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Showing posts with label Neurology. Show all posts
Showing posts with label Neurology. Show all posts

Oct 1, 2011

Cases Of Epilepsy - By T. F. Allen

These cases were published in article "Cases Of Epilepsy" by T. F. Allen, in American Homeopathic Review, Vol III, New York, November, 1862. No 6.



CASES OF EPILEPSY
BY T. F. ALLEN, M. D., BROOKLYN, N. Y.

Case I
May 9th, 1861. J. W., paper-hanger and frescoer, formerly healthy and temperate, came under my care. His wife, who came with him, stated that three months before, while at work, he was suddenly taken with a fit, he fell down, was convulsed, foamed at the mouth, bit his tongue and was unconscious for several hours. He was then treated with purgatives and the “heroic” remedies of the old school.
About six weeks from the first fit he was again taken while at stool, and then had three fits in succession, and was insensible for twelve hours after them. The day before I saw him he had three more fits which left his mind much confused. The patient looked pale and haggard; mouth half open; eyes staring; starting at the least noise; hands cold, clammy and trembling; he continually interrupted his wife saying "let me tell," and then would seem to forget and say, " yes, yes, yes," the words would seem to stick in his mouth as if his tongue was too large. The fits, of yesterday, had convulsions only on one side, the left; they began with a cold feeling in the hand which crept up the arm to the cheek, when a gush of ice-cold water came from his mouth, which water "gave the mouth a nasty taste" for some time after. This peculiar sensation was repeated three or four times before the fit came on. During the fit the left side of the face was red, the right side, the hands and feet were cold and white. After the fit he constantly complained of ringing in the ears as of a hundred bells.
I gave Calcarea carb. 200

June 18th. The ringing in the head gone, every way much better.

July 25th. Had three fits much lighter than the previous ones and he was conscious throughout them all, though he could not control them; bit his tongue somewhat until a spoon was put in his mouth. The fits were followed by a tightness in the throat as if constricted; slight dimness of sight and numbness of fingers. Gave Calc. carb. again.

August 1st. Had great roaring in the ears, with slight diarrhoea, and constant inclination to stool, with griping pains in abdomen. No fit.

August 15th. Was taken with dizziness in the head; confused noises in the ear, and thick talking (the tongue seemed too large), which symptoms were followed by three severe fits, after which he entirely lost his speech for twelve hours; he also had cramps in the hands and fingers with soreness of the bowels. I gave Calc. carb.2000, since that time he has had no fits. In October I repeated the remedy owing to some of the premonitory symptoms reappearing. In March, 1862, I gave Lycopodium for other troubles and have not seen the patient since April.
Note.—The following symptoms of Calcarea carb. from Hahnemann's Chronische Krankheiten, Second Ed., Vol. II, pp. 308, et seq., show the correspondence between the individual characteristic symptoms of this remarkable case and of the remedy which cured it:
"17.. Anxious restlessness and disposition to busy oneself; she is constantly disposed to do a variety of things, but does not succeed in accomplishing anything; after this display zeal, she is very much exhausted.
"65. Great weakness of the faculty of conception and expression, after a very trifling effort at speaking, it seemed as if the brain were paralysed, chiefly in the occiput; he could not think of anything, nor remember the subject of conversation, by reason of the confusion of his head.
"66. She confounds words and easily makes errors in speaking
  "206. Icy coldness of the head within and without.
  "507. Difficulty in moving the tongue.
  "508. Speaking is difficult.
"509. He moved the mouth, as though he would speak or cry out, but could not utter a word.
 "351. Ringing in the ears.
 "1236. Trembling in the hands, for several hours.
 "1237. The palms of the hands sweat, on slight bodily exertion.
 "1252. The fingers become insensible as if dead.
 "1253. The three middle fingers become insensible as if dead; they are white, cold, and without sensibility."
Many symptoms of the upper extremities describe sensations and pains which pass or extend quickly from one end to the other of the extremity.
 "1332. Cramp in the right leg, lasting one hour, with a turning inwards and a doubling up of the foot.
 "1332. Cramp in the muscles next the shin, at night.
 "1335. Violent cramp in the calf, at night.
 "1336. Cramp in the calf and in the popliteal region on stretching out the leg (as in drawing on the boot), which ceases on flexing the leg, but recurs when it is extended.
 "1396. Quivering in the muscles.
 "1397. Painless jerkings of single members.
 "1398. Single, involuntary movements and jerkings in the right thigh, in the left shoulder and the left arm."
These and a number similar symptoms in various parts of the proving show the power of Calcarea to produce convulsive action of isolated parts of the body.
   "1421. Trembling, early.
 "l422. Anxiety and trembling, with lassitude.
 "1423. Continued trembling in the whole body, which became worse when he came into the open air."
We have here a general condition strongly resembling that of the patient whose cure was so successfully made with Calcarea. The affections of the muscular and nervous system are such as we should look for, as precursors of an epileptic attack. That Calcarea, however, does actually produce an epileptic attack the following symptom shows:
 "1445. Epileptic attack; while standing engaged in manual labor, he suddenly fell sideways to the floor without consciousness, and when he came to his senses, he found himself lying with outstretched arms; this was followed by heat and somewhat of sweat." Dunham. 


Case II
Mary F., aged nine, fair complexion, large deep blue eyes, large head, very fond of books and music.
September 19th, 1861. For nine months has had severe epileptic fits, generally one every two weeks. The morning before the attack plainly indicates that the dreaded paroxysm will overtake her before nightfall, she rises with a severe boring pain in the crown of the head, which extends to the occiput, and in an hour or two a most severe pain in the pit of the stomach also arises. This last pain is so severe that she bends double, lays herself across anything hard and resorts to all kinds of postures to relieve herself. Generally about six, p.m., the spasm sets in attended with unconsciousness; convulsions of the head and limbs; rolling of the eyes, especially so, as to appear "cross-eyed," both eyes being drawn inwards; foaming at the mouth; grating the teeth; biting the tongue, and invariably opisthotonos so that two men could not keep her body straight. These fits last about two hours, when she falls into a deep sleep, from which she wakes the next morning with severe pain across the forehead, severe retching and vomiting, and for a few days her evacuations consist of clear water covered on the top by white flakes. She is gradually becoming more and more dull and stupid, inclined to sleep a great deal; her sleep being full of startings up from dreams of falling into the water. I prescribed Nux vom200 every other day for two weeks.

October 19th. No fit until today, about four weeks, which was attended with the same severity of symptoms. I repeated the remedy.

November l1th. Another fit; no change. Nux vom 30 

November 12th. Another fit; no change. Bell. 30

November 24th. Another fit; has been better; has ceased to dream of water and has seemed brighter. Bell.200 once.

November 30th. Another fit; seems worse again. Hyos.30

December 6th. Had a slight fit; is every way much improved; no more retching and vomiting; evacuations more natural; seems brighter. Hyos.30 twice a week.

January 15th. A slight convulsion with no previous symptoms and slight subsequent ones. Medicine discontinued.
Since that time has had no more fits; her mind is rapidly improving and she is going to school.

Case III
  Child, boy, aged eleven months, of the size of a small child of six months. Head large and triangular; anterior fontanelle widely open; eyes large, protruding, vacant, fixed. Two red marks one between the eyes the other below the occiput which the mother says were caused by the forceps with which the child was delivered.
The father is tuberculosis, has cough, night sweats, emaciation and physical signs of pulmonary phthsis. The child is not able to hold the head up straight and it rolls about on the shoulders. The left arm and hand seem nearly powerless, as the mother remarks that he does not throw it about as he used to and will not close the fingers as with the other hand. The child has not grown any since it was seven months old; has no signs of any teeth; never crept, nor stood alone.
When seven months old, was taken with screaming violently and continued restlessness. In about a week each fit of screaming would terminate in a convulsion, with rolling the eyes upward into the head, foaming at the mouth and violent struggles; the child in a few minutes went to sleep, and when it awoke the eyes for some time seemed turned up onto the head, the child “looking as if dead.”
The convulsions gradually increased in frequency until the, child had them every other day every ten or fifteen minutes, and the alternate days every one or two hours. The child seemed perfectly idiotic, was treated by all the heroism of the old school for four months with no effect. I saw the, child on

June 20th. Left arm and leg paralysed apparently, as the child did not move them; the tongue seemed too large, the mother said it almost prevented it swallowing; urine very scanty. I gave one powder of Sulph.30 and waited five days.

June 25th. Child the same except a pimply rash all over the child. I gave Apis 6 ter die.

July 1st. Left arm and leg seemingly well, as the child moved them as well as the other side; swallowed easily; urine copious, frequent and very offensive; spasms not so frequent and only on alternate days; child awakes with eyes natural; can hold its head up straight for a short time. Apis 200   Once a day

July 4th. The fits came on, on the wrong day every two hours, but has none for one day; has been continually screaming with all its might, and indeed it was doing so when I saw it. Last night they gave it "Mrs. Winslow's Soothing Syrup," but without effect!!! I gave Ars.200

July 7th. The child stopped screaming in one hour after taking the Ars., and has rested quietly and seemed much better; no convulsions; but has diarrhoea of water and some ftecal matter; urine offensive and copious; "the child's hat is too large," says the mother. Gave Sacc. lac.

July 15th. The child moans during the day as if in pain, and rolls the head about; the head is hot, especially the occiput; rests well at night; diarrhoea gone; the child seems bright and notices things and people. Ars.200 once a day.

July 28th. Cries some, but seems to be cutting teeth; some diarrhoea; drooling from the mouth, and constant inclination to put something into the mouth. Cham.30

August 4th. Child better; will laugh; but has a lump coming just in front of the ear, which came out one night; is painful to touch. One dose of Apis 200.

Sep 18, 2011

THERAPEUTICS OF TIC DOULOUREUX By Walter J. king



Trigeminal neuralgia (TN), tic douloureux, prosopalgia, the Suicide Disease or Fothergill's disease is a neuropathic disorder characterized by episodes of intense pain in the face, originating from the trigeminal nerve. These episodes of stabbing pain may be paroxysmal and usually there is no pain between attacks. Most of the time this is unilateral disorder and most patients are above 50 years.

The following article was published in THE CRITIQUE, Vol. 5, 1898, on page 14-19.


THERAPEUTICS OF TIC DOULOUREUX

Compiled by Walter J. King, MD

Tic douloureux, or neuralgia of the facial nerve, is characterized
by intense, darting pains, indescribable or excruciating;
coming on in paroxysms of shorter or longer duration; usually
but one side affected.
Dry heat is often of great service; applied locally.
Attention to hygiene and the use of electricity are often
valuable aids in perfecting a cure. Fats should enter largely
into the diet.
ACONITE NAP.  Left side; face red and hot; violent stinging
 pains, with restlessness and anguish; from exposure to dry
west winds; worse at night; acute congestion and active inflammation.

ARGENT. NITR.  Sonet of head feel as if separating, or
the head feels as if it was enormously large; pains increase to
such a degree that the patient almost loses her senses; relieved
by binding the head up tightly; at height of paroxysm, unpleasant
sour taste in the mouth, and the attack ends in vomiting.

ARSENICUM ALB.  Burning as of red-hot needles; worse
about midnight, relieved by heat; face pale, shrunken and distorted;
 great restlessness; typical paroxysms of miasmatic or
purely nervous origin.

BARYTA CARB.  Left side; chronic or anaemic form; sensation
as if the skin were covered with cobweb.

BELLADONA. Right side; worse from light, noise, touch, or
the slightest motion of the eyelids or jaws, face flushed; pains
come and go suddenly; worse towards midnight.

BISMUTHUM.  Relieved by taking cold water in the mouth
and walking quickly about.

CACTUS GRAND.  Right side; tolerable only while lying still
in bed; caused by wine, strong light, music or missing dinner at
usual hour; returns daily at same hour.

CAPSICUM.  Patients of lax fibre; burning pungent pain,
worse from slightest draught of air, either warm or cold.

CAUSTICUM.  Right side; from malar bone to the mastoid
process; aggravated at night; better by rubbing with cold water;
chilliness.

CEDRON.  Chronic intermittent,  prosopalgia always coining
on at 7 or 8 p. m., lasting two to four hours; intense, burning
pain wandering from one place to another, although emanating
from a carious tooth; puffiness of the face.

CHAMOMILLA. Hot perspiration about the head; twitching
in eyelids, eyeballs, lips, and facial muscles; patient screams,
can't endure pain, is wild and unruly, tossing and rolling about.

CHELIDONIUM.  Neuralgic pains across eyes from left to
right, accompanied by most profuse lachrymation and dread of
light; right sided supraorbital and temporal neuralgia.

CHINA.  Violent, tearing, laming, burning, left side, every
morning; worse from draughts of air, slightest touch, lying down
and in the night; great weakness after the paroxysm.

CHININUM SULPH.  Recurring same hour every day; intervals
 free from pain; no complication with gastric or other derangements.

CIMICIFUGA.  Reflex from uterine or ovarian affection;
sensation of heat of vertex, or as if the top of the head would fly
off; pain goes off at night and reappears the next day; frequent
flushes of heat, want to be in the open air.

CINA.  Pain as if both malar bones were pressed together
with pincers; worse from external pressure.

COFFEA.  Excited nervous erethism; headache, as if the
brain were torn or would be dashed to pieces, coming on during
walking in the open air; worse from heat; clavus.

COLOHICUM.  Remarkable tolerance of pain; general semiparalytic
 condition; left sided; tearing and tensive pains in
facial muscles, moving from one location to another; drawing in
bones of face and nose, with sensation as if they were being
rent asunder.

COLOCYNTHIS.  Tensive tearing with heat and swelling; left
side; caused and aggravated by chagrin or indignation; worse
from touch or motion; better in perfect rest, and from external
application of warmth.

CONIUM MAC.  Right side; bluish swollen cheek, with sore-
ness as from excoriation; worse from cold and from eating and
drinking.

FEERUM MET.  During the paroxysms the face gets fiery
red; during intervals the face looks earthy and pale; cannot keep
the head quiet; after overheating and cold washing.

GELSEMIUM.  Acute, sudden, darting and shooting pains,
with contractions and twitchings of the muscles supplied by
the affected nerves; muscles sore; inability to raise affected
eyelid.

HEPAR SULPH. Chronic cases; pains in malar bones, extending
to temple, ear and upper lip; worse in the fresh air,
better from wrapping up the face; at the same time coryza,
hoarseness, much sweating, and rheumatic pains elsewhere;
especially after the abuse of mercury or metallic preparations.

IGNATIA.  Supraorbital; convulsive twitching of facial muscles;
 pain felt only when touching the part; clavus hystericus;
forcing and pressing out pain.

IRIS VERS.  Pain in head, temples and eyes, attended with
most distressing vomiting of sweetish mucus, and if attended
by much straining with a trace of bile; relieved by vomiting.

KALI BI.  Pain in left upper maxillary, shooting towards
the ear; supra-orbital with gastric disorder; face pale; cold
sweat on face and body; weariness after the pain.

KALI CARB. Stinging in cheeks, with tearing stitches into
forehead, eyes and temples.

KALMIA. Bight half of the face; rending, agonizing or
stupefying neuralgia of superior maxillary branch and of teeth,
not from caries but after exposure to cold; worse from worry,
mental exertion or heat; better from cold.

LACHESIS. Left sided orbital neuralgia; lachrymation, rising
of heat in face before, and weak, nauseous feeling in abdomen
after attack. Delirium appears as soon as the eyes are closed.

MAGNESIA PHOS. Darting, tpasmodic pains; relief from
pressure and warmth; patient languid, tired, and exhausted.

MERC. COR. Tearing pains, worse at night in bed; ptyalism;
 constant inclination to perspire, especially of affected part,
but perspiration does not relieve the pain; recent cases from
cold and chill; from syphilis.

MEZEREUM. Left side ciliary neuralgia with lightning-
like pains extending to neck; from carious tooth (Kreosote,
Staphisagria); numbness in the region of the pain; constant
chilliness, but pain worse from heat; pains come on with great
suddenness; or come on daily, increasing from 9 a. m. to 12 m.
and then decreasing until 4 p. m.

NATR. MUR.  Pain in malar bones, worse from chewing;
periodically, especially after checked ague; great thirst.

Nux VOMICA.  Patient is morose, irritable, belches a great
deal, and is constipated; worse from coffee, liquor and quinine;
face numb, with flow of clear water from eye and nostril of
affected side.

PHOSPHORUS. Neuralgia following nervous strain from
great mental exertion or excitement, with tinuitus aurium and
vertigo; worse from every movement of the muscles of the face;
from taking cold over the washtub.

PLUMB MET.  Burning, neuralgic pains, relieved by diversion
 of the mind by some new topic, or by any excitement or
change of position.

PLANTAGO MA JOR.  Left side; shooting, tearing pains extending
 from jaw into ear.

PLATINA. Right sided; painful feeling of numbness in
malar bone, mastoid and chin, as if parts were between screws;
with anxiety, weeping, and palpitations; profuse lachrymation
and swelling of face; worse on rest and at night; wants to rub
the part.

PULSATILLA.  Jerking, tearing pain, worse in the evening
and in a warm room, or when chewing, talking, or from hot or
cold things in the mouth; tearful disposition; excited nervous
erethism.

RHODODENDRON. Violent, tearing, jerking faceache; worse
from changes in weather or from wind; better from warmth and
while eating; neuralgia of dental nerves; great weakness after
he pain.

RHUS TOX.  After getting wet; feeling as though the teeth
were too long, with drawing, burning, tearing pains necessitating
moving around; great restlessness; relieved somewhat by the
external application of cold.

ROBINIA.  Left side; sensation of disarticulation and fracture
of jaw bone; whole features of patient changed by the
neuralgia.

SANGUINARIA. Must kneel down and hold head tightly to
the floor; lassitude; torpor; spongy bleeding gums; shooting,
burning pains.

SEPIA. Intermittent faceache, with congestion of eyes and
head; shuddering; pain not felt during violent exercise, as walking
in the open air; relieved by warmth; nausea and vomiting;
jerking like electric shocks, upwards; neuralgia during pregnancy
 or the menopause.

SPIGELIA. Sticking, darting pains affecting the right
temple, orbit and eyeballs always attended by feeling of anxiety
at heart, and great restlessness and intolerance of pain; parts
become swollen and very sore; flow of water from eyes and nose;
worse in damp weather from touch or motion; periodical from
morning until sunset, worse at noon.

STANNUM. Gradually increasing and then gradually de-
creasing; feels as if she would faint; prosopalgia after ague, sup-
pressed by quinine.

STAPHISAGRIA.  Pressing and beating pain extending from
the decayed tooth to the eye; worse from slight pressure or from
contact of a metallic substance, better from heavy pressure;
spasmodic weeping; cold hands and cold sweat on face.

STRAMONIUM.  Pain in cheek near left ear, as if sawing the
bone; twitching of the muscles of face; spasms of the chest
hindering breathing; frowning; prosopalgia nervosa; pains maddening;
delirious talk, with open eyes; grinding of teeth.

SULPHUR.  Psoric tendency; chronic cases, where other
remedies fail.

TARANTULA.  Pain in angle of inferior maxilla, so severe as
to think he is going crazy; dizziness; vanishing of sight and
lugging in ears.

THUJA. After suppressed gonorrhoea, or eczema of ear;
sensation as though a nail were being driven into the vertex or
frontal eminences; intense stabbing pain drives almost to distraction;
must lie down; pain changes from left to right; better
at night; painful spots burn like fire and are sensitive to the sun

VALERIANA. Hysterical neuralgia; pains appear suddenly
and in jerks; fierce pains through left side of face, darting into
teeth and ear.

VERATRUM ALB. Icy coldness of part; copious cold perspiration;
 great exhaustion; nausea and vomiting; drawing,
tearing pains, with bluish pale face and sunken eyes; pains
worse in damp weather; right side or left to right; tearing in
cheeks, temples and eyes, with intense heat and redness, driving
to madness.

VERBASCUM. Violent pain, jerking like lightning, or crushing
 as with tongs; especially right zygoma; brought on by pressure,
 sneezing, talking, chewing, change of temperature, or
exposure to cold air; daily from 9 a. m. to 4 p. m.; attended with
feeling of fullness in the head, vertigo, belching, discharge of
tough saliva, together with great coldness of the rest of the
body.

ZINCUM. Burning, quick stitches, and jerking along the
course of right infraorbital nerve, attended with bluish eyelids;
cold sweat on forehead; numbness of tongue; sensation of constriction
 in throat; worse from the slightest touch, and in the
evening.