Acquaintance with our Materia Medica is the, vital point of all homoeopathic knowledge. It is, therefore, greatly to be lamented that so many of our younger Homoeopathists regard this as a bagatelle of which it is impossible and not worth while to make a deep study; it is a pity that these colleagues should still be held under the influence of the pestilential vapor of skepticism and objectivity which they have inhaled in the pathological-anatomical hospitals'; and instead of making their attainments in pathology and diagnosis available for the development of Homoeopathy, regard the former as the most important requisites for the practitioner, and consider Therapeutics, on the other hand, as a sort of contingent accessory; for which reason too they seem to be content with a knowledge of some of the most obvious and most frequently encountered properties of Aconite, Bell., Puls., etc., without concerning themselves about the peculiar treasures of our Materia Medica. Against such a treatment of Homoeopathy, we must protest again and again until a reform is effected. But in regard to our Materia Medica, we older Homoeopathists are not quite clear of reproach. We do not devote industry enough to it and we allow many a grain of gold to lie in it unsought and unused. And we especially deserve this reproach with reference to the newer provings, among which unquestionably those of Hering take first rank. “What does it profit, if we express in words our admiration of the industry and devotion of the provers instead of testifying our thanks by deeds, by verifications at the bedside. There lies before us a large volume of new provings, and how little have we as yet availed ourselves of them! Had not one of our own most skilful students of Materia Medica, Wolf in Berlin, called attention in so eloquent and convincing a manner to the practical value of Apis mellifica, who knows whether this widely acting and inestimable remedy might not still be lying quietly in its grave along with the rest? It is all the more incumbent upon us to make ourselves familiar with Hering's provings, because they avoid, as much as possible, the deficiencies that have been charged against the provings of Hahnemann (the failure to give the day-book, the size of doses, etc.), and in the schema of symptoms many changes have been introduced which facilitate the search for any special symptom.
If we carefully read the individual provings and the pathognomonic effects of Glonoine, we shall have no great difficulty in apprehending the complete picture of its action upon the human organism. This may be depicted in its general features in a very few words. It is in fact a Hyperaemia, in some parts very turbulent, or an active congestion of the organs which lie above the diaphragm. Its primary action, which is very speedily manifest, consists in the excitement of a storm in the vascular system. The blood is driven to the upper parts of the body with greater rapidity and increased force, the capillaries are overfilled and distended, the reflux of the blood is impeded and so there arises a hyperemic condition of the first degree. It is true the Glonoine congestion is rather fugitive in its character and short in duration, that is to say, we soon see the increased vascular activity returned to its normal grade and so the congestive symptoms disappear again, but nevertheless the Glonoine-Hyperaemia is not only accompanied but also followed by all those symptoms which are peculiar to congestions that depend on other causes. Thus we find connected with it, loss of consciousness, syncope, increased warmth and abnormal sensations, heaviness, fullness, oppression and pains of the most various character. As sequelae attending the reaction, we have in this case, as after hyperemia depending upon other causes, relaxation of muscular tone, lassitude, which, as already said, may amount even to syncope, trembling, indications of spasm and finally a paretic condition. Even the mucous membranes are affected by this hyperaemia as is shown, at first, by their abnormal dryness and subsequently by increased secretion. The same is true of the alimentary tract although its functions are involved to a less extent. The action does not go so far, it is true, as to produce hemorrhages and exudations, but it cannot be doubted that, by a longer continued use of the remedy and a longer maintenance of the congestion produced by it, these phenomena would be induced.
Let us now seek to fill up this general outline of the effects of Glonoine by its special characteristic phenomena, and to discover the peculiarities which mark the hyperaemia of Glonoine. Inasmuch, however, as the circumspect physician makes it his first business to discover the focus and primary seat of the disease, so must we, if we are striving to get a clear insight into the pathological action of any remedial agent, first of all seek to discover what organs are first affected by its medicinal power. If we do this now, we shall find that Glonoine attacks first and by preference the central organ of the circulation — the Heart — and from this point forth, its other effects are developed in stormy haste.
This primary attack then manifests itself, first, by a painful feeling of fullness and constriction in the cardiac region, which sometimes extends the throat and simultaneously with which the pulse decreases in frequency Soon however comes a feeling of heat in the heart, it is freed from its condition of spasmodic constriction, its activity is increased, the impulse of the heart is perceived by means of the stethoscope to be loud, stronger and irregular, indeed it is often so violent that it may be heard through the clothing. Of course, this increased force of circulation is observable in the larger vessels and throbbing of the carotid and temporal arteries and distension of the jugular veins are distinctly visible. The pulse corresponds to the above symptoms; it increases rapidly in frequency and fullness so that it sometimes leaps from 60 to 120 beats; only in now and then a single case is an alternation between slowness and frequency of the pulse remarked; sometimes the pulsations are irregular or intermittent; in rare instances the pulse is dicrotos and thready. The violent pulsation is not confined to the arteries which are visible. It is felt in the neck, the ends of the fingers and even through the whole body, which fact makes the frequent feeling of anxiety and restlessness easy to comprehend.
Along with this vascular storm, certain painful sensations exist in the heart itself, which are described sometimes as sharp, sometimes as extending through to the supra-scapular muscle. But these are hardly noteworthy in comparison with the pains which Glonoine produces in the head.
A feeling of fullness and heaviness, as if from a weight, and which extends as far as the eyes and ears, is very soon experienced. Then comes a feeling, as if all the blood in the body had ascended to the head, as if the head were constricted by a band, as if something distended the brain in all directions, as if the head were too long and the cranium too small, as if the head would burst, as if the brain itself moved when the head is shaken, and as if warm water were trickling down the forehead. At the same time there is a constant heat of the face and, along with either painful or painless throbbing, the head is confused as if from drunkenness.
Among the varieties of pain in the head, squeezing and pressure are the most prominent and most frequent, and this sensation of pressure has the following peculiarity: that its direction is, for the most, from below upwards and from within outwards. In addition to the pressing pain, others are observed though in a less degree and less frequently, such as sticking, cutting, jerking, soreness and a bruised sensation in the head and among these the feeling of soreness appears most frequently. In one prover it was so severe that he feared to move his head with any considerable freedom, because motion produced a feeling as though his head would fall in pieces.
All of these varieties of pain, especially the pressing and squeezing, may reach so excessive a severity as to bring the provers to a state of desperation, and when the pressive pain is in the occiput to cause failure of the senses. Indeed the severity of the pains causes sometimes syncope and loss of consciousness with sweat.
The locations of these head-pains is generally the forehead, often over only one eye, but not unfrequently also in the temples, vertex and occiput. Sometimes the pain begins in the occiput and proceeds thence to the vertex and forehead, so that several provers have remarked a kind of wavelike ascending of the blood from the heart through the nape of the neck into the head.
Among the concomitant phenomena of the headaches, we must call especial attention to the vertigo which sometimes comes after the headache, but is most apt to arise on stooping, shaking the head or inclining it backwards or when stepping into the open air (?) and then may be compared with the sensation which is sometimes experienced when we first step ashore after a long journey in a boat. The headache is accompanied by general heat or by heat of the face only, accelerated and hard pulse which is often felt in the head. Nor are even the nausea and vomiting which not unfrequently attend severe cephalgia wanting in these cases.
In the eyes a feeling of heat and confusion is noticed; they become injected and protrude, the pupils being dilated; the lower lids are reddened, puffed and have sometimes a darkened appearance, or a blue ring under them. The eye itself is unsteady and trembles; occasionally it is staring. Sparks and flashes of light, or else a cloud appear before the eyes and affect the powers of vision. Heaviness, pressure, sticking and soreness in the eyes and the orbits sometimes accompany the above described phenomena.
The external ear becomes redder than usual and the congestion of blood in the part induces a feeling of sticking. A further consequence of the congestion of the organ of hearing is a buzzing, ringing, hissing, a feeling of fullness and obstruction in the ears, which may also give rise to a certain degree of deafness.
In the teeth, a painful pulsation is experienced, and in the malar bones and maxillae a more indefinite or twitching pain with a feeling of stiffness. Similar sensations are experienced in the nape of the neck.
Inasmuch as the central organ of the circulation is first and most of all affected by the action of Glonoine, it is not to be wondered at that at the same time with the headache or shortly after it, the thoracic organs should be drawn into sympathy. A feeling of disquiet, of oppression of the chest and of constriction as if with chains, superficial and accelerated respiration, dyspnea with disposition to deep inspiration and sighing, and here and there sticking pains in the chest are among the symptoms of Glonoine.
The symptoms already enumerated bear the distinct impress of hyperaemia, but the circumstances and conditions under which the head-affections are aggravated or ameliorated, furnished additional evidence of the purely, congestive character of the action of Glonoine.
The headache is aggravated by moving and shaking the head, with this peculiarity that it is aggravated not by violent, but rather by moderate and gentle shaking; also by stooping; by going up and down stairs when every step is felt like a shock in the head; also by long and steadfastly looking at an object, by writing, reading, mental exertion, tobacco smoking, after being overheated, and after dinner; finally, according to an observation of Hering upon himself, it is worse after an expiration, especially if the following inspiration be delayed.
On the other hand the Glonoine headache is relieved by rest, by lying down, by sleep, in the open air and by compressing the head bo that one prover had a band tied tightly about his head for the relief of an exceedingly severe pain.
From all of these symptoms it is very clear that the entire action of the drug in question consists in an increased propulsion of the blood, especially towards the organs which lie above the diaphragm.
In the sequelae moreover, a true picture is developed of such phenomena as are wont to manifest themselves after violent or long continued congestion. If, for example, the Glonoine-hyperaemia is of long duration or if it is kept up by repeated doses of the drug, the mucous membranes participate in the morbid affection. Coryza appears; the secretion of saliva and of mucus is increased; a feeling of heat and burning in the fauces arises, and at last there is clear evidence that the whole digestive tract is involved. The tongue has a white coat; it appears large and somewhat swollen; the papillae project as if raw, with a biting and sticking pain. Nausea and retching set in, with pressing, gnawing and a sensation of emptiness and soreness and a restlessness in the stomach, stickings in the hypochondria, cutting, pinching, and rumbling in the intestines, flatulent distension and for the most thin stool. The secretion of urine is increased.
If now we take a wider survey we perceive that the nervous system is secondarily affected. Despite the fact that the Glonoine-hyperaemia is rather of fugitive character, and is easily removed by resolution so that the disturbances are again set at rest by a speedy reflux of the blood from the overfilled organs, nevertheless many facts indicate that, whether in consequence of the pressure exercised upon the brain and medulla oblongata by the congestion, or by reason of the anaemia of other parts which is a correlative result of the hyperaemia of the congested organs, the nervous system is disturbed in many of its functions.
We find, accordingly, in the nervous sphere of sensibility, pains in the whole spine, in the sacral region, in the shoulders whence the pain extends into the arms and occurs with especial violence in the dorsum of the hand in the metacarpus of the middle finger; also pains in both elbows in the ulnar nerves, in the ulnar side of the wrist joint, in the inner side of the right middle finger from the metacarpus outwards, on the lateral parts of the knees under the patella, in the calf, in the heel and along the sciatic nerve.
But the consequences of the hyperaemia which has taken place, are much more distinctly pronounced in the region of the motory nervous system. As after every strong excitement a corresponding and opposite reaction follows, so is it here also. Soon after the hyperaemia has reached its climax and the distended vessels begin to empty themselves, a sense of exhaustion and weakness begins to be felt throughout the whole body, which seems somewhat like the sensation after a violent fright; but it is especially the joints of the extremities and the extremities themselves which are seized with a kind of weakness and trembling; the legs and knees refuse their office and give way; the limbs totter; the hip and knee joints crack in walking. But this feeling of weakness and want of power are not all. There are not lacking many indications of the beginning of a paretic condition. — A creeping sensation is felt, like the streaming of electricity through the whole body, an unpleasant nervous feeling of disquiet in the arms and hands requiring them to be kept continually moving and turning, heaviness in the arms, which when they are hanging down cannot be lifted up again above the head, numbness and weight in the arms which really render it difficult to move them, numbness and feeling of fatigue in the left arm with stiffness of the middle finger-joints, numbness of the left leg and thigh, and finally when prover is sitting the legs easily “go to sleep.”
The above would serve as a condensed picture of the action of Glonoine upon the healthy human body, in so far as this action has as yet been investigated. Assuredly this remedy is worthy of a repeated and more extended proving, to which indeed Constantine Hering has himself invited us, for it may with the greatest probability be assumed that the sphere of its action would prove to be much more extensive than that with which we are at present acquainted. Mean-while, however, on the basis of our present knowledge of it, its clinical valuation must be by no means a very limited one.
If we enquire now; in what morbid conditions Glonoine may be administered in accordance with the homoeopathic principle, congestive headache of a severe grade would certainly take first rank, such headache as frequently ensues after violent mental or emotional excitement, such as fright, anger, etc., the first hurtful influences of which appears like wise to be exerted upon the nerves which control the functions of the heart.
We should also be inclined at least to test its efficacy in those cases in which hyperaemia (attended with pain) of the upper organs of the body depends upon a modification of the function of the heart resulting from internal pathological causes. Even in congestions caused by hypertrophy of the left side of the heart, the administration of Glonoine might be recommended at least by way of experiment; especially since we have a slight indication for such a use of it in symptoms 636 of Hering's proving, viz.: “636. In the evening, after lying down, an anxious feeling in the region of the heart, with throbbing, a purring noise and intermittent pulse; he must lie with the head elevated; intolerable when lying on the left side, better when lying on the right side; after getting up and walking about, it passes away. The same sensations after dinner when leaning against the chair for three months“The long duration, as well as the concomitants of this symptom, among which the purring noise may be specified in particular, justify the assumption that in this case, an important organic lesion of the heart had already previously taken place. Furthermore some essays might be made with Glonoine in cases of Pericarditis and Carditis, when with these are associated congestive conditions and when our already well proved and trusty remedies have left us in the lurch, even if it were only in the expectation of overcoming certain single symptoms, for, if we hold ourselves strictly to the physiological results of provings, the cure of inflammations does not seem to lie within the sphere of the action of Glonoine.
In the same symptomatic way it might be tried also in cases of Encephalitis and Hydrocephalus acutus as well as in the so-called cerebral typhus. In cases of sunstroke it has already, according to several communications from America, accomplished remarkable results.
But I regard Glonoine as of the greatest importance, in a therapeutic point of view, in cases of threatening cerebral apoplexy. When the following symptoms appear as precursors of that affection, viz.: violent headache, fugitive redness and heat of the face or head, exaltation or depression of spirit, feeling of anxiety or distress in the chest, violent palpitation of the arteries of the head and neck, vertigo and confusion of the head, sparks, flashes of light and a cloud before the eyes, humming in the ears, general lassitude and heaviness of the limbs, restless sleep and frightful dreams, etc., etc., — we. should not, in such cases delay having recourse to the powerful action of Glonoine, for it is possible that we may still succeed in calming the storm before a vessel has given way and apoplexy has ensued. I would therefore recommend most earnestly a trial of this remedy in such like cases of threatening apoplexy. In such essays; however, most especial attention must be directed to the size of the dose, which should be such as to obviate any chance of a primary action. For too large a dose might easily increase to a still greater extent the tension of the vessels, and this, even though it should last the shortest possible time, might yet bring about a result altogether contrary to our expectations, for in such cases the question is often one of instants of time.
But, how far Glonoine may exert a curative action, when an extravasation of blood has already taken place, must for the present be regarded as an open question. Assuredly the proving contains, as we have seen, no small number of symptoms which bear a certain resemblance to the conditions which follow an apoplexy, but these are only faint traces and intimations. Nevertheless we may not too decidedly depreciate their value, for we must not forget that every physiological proving has its limits, and these cannot and ought not to be transgressed without enduring injury to the provers.
We may, nevertheless, assume at present, with tolerable certainty that Glonoine will verify its curative power in relation to all those conditions of debility and paretic phenomena of which we took a comprehensive view, when treating of its action on the motory nervous system.
Whether, on the other hand, it be likely to render any service in certain kinds of spasms, such as Epilepsy and Eclampsia, we must the rather leave to clinical experience, inasmuch as the symptoms which seem to bear on this point, to wit; “convulsions, especially on the left side, with outstretched fingers” — “falling with loss of consciousness with congestion of head or heart, face first pale and then red” — and, “falling with loss of consciousness and jerkings and frothing at the mouth after alternation of palpitation and cerebral congestion” — were observed only as curative symptoms of Glonoine on two patients. It likewise remains a question, how much aid Glonoine is likely to afford in certain mental disorders.
More than this we may not venture to deduce from the physiological proving that lies before us if we would not betake ourselves to the region of the Hypothetical. But I am of opinion that if Glonoine make good its promises only in the affections already named, we possess in it a most precious remedy for which our heartiest thanks are due to our colleague — Dr. Hering.
In conclusion, I take leave to call attention in few words to certain obvious points of differential diagnosis between Glonoine and two old and well approved remedies of our Materia Medica — I mean Aconite and Belladonna. It may not be denied that both of these remedies present a great similarity to Glonoine in its chief action, for both produce, as is well known, a high grade of hyperaemia, which, when superficially regarded, seems hardly distinguishable in its elements, course and sequelae from the congestion produced by Glonoine. On a more attentive consideration however the differences are easily perceived. While, for example, as we have already shown, Glonoine makes its attack only upon the central organ of the circulation, or, to speak physiologically, upon the motory nerves of the heart, Aconite and Belladonna attack the ganglionic system and exert their action in an especial manner upon the whole vaso-motory nervous system. It naturally follows that they likewise, by such action, produce violent hyperaemiae, but aside from the fact that these present themselves with different phenomena, the description of which would lead us too far from our purpose, they differ in other important respects from the Glonoine-hyperaemiae. As we have already seen, the latter have a definite direction marked out for them and their peculiar rendezvous is the head, whereas the congestion of Aconite and Belladonna may establish itself in almost every organ. But even if the latter take up its position in the head, a clearly marked difference is discernable. The Glonoine affection is of a more fugitive and superficial nature. That of Aconite and especially that of Belladonna is of a more lasting and intense character. Notwithstanding the fact that the Glonoine pains, when they are first experienced, are of a more violent and tormenting character than is generally the case with Aconite and Belladonna, yet the concomitant phenomena show that the onslaught of Glonoine is much the lighter and less energetic. It would seem to me then as though the congestion produced by Glonoine might perhaps affect only the vessels of the external head or at most those of the meninges, while both the other remedies affect the vasa cerebri and the brain itself. We therefore see so frequently under the two latter remedies, as concomitants of the congestions, delirium, hallucinations, coma, etc., and on this account the sequelae of the hyperaemia of Aconite and Belladonna are of greater gravity, viz.: hemorrhages, extravasations, real paralysis, spasms and convulsions. But of all this train of phenomena, we find under Glonoine nothing at all, or, as already remarked, only slight traces of beginnings.
The most essential distinction, however, seems to me to be this, that the hyperaemia of Aconite and Belladonna seems to require only one step farther to result in inflammation, and that straightway the whole arterial system is brought into a condition of excitement, whereas, on the other hand, the physiological proving of Glonoine shows not the slightest trace of inflammation or fever.
We might therefore briefly express ourselves as follows: Whereas Glonoine, in comparison with the two other remedies, exerts a more local and fugitive influence, the action of Aconite and Belladonna is of a more general and a more intense character, inasmuch as it speedily brings into sympathy the whole vascular and nervous system and consequently far outstrips Glonoine in its extent and consequences.
|The American Homoeopathic Review Vol. 03 No. 06-07, 1862-1863, pages 273-279, pages 314-319
|The Action of Glonoine.
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