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The drug picture of Stramonium
THE DRUG PICTURE O F STRAMONIUM
129
POSOLOGY T i e indications for the use of this remedy are much the same as for Hyoscyamus o Belladonna with slight variations in symptoms as mentioned above. Acute maniacal states, puerperal mania, delirium tremens may call for the remedy. I t is said to be of special value in chorea, especially if involvement of the face muscles is a prominent feature.
The drug picture of Stramonium DR
MED.
DIETRICH
BERNDT
Concentrated in its ripe seeds, Datura stramonium, the thorn.apple, contains atropine, scopolamine and 1-hyoscyamine as its chief alkaloids, similar to B~lhdonna and Hyoscyamus. This seems to account for the similarity in the t~xicological actions of these three poisonous plants. It is difficult--and not only for someone who is new to differential homceopathic remedy diagnosis-to select the right one among these three, particularly if the patient is dangerously ill and a quick decision is vital. For there must on no account be confusion between Belladonna, 8tramonium and Hyoscyam~ when it is a matter of averting catastrophy in a clinical situation. These three remedies are not interchangeable. At the end of this paper a table is given which shows some of the clinically important differential characteristics. Typhoid and septic conditions with typhoid characteristics, sometimes also scarlet fever and its acute sequelse, for which nearly always only Belladonna i~ being considered, septic pneumonia, otitis media with meningeal eomplica. tions, before or after perforation or after incision, acute glomuleronephritis with residual nitrogen intoxication, septic erysipelas, septic tonsillitis, dysentery, lymphatic diathesis with continuous fever, bad cases of whooping cough and apoplexy followed by continuous fever--these and many others are acute clinical conditions where often ,.~tramonium is among the final choice as a lifesaver and indeed curer--and may prove to be of outstanding therapeutic value. In the sub-acute and chronic sphere it comes into consideration as a remedy for bronchial asthma, St Vitus' dance, delirium tremens, Parkinsonism, stuporous states, tic, paranoid syndromes, epilepsy, enuresis, postapoplectic loss of function, certain abnormalities in the female cycle, a certain type of disturbed sleep and specific visual disturbances at all ages, erotomania of both sexes and nymphomania. Translation of a paper from Zeit~chriftfftr klassi~che Homdapathie. 7 222-230, Sept/Oct 1963 and published with the kind permission of its Editor and of the K. F. Haug-Verlag, Ulm. Translated by R. E. K. M~lss, F.LL.
].30.
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BRITISH
HOM(EOPATHIC
JOURNAL
This confusing though not yet complete list of clinical diagnoses needs a governing archetypal picture for homceopathic therapy. I n order to decide whether Stramonium is the similimum in the individual case, one must know the whole picture of it and have grasped its essential nature. The thorn-apple occurs in central and southern America and according to a more recent hypothesis it was at some time or other brought from there to Europe. But it also comes from the western parts of Asia, i.e. the Kingdom of Ghengis Khan. I n the European flora it has only been noted from the 17th century onwards. There is one very credible older tradition that the gipsies brought the seed to the western parts of our continent. W h a t have the gipsies got to do with S t r a m o n i u m ? - - A p p a r e n t l y quite a lot! They always carry the seed of the thorn-apple with them. On the one hand they use it as a narcotic and to prepare love potions. I n m a n y crises of conscience it also serves them as a talisman. I t furthermore plays an outstanding and convincing role as a remedy in their traditional medicine, which is not surprising considering its wide range of clinical use. I f we consider t h a t h e r e - - a s usually in folk medicine--we have the unconscious, instinctive application of H a h n e m a n n ' s law of healing, the law of similars, one m a y assume that some close inner relation exists between the two partners: the gipsy and the drug picture of the thorn-apple which in older herbals was also called "Tollkraut" (herb of madness; vid. "Tollkirsche"~Belladonna ~ mad cherry. Translator). Before I a t t e m p t to describe the extremely complex psychophysical drug picture of Stramonium I would like to give a personal reminiscence, from the final phase of the second world war when nations were in the melting pot, in a camp in Eastern Europe. Among the Hungarian prisoners were a group of about 25 gipsies, all in civvies because quite obviously they had never been soldiers. These kept as far as possible apart from their fellow-countrymen who spoke the same tongue, so that they might go on living their own life--undeterred by other camp affairs - - a n d this quite insouciantly. I n contrast to almost all the other inmates of the camp they were never hungry or emaciated. They ate their fill of the rats which were there in hordes and a great plague to the rest of the camp. Any a t t e m p t on the p a r t of those in power, however gentle or harsh, to get them to perform the imposed labours they repelled in such a way that in the end nobody dared approach them. They reacted heatedly, aggressively or stuporously. In some cases it was impossible to say with certainty whether illness was being simulated or really did exist. I f they were not sleeping or brooding they nattered unceasingly, day and night, rather loudly and with wild gesticulations. Although anything that would burn was scarce and dear, their barrack room was always dimly lit at night. At the same time others were lying on their bunks fast asleep, not even waking if one shook them by the foot. Some individuals would sometimes sit on their bunks for hours, bent forwards, forehead on their knees, murmuring to themselves or humming monotonous tunes. Now and then they quite unexpectedly presented the whole camp with spontaneous, wildly ecstatic performances in the main street. Some would sing and gesticulate wildly, usually rhythmically, others dance bizarrely, with acrobatic exhibitions in between. Their complexion was normally a pale yellow, but on these occasions their faces acquired a peculiar shiny light red coloration.
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131
In their personal contacts they were amiable, devoted and mistrustful. They stole like magpies, everything that was not nailed to the ground. Often the tracks of the culprits could be seen to lead to their place through the freshly fallen snow. But nobody would have dreamt of facing them with it, for one had an idea that that might be the end of one. After all, it was known that even among themselves they easily drew their knives. They demanded a high price in consumer goods for their fortune telling. But in spite of the great hunger everybody paid up gladly: For one hoped in fear and trembling that one might ~urvive and return home. By the way, gipsy women are said to know a great deal more about the art of fortune telling than the men do. It is as impossible for us to understand the mentality of these people as it is for each of us even to understand himself. But perhaps a secret gipsy corner exists nevertheless somewhere within the convolutions of one's brain. If we now study the toxicology of the plant and its more subtle form, the drug provings on healthy persons, and add to this the consistent clinical experiences gained from the use of Stramonium, we shall find enough to establish the link between gipsies, children or old people on the one hand and the thorn-apple on the o~her. What is it that matches so neatly in ethnology, toxicology a n d biography? A tendency to violence, ecstasy, passion, shouting and screaming, fantastic notions and visions, often producing fear and horror. Pseudologia fantastica in childhood and old age, fearfulness, hallucinations of all kinds, reaching for objects which are not there. Pavor nocturnus. Is wide wake, fearful, but does not recognize own family. Insists one or more of the limbs are too large. Confusion, laughing and weeping, often alternating abruptly. Whimpering, shrieking, unrest, cantankerousness, unpredictability, attempts at escape (e.g. from bed). Kleptomania, nonsensical ceaseless chatter, dancing and singing, convulsive laughter, grimacing, swearing and praying in constant alternation, convulsions. This is the manic phase of the drug picture. Now the depressive phase: sadness, thoughts of death, despair, staring in front of themselves, catatonia, thought block, weakness of memory, lack of power of concentration and inability to express oneself clearly. Stammering and stuttering. Absolute desire for company. The child sleeps only when it is holding its mother's hand. That would be a rough outline of the outstanding psychic changes in the Stram9nium picture. In the vegetative sphere the drug picture shows: epileptiform spasms, intermittent jerks in individual muscle groups, but also periodic, regular jerking movements of the whole body. Rolling the head, grinding of teeth, biting. Talking and screaming in dreams. Movements are hasty and incalculable. Dizziness and reeling as if drunk, heaviness of limbs, motor unrest, tremor, ophistotonus. Total anuria, incontinence of stools and urine. A description of the more organotropic, physical symptoms which would be next on the list and which quite by the way may indicate Stramonium, will be omitted. Our sifted, complete or abridged materia medicas and not least of all the repertories give sufficient information about details. The study of these belongs to personal endeavour or directly at the bedside. The practitioner would certainly profit greatly by an occasional recapitulation of the organic symptoms of Stramo~ium. For unless he is familiar with the whole picture of
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this remedy he will hardly be able to cope with everyday practice homceopathically. All physical diseases which have the characteristic that the symptoms appear in combination with striking and possibly bizarre psychic changes demand a glance at the psychic picture of Stramonium. The mental symptoms and the peculiar symptoms or modalities are the most decisive for selection. Just a few of the modalities and peculiar symptoms which have proved valuable in practice and seem important shall be mentioned for this remedy, which has so many paradoxes, apart from those mentioned already. The list below, which is left unsystematic on purpose, does not claim to be complete: Always wants light, but turns away from direct light. Direct look at light produces muscular spasm, mental confusion, epileptiform attack, asthmatic state, attack of coughing or screaming. And even more: I f one shines a light into the face of a Stramonium.sick child to test the reaction of the pupils, the child is likely to hit out and strike the pencil light from one's hand, he shrieks and raves, goes into spasm or coughs. The physician might think the child was badly brought up and sometimes that may be the case. But much more often it means that the child needs the right dosis of Stramonium. Awful thirst, but nevertheless increased restlessness or tendency to spasm if a drink is given, and even spasm in swallowing if tries to swallow a drink. The appearance of mental changes, manic or depressive in type, showing a direct time link with the female period or with inexplicable, sudden cessation of menses, e.g. also with elimacterium preecox. Pathological mental or neuro-vegetative symptoms in connection with sudden cessation of secretions or excretions should also remind of Stramvnium. This arises for instance in connection with eczema, ulcus cruris, fistulm, otitis media, diarrhceie diseases. It is immaterial whether the cessation of secretion was due to chemical, exogenous action or unknown internal causes. When an endemic of measles is dying down, a minor series of illnesses usually appears in children who were not affected, and without any particular previous warning the ear drum perforates spontaneously. This is probably a substitute reaction which one might call "outsiders' measles". The excellent work of the wise orthodox physician and p~ediatrician Prof. Czerny provides a detailed description of this problem. The accompanying mental symptoms very often indicate Stramonium. Its prompt healing action is evident and usually surprises even the physician! One example: CASE 1: Two older siblings had just got over the measles in the course of a normal endemic when in the youngest of the family, a boy of three at the time, the left ear drum perforated suddenly and there were loud howls of pain. Cloudy serous discharge, with a little blood in it at first. No rise in temperature. No stools for three days. Great thirst, refuses food, tongue clear, but eoloured a striking deep red. No therapy on my part to begin with. Two days later the ear suddenly ceased to discharge, but instead there was vomiting, temperature of 103.1 ~ F rectally, headuche in forehead and back of head, pink scler~e, sensations of fear, the light must be left on, the mother must sit by his bed all the time and hold his hand. Murmuring, whining, suddenly shrill laughter. Wants to get out of bed quickly. Jerking movements through the whole body. "Mummy, my foot is much too long"--"Mummy, there a r e mice on the wall." "Mummy, hold t i g h t - - t h e y are coming to get
THE DRUG PICTURE
OF S T R A M O ! ~ I U M
13~
me!" The small hand keeps reaching into the air, fending off what is not there. I was called at about 5 p.m. Test for Kernig's sign indicated severe meningism. Mastoid process on left very painful on percussion. Pupils wide and reacting sluggishly to light. At any attempt to shine a light on them loud screams of pain. Fearful, wild facies. Rigors. The clinical diagnosis for such a process is septic otitis media with basilar meningitis, i.e. a case which is usually sent to hospital. And not infrequently a young life reaches an untimely end under lumbar puncture and antibiotic therapy, not to mention the chisel. The remedy diagnosis Stramonium and one dose of the 30c of this on the other h~nd brought instant deep sleep, lowering of the temperature towards morning and after an offensive black stool desire to eat, reappearance of strong serous discharge from the ear which decreased slowly and continued for one week. Eight weeks later no defect could be seen on the ear drum.--This happened nine years ago. Apart from an occasional cold the boy has never been ill since. Such a clinical course under homceopathie treatment is not unique in practice. And fairly often, though certainly not always, the remedy diagnosis is Stramonium. That sudden severe fright may give rise to severe clinical sequelae is a fact known to practitioners of all schools of medicine. Stramonium has striking relations to fear, fright and shock. Again an example: CASE 2: In a newly built estate house the ceiling of one room comes down suddenly in the middle of the night, with a noise like an earthquake. A little girl of 2~ in the next room starts up and will not stop screaming for the rest of the night. The light must be left on and the child holds tightly and fearfully on to her mother. No more sleep for both of them. The next day lack of appetite, constipation and unusual thirst. In the afternoon a high temperature of 106-3 ~ F sets in suddenly with rigours. So I was called. A perfect Aconite picture--that's how it looked. But Aconite did not show the least effect. Then it seemed that Belladonna symptoms became discernible. Belladonn~ added severe t u m m y and headache, contributing anything but a therapeutic action. On the third day with a temperature of 106.3 ~ F disquietude and mistrust arose in both the child and her parents, and disquietude also in the physician. Thv unrest of the child developed to an extreme degree and became confused: un~gtivat~d shrieking, whining, shouting, folding the hands up tight, suddenly re~ching out for rabbits which apparently were running along there. When given a drink which she had asked for, she swallowed the wrong way. The light must be left on in the room. "Mummy, put the light on again", and y e t she turns away from the light. Pupils are fairly small and react sluggishly. Incoming light produces convulsive defensive move nents.--Temperature still 103-0 ~ The Stramgnium picture had developed so fully that even the physician could see it now and the remedy was at last given in the 30th potency. After about 15 minutes' deep sleep. The next morning the fever went down and the appetite returned. In the afternoon a horribly smelly, greeny-blackish slimy stool. The next day it was as though none of this had ever happened. During the following seven years no other illnesses except for one attack of whooping cough which was very mild.
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Aconite, Belladonna and other remedies also have "results of fright" in their drug pictures. But this case was quite obviously Stramonium. Goethe's "Erl-king" gives a much more impressive description of what fear, fright and terror can do, even if they are entirely due to the imagination. Death may occur, even in childhood. As a poison, Stramonium leads into the sphere of death. But if it is used in the right sense, in particular, very acute, results of fright, it can also just as surely lead one out of this sphere again. The eye connections of Stramonium are varied and worth special consideration. I f eye diseases or disturbed vision appear in childhood and there are accompanying symptoms belonging to the general Stramonium picture, then this remedy comes very much into the final choice. Among other things for blepharospasms, blepharophlegia, injection of sclerse and cornea, fixed stare, pupils too wide or too narrow. Chromatopsy, colour confusion, seeing coloured borders around objects, double vision, objects appear at an angle, float away, are too big or too small. Temporary far-sightedness. In more general terms: weakness of accommodation. Many a school child has been permanently relieved of compulsory accommodation glasses through Stramonium. Strabismus also belongs into the therapeutic range of this remedy. In this context onepartieularly important key symptom which experience has confirmed shall be mentioned: Visual disturbance or even temporary blindness through mental over-exertion, e.g. the assiduous scholar or student. But these are not the only categories involved. CASE 3: Please consider a puppy. Barely one year old, one of the favourite types of hunting dog, amenable to training and highly intelligent. Gelman short hair, highly bred and probably also slightly inbred. Veiy playful, full of wild movement impulses, full of fantasy, sensitive, depressive. AecoIdi~g to the breeder, there have been some cases of blindness followed by epilepsy in his family, always near the end of the first year. :Not one of the affected animals survived this particular phase. Death in the veterinary clinic, by injections from the vet, or release through a bullet. In the puppy of which I am speaking total blindness came on suddenly. The owner, a good observer of animals and full of good sense, said spontaneously that this was the result of inhibiting the movement impulses by training. Two days later epileptic attacks with long aura (whimpering, crying, whining) and severe convulsions, biting of tongue, urination and defsecation, followed by comatose sleep filled with fearful dreams and occasional movements of flight. Barking, biting, whimpering, aura, attack and dream sleep follow one another almost without pause. Refuses food and has great thirst, in the end also lack of thirst. The first vet thought it might be tetanus and gave calcium injections. The second vet took the temperature and found a slight rise, assumed it was encephalitis or meningitis and gave streptomycin. The great number of attacks, their length and severity were meanwhile increasing. The veterinary hospital was recommended. On the sixth day someone among the hunting friends thought of the homceopath for a change, for a last attempt. The therapeutic ambition of the latter was stimulated. One's ability to grasp things is not the same every day. Whether on this day it was good enough or not will be seen from what followed. Blindness at school age in a dog due to inhibition of movement and other non-physiological compulsions imposed. Then the near fatal epileptic attacks.
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OF S T R A M O N I U M
R e striking f a n t a s y e l e m e n t i n the m a k e - u p of the animal. Such a c o m b i n a t i o n .f associations exists in h a r d l y a n y other picture b u t S t r a m o n i u m . One dose of 0c, given i n the e v e n i n g d u r i n g a n aura, a t once leads to a deep sleep, i n s t e a d f the expected convulsions. This sleep ended i n the m o r n i n g with r e t u r n of onsciousness, t h i r s t a n d hunger, b u t with the t o t a l blindness still persisting. Lround n o o n one f u r t h e r dose of S t r a m o n i u m 200. I t m a y be t h a t this was uperfluous: to prove the opposite i s - - a s always i n b i o l o g y - - n o t possible. B u t t a n y rate a t 3 p.m., i.e. two hours later, the owner telephones: "Doctor, i t ' s .1credible, he can see again. J u s t t h i n k , he is p l a y i n g hide a n d seek a g a i n i n
Belladonna
lharacter, type
I n health: highly
~eneral
Acute, little delirium. Inflammation usually localized, e.g. head hot, abdomen hot, feet icy cold; sometimes also icy cold hands. Overpowering pain; desire for company rather than
intelligent, good, gentle, affectionate, docile, timid, but: desire for independence until almost unapproachable. When ill: Insufferable, irritable, rude, not amenable to discipline, accusing, complaining, wild yelling.
aversion.
"
Straraonium I n health: contradic-
tory, difficult, incalculable, quarrelsome, anxious, desire for independence yet devoted. When ill: Unbelievable inferno of these same traits, aggressive.
Hyoscyamus
Suspicious, jealous, impatient, intolerant, anxious, incalculable, offensive.
Post-acute: sequelae Acute, subacute: of unresolved a c u t e Infernal delirium conditions; with tendency to slip cedematous (skin into agony suddenly or internal organs), when it is at its poor reactivity, greatest height. shackled energies'--Pain rare, often wants to, but can aggravation. no more. Disinclined Absolute desire for to answer, answers company. a n d at once relapses into deep sleep.Indolent, indifferent to company, neither for nor against.
type of fever
Preferably: high and discontinuous, alternating--first high, then low, then high again. Body warmth often irregularly distributed.
Continuous: high temperatures rare, usually medium, sometimes slight. Body warmth is distlibuted evenly.
Hardly any temperature. When strength to produce a temperature has gone or never existed to begin with.
~omplexion
Deep red to blue-red head, colourless extremities.
Pink (only rarely deep red). Hardly ever pale.
Pale (rarely slightly red).
~ttitude to light
Aversion to light.
Absolute desire for light; direct light is disliked, evokes spasms, anger, cough,
Indifferent as to whether it is light or dark.
etc.
This attempt at a differential diagnostic comparison is partly based on the paper g i v e n by Dr H~nni (Bern) and Dr Welter (Ottersberg) at Bad Brtickenau in May 1963. It requires more to complete it and it is hoped that those with clinical experience will contribute furthar indications, h o w e v e r small.
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the garden with our dachshund."--That is what he is still doing now, fcur months later, and judging by my personal experience with Stramonium one m a y assume that he will continue to do so. The differential diagnosis of Belladonna, Hyoscyamus and Stramonium, which in individual cases can be extremely difficult, should, as I have stated before, be definitely established. Sometimes even urgently. This is easier said than done, as daily practice keeps reminding one. We therefore keep on the look-out for the most reliable distinguishing characteristics. A table of these has been compiled (see Table). The more complete our differentiation the safer we may feel in applying the therapy. But in those cases which frequently yield few symptoms the final decision as to whether Stramonium is indicated or not will always have to be based on one's own inner grasp of the archetype of Stramonium. Characteristic are: An inferno of lack of restraint, being an outsider, incalculability, paradoxy and unleashed power of nature, like an invasion by Mongolian hordes, earthquake, volcanic eruption, or a wild flood destroying everything-but on the other hand, to the observer, terrifying despression.--That is
8tramonium. I f our concern were with no more than the toxicology of what has been called the herb of madness this plant would hardly interest us. For even without. the help of such a poison our age has plenty of madness. But this poisonous plant seems particularly to derive from the spirit of that power which always desires evil and yet produoes good. Often enough that is the case if Stramonium is given to the suffering creature at the right moment as a homceopathic remedy, carefully aimed and potentized high enough to prevent damage. It is thus given by the hand of the homceopathic physician who humbly is nothing more and wishes to be no more than a grateful follower of Hahnemann.
Book reviews II manuale pratico della medicina omeopatica (Practical manual of homceopathic medicine). By Drs Beucci and Bardelli. Casa Ed. ,Barbera, _Florence, 1962. pp. 826. Today, science has been able to show that there is no schism between the visible and the invisible, the continuity between matter and energy has been proved, radiation and ultrasonics are ~employed therapeutically, and no one would deny the achievements of Filatov simply because the biostimuli have not been identified. There would thus seem to be ample justification for a revival of interest in Homceopathy, with the new horizons that it opens up, even though
129
POSOLOGY T i e indications for the use of this remedy are much the same as for Hyoscyamus o Belladonna with slight variations in symptoms as mentioned above. Acute maniacal states, puerperal mania, delirium tremens may call for the remedy. I t is said to be of special value in chorea, especially if involvement of the face muscles is a prominent feature.
The drug picture of Stramonium DR
MED.
DIETRICH
BERNDT
Concentrated in its ripe seeds, Datura stramonium, the thorn.apple, contains atropine, scopolamine and 1-hyoscyamine as its chief alkaloids, similar to B~lhdonna and Hyoscyamus. This seems to account for the similarity in the t~xicological actions of these three poisonous plants. It is difficult--and not only for someone who is new to differential homceopathic remedy diagnosis-to select the right one among these three, particularly if the patient is dangerously ill and a quick decision is vital. For there must on no account be confusion between Belladonna, 8tramonium and Hyoscyam~ when it is a matter of averting catastrophy in a clinical situation. These three remedies are not interchangeable. At the end of this paper a table is given which shows some of the clinically important differential characteristics. Typhoid and septic conditions with typhoid characteristics, sometimes also scarlet fever and its acute sequelse, for which nearly always only Belladonna i~ being considered, septic pneumonia, otitis media with meningeal eomplica. tions, before or after perforation or after incision, acute glomuleronephritis with residual nitrogen intoxication, septic erysipelas, septic tonsillitis, dysentery, lymphatic diathesis with continuous fever, bad cases of whooping cough and apoplexy followed by continuous fever--these and many others are acute clinical conditions where often ,.~tramonium is among the final choice as a lifesaver and indeed curer--and may prove to be of outstanding therapeutic value. In the sub-acute and chronic sphere it comes into consideration as a remedy for bronchial asthma, St Vitus' dance, delirium tremens, Parkinsonism, stuporous states, tic, paranoid syndromes, epilepsy, enuresis, postapoplectic loss of function, certain abnormalities in the female cycle, a certain type of disturbed sleep and specific visual disturbances at all ages, erotomania of both sexes and nymphomania. Translation of a paper from Zeit~chriftfftr klassi~che Homdapathie. 7 222-230, Sept/Oct 1963 and published with the kind permission of its Editor and of the K. F. Haug-Verlag, Ulm. Translated by R. E. K. M~lss, F.LL.
].30.
TYE
BRITISH
HOM(EOPATHIC
JOURNAL
This confusing though not yet complete list of clinical diagnoses needs a governing archetypal picture for homceopathic therapy. I n order to decide whether Stramonium is the similimum in the individual case, one must know the whole picture of it and have grasped its essential nature. The thorn-apple occurs in central and southern America and according to a more recent hypothesis it was at some time or other brought from there to Europe. But it also comes from the western parts of Asia, i.e. the Kingdom of Ghengis Khan. I n the European flora it has only been noted from the 17th century onwards. There is one very credible older tradition that the gipsies brought the seed to the western parts of our continent. W h a t have the gipsies got to do with S t r a m o n i u m ? - - A p p a r e n t l y quite a lot! They always carry the seed of the thorn-apple with them. On the one hand they use it as a narcotic and to prepare love potions. I n m a n y crises of conscience it also serves them as a talisman. I t furthermore plays an outstanding and convincing role as a remedy in their traditional medicine, which is not surprising considering its wide range of clinical use. I f we consider t h a t h e r e - - a s usually in folk medicine--we have the unconscious, instinctive application of H a h n e m a n n ' s law of healing, the law of similars, one m a y assume that some close inner relation exists between the two partners: the gipsy and the drug picture of the thorn-apple which in older herbals was also called "Tollkraut" (herb of madness; vid. "Tollkirsche"~Belladonna ~ mad cherry. Translator). Before I a t t e m p t to describe the extremely complex psychophysical drug picture of Stramonium I would like to give a personal reminiscence, from the final phase of the second world war when nations were in the melting pot, in a camp in Eastern Europe. Among the Hungarian prisoners were a group of about 25 gipsies, all in civvies because quite obviously they had never been soldiers. These kept as far as possible apart from their fellow-countrymen who spoke the same tongue, so that they might go on living their own life--undeterred by other camp affairs - - a n d this quite insouciantly. I n contrast to almost all the other inmates of the camp they were never hungry or emaciated. They ate their fill of the rats which were there in hordes and a great plague to the rest of the camp. Any a t t e m p t on the p a r t of those in power, however gentle or harsh, to get them to perform the imposed labours they repelled in such a way that in the end nobody dared approach them. They reacted heatedly, aggressively or stuporously. In some cases it was impossible to say with certainty whether illness was being simulated or really did exist. I f they were not sleeping or brooding they nattered unceasingly, day and night, rather loudly and with wild gesticulations. Although anything that would burn was scarce and dear, their barrack room was always dimly lit at night. At the same time others were lying on their bunks fast asleep, not even waking if one shook them by the foot. Some individuals would sometimes sit on their bunks for hours, bent forwards, forehead on their knees, murmuring to themselves or humming monotonous tunes. Now and then they quite unexpectedly presented the whole camp with spontaneous, wildly ecstatic performances in the main street. Some would sing and gesticulate wildly, usually rhythmically, others dance bizarrely, with acrobatic exhibitions in between. Their complexion was normally a pale yellow, but on these occasions their faces acquired a peculiar shiny light red coloration.
THE
DRUG
PICTURE
OF
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131
In their personal contacts they were amiable, devoted and mistrustful. They stole like magpies, everything that was not nailed to the ground. Often the tracks of the culprits could be seen to lead to their place through the freshly fallen snow. But nobody would have dreamt of facing them with it, for one had an idea that that might be the end of one. After all, it was known that even among themselves they easily drew their knives. They demanded a high price in consumer goods for their fortune telling. But in spite of the great hunger everybody paid up gladly: For one hoped in fear and trembling that one might ~urvive and return home. By the way, gipsy women are said to know a great deal more about the art of fortune telling than the men do. It is as impossible for us to understand the mentality of these people as it is for each of us even to understand himself. But perhaps a secret gipsy corner exists nevertheless somewhere within the convolutions of one's brain. If we now study the toxicology of the plant and its more subtle form, the drug provings on healthy persons, and add to this the consistent clinical experiences gained from the use of Stramonium, we shall find enough to establish the link between gipsies, children or old people on the one hand and the thorn-apple on the o~her. What is it that matches so neatly in ethnology, toxicology a n d biography? A tendency to violence, ecstasy, passion, shouting and screaming, fantastic notions and visions, often producing fear and horror. Pseudologia fantastica in childhood and old age, fearfulness, hallucinations of all kinds, reaching for objects which are not there. Pavor nocturnus. Is wide wake, fearful, but does not recognize own family. Insists one or more of the limbs are too large. Confusion, laughing and weeping, often alternating abruptly. Whimpering, shrieking, unrest, cantankerousness, unpredictability, attempts at escape (e.g. from bed). Kleptomania, nonsensical ceaseless chatter, dancing and singing, convulsive laughter, grimacing, swearing and praying in constant alternation, convulsions. This is the manic phase of the drug picture. Now the depressive phase: sadness, thoughts of death, despair, staring in front of themselves, catatonia, thought block, weakness of memory, lack of power of concentration and inability to express oneself clearly. Stammering and stuttering. Absolute desire for company. The child sleeps only when it is holding its mother's hand. That would be a rough outline of the outstanding psychic changes in the Stram9nium picture. In the vegetative sphere the drug picture shows: epileptiform spasms, intermittent jerks in individual muscle groups, but also periodic, regular jerking movements of the whole body. Rolling the head, grinding of teeth, biting. Talking and screaming in dreams. Movements are hasty and incalculable. Dizziness and reeling as if drunk, heaviness of limbs, motor unrest, tremor, ophistotonus. Total anuria, incontinence of stools and urine. A description of the more organotropic, physical symptoms which would be next on the list and which quite by the way may indicate Stramonium, will be omitted. Our sifted, complete or abridged materia medicas and not least of all the repertories give sufficient information about details. The study of these belongs to personal endeavour or directly at the bedside. The practitioner would certainly profit greatly by an occasional recapitulation of the organic symptoms of Stramo~ium. For unless he is familiar with the whole picture of
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this remedy he will hardly be able to cope with everyday practice homceopathically. All physical diseases which have the characteristic that the symptoms appear in combination with striking and possibly bizarre psychic changes demand a glance at the psychic picture of Stramonium. The mental symptoms and the peculiar symptoms or modalities are the most decisive for selection. Just a few of the modalities and peculiar symptoms which have proved valuable in practice and seem important shall be mentioned for this remedy, which has so many paradoxes, apart from those mentioned already. The list below, which is left unsystematic on purpose, does not claim to be complete: Always wants light, but turns away from direct light. Direct look at light produces muscular spasm, mental confusion, epileptiform attack, asthmatic state, attack of coughing or screaming. And even more: I f one shines a light into the face of a Stramonium.sick child to test the reaction of the pupils, the child is likely to hit out and strike the pencil light from one's hand, he shrieks and raves, goes into spasm or coughs. The physician might think the child was badly brought up and sometimes that may be the case. But much more often it means that the child needs the right dosis of Stramonium. Awful thirst, but nevertheless increased restlessness or tendency to spasm if a drink is given, and even spasm in swallowing if tries to swallow a drink. The appearance of mental changes, manic or depressive in type, showing a direct time link with the female period or with inexplicable, sudden cessation of menses, e.g. also with elimacterium preecox. Pathological mental or neuro-vegetative symptoms in connection with sudden cessation of secretions or excretions should also remind of Stramvnium. This arises for instance in connection with eczema, ulcus cruris, fistulm, otitis media, diarrhceie diseases. It is immaterial whether the cessation of secretion was due to chemical, exogenous action or unknown internal causes. When an endemic of measles is dying down, a minor series of illnesses usually appears in children who were not affected, and without any particular previous warning the ear drum perforates spontaneously. This is probably a substitute reaction which one might call "outsiders' measles". The excellent work of the wise orthodox physician and p~ediatrician Prof. Czerny provides a detailed description of this problem. The accompanying mental symptoms very often indicate Stramonium. Its prompt healing action is evident and usually surprises even the physician! One example: CASE 1: Two older siblings had just got over the measles in the course of a normal endemic when in the youngest of the family, a boy of three at the time, the left ear drum perforated suddenly and there were loud howls of pain. Cloudy serous discharge, with a little blood in it at first. No rise in temperature. No stools for three days. Great thirst, refuses food, tongue clear, but eoloured a striking deep red. No therapy on my part to begin with. Two days later the ear suddenly ceased to discharge, but instead there was vomiting, temperature of 103.1 ~ F rectally, headuche in forehead and back of head, pink scler~e, sensations of fear, the light must be left on, the mother must sit by his bed all the time and hold his hand. Murmuring, whining, suddenly shrill laughter. Wants to get out of bed quickly. Jerking movements through the whole body. "Mummy, my foot is much too long"--"Mummy, there a r e mice on the wall." "Mummy, hold t i g h t - - t h e y are coming to get
THE DRUG PICTURE
OF S T R A M O ! ~ I U M
13~
me!" The small hand keeps reaching into the air, fending off what is not there. I was called at about 5 p.m. Test for Kernig's sign indicated severe meningism. Mastoid process on left very painful on percussion. Pupils wide and reacting sluggishly to light. At any attempt to shine a light on them loud screams of pain. Fearful, wild facies. Rigors. The clinical diagnosis for such a process is septic otitis media with basilar meningitis, i.e. a case which is usually sent to hospital. And not infrequently a young life reaches an untimely end under lumbar puncture and antibiotic therapy, not to mention the chisel. The remedy diagnosis Stramonium and one dose of the 30c of this on the other h~nd brought instant deep sleep, lowering of the temperature towards morning and after an offensive black stool desire to eat, reappearance of strong serous discharge from the ear which decreased slowly and continued for one week. Eight weeks later no defect could be seen on the ear drum.--This happened nine years ago. Apart from an occasional cold the boy has never been ill since. Such a clinical course under homceopathie treatment is not unique in practice. And fairly often, though certainly not always, the remedy diagnosis is Stramonium. That sudden severe fright may give rise to severe clinical sequelae is a fact known to practitioners of all schools of medicine. Stramonium has striking relations to fear, fright and shock. Again an example: CASE 2: In a newly built estate house the ceiling of one room comes down suddenly in the middle of the night, with a noise like an earthquake. A little girl of 2~ in the next room starts up and will not stop screaming for the rest of the night. The light must be left on and the child holds tightly and fearfully on to her mother. No more sleep for both of them. The next day lack of appetite, constipation and unusual thirst. In the afternoon a high temperature of 106-3 ~ F sets in suddenly with rigours. So I was called. A perfect Aconite picture--that's how it looked. But Aconite did not show the least effect. Then it seemed that Belladonna symptoms became discernible. Belladonn~ added severe t u m m y and headache, contributing anything but a therapeutic action. On the third day with a temperature of 106.3 ~ F disquietude and mistrust arose in both the child and her parents, and disquietude also in the physician. Thv unrest of the child developed to an extreme degree and became confused: un~gtivat~d shrieking, whining, shouting, folding the hands up tight, suddenly re~ching out for rabbits which apparently were running along there. When given a drink which she had asked for, she swallowed the wrong way. The light must be left on in the room. "Mummy, put the light on again", and y e t she turns away from the light. Pupils are fairly small and react sluggishly. Incoming light produces convulsive defensive move nents.--Temperature still 103-0 ~ The Stramgnium picture had developed so fully that even the physician could see it now and the remedy was at last given in the 30th potency. After about 15 minutes' deep sleep. The next morning the fever went down and the appetite returned. In the afternoon a horribly smelly, greeny-blackish slimy stool. The next day it was as though none of this had ever happened. During the following seven years no other illnesses except for one attack of whooping cough which was very mild.
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Aconite, Belladonna and other remedies also have "results of fright" in their drug pictures. But this case was quite obviously Stramonium. Goethe's "Erl-king" gives a much more impressive description of what fear, fright and terror can do, even if they are entirely due to the imagination. Death may occur, even in childhood. As a poison, Stramonium leads into the sphere of death. But if it is used in the right sense, in particular, very acute, results of fright, it can also just as surely lead one out of this sphere again. The eye connections of Stramonium are varied and worth special consideration. I f eye diseases or disturbed vision appear in childhood and there are accompanying symptoms belonging to the general Stramonium picture, then this remedy comes very much into the final choice. Among other things for blepharospasms, blepharophlegia, injection of sclerse and cornea, fixed stare, pupils too wide or too narrow. Chromatopsy, colour confusion, seeing coloured borders around objects, double vision, objects appear at an angle, float away, are too big or too small. Temporary far-sightedness. In more general terms: weakness of accommodation. Many a school child has been permanently relieved of compulsory accommodation glasses through Stramonium. Strabismus also belongs into the therapeutic range of this remedy. In this context onepartieularly important key symptom which experience has confirmed shall be mentioned: Visual disturbance or even temporary blindness through mental over-exertion, e.g. the assiduous scholar or student. But these are not the only categories involved. CASE 3: Please consider a puppy. Barely one year old, one of the favourite types of hunting dog, amenable to training and highly intelligent. Gelman short hair, highly bred and probably also slightly inbred. Veiy playful, full of wild movement impulses, full of fantasy, sensitive, depressive. AecoIdi~g to the breeder, there have been some cases of blindness followed by epilepsy in his family, always near the end of the first year. :Not one of the affected animals survived this particular phase. Death in the veterinary clinic, by injections from the vet, or release through a bullet. In the puppy of which I am speaking total blindness came on suddenly. The owner, a good observer of animals and full of good sense, said spontaneously that this was the result of inhibiting the movement impulses by training. Two days later epileptic attacks with long aura (whimpering, crying, whining) and severe convulsions, biting of tongue, urination and defsecation, followed by comatose sleep filled with fearful dreams and occasional movements of flight. Barking, biting, whimpering, aura, attack and dream sleep follow one another almost without pause. Refuses food and has great thirst, in the end also lack of thirst. The first vet thought it might be tetanus and gave calcium injections. The second vet took the temperature and found a slight rise, assumed it was encephalitis or meningitis and gave streptomycin. The great number of attacks, their length and severity were meanwhile increasing. The veterinary hospital was recommended. On the sixth day someone among the hunting friends thought of the homceopath for a change, for a last attempt. The therapeutic ambition of the latter was stimulated. One's ability to grasp things is not the same every day. Whether on this day it was good enough or not will be seen from what followed. Blindness at school age in a dog due to inhibition of movement and other non-physiological compulsions imposed. Then the near fatal epileptic attacks.
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R e striking f a n t a s y e l e m e n t i n the m a k e - u p of the animal. Such a c o m b i n a t i o n .f associations exists in h a r d l y a n y other picture b u t S t r a m o n i u m . One dose of 0c, given i n the e v e n i n g d u r i n g a n aura, a t once leads to a deep sleep, i n s t e a d f the expected convulsions. This sleep ended i n the m o r n i n g with r e t u r n of onsciousness, t h i r s t a n d hunger, b u t with the t o t a l blindness still persisting. Lround n o o n one f u r t h e r dose of S t r a m o n i u m 200. I t m a y be t h a t this was uperfluous: to prove the opposite i s - - a s always i n b i o l o g y - - n o t possible. B u t t a n y rate a t 3 p.m., i.e. two hours later, the owner telephones: "Doctor, i t ' s .1credible, he can see again. J u s t t h i n k , he is p l a y i n g hide a n d seek a g a i n i n
Belladonna
lharacter, type
I n health: highly
~eneral
Acute, little delirium. Inflammation usually localized, e.g. head hot, abdomen hot, feet icy cold; sometimes also icy cold hands. Overpowering pain; desire for company rather than
intelligent, good, gentle, affectionate, docile, timid, but: desire for independence until almost unapproachable. When ill: Insufferable, irritable, rude, not amenable to discipline, accusing, complaining, wild yelling.
aversion.
"
Straraonium I n health: contradic-
tory, difficult, incalculable, quarrelsome, anxious, desire for independence yet devoted. When ill: Unbelievable inferno of these same traits, aggressive.
Hyoscyamus
Suspicious, jealous, impatient, intolerant, anxious, incalculable, offensive.
Post-acute: sequelae Acute, subacute: of unresolved a c u t e Infernal delirium conditions; with tendency to slip cedematous (skin into agony suddenly or internal organs), when it is at its poor reactivity, greatest height. shackled energies'--Pain rare, often wants to, but can aggravation. no more. Disinclined Absolute desire for to answer, answers company. a n d at once relapses into deep sleep.Indolent, indifferent to company, neither for nor against.
type of fever
Preferably: high and discontinuous, alternating--first high, then low, then high again. Body warmth often irregularly distributed.
Continuous: high temperatures rare, usually medium, sometimes slight. Body warmth is distlibuted evenly.
Hardly any temperature. When strength to produce a temperature has gone or never existed to begin with.
~omplexion
Deep red to blue-red head, colourless extremities.
Pink (only rarely deep red). Hardly ever pale.
Pale (rarely slightly red).
~ttitude to light
Aversion to light.
Absolute desire for light; direct light is disliked, evokes spasms, anger, cough,
Indifferent as to whether it is light or dark.
etc.
This attempt at a differential diagnostic comparison is partly based on the paper g i v e n by Dr H~nni (Bern) and Dr Welter (Ottersberg) at Bad Brtickenau in May 1963. It requires more to complete it and it is hoped that those with clinical experience will contribute furthar indications, h o w e v e r small.
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the garden with our dachshund."--That is what he is still doing now, fcur months later, and judging by my personal experience with Stramonium one m a y assume that he will continue to do so. The differential diagnosis of Belladonna, Hyoscyamus and Stramonium, which in individual cases can be extremely difficult, should, as I have stated before, be definitely established. Sometimes even urgently. This is easier said than done, as daily practice keeps reminding one. We therefore keep on the look-out for the most reliable distinguishing characteristics. A table of these has been compiled (see Table). The more complete our differentiation the safer we may feel in applying the therapy. But in those cases which frequently yield few symptoms the final decision as to whether Stramonium is indicated or not will always have to be based on one's own inner grasp of the archetype of Stramonium. Characteristic are: An inferno of lack of restraint, being an outsider, incalculability, paradoxy and unleashed power of nature, like an invasion by Mongolian hordes, earthquake, volcanic eruption, or a wild flood destroying everything-but on the other hand, to the observer, terrifying despression.--That is
8tramonium. I f our concern were with no more than the toxicology of what has been called the herb of madness this plant would hardly interest us. For even without. the help of such a poison our age has plenty of madness. But this poisonous plant seems particularly to derive from the spirit of that power which always desires evil and yet produoes good. Often enough that is the case if Stramonium is given to the suffering creature at the right moment as a homceopathic remedy, carefully aimed and potentized high enough to prevent damage. It is thus given by the hand of the homceopathic physician who humbly is nothing more and wishes to be no more than a grateful follower of Hahnemann.
Book reviews II manuale pratico della medicina omeopatica (Practical manual of homceopathic medicine). By Drs Beucci and Bardelli. Casa Ed. ,Barbera, _Florence, 1962. pp. 826. Today, science has been able to show that there is no schism between the visible and the invisible, the continuity between matter and energy has been proved, radiation and ultrasonics are ~employed therapeutically, and no one would deny the achievements of Filatov simply because the biostimuli have not been identified. There would thus seem to be ample justification for a revival of interest in Homceopathy, with the new horizons that it opens up, even though