The tincture of the root of BRYONIA ALBA, or dilutions made from it, were used by Hahnemann in his provings. The root of this vine, which grows in hedge-rows and along fences in England and on the continent of Europe, furnishes us the tincture from which our preparations are made.
Pereira calls Bryonia a violent emetic and purgative. Trousseau and Pidoux speak of it as an active purgative, to be used like Colocynth and Elaterium. But Hermand de Montgomery declared that he had frequently cured vomiting, colic, diarrhoea and dysentery, with Bryonia,—an illustration, from allopathic sources, of the homeopathic curative action of this drug.
In the majority of modern works on materia medica, of the allopathic school, Bryonia is not mentioned. Yet it has for centuries been recognized, among the people of Europe, as a specific for certain ailments, and eminent physicians of earlier ages have recorded many cures by it. Cataplasms of the root were successfully used to scatter inflammatory swellings of the joints. This was a homeopathic prescription in so far as the selection of the drug was concerned. The ancients cured dropsy with it, and especially hydrothorax (and we use it for pleurisy with fluid exudation). Sydenham used Bryonia as a remedy for intermittent fever. Teste says the French peasants of Lorraine use the root as a specific remedy for hernia. I learned from observation that among the peasants residing in the Maremma, on the shores of the Mediterranean, north of the Pontine marshes, Bryonia is commonly (and successfully) used as a remedy for the peculiar type of intermittent and remittent fever which is endemic there. We shall see how these instances confirm the law of SIMILIA SIMILIBUS CURANTUR.
Our entire knowledge of the action of Bryonia on the healthy subject is derived from the proving by Hahnemann and his pupils, and from the Austrian provings, arranged by Professor Zlatarovich. From these sources we construct the following RESUME in which, as before, we follow the anatomical order:
SENSORIUM. The action of Bryonia is well defined and constant. Every prover describes, in language more or less emphatic, a " confusion of the head," a " distracted state of the sensorium." When we consider this symptom in conjunction with the peculiar febrile symptoms, the lassitude, etc, we shall perceive its significance. Great heaviness of the whole head. Weight upon the vertex. Vertigo, when fasting, when standing, and especially on first rising from a seat, compelling to sit; often conjoined with headache in the occiput, aggravated by motion.
HEADACHE. Dull, pressing headache in the forehead and temples; drawing and tensive headache in the temporal region; drawing and tearing pain from the temple down to the malar bone and to the lower jaw (this symptom promises aid from Bryonia in prosopalgia). Sticking, jerking, throbbing headache from the forehead backward to the occiput. (This symptom is characteristic, being paralleled in no other drug. Spigelia has pain darting from behind forward through the left eyeball. Silicea has pain coming up from the nape of the neck, through the occiput and over the vertex, and so down upon the forehead. Carbo vegetabilis has dull, heavy pain extending through the base of the brain, from the occiput to the supra-orbital region.)
The majority of the head-symptoms of Bryonia refer to the occiput, and we shall find it more frequently called for in headache involving the occiput. In this respect it may be compared with Petroleum.
The sensorium is blunted.
All the symptoms of the head are aggravated by motion and exertion.
The pathologico-anatomical results of Bryonia poisoning are : " Redness of the diploe, injection of the inner surface of the cranium. Congestion of the membranes. A section of the cerebral substances is dotted here and there with blood."
Zlatarovich says: "The head-symptoms point to congestion and inflammation of the brain ;" but, I think, the character of the fever and of the affection of the sensorium is such as to show that it is not likely to be a remedy in pure idiopathic encephalitis. If a remedy in encephalitis at all, it must be in those cases in which meningitis has supervened, by metastasis or otherwise, upon some previously existing miasmatic or other disease, E. G., one of the exanthemata. The pains and perverted function of the two upper branches of the fifth pair of nerves call to mind prosopalgia.
The affections of the head and sensorium are worse in the morning; not immediately on awaking (as with Lachesis), but after waking and moving the eyes and head (see stool—diarrhoea).
FACE. Red, hot and puffed. Red spots on the face and neck. The face is swollen; sometimes so much so as to close the eye. The pains are those that have been described as extending between the temple and the malar bone, and are of a tearing, drawing character.
EYES. Lids swollen and puffed. A sensation of pressure from within outward in the globe of the eye, a kind of distention. The conjunctiva seems to be moderately inflamed, judging from these symptoms: sensation as if there were sand in the eyes; increased secretion of tears ; discharge of muco-pus from the eye, obstructing vision; itching and burning of the margin of the lids. The right eye is most affected.
Contrary to the general rule with Bryonia, the eye symptoms are aggravated by warmth. The special sense of vision is not affected in Hahnemann's proving, but Zlatarovich mentions a play of colors.
EARS. Sensation of obstruction in the external meatus and noises in the ears are the chief symptoms. Discharge of blood from the ear is mentioned ; this may possibly be accounted for as an instance of vicarious menstruation.
NOSE. Often swollen at the extremity, with a sharp pain and sensitiveness to the touch. Frequent and repeated epistaxis,—a symptom recorded by many provers. It occurs in the morning, sometimes awaking the prover from sleep. The blood is florid. Nose-bleeding after the sudden suspension of menses has been observed under the action of Bryonia. It is probably this symptom which has induced the use of Bryonia in vicarious menstruation.
MOUTH. The lips are swollen, with a biting, burning eruption. Aphthous patches appear on the lining membrane of the mouth and fauces. Dr. Huber, of Lenz, one of the Austrian provers, states that his proving of Bryonia cured him of a constitutional tendency to aphthous formations in the throat. The tongue is dry.
The teeth feel long and loose; drawing or jumping toothache when eating or just after eating, or in the evening in bed; aggravated by warmth, contrary to the general rule with Bryonia. Teeth and gums are sore.
THROAT. Sticking pain on swallowing, on feeling of the throat and on bending the neck. Sensation of pressure or fullness. Great dryness in the throat.
DIGESTIVE ORGANS. Taste unpleasant, flat, even with good appetite; sometimes bitter, sometimes putrid, with offensive breath; appetite generally diminished or destroyed, with aversion to food. One prover (Fr. H.) records an excessive desire for food, which, however, ceased as soon as the prover began to eat.
After eating, eructations, sometimes tasting of the food but generally bitter or sour, with an accumulation of sour water, sometimes tasteless, in the mouth.
Hiccough is a frequent symptom.
Nausea after a meal, although the food tasted well and was eaten with relish.
Nausea and vomiting, morning and evening, chiefly of water and mucus. Also, vomiting of food and of a fluid consisting of mucus and bile, and very bitter.
Food oppresses the stomach, is felt like a load at the epigastrium, and is often regurgitated.
STOMACH AND ABDOMEN. Pressure in the epigastrium, worse after eating and when walking. This pain sometimes extends down to the umbilical region; sometimes even to the bladder and perineum.
\After eating, there is often a constricting pain in the stomach, then a cutting in the epigastrium and then vomiting of food. The pains are worse during motion as is the general rule with Bryonia pains.
Sensation of distention, and sometimes actual swelling in the umbilical region.
Pains, sticking and shooting in both sides of the abdomen, aggravated by motion and sometimes changing into stitches from the abdomen into the stomach. The stitches are most frequent in the region of the spleen.
In the hepatic region, on the contrary, we find a tensive, burning pain; with a stitch which occurs only when the region is pressed upon, or when the prover coughs or takes a deep inspiration.
Flatulence moderate. Its movements occasionally produce pain.
STOOL. It is a peculiarity of Bryonia that, in moderate doses, it produces, in the healthy prover, retention of stool; the stool is infrequent, large in form, solid and evacuated with difficulty and attended by prolapsus of the rectum and burning sensation. Besides this characteristic action, Bryonia produces also, as an alternate action, a kind of diarrhoea preceded by colic, occurring especially at night (or early morning as soon as the patient rises and begins to walk about), and coming on so suddenly that the prover can hardly prevent an involuntary evacuation.
Zlatarovich calls especial attention to the tenderness of the abdominal walls generally; to the burning pains along the anterior connection of the diaphragm with the ribs; to the sensitiveness of the hepatic region to touch and on deep inspiration; also to the fact that Bryonia diminishes the intestinal excretions, weakens the peristaltic action of the bowels, and retards the stool. It produces diarrhoea, he thinks, only when taken in very large doses.
URINE. The urine is high-colored, concentrated ; passed frequently, sometimes with pain. Occasionally, during exertion, it is passed involuntarily.
MENSTRUATION. Bryonia uniformly hastens the coming on of the menses, and increases the flow. It may, therefore, as experience has shown, be a valuable remedy in too frequent and too copious menstruation.
RESPIRATORY ORGANS. The action of Bryonia on this region of the body is well marked, and has enabled us to make many brilliant cures.
NASAL MEMBRANE. Fluent coryza, beginning with violent and frequent sneezing, accompanied by stitching headache, when the prover stoops, and by hoarseness and an altered tone of voice.
COUGH. Generally dry ; it seems to come from the region of the stomach, and is preceded by a crawling and tickling sensation in the epigastrium. This is the general characteristic ; sometimes there is a crawling sensation in the throat also, inducing a cough, followed by mucous sputa.
Hacking cough, as if caused by something (mucus?) at a definite spot in the trachea; after coughing for some time this spot becomes very sensitive, and it is worse from talking and smoking.
Cough induced by coming from the open air into a warm room; from a sensation as of a vapor in the trachea, which prevents the prover getting air enough.
CONCOMITANTS. The cough is accompanied by stitching pains in the brain; by rawness in the larynx; by stitches in the intercostal spaces and in the sternum; by soreness in the epigastrium; by gagging, without nausea; by vomiting of food when coughing.
It is very characteristic of the Bryonia cough that, while coughing, the patient presses with his hand upon the sternum, as though he needed to support the chest during the violent exertion. Also, that the parts which are the seat of subjective pain become subsequently sensitive to external pressure; E.G., the sternum. (So also the joints.)
The expectoration, which is infrequent and scanty, is tough and sometimes bloody.
Respiration is impeded, as though by a pressure on the epigastrium, and is accelerated, as though by a feeling of heat in the epigastrium and chest. The prover feels a desire to take a deep inspiration, but when he attempts to do so he experiences a pain which does not allow him to expand the chest. Thoracic respiration is often almost impossible, by reason of the stitching pains in the sides of the thorax. These symptoms might call our attention to Bryonia in pleurisy, pneumonia and asthma. Ranunculus bulbosus has similar symptoms which, equally with the Bryonia pains, impede thoracic respiration; but the stitches are not so sharp and knife-like as those of Bryonia.
THORAX. Pressing pains, sometimes just above the epigastrium, sometimes over the whole chest, or on the sternum, impeding respiration. Stitching, lancinating pains are, however, more frequent. They occur on inspiration, or on turning around in bed; they are situated sometimes in the sides of the thorax, and sometimes they extend through the thorax from the front to the scapulae ; generally the seat of the pain is sensitive to pressure, and when the arms are moved.
BACK. Here we meet a new variety of symptoms. Sticking and jerking pains pressing between the scapulae and extending thence through to the epigastrium, when sitting; pain in the lumbar and sacral region, as if beaten; stiffness, tearing and tenderness in the joints and muscles of the lumbar region, which prevent motion and stooping; these are felt most when standing or sitting, and not so much when lying.
EXTREMITIES. In the extremities we have stitching pains in the region of the large joints, as in the shoulder, over the trochanter, and at the knee, —all greatly aggravated by motion, touch, or any jar or shock. Drawing and pain, as if luxated, in the medium and smaller joints.
The limbs and the joints swell, become red, and are very sensitive to touch or motion. The pains are relieved by warmth.
SKIN. Various eruptions. Small red spots on various parts of the body; some with sensibility, and not disappearing on pressure; some burning, and disappearing on pressure.
SLEEP. Great sleepiness by day, with yawning, lassitude, stretching, etc. Yet, at night, the prover cannot sleep, because of the tumultuous course of the blood, anxiety and heat. A concourse of anxious thoughts keeps the prover awake till three or four A. M. Sleep full of dreams. Often a prattling and muttering delirium. Also, sleep-walking has been observed under the action of Bryonia, and has been cured by it.
FEVER. In the fever which Bryonia produces, cold predominates. Coldness and shivering over the whole body. Heat often only internal, or on single parts of the body, and it is conjoined with great thirst. So, indeed, is the chill. Sweat on slight exertion, even when walking in the cool air. It is frequent at night, and is often sour.
DISPOSITION. Anxious, peevish and hasty.
1. VITAL FORCE. That Bryonia exerts, in some respects, a depressing action on the vital force, appears from its effect on the sensorium, which is depressed and benumbed; there is a decided sensation of weakness and lassitude; the arms incline to sink by one's side; the limbs move but sluggishly. This sensation of lassitude is most marked early in the morning, as though the night's sleep had brought no refreshment. The least exertion seems to use up the forces of the body.
Nevertheless, this prostration is not excessive, nor is it universal. For the disposition is not indifferent, as might have been expected; on the contrary, the prover is hasty and peevish. Again, the special senses are not materially affected; the sphincters are not relaxed, nor do any involuntary muscles seem to be greatly embarrassed in the exercise of their functions. There is no laxity of fiber, such as is shown by the occurrence of involuntary excretions.
The depressing effect seems to be confined to that part of the nervous system which presides over voluntary motion, and over the operations of the mind.
2. The ORGANIC SUBSTANCE of the body is affected as follows: The secretions from the intestinal surfaces are diminished; the capillary circulation appears to be somewhat impeded in the mucous membranes, but is particularly so in the serous membranes which line the closed cavities of the pleura, peritoneum, pericardium, and joints. As a sequel of this impediment we have effusion (so called) into these cavities.
3. SPHERE OF ACTION. The action of Bryonia, as appears from the proving, is exerted chiefly upon the nervous system of animal life, presiding over ratiocination and voluntary motion; upon the gastro-intestinal region, producing various perversions of digestion, a deficient intestinal secretion and a form of constipation, and, moreover, the symptoms of a well-marked hepatitis. Upon the respiratory mucous membrane, the action of Bryonia, though evident, is subordinate. The serous membranes of the large cavities, and of the joints and the ligaments, are eminently affected. Finally, the female sexual organs are in such wise affected that menorrhagia is produced, the discharge being florid.
4. SENSATIONS. The sensations peculiar to Bryonia are stitching, lancinating pains,—such pains, in fact, as usually attend and characterize acute affections of the serous and fibrous tissues. Drawing pains are analogous to these. In addition, we note the peculiar sensations of lassitude in the limbs that have been already described. It must not be forgotten that many other remedies likewise produce stitching, lancinating pains,—as Squilla, Ranunculus bulbosus, Asclepias.
5. PERIODICITY. A disposition to a recurrence of the pains in the morning early, not immediately on awaking (as with Lachesis), but on first moving after waking.
6. PECULIARITIES. The great feature characteristic of the Bryonia symptoms is their aggravation by motion and touch. This applies to all, except a few isolated symptoms, which it is evident, from the context, are purely nervous.
It is also noteworthy, that the seat of the subjective pain soon becomes objectively sore, and then swollen and red.
The pains of Bryonia are, in general, relieved by warmth and aggravated by cold.
They are aggravated by mental excitement.
Hahnemann mentions the importance of Bryonia in the treatment of various kinds of fevers, and refers to his treatment of a malignant typhus that was epidemic in Saxony in 1813, after the retreat of the French army. This will be spoken of when we treat of Rhus toxicodendron.
Hahnemann recommends Bryonia in certain kinds of abdominal cramps in women, of course, when the symptoms correspond.
HEAD. Seeing the action of the Bryonia on the serous membranes one might infer that it would occupy a prominent place in the treatment of meningitis. But this inference is not justified by the symptoms. They represent a fever too asthenic to correspond with any form of idiopathic meningitis.
In repercussed eruptions, however, as, for example, during the course of an exanthematous fever,— scarlatina or measles,—when the eruption has disappeared, and the sensorium becomes immediately affected, Bryonia has often done excellent service. The oppression of the senses, the general prostration, the peculiar form of fever, consisting of predominant coldness, first a chill and then a fever, mixed up of chill and heat, with a small pulse, and which never, even when the heat is greatest, becomes very full or hard,—these symptoms correspond well to the kind of case to which we refer.
But it is only in a certain class of cases of repercussed exanthemata that Bryonia is indicated and useful, viz., where the sensorium and the system of animal life are depressed, benumbed, but the functions not perverted. There is another class in which they are perverted, and in which, consequently, convulsions more or less complete occur. In such cases Cuprum aceticum (or metallicum) is likely to be indicated, a fact for the knowledge of which we are indebted to Dr. G. Schmidt, of Vienna. In other cases of this kind, without fever or disturbance of the general system, the entire sensorial life is suspended. Here Hellebore may be required, as Hahnemann has shown in his introduction to the proving of that drug. Or, again, together with this suspension of sensorial life, there may be signs of effusion within the cranium ; the patient lies like an animate but not intelligent log; the pupils are dilated ; the eyes converge or diverge; and here Zincum metallicum will sometimes save the patient. I made this observation in 1853, in a case of scarlatina. About the same time, and unknown to me, Dr. Elb, of Dresden, published some similar cases in the " Allgemeine Homeopathische Zeitung."
Under these circumstances the vital processes move very slowly, and I believe it is necessary to repeat the Zinc frequently, and to continue it for many days.
EPISTAXIS. Bryonia has been named as a remedy. The blood is florid. The epistaxis occurs in the morning, often waking the patient from sleep. It is often a concomitant of suppressed menstruation, or where the symptom accompanies a case of typhoid fever.
FEVERS. In the fevers marked by gastrointestinal localizations, such as bilious remittent, some forms of intermittent and some forms of typhus fever, Bryonia has done good service. It compares with Eupatorium and Rhus toxicodendron, and with Nux vomica and Mercurius.
The fever is marked by gastro-hepatic complications, resembling the symptoms. The headache is a splitting pain through the temples, and at the same time, more severely, in the occiput. Oppression at the pit of the stomach and tenderness there; vomiting of food, mucus and bile, stitches in the hypochondria, and soreness and tension in the hepatic region, along with dry cough and decided constipation, without any desire for evacuation of the bowels. Together with these local symptoms there are frequent short chills, alternating or mixed up with heat of the body; a pulse small and frequent, but somewhat hard. Add to the above a slimy and bitter taste, aversion to food, eructations, pains in the back and limbs, much aggravated by touch and motion, together with dullness of the sensorium, and aversion to noise and to mental exertion, and we have a picture of the form of fever for which, whether remittent or intermittent, Bryonia is appropriate.
Similar symptoms often characterize what is popularly called "a bilious attack." These "attacks" are very common in persons who have for years been accustomed to take frequent doses of calomel or of blue mass for headache and " biliousness." And we are often called upon to supply a substitute for these drugs. In the majority of these cases Bryonia is the remedy. If early resorted to, it will generally break up the attack; and a repetition of this treatment rarely fails to destroy a tendency to its recurrence.
Boenninghausen gives the following picture of the Bryonia fever: " Pulse hard, frequent and tense. Chill and coldness predominate, often with heat of the head, red cheeks and thirst. Chill, with external coldness of the body. Chill and coldness most at evening, or on the right side of the body. Chill more in the room than in the open air.
Dry, burning heat, for the most part only internally, and as if the blood burned in the veins. All the symptoms are aggravated during the heat.
Much sweat. Easy sweating, even from walking slowly in the cold, open air. Copious night and morning sweats. Sweat sour, or oily.
Hahnemann gives the following groups of symptoms, as characterizing those cases of typhus for which he gave Bryonia so successfully:
The patient complains of dizziness, shooting (or jerking-tearing) pains in the head, throat, chest, abdomen, etc., which are felt particularly on moving the part, in addition to the other symptoms, the haemorrhages, the vomiting, the heat, the thirst, the nocturnal restlessness,etc.
In acute hepatitis it is very evident, from the symptoms, that Bryonia may be a most valuable remedy. Experience has confirmed the indication.
Bryonia is also a remedy for constipation, being, as Hahnemann remarks, one of the few remedies of which the primary action is to diminish the intestinal excretion, and likewise the peristaltic action of the intestine.
It differs from Nux vomica, as we shall see, in this respect, that the action of the intestine is diminished. Nux vomica does not diminish the action of the intestine. It rather increases it, but at the same time renders it inharmonious and spasmodic, a hindrance, therefore, and not a help to evacuation. This is the reason why the constipation characteristic of Nux vomica is accompanied by frequent ineffectual desire for stool, the action of the intestine being irregular and spasmodic, and the constipation resulting from this irregularity of action, and not from inaction. Bryonia has nothing of this. Under its influence the intestinal activity is really diminished,—there is no desire for stool. As a remedy for constipation, Bryonia is analogous to that other valuable remedy for the same trouble— Veratrum.
It has been already remarked that Bryonia is our great remedy in the treatment of vicarious menstruation—a perversion of function which is not so rare as has been supposed. At the period when the menstrual discharge should naturally take place, there occur haemorrhages from some other parts of the body, as from the nose, mouth or lungs. I have seen, under such circumstances, likewise, haemorrhage from the eye, the ear, and once from the nipple. These vicarious discharges are not difficult to distinguish from haemorrhage attending and consequent upon diseased conditions of these organs themselves. If, for example, about the time of menstruation, this phenomenon not occurring, a copious expectoration or vomiting of blood take place, without any other symptoms of disease of the lung or stomach,—if it last two or three days, with no greater disturbance of the general health than commonly attends menstruation,— if it then cease, leaving no sign of disease in the organ apparently affected, and, if it recur again after the usual menstrual interval, there can be no reasonable doubt of the nature of the trouble. Clinical experience has shown that Bryonia generally cures these cases.
About the third day after confinement, women are liable to chill and an access of fever, just when the mamma begins in earnest the performance of its peculiar function. Experience has shown Bryonia to be one of our most valuable remedies in this condition. The correspondence of symptoms indicates this; for, the "milk fever" is one in which chill predominates; it is a mixture of chill and fever, the former much in excess, and, moreover, the gland, which is the seat of pain, becomes rapidly sore and sensitive to touch or motion. In addition, there are drawing tearing pains in the limbs and a headache resembling that of Bryonia. Bryonia is likewise our foremost remedy in inflammation of the mammae during lactation.
A word of caution, bearing on the diagnosis of the latter affection, may not here be inappropriate. It is of the utmost importance to avoid mistaking symptoms of exhaustion of the supply of milk in the gland for symptoms of commencing inflammation, and treating, with medicine, a condition which should be met by rest of the organ and an appropriate diet.
In primiparae the secretion is often established tardily, and the milk fever is severe. For this reason the patient is apt to be kept on a very low diet, with a view of preventing inflammation of the mamma and, for the same object, the child is applied to the breast at very short intervals, in order to prevent "accumulation of milk in the gland," "to keep it free." Under these circumstances, the supply of milk is apt to be scanty. If, now, the child be vigorous, the supply will soon be exhausted, and the child will "draw upon a vacuum." Very soon an acute dragging pain is experienced by the mother, extending from the nipple through the gland and the thorax to the scapula. It would be a sad mistake to regard this as always a sign of existing inflammation, to still farther curtail the diet and to resort to medication. It is not always a sign of inflammation, it is a " dragging on the milk-tubes." The diet should be increased in its nutritive qualities, and directions given to apply the child less frequently to the breast, and to remove it as soon as this peculiar pain begins to be felt. This is very important; for, if the "dragging" be allowed to continue long, and be often repeated, it will produce inflammation, first of the nipple and subsequently of the gland. This is the origin of perhaps a majority of the cases of "sore nipples" met with in practice, and attention to these precautions constitutes one of the best preventives of that distressing affection.
It should be observed, however, that cases sometimes occur, in which, as soon as the infant begins to nurse, the patient experiences severe acute dragging and stitching pain, extending from the extremity of the nipple to the scapula, and rendering the pain of nursing almost unendurable, and this, too, when there can be no reason to suspect a deficiency of milk. Indeed, the pains set in as soon as the child begins to nurse, and not, as in the case before described, after the child has already nursed, for a time, satisfactorily. These are cases of irritable nipple, and they often result in mammary abscess, because the mother cannot endure the pain of having the breast freed from the milk that is secreted. Such cases find their best remedy, as I learn from Professor Guernsey, of Philadelphia, in Croton tiglium. But if the pains come on and exist only or chiefly during the interval between nursing, they are relieved by Phellandrium aquaticum (Gross).
On the respiratory organs the action of Bryonia is very emphatic.
Dr. Wurmb says of it: "Although Bryonia be not so often administered in diseases of the mucous membranes as in those of the serous and fibrous tissues, it is, nevertheless, in the former, a very important remedy. Its action on all the membranes must be a very extensive one, because of its powerful influence upon the processes of secretion and absorption, and because the mucous membranes, in particular, belong to those organs by means of which these operations are, for the most part, carried on.
The results of provings show that Bryonia produces powerful irritation in the mucous membrane of the respiratory organs. This condition is important, not only inasmuch as it enables us to designate Bryonia as an important remedy in acute bronchial catarrh, but also as giving us a POINT D'APPUI in studying the remedy. For experience teaches us, on the one hand, that the more violent forms of catarrh almost always involve the pleura, causing stitch in the side, and, on the other hand, that stitching pains almost always yield, and in a short time, to Bryonia.
We lay great stress on the fact that in the Bryonia catarrh the mucous secretion is diminished, because a great majority of the symptoms which are considered to indicate Bryonia derive their significance from this fact, and it will serve to keep them in memory. They are: hoarseness, hacking cough, which sets in especially in the morning and evening, and is generally dry or yields but a little tenacious mucus (which is sometimes streaked with blood), and which sometimes, through its violence, causes retching and actual vomiting. As rarely failing concomitants of the Bryonia cough, we have stitching pains in the throat and chest, and pressing pains in the head.
In the bronchial catarrh, with scanty secretion, and attended by dyspnoea and nervous erethism, to which infants are subject, and which is often mistaken for true pneumonia, Bryonia is a most valuable remedy. In a subsequent stage of the same affection, when the secretion has become very abundant, every paroxysm of coughing producing nausea and copious vomiting of mucus, with dyspnoea, exhaustion and sweat, Ipecacuanha is likely to be required. In former days, before I learned to distinguish sharply between the indications for these remedies, I used to give them, as was and is so commonly advised and practiced, in alternation,—a slovenly practice which cannot be too strongly condemned. Each of the remedies has its place in the appropriate stage of the malady.
In the pneumonia of adults, especially in that form in which the deposit or exudation is scanty and fibrinous, Bryonia is the remedy most frequently required. So true is this, and so valuable is Bryonia in this case, when indicated, that some practitioners have not hesitated to say that Bryonia is the sole and all-sufficient remedy for pneumonia, and that they give nothing else. This view, however, restricts the idea of pneumonia to one pathological form, ignoring that form in which the exudation is not purely fibrinous, and in which Phosphorus or Tartar emetic is likely to be indicated, as we shall see when we come to Phosphorus.
A reference here may be permitted to the singular fact that whereas, in New England, where pneumonia is frequently met with, more than one busy practitioner places his whole reliance on Bryonia in pneumonia, and claims to cure every case with it; in Vienna, on the other hand, where pneumonia is still more common, Dr. Fleischmann regards Phosphorus as the specific, and uses it almost exclusively.
Admitting the looseness of the practice, which, in any locality, looks to one remedy exclusively as the specific for any disease whatever, may it not be that the character of the pneumonia, in the two regions, is radically different, depending on differences in the constitutions and habits of the races in the two countries? Be this as it may, the facts are a warning not to prescribe on the basis of the name of the disease.
Important as is the action of Bryonia on the regions already designated, it is still more marked in the serous and fibrous tissues.
The stitching pains in the thorax and abdomen, especially the stitch in the intercostal regions on taking a deep inspiration, all point to the efficacy of Bryonia in pleuritis, an indication which experience has confirmed. It is believed to be more suitable for pleurisy of the right side.
In pericarditis, also, it is valuable, though perhaps less frequently indicated than Spigelia. (Asclepias tuberosa.)
In its relations to affections of the pleura, Bryonia is resembled by Spigelia, Squilla, Ranunculus bulbosus and Kali carbonicum, and amongst the new remedies, Asclepias tuberosa.
In rheumatism, Bryonia is one of our most important remedies. Its symptoms of the extremities simulate a muscular rheumatism, with moderate fever; while the symptoms of the joints show it to be still more appropriate to articular rheumatism.
The joints are much swollen and are reddened; streaks of red extending up and down the limb. They are very sensitive to touch, and are especially painful during motion, the pain being less the more perfect the repose. Dr. Wurmb gives the following indications: " The fever not very violent, or, if so at first, much diminished; the rheumatism does not change its location; the local phenomena, especially the swelling and pain, very violent; the irritation of the skin but slight; the redness not very great." The aggravations as to time are in the morning some time after waking, and in the evening. The pain is of a sticking and tearing character.