The Therapeutics of Fevers

Pulsatilla Nigricans puls.

Allen (1879)In every bookSave

Characteristic

Adapted to persons of indecisive, slow, phlegmatic temperament; sandy hair, blue eyes, pale face, easily moved to laughter or tears; affectionate, mild, gentle, timid, yielding disposition—the woman’s remedy.

Weeps easily; almost impossible to detail her ailments without weeping (weeps when thanked, Lyc.).

Women inclined to be fleshy, with scanty and protracted menstruation (Graph.).

The first serious impairment of health is referred to puberic age, have “never been well since”—anæmia, chlorosis, bron- chitis, phthisis.

Secretions from all mucous membranes are thick, bland and yellowish-green (Kali s., Nat. s.).

Pains: drawing, tearing, erratic, rapidly shifting from one part to another (Kali b., Lac c.); are accompanied with con- stant chilliness, and the more severe the pain the harder the chill; appear suddenly, leave gradually, or tension, which in- creases until very acute, and then “lets up with a snap” (toothache, neuralgia); on first moving (Rhus).

Symptoms ever changing; no two chills, no two stools, no two attacks alike; very well one hour, miserable the next.

Thirstlessness with nearly all complaints.

Gastric difficulties from eating rich food, cake, pastry, espe- cially fat pork or sausage; the sight or even thought of pork causes disgust; “bad taste” in the morning.

"All-gone" sensation in stomach, in tea drinkers especially.

Diarrhœa: only, or usually at night; watery, greenish-yellow, very changeable; soon as they eat; from fruit, cold drinks, ice-cream (Ars., Bry.—eating pears, Ver., China; onions, Thuja; oysters, Brom., Lyc.; milk, Cal., Nat. c., Nic., Sul.; drinking impure water, Camp., Zing).

Derangements at puberty; catamenia, suppressed from getting the feet wet; too late, scanty, slimy, intermitting flow, with evening chilliness; flows more during the day (Lil.—on lying down, Kreos.; only at night or when lying, Mag. c.).

Sleep: wide awake in the evening, does not want to go to bed, first sleep restless, sound asleep when it is time to get up; wakes languid and unrefreshed (rev. of Nux).

Styes, especially on upper lid, from eating fat, greasy, rich food or pork (compare, Lyc., Staph.).

Threatened abortion: flow ceases and then returns with increased force; pains spasmodic, excite suffocation and fainting; must have fresh air; during chill.

Relations

Complementary: Kali m., Lyc., Sil., Sulph. ac.

Follows well: after Kali bi., Lyc., Sep., Sil., Sul.

Ailments: from Cham., Quinine, Mer., Sul., tea-drinking.

Silicea is the chronic of Pulsatilla in nearly all ailments.

One of the best remedies with which to begin the treatment of a chronic case (Cal., Sulph.).

Patients, anæmic or chlorotic, who have taken much iron, quinine and tonics, even years before.

Aggravation

In a warm, close room; evening, at twilight; lying on the left or painless side; indigestible food, fats, pork, ice cream, etc.; on beginning to move; heat, warm applications (< Kali m.).

Amelioration

In open air; lying on painful side (Bry.); cold room; eating or drinking cold things; cold applications.

Type

Every type; simple and compound. Quotidian; tertian; quartan. Monthly (Nux, Sep.); every fourteen days (Ars., Cinch., Plan.). Irregular type; irregular stages; long chill, little heat, no thirst (short chill, long heat, no thirst, Ipec.); stages not marked and apt to run into each other (Ars., Nux, Pod.). Bilious, remittent, continued.

Time

1, 8 and 11 A. M. 1 and 4 P. M. Afternoon and evening. The 4 o'clock paroxysm predominates. Evening paroxysm lasts all night (Lyc., Nux, Rhus).

Cause

Dietetic irregularities. Eating rich, fat food, pastries, pork, often originates an attack, or during convalescence produces a relapse (Ant. c., Ipec.).

Prodrome

Thirst; drowsy and sleepy all day, with mucous diarrhœa; nausea or vomiting of mucus. If morning chill diarrhœa previous night without thirst.

Chill

Cold chills all over; chilliness all the time; feels cold even in a warm room, in the evening. Chilliness the whole evening before bedtime, even while walking. Chilliness; on going from a warm room into the cold air; with pains in the evening. Chill at 4 P. M., no thirst; vomiting of mucus when the chill comes on; anxiety; dyspnœa; flitting chilliness; in spots, now here, now there; worse in the evening. One-sided coldness, with numbness (Bry., Nat. right side;—Caust., Carbo v., Lyc., Thuja—the left). Chilliness over the abdomen extending around the sacrum and back. Shivering on the back extending into the hypochondria, especially into the anterior portion of the arms and thighs, with a coldness of the limbs, and a feeling as if they would fall asleep, about 4 P. M. Shivering running up the back all day; creeping-shivering over the arms, with heat of the cheeks; the air of the room seems hot. Cold hands and feet, they seem dead (Lyc., Sep.—whole body numb, Ced.). Hand and foot of one side cold and red; the other side hot, in the evening. The morning paroxysm at 8 A. M. has nausea, vomiting, headache and vertigo; chilliness, heat and sweat intermingled, or simultaneous (Ars), and usually much thirst during entire attack. Evening paroxysm; violent chill, with external coldness, without shivering or thirst; in the morning sensation of heat, as if sweat would break out, without thirst or external heat, though with hot hands and aversion to uncovering.

Heat

With thirst; with red face, or one cheek red and one pale (Acon, Cham.). Heat of right side (left side and left arm, Rhus), or on upper part of body, lessened by motion or washing (Caps.—increased by motion, Nux); heat of face, or of one hand, with coldness of the other; body hot, limbs cold (Bell., Carbo v.). Anxious heat, as if dashed with hot water (Rhus). Intolerable burning heat at night in bed with uneasiness. Dry heat of the body in the evening, with distended veins and burning hands, that seek out cool places (Opium). He is hot, wishes to be uncovered (Apis, Camph., Sec.). Moans and groans, licks the lips, but does not drink. Heat of the whole body, except the hands, which are cool, with pressive headache above the orbits. Internal dry heat with thirst; flushes of heat; with clothes on was too warm, on taking them off was chilly. External warmth is intolerable (heat of room is intolerable, Apis); the veins are enlarged (Bell., Cinch.). Fever; thirst at 2 P. M., followed by chill at 4 P. M., without thirst, with coldness of the face and hands; anxiety and oppression of the chest; afterward, when lying down, drawing pains in the back, extending to the occiput, and thence into the temples and vertex; after three hours, heat of the body, without thirst; the skin was burning hot, but there was sweat only on the face, trickling down in large drops like pearls, sleepiness without sleep, and restlessness; next morning sweat over whole body.

"The intermittent fever that Pulsatilla is able to excite has thirst only during heat (not during chill), seldom after the heat or before the chill. When there is only a sensation of heat, without externally perceptible heat, the thirst is wanting."—HAHNEMANN.

"When heat follows the chilliness, if it be only a sensation of heat with no objective warmth, there is no thirst; but if the heat be, as it sometimes is, both objective and subjective, it is then at- tended by thirst. Remember this, because absence of thirst is said to be a characteristic of Pulsatilla, and presence of thirst, there- fore, to contra-indicate. This is true with the limitation stated."

—DUNHAM.

Sweat

One-sided; only on the left, or only on the right side of the body; sweat on the right side of the face (sweat on the side on which he lies, Acon., Chin. s.—on the side not lain upon,

Benz., Sanicula—on single parts only, Bry.); sweat worse at night or in the morning, ceases when waking (see Samb.) Per- spiration on the head, face, and scalp. Sweat all night, with loquacity during stupefied slumber (loquacity during chill,

Pod.—during heat, Lach. and Pod.). Pains continue during sweat (Eup., Lach., Nat., Nux—worse during sweat, Ipec.).

Tongue

Coated white or yellow, and covered with a tenacious mucus; too large, too broad. Taste foul, of putrid meat; dis- gusting; bitter, slimy, bilious taste after eating, drinking and smoking. Desire for beer, alcohol, stimulants, sour, refreshing things. Aversion to fat pork, milk, bread.

Pulse

Weak, small, but accelerated. Pulsations through the whole body; in violent paroxysms; from chagrin, fright, joy; with anæmia, chlorosis; great anxiety, was obliged to throw off his clothes.

Apyrexia

Spleen enlarged and sensitive. Constant chilliness during apyrexia. Headache, moist cough, painful oppression of the chest, somnolence, loss of appetite, bitterness of the mouth, sour eructations, nausea and vomiting of mucus, diarrhœa of glairy, watery stools, with prevalence of gastric and bilious symptoms.

After abuse of Quinine, with bitter taste of food and clean tongue. Suppression of menses, or irregular menses (Sep.).

Slightest derangement of the stomach will cause a relapse (Ipec.).

Mild, tearful disposition of women and children often becomes converted into a peevish, irritable, fretful mood; symptoms of threatened abortion during paroxysm in early months of preg- nancy. Paroxysm of increasing severity and ever chang- ing symptoms; no two attacks alike.

Analysis

Chill; evening, 4 P. M.; cold all over; one-sided.

Heat; of single parts, or heat of one hand, coldness of the other, or body hot, limbs cold; thirst and < from external warmth.

Sweat; one sided; of single parts; with loquacity during stupefied sleep.

No two paroxysms alike, ever changing symptoms; increasing severity.

Abuse of Quinine; relapse from slight errors in diet.