic field. Bad effects from over-exertion whether mental or physical. Strained and sprained feeling following hill or mountain climbing. Aggravation from ascending is characteristic. Worse from cold and dampness. Plethoric type with easy sweating tendency.
Bryonia following injury to the chest and ribs with aggravation on the least motion and relief from pressure. Worse taking a deep breath, raising arms or coughing. Suited to cases of both pleurisy and intercostal neuralgia. Amelioration in either case by tightly strapping the chest.
Ruta for strained or over-stretched tendons, also for eye- strain as noted above. Worse from cold and from rest. Better from warmth and motion. Affinity for fibrous tissues, wrists, ankles and lumbar spine.
Ammonium mur. is frequently required for the chronic effects of sprains. Tightness as if the tendons were too short. Tense, sprained sensation in the groin with difficulty in walking erect. Better in open air and from continued motion.
Carbo animalis has the symptom “easily sprained from lifting even small weights”, also “great debility and easy spraining of the joints”. Elderly people who are feeble, subject to colds and when slight causes appear to produce unduly severe effects.
Sudden chilling when overheated or sudden suppression of sweat from a cold wind or in an air conditioned room when the outside temperature is in the nineties will often cause neuralgia or even a neuritis. In such cases Dulcamara may be the remedy when there is a sudden, severe drop in temperature from hot and dry to cold and wet in patients with a strong catarrhal predisposition. Causticum following exposure to dry, cold winds. Bells palsy, affecting especially the right side of the face. Paralysis of single muscles. Weakness of bladder with inability to control the urine.
Psorinum has an affinity for the nerve of supply to the deltoid muscle and has cleared many cases in psoric constitutions when the chronicity and recurrence are conspicuous features. Silicea following exposure to a draft, especially when perspiring, also for cases of neuritis following a suppressed foot sweat. Silicea patients are better from warmth and from wrapping up the affected part.
Anemia predisposes to many cases of neuritis. Toxic causes include many of the acute infections also malaria, gout, syphilis, lead poisoning and organic disease involving the cerebro-spinal axis. Dental caries and badly infected tonsils are responsible for some cases.
Remove the cause of the neuritis in so far as possible. Stop causing disease and then prescribe the indicated remedy. To neglect diet in patients with gout is to invite recurrence. Chronic lead poisoning or aluminum poisoning must be stopped at the source or the homoeopathic remedy will fail, or more correctly the physician will fail to cure the case.
Trifacial neuralgia (tic douloureux) cannot respond to proper treatment if there has been over-exposure to either the infra-red heat lamp or the ultra-violet, so called sun lump. Alcoholic injections and the x-ray have spoiled more cases than they have ever alleviated.
How foolish to prescribe “the apparently indicated remedy” in a case of beriberi without first removing the cause which is usually an obvious nutritional deficiency. Correct the diet and then prescribe the remedy. Either a food toxemia or a nutritional deficiency is the underlying cause of most cases of either neuralgia or neuritis. Much acute illness is due to a toxic over- load in the body. Much chronic illness is due to mild but multiple and therefore complex nutritional deficiencies, starvation in the midst of an apparent abundance of food.
As soon as an individual arrives at the age of personal responsibility, as soon as he is on his own, in other words, he then proceeds to cause disease through one or more avenues of unhygienic living:
1. Emotional stresses and conflicts.
2. Excesses and depletions.
3. Nutritional deficiencies.
4. Food toxemia.
The kind or type of disease from which he will suffer depends upon the direction of susceptibility in his own constitution. Disease attacks the weakest structures in the constitutional chain. The strong parts of the body are disease resistant.
DR. WILLIAM GUTMAN: I will never forget a case of acute neuritis because it was the most extreme expression of pain I have ever seen in my life and because it gives us such a good example of the importance of exact case taking.
A patient came to me with an acute neuralgia of both brachial plexi. He was rolling on the floor and crying out from pain. It was a terrific and terrifying picture. I was not able at first to establish a diagnosis, to get even words out of this man, but I found out, to make it short, that it was acute neuralgia of both brachial plexi due etiologically to suppression of sweat. He was standing in a draft in winter, sweating in his armpits just shortly before entrance to a house. I gave this man one dose of Belladonna 200. and the pain subsided in no time.
A couple of weeks later he was brought by car to my office in exactly the same condition, not the slightest difference, a terrific recurrence, maybe more terrific than the first one. Naturally, I gave a dose of Belladonna 200. No result. My office was full of people waiting, so this was one of the very few cases where I finally gave a hypodermic because the patient just begged me to do something in this terrific attack of pain.
I did it with a very bad conscience, feeling I could make a chronic out of such a case, or a suicidal case out of such a condition. After fifteen to twenty minutes the pain subsided and he was brought home; but as I expected, in the late evening I was called again urgently to see the man. Naturally, I had given the man only a hypodermic, no curative remedy, so, seeing the patient again, I established that he was exposed to a situation which had caused a fit of anger which he had suppressed.
I gave him one dose of Chamomile. Within three minutes the pain was gone and never recurred. What the morphine could not do before fifteen or twenty minutes, being only a palliative, Chamomile in high potency did in three minutes and cured him.
It shows it is an example for teaching students how exact case-taking is in homoeopathy, even if you have a perfectly clear picture, and shows the extreme importance which Dr. Underhill stressed of the emotional influence in neuralgia.
DR. J. W. WAFFENSMITH: In reference to neuritis, very often we get typical Rhus toxicodendron symptoms and especially in sciatica, and there is a temporary favorable reaction to the Rhus toxicodendron but it doesnt hold.
I want to call your attention to Calcarea arsenicosa. It has been very beneficial to me in studying these cases. I had one case particularly through the winter, an aged gentleman whom I had treated constitutionally for several years, and he had this terrible case of sciatica, with characteristic Rhus symptoms, and the Calcarea arsenicosa fitted in nicely.
DR. A. H. GRIMMER: Dr. Underhill mentioned the effects of coffee, and it is true that excessive coffee predisposes not only to nerve conditions but extreme sensitivity. Here is a little remedy Clark mentioned, to add to what we know about Nux and Chamomilla and others, Guarana, a South American plant. Clark mentioned it as being a wonderful remedy for those who are prostrated or aggravated nervously or otherwise, from excessive coffee.