THERAPEUTICS OF INTOXICATION F.BERNOVILLE
It is curious to observe with what precision and certainty Homoeopathic medicines act in the troubles of intoxication in general and how infinitesimal doses are capable of fighting victoriously against the ills caused in the human organism by long continued doses of toxines.
We, being Homoeopaths, know how to antidote the abuses of alcohol as well as of other toxines or poisons, liquid or solid, and sometimes even we can, very rarely of course, make the drunkard immune against his vice.
But before broaching the study of Homoeopathic medicines of alcoholism let us frame some notions about the constitution and temperament of persons who give themselves up to it.
1. The Ground in Alcoholic Persons
In addition to the habit that is either due to frequentation to social surroundings or to profession, or to a more or less invincible inclination it cannot be denied that there exists in most drunkards a special ground of predisposition due to the heredity. Alcoholism of a father may be inherited by his sons.
Sons can stand much less alcohol; ebriety is very rapid, more dangerous in alcoholic persons whose habit of drinking is clearly hereditary. Inversely a sufficiently moderate use of alcohol and of wine specially transmits to the descendants certain resisting power against intoxication (Compare the Romans and the Anglo- Saxons).
But from the standpoint of Homoeopathy an alcoholic person is always Psoric. Psora exists before alcoholism. Why?
If we admit the tempting ideas of A. Nebel: Psora is nothing but the result of hereditary tubercular intoxication moreover according to Dr. Nebel, tuberculosis endangers the desire for alimentary stimulants (meat and above all alcohol), while syphilis provokes very often the need for drugs and toxines of the nervous system (Opium Morphia).
This seems to be right, and just as psora may provoke the habit of alcohol, so alcoholic intoxications diminish the power of resistance of the tuberculous persons and obliges them to revert to that stage which already existed in his ancestors, with more or less intensity.
2. Treatments of Troubles of Alcoholism
We will group our arsenal in three groups of remedies:
1. Remedies of neutralization and of immunity.
2. Constitutional remedies.
3. Functional remedies.
We must know them well, in order to prescribe them systematically each time when possible.
Quercus. A very good antidote for the bad effects of alcohol, specially for the effects on glands and humour. When repeated for a long time it may sometimes diminish the desire for alcohol. Apocynum generally acts better in this respect. It should be continued for a very long time for months together in T.M. or in the 1st or 2x in doses of 5 to 10 drop a dose. This remedy acts directly on the spleen as Rademacher has already noticed, who applied it in chronic complaints of the spleen.
The principal symptoms of this medicine are:
Vertigo, noise in the ears, heavy head, dyspeptic troubles, flatulence and tendency to oedema.
Quercus glandium spiritus certainly the typical medicine for general drainage of alcoholic intoxication.
Angelica: It can provoke a dislike for alcohol. We use it generally in M.T. in doses of 5 drops repeated three or four times a day. It has among its symptoms, atomic dyspeptic troubles and nervous headache.
Capsicum. In some cases it provokes a dislike for alcohol; when it is given in M.T. a teaspoonful with a litre of wine. Its symptoms are:
Perspiration and slow digestion, flatulence and intense desire for stimulants. Great thirst, red mucous specially of the pharynx. There may exist insomnia, with the tendency to suicide, or desire to remain alone.
It may be used in some cases of delirium tremens. It acts well of en to indolent persons, of sedentary habits having tendency to obesity, and some aversion for physical exercise. In this case it is nearer to Nux-vomica.
Apocynum Canabinum. This medicine is very often used to check the bad habit of drunkards. We may give it in chronic as well as in acute cases.
Very often there exists nausea, vomiting and somnolence, certain weakness of cardiac muscles causing oedema.
Dose required : 10 to 20 drops of M.T. to be repeated once or twice daily.
These remedies may very often be prescribed: Angelica, Capsicum and Apocynum-can, without the patient knowing it, which may be very useful in practice in subjects who do not wish to submit themselves to any treatment.
It is evident that all the means that we may have recourse to in order to create dislike for alcohol, intemperate persons are always in medicinal intoxication whether we employ a drug in very heavy doses or continue it for a long time we will then substitute another toxic for the toxic under treatment which is not rational.
Remedies that are used by empericists or quacks act in this manner, intoxicating violently the person for several days. They produce only ephemeral action and are dangerous if they are to treat patients whose kidney, heart and the liver are weak. Our Homoeopathic procedure is more judicious, and does not admit of such inconveniences. However we must know that if we repeat for a long time, Apoc-can. or Angelica or Caps. We can also intoxicate the person and provoke in him the appearance of pathogenetic symptoms of their troubles which moreover act only so long as they are used. Generally the person takes up again his bad habit as soon as he stops taking those medicines. There is then no hope except in the will of the person and in moral persuation. The results are therefore very uncertain.
What is required in future is to be able by judicious treatment bearing on the temperament and constitution of the persons to annihilate very precautiously the desire of stimulants and of alcoholic drinks the cause of which appear to be connected with Psora and Tuberculosis of the antecedents.
3. Constitutional Remedies
They are less numerous. Practically we see in all alcoholic persons symptoms that indicate Nux-vomica, Sulphur, Lachesis, Lycopodium and Phosphorus.
Sulphur. When we study the pathogenesis of Sulphur it is easy to understand how a person having morbid temperament represented by substance, can advance towards alcoholism.
The typical patient of Sulphur has quick imagination but repugnant to action. He is a man of vain words and schemes. He likes to philosophise perpetually, to discuss diverse subjects and to build castles in the air.
He is a perpetual student and often brilliant in conversation but is unarmed for the battle of life. He is filthy philosopher- negligent in dress, with grey hairs, pellicles on collar, he discusses about brew- houses before some persons and he puts off very late the decision he is to take.
Even if the patient does not show this well-known type which was represented in the antiquity by Diogenes, a Sulphur patient has also tendency to cutaneous eruptions. He has an unusual hunger, always in the morning towards 11 a.m. He drinks much and eats little. He has a burning sensation in the feet, when he lies down, and searches always for a fresh place and throws away his covers.
Objectively the patient very often shows a high arterial tension. His lips are red as well as mucous membranes and orifices of the body. Alcohol congests him and creates in him a tendency to ictus apoplectic. Specially Alcohol provokes sign of congestion in the person. He has very often pains in the stomach and pyrosis, specially in the morning and when fasting. Morning pituitus. There may exist neuralgias and neuritis. Sciatica on the left side. Aggravated at night or he also may have intercostal pleurodynia or neuralgias.
Nux Vomica. Desire for stimulants is one of the greatest characteristics of this remedy. The desire very often leads to abuse of alcohol. The person thinks it urgent for him, because no sooner he takes it then he feels himself better, his intellectual words become easy; physical dullness that he experiences in the morning does not continue longer, but the amelioration is nothing but ephemeral. The numerous lashes given to the organism by the repeated uses of stimulants diminish the resisting power of the person who gradually becomes more and more fatigued, irascible, and irritable. Those stimulants are coffee, tobacco, rich food, and above all alcohol or wine. This urgent need so frequent in psoric agents may lead to alcoholism as well as to arthritic manifestations. The alcoholic persons who show hereditary tubercular infection as shown by Dr. Nebel.
Nux-vom. is a very curious remedy. It suits particularly to business men of Anglo Saxon origin, who lead a very sedentary life and are always overworked, feeling the need of stimulants in order to accomplish their daily work. Latin and specially French people who are amenable to Nux-vomica belongs rather to the pre- war type, the type of persons who like to lead a good and cheerful life, who is proud of a choice cellar, sports are unknown to them; he works slowly and regularly. Businessmen of French origin of post war period responds less to. Nux-vomica than their English and American counterparts They do not very well maintain the apparent mastery of their nerves. They feel more the need of giving vent to that nervous energy that they possess in a morbid manner. Their nervous system is rendered feminine and very often they become Ignatia patients.
Ignatia. It is a remedy for females which is opposed in a classic fashion to Nux-vomica, a remedy for males, is also a remedy that suits busy men in the share markets, the over – worked intellectuals, hypersensitives, artists whose manifestations are paradoxal in character. But an Ignatia patient does not show urgent need of stimulants. On the contrary, stimulants often aggravate his ills. In another stage arrives when he can no longer bear them or even if he smokes he can no longer bear the smoke of tobacco of others.
But let us now turn to our Nux-vomica, to know how it can suitably be applied to certain alcoholic persons, who can bear neither noise, nor smell, like Ignatia who become irritable and are subject to vertigo always towards the morning until they take breakfast or some stimulants.
Sleep is disturbed, the patient has somnolence after dinner but he wakes up at night at 2 a. m. and cannot sleep again before 5 to 6 a.m., or still more he experiences from the very beginning of the night a total loss of sleep up to 1 O’ clock at night. Heavy head, headache specially on the occiput after a good meal or a good drink. He shows dyspeptic troubles, nausea, vomiting sometimes sour taste in the mouth and a sensation of weight as if a stone was lodged in the stomach. He thinks that he will be better if he vomits but he cannot or only after great effort. Nux-vomica suits particularly to persons who have nausea and morning pituitus.
Lycopodium. An alcoholic person, feels the need of Lycopodium when he has overworked his liver by his bad habits.
Patient begins to be dyspeptic – he goes to the table with a good appetite but is soon satisfied with a few mouthfuls, fulness of the abdomen is extreme, inspite of the most meagre meal. Frequent goes in the intestines; flatus predominantly passing below. Small liver, insufficient, painful, and sensitive. Constipation constant, small stools, insufficient, hard and difficult to pass.
He is irritable. Patient loses confidence in himself. Loss of memory, forgets words and commits mistakes while writing. Apprehensive and melancholic. Feels fatigued in the morning and takes a very pessimistic view of life.
Urine is often full of Urobinine. There exists sometimes in the lower extremities sciatic pains. The disease which represents an association of alcoholic polyneuritis, with a hepatic insufficiency generally passes through the Lycopodium stage before becoming a Phosphorus state.
We must not forget the great characteristic of Lycopodium. Aggravation from 4 to 8 p.m. and mostly at 5 p.m. It is a rightsided remedy. Thermal unstability one foot hot and the other cold.
Lachesis. This serpent poison is very curious and very important to study as a basic remedy of alcoholism. It suits as well to intemperance, persons who are suffering for their bad habit from deep glandular troubles, as women who have arrived at the stage of menopause or an overworked mental condition, after a long and painful effort for producing something.
The Sulphur patient who was has some congestive troubles, gush of heat in the head arterial hypertension very often goes towards Lachesis, at the end, with the same symptoms in these two remedies but in Lachesis with varicocities on the cheeks and nose. Lips are purple and sometimes livid.
The sensitiveness of a patient is such that he cannot bear to have anything tight around his neck or a band of any sort. This difficulty of having anything tight is more marked in the neck, chest and in the waist. Left sidedness like Sulphur. Intense headache aggravated in the sun and in the heat with throbbing, flamming sparks before the eyes. There may be vertigo. Liver is very sensitive. Cannot bear the least pressure, sometimes even the clothes and covers of the bed are thrown away by the person on account of the impossibility that he feels to bear their weight. There exists very often pain in the tibias.
In the case of acute alcoholism we note loquacious delirium a condition of mania with manifested jealousy, suspicious without motive or mysticism or religious ideas.
We must not forget the great modality of Lachesis aggravation during and after sleep.
The patient of Lachesis can keep himself in approximate equilibrium so long as he is awake because he may then control his sympathetic nervous system but if he let the parasympathetic dominate in him everything in him will be aggravated. It is because he sleeps so ill with nightmares, death-like sensation, dreams of funeral and of his own death, it, therefore, he wakes up after a few minutes with stuffed sensation.
Phosphorus. It is hardly classic to put Phosphorus, in the first plan of the ground remedies of alcoholic persons. This is a mistake in our opinion because in each case there exists nervous or glandular degeneration Phosphorus is indicated.
Prostration, fainting, easy sweats, tendency to fatty degeneration vertigo when rising up, different neuralgias, deep sensoral troubles, in the ears as well as in the eyes, vomiting of water taken as soon as it becomes hot in the stomach. Tendency to painless debilitating diarrhoea with great weakness after stool; such are the habitual symptoms of this medicine. Moreover we will note a weak heart, fainting, violent palpitations, small and rapid pulse related to the dilatation of the right heart, sometimes even with a certain degree of arterial hypertension.
Mentally the patient is at first hypersensitive, exalted at last indifferent and depressed.
Liver is large and painful. The patient suffers first of all hepatic congestion, then from hypertrophic pyrosis. But at other times he may also, if he shows cirrhosis of Laennec with a small liver, be treated with Phosphorus, which exist some motor or nervous troubles in the extremities related to neuralgias, neuritis and polyneuritis. Arm and leg get benumbed.
Phosphorus like Lycopodium is as well a remedy of alcoholics cirrhosis as ethylic polyneuritis or of the syndrome of Korsakoff.
These are the great remedies or the remedies of morbid temperaments of alcoholic persons. It is easy to understand and remember them by their symptoms.
Sulphur, before all is indicated by congestion, Nux by desire and abuse of stimulants and consequently by some dyspeptic troubles, nervous and sensorial hyperexcitability. Lycopodium represents hepatic insufficiency and insufficiency of small liver. Lachesis is indicated by profoundly deranged glandular function as well as by tumours. Phosphorus is indicated in a tendency to degeneration, cerebral or sensorial, as well as of peripheral nerves and of hepatic parenchyma.
4. Functional Remedies
We shall divide them into six groups in order to study them in a more schematised manner, because the essential thing is always to give our work a practical basis. The schema published here with will allow us to connect them with their contemporaries and to medicines of temperament:
1. In delirium tremens: Absinthium, Stramonium, Hyoscyamus, Belladonna, Atropinum.
2. In spasms, cramps and tremblings: Cimicifuga, Agaricus, Gelsemium, Strychninum, Phosphorus.
3. In nervous and mental troubles: Avena sativa, Kali phos kali bromatum and Passiflora.
4. In digestive and hepatic troubles: China, Digitalis and Kali bichromicum.
5. In tendency to uremia and apoplexy: Opium, Cuprum ars.
6. In pleurodynia and neuralgia: Ranunculus.
1. Delirium Tremens
Absinthium. Absinthium produces in time of experiment delirium tremens and it is due to the prohibition of manufacture of liquors that contains it, that the cases of delirium tremens have become rare in France. It has some convulsive epileptiform movements, hallucinations and loss of consciousness. Intense trembling. Fearful visions, patient becomes wicked and brutal.
Stramonium. Delirium and violent fury. Desire for beating, biting and tearing. Rhythmical convulsive movements in bends. Loquacious delirium. The patient laughs, prays, vows, and cries. Cannot bear solitude or darkness. He wants light and society. Often he seeks the way to escape. He is full of hallucinations, extends his voice, speaks with eagerness. In visual hallucinations the patient thinks himself greater than he is.
Hyoscyamus. This plant tallies with Belladonna and Stramonium in nervous manifestation.
Obscure delirium, less furious than that of Stramonium. Nervous restlessness, jerkings, dancing of muscles, suspicious, or still more he begins to laugh without stop; or he speaks low and murmurs between his teeth in prostrated and stupified condition. Aggravation at night and when lying down.
Belladonna. Delirium, the patient seeks to escape out of his bed and runs away. Dilation of pupils. Photophobia. There exists no habitual loquacity as in Stram, or Hyosc. but the patient complains of a headache specially in the forehead, increased by light and noise when lying down. There exists always a dryness of mouth and throat.
There may exist some hallucinations with hazy images. The patient sees some monstrous and hideous faces.
Atropine. Dilatation of pupils, photophobia, great dryness of the throat with extreme difficulty of deglutition, visual hallucinations, things seem to be very big.
2. Spasms Tremblings Cramps
Cimicifuga. Dancing of muscles and cramps all over the body. The patient experiences cramps in the long muscles and above all in calves. He is agitated. He may have some access to delirium tremens sometimes in course of which he has visual hallucinations. He sees rats and mice. He hurts himself and has an insane condition or he may speak without stop.
This condition of hesitation is followed by an intense depression with fear and a sensation as if a cloud develops and envelops his head.
In the modalities we find aggravation in the morning specially at intervals. The disease belongs to feminine sex and is always aggravated during the periods (Inversely Lach).
Agaricus. Cramps and muscular dancing. Very violent spasms Vertigo in the sun when walking. All sorts of neuralgias with a sensation of icy coldness in the head, often the patient has polyneuritis, sensation of pricking by icy pins. Chorea like spasms, troubled sleep, the patient wakes up no sooner he is asleep, and is a prey to twitchings of muscles.
Mentally he may have some fits of delirium tremens during which he has loquacity; he sings, murmurs, composes poems, or prophesies. Later condition of intense hesitation of gaiety: there generally may exist another period of violence and injury. Sometimes the patient at this stage is besides himself and injures his own person In the last stage the depression carries him with langour, indifference and incapacity for work and even mental confusion.
In polyneuritis the symptoms appear diagonally, as for example, in the lower part of right and the upper part of the left legs.
3. Predominance of the Reflex Symptoms
Gelsemium. Vertigo, somnolence and trembling, slow pulse, mental apathy and sensation of muscular weakness and prostration. Often patient desires to be alone and calm. Always he is the prey to all emotions, fears, excessive excitement by all news and circumstances to come.
In the face we see some signs of ptosis; eyelids are heavy, the patient can hardly open them, sensation of smoke, possibility of dilatation of pupils, and diplopia above all.
But the key-note symptoms in Gelsemium, are the tremblings and the weakness of limbs. It is why we place it in the first place in the peripheric phenomena of nervous system of alcoholic patients.
Strychninum and Strychninum Phosphorus Spasms are much more violent than in Nux or Ignatia. The reflex symptoms are aggravated. Muscle dancing, convulsive movements, stiffness of the muscles of the face or of the neck. Opisthotonos. Spasms appear very often and come at periodic intervals, if not very frequently. The patient is very irritable, cramps are very painful and come very often.
Strychninum phos resembles to Strychninum with a great weakness of muscles, or the period of relaxing may reach up to a atony and degeneration. Tendency to paralysis.
Sticky sweat in the arm pits.
4. Nervous and Mental Troubles
Avena Sativa. Suits as well to alcoholism as to morphine mania This remedy is always indicated in insomnia of alcoholic patients, with nervous weakness, debility, frequent trembling, impossibility to concentrate the mind upon any subject; neuralgic headache, and decalcification (Phosphaturia).
Passiflora. This remedy is specially for insomnia, might also be indicated in drunkards who cannot sleep and who has nocturnal spasms with a habitual atony, convulsive movements, and restlessness with weakness afterwards. Passiflora specially acts in intellectual diseases or in diseases of cerebral origin. It might also be indicated in some cases of delirium tremens and like Avena-sativa may be applied in morphiromania.