The seed of the fruit of a large tree found in the East Indies. Whether this very powerful and most useful drug was known to the ancients is a disputed question. It is only within the last 150 years that its value in medicine has begun to be recognized.
Nux vomica is supposed to owe its activity to two alkaloids, Strychnia and Brucea; but it is found in practice that the action of Nux Vomica on the organism is not identical with that of either of these substances.
Nux vomica is very bitter, and Strychnia is SO intensely bitter that a solution of one grain of it in 666,700 grains of cold water still retains a decided and strong bitter taste.
Nux vomica is classed among the spinants or tetanica, the current physiological theory of its action restricting it to the spinal marrow.
When taken in very small doses, Nux vomica is said by Stille (" System of Materia Medica and Therapeutics," Phila., 1864) to "derange the digestion ; to augment the secretion of stomach and mouth and of liver and pancreas. It disposes to frequent urination, and, when given in larger doses, causes retention of urine; first, by producing spasm of the neck of the bladder, and ultimately loss of power in the muscular coat of the bladder. It excites uterine contraction and promotes the menstrual flow.
It acts more quickly on paralyzed muscles than on others (perhaps because these are withdrawn from the realm of volition and are affected through reflexion alone), and produces formication in the limbs, and a slight rigidity of the lower jaw and limbs; a sense of heaviness and debility, with general stiffness of the muscles and clonic spasms.
In larger, poisonous doses, after general uneasiness, soreness, stiffness and heaviness of the limbs and joints, spasmodic symptoms set in, clonic spasms or violent muscular twitches, seeming like an electric shock.
Then come tetanic spasms of all the muscles, during which the limbs are rigidly flexed or extended, the lower jaw firmly set against the upper, and the body arched as in opisthotonos. The rigid contraction of the respiratory muscles renders breathing laborious, or even suspends it for a time, and the skin becomes livid from stasis of the blood. The corners of the mouth are contracted, showing the set teeth, with foam issuing from between them; the eyes stare and the brow is contracted.
Amid all this horrible array of symptoms the mind is not at all affected, and it is probable that but little pain is felt.
The convulsions are generally interrupted by periods of calm, from which, however, the least noise, a breath of air, or the lightest touch may act with the suddenness of lightning to renew the scene. (Stramonium.)
Death at last occurs either from asthenia or asphyxia.
The smallest fatal dose of Nux vomica is three grains; of Strychnia, one grain.
The anatomical lesions are not uniform. The muscles are rigid, all the internal organs are gorged with blood; and this is all.
These are the effects ascribed by the most recent authorities to Nux vomica. They may be reduced by analysis into the following:
Nux vomica acts chiefly upon the spinal marrow. It affects that portion which presides over the reflex function of the muscular system. The variety of effect produced by it is this: it excites muscular action, causing incoherent contractions to take place; deranges the normal order in which muscular motions succeed each other; finally it puts an end to these motions altogether, producing a kind of paralysis.
Our much more exact and available knowledge of Nux vomica is derived from a proving by Hahnemann and his pupils; a most excellent proving from which we make the following analysis of the action of Nux vomica on the healthy organism:
The effects on the sensorium are as follows: There is indisposition to mental exertion, and particularly to that form which involves the elaboration and connections of subjective ideas independently of external objects (subjective ratiocination). The prover easily errs in speaking or writing. This corresponds with a certain manual clumsiness.
Vertigo is produced, with momentary loss of consciousness, obscuration of vision and staggering. It occurs more particularly while eating and immediately after eating; when walking and even when lying down in bed. It resembles vertigo produced by alcohol; for which, indeed, Nux is a specific remedy.
HEAD. Nux produces, moreover, confusion and dullness in the head, especially in the morning and after meals. Also great and bewildering heaviness, especially on stooping.
The headache is pressing, tensive and drawing. It affects chiefly the forehead and the supra-orbital region ; sometimes extending through the base of the brain to the occiput.
It is sometimes described as a feeling of internal soreness, as though one had received a blow with an ax. With the acute headache is conjoined almost always qualmishness, nausea, and even vomiting.
When the prover walks, the brain feels shattered. Externally the scalp is sensitive and sore.
Rhus toxicodendron has the sensation when the patient walks, and especially when he goes upstairs, as if at every step or rising the brain were loose and struck against the skull; hence worse from motion. China has, along with a sensation of great fullness in the head and outward pressure in the temples, a feeling as if the brain were balancing to and fro within the cranium and were striking against the skull, occasioning great pain and obliging one to move the head (hence better from motion).
FACE. The chief symptoms noted on the face are small papules,—some of which even contain pus,— isolated, occurring on the forehead, cheeks and scalp, a kind of acne. Nux is a remedy for the acne which is aggravated by eating cheese, although the great constipation sometimes produced by cheese is relieved by Colocynth.
EYES. Drawing and pressing pains in the eye-lids, the margins of which become thickened and sore. The lids are agglutinated in the morning.
In the eyes themselves biting, burning and itching, relieved by rubbing.
The conjunctiva sometimes becomes very red, and there is great photophobia.
Clinical experience has led me to regard morning and forenoon photophobia as especially indicating Nux vomica. (See Euphrasia.) The patient covers the eyes or buries the head in a pillow in the forenoon, and looks around without suffering in the afternoon.
As regards the special sense, there have been observed a glittering appearance just outside the field of distinct vision, and also black and gray points floating before the eyes.
EARS. In the course of the Eustachian tube, an itching and tickling, inducing a desire to swallow. (Gelsemium has produced and cured a similar tickling, compelling the prover to cough.)
Stitches, pressure and shocks in the ear, often violent. Hissing and whistling in the ears, and sometimes a whirring and noise like that of a mill.
The cuticle peels off from the lips; on the inner part of the lips and on the vermilion border ulcers form, which burn and stick.
The gums swell and pain like ulcers; indeed ulcers actually form upon them, having a drawing and burning pain.
The stomatitis indicating Nux vomica must be distinguished from that which requires Alumina, Borax, Carbo vegetabilis, etc., chiefly by the symptoms of stomach and bowels and sleep.
In the teeth various pains occur; soreness increased (as all the Nux vomica pains are) by mental exertion, and by going into the open air. The pain may be throbbing, boring, drawing; extending into the gum, which is swollen, and into the bones of the face. It is worse after eating, and from cold water or cold air, and from exertion of mind or body.
The tongue becomes heavy as if half paralyzed. Papules and vesicles appear on it.
The mouth is dry, even without thirst, as after alcoholic drinks. In the morning the mouth and fauces are full of thick and unpleasant mucus.
The fauces are sore as if raw; felt on swallowing and on contact with cool air. The mucous membrane covering the hard palate, and the velum and uvula become swollen with a pressive pain felt particularly on swallowing saliva., There is a sensation as if there were a plug in the throat, felt no more when swallowing than at other times. Probably a gastric symptom. Pulsatilla and Lachesis have a similar sensation; as if a mass of food had remained in the throat.
A kind of burning in the throat and a scraped, raw sensation in the pharynx, as after water-brash.
It is apparent that Nux does not correspond to angina tonsillaris or submucosa, but rather to a sub-acute affection confined to the mucous membrane of the palate, uvula, and pharynx.
The taste is much altered, especially early in the morning. It is sour, herby or metallic, or all three combined; sometimes putrid, especially after eructation.
Sometimes it is bitter, especially just after ejecting mucus from the mouth and fauces. As a general thing, food and drink have their normal taste.
Under Pulsatilla, food and drink very often do not have their natural taste. Under Natrum muriaticum they have no taste whatever.
The appetite is generally impaired, and there is a general repugnance to food and to the accustomed stimuli, wine and tobacco.
On the other hand, there is sometimes an abnormally great hunger.
I have often observed that persons subject to frequent attacks of gastric disorder requiring Nux vomica have, for twenty-four or thirty-six hours before an attack, a wonderfully good appetite, especially for meat and fat. If, as soon as this unnatural hunger is noticed, they cut down their bill of fare to bread and water for one day, they avert the attack.
After the midday meal, a host of symptoms of all kinds appears, relating to the stomach and also to the head and entire organism,—a general aggravation after dinner (different from Pulsatilla).
The eructations are generally painful, as if from spasm of the oesophagus. In taste they are bitter and sour.
Hiccough is a frequent and distressing symptom. There is a good deal of thirst, but water burdens and distresses the stomach.
Nausea is a constant symptom. It occurs especially early in the morning and just after a meal, and is conjoined with a kind of faintness and feeling of illness, such as is produced by a strong purgative.
The vomiting is generally of sour mucus and food, sometimes of blood.
The region of the stomach is very sensitive to external pressure, and so indeed is the abdomen generally. Tight pressure from clothing is unpleasant. There is a pressing pain as from a load in the stomach, and this even though the amount of food or drink taken has been very small.
Several remedies resemble Nux vomica in these symptoms. Mercurius has a peculiarly deadly faintness produced by pressure in the pit of the stomach. Calcarea carbonica has tenderness of the pit of the stomach.
Lycopodium has pain in the pit of the stomach when the hypochondria are pressed, and pain in the hypochondria when the pit of the stomach is pressed. Lycopodium has also a sensation of fullness in the gastric region as soon as one has eaten but little, although one sat down with a good appetite. Lycopodium has also much flatus incarcerated here and there, but it lacks the irritability of the large intestine so characteristic of Nux vomica.
Sepia and Murex have an all-gone sensation in the pit of the stomach, worse about eleven A. M., and relieved by eating and lying down.
The abdomen feels greatly distended and is moderately so; respiration is embarrassed. These symptoms are all worse from walking in the cool air.
There is much flatus in the bowels. Sudden attacks of spasmodic pain in the region of the stomach.
Burning in the cardiac and pyloric region.
Nux produces sticking pains, and soreness and swelling in the region of the liver, which are aggravated by motion and by deep inspiration, as well as by pressure.
All varieties of flatulent colic are simulated; griping pains, pains as if the intestines were squeezed between stones, etc.
Great distention immediately after eating or drinking. Frequent sharp pain with desire for stool, ineffectual.
Nux vomica is often a better remedy than Chamomilla for the colic of infants, that is, when it is better indicated; as by the large amount of flatus and by the constipation with apparent frequent desire and effort to evacuate the bowels ; Chamomilla having, rather, a diarrhoea.
All symptoms relieved by repose, when sitting or lying down.
In the abdomen a sensation as from a load or burden,—a pressure or dragging toward the genital organs, as from a constrictive cramp ; the abdomen is sore and sensitive.
The following symptom is very important: a sensation of weakness in the region of the abdominal ring, as if a hernia would occur or were getting strangulated. Hernia actually appears. This symptom has led to the successful use of Nux vomica for incarcerated and other hernia.
As regards the stool, Hahnemann remarks that copious diarrhoeic stools are never produced by Nux vomica; but that what is called diarrhoea from Nux are rather small evacuations mixed with mucus, and attended by tenesmus and straining. This tenesmus is attended by a smarting burning in the rectum.
The most frequent primary (?) action of Nux is the production of constipation, as if from constriction or inactivity of the intestines, or rather, it produces an ineffectual urging to stool, and whenever at last the stool takes place, it seems to be incomplete and unsatisfactory, and as if a part of the faeces failed to be expelled; or the stool is very hard, and its evacuation requires great effort, and leaves a stitching and aching pain in the rectum. But, after the evacuation, there is no desire to sit and continue to strain, as with Mercurius.
Often, the stool is soft, mixed with mucus and streaked with blood; or there is clear blood along with the faeces. (Dysentery and haemorrhoids.)
In the rectum and anus, sharp, pressing pain, especially after mental exertion. Painful constriction of the rectum after mental effort and after eating.
As regards the urinary organs: painful, ineffectual effort to pass water, with scanty discharge. Often, with the urine is mixed a tenacious mucus. Burning pain during micturition.
The menses occur too soon and continue longer than they should. The inter-menstrual interval is too brief.
They are accompanied by nausea, chills, and faintness, after previous spasmodic movements in the abdomen. Sometimes great prostration and severe headaches and pains in the limbs. (Useful in anticipating menorrhagia and in menstrual colic.)
In the respiratory tract Nux produces a variety of catarrhal symptoms, but none of sub-mucous or parenchymatous inflammation.
The nares become sore and ulcerated, the smell perverted; there seems before the nose a smell of sulphur, or of bad cheese or of candle-snuff. Frequent discharge of thin, acrid fluid from the nose, and yet the nares are obstructed.
Much sneezing. The coryza is fluent early and by day; and in the evening it is dry and so is the mouth.
Coryza fluent during the day; dry evening and night.
The voice is hoarse and raw; the larynx pale, rough and scraped; the prover hems and clears the throat constantly. There is a moderate amount of mucus in the throat and chest. (Coryza and influenza.)
The cough of Nux is induced by motion of the body or exertions of the mind; by forced expiration, reading, etc. ; is worse every other day; appears in the evening or at night after lying down, and prevents going to sleep. It is short and dry but fatiguing; lasts often from midnight to day-break, and is accompanied by severe headache and pain and soreness in the epigastric zone.
It is not a deep, chest cough, but seems to come from the larynx. A more important remedy in coughs than has been supposed.
Respiration is embarrassed; a kind of asthma worse at night and after a meal; worse from having the clothing tight on the thorax, relieved by removing the clothing. (Useful in asthma.)
The pains in the thorax are chiefly such general sensations as accompany the asthma and the fatiguing cough just described.
No heart symptoms.
In the sacral region, pain at night which hinders turning in bed.
Contracting and constricting pain in the sacrum, and thence into the sides and back and the interscapular region.
Lassitude and pain as if beaten; dragging and bearing down in the pelvis.
In the extremities, lassitude, heaviness and aching and drawing pains.
We come now to the
On the functional activity the action of Nux vomica is well marked. It affects the sensorium but little in comparison with its effects on other parts of the nervous system, offering a marked contrast to Stramonium, which produces tetanic convulsions resembling those resulting from Nux vomica, and at the same time produces violent mania; whereas during the convulsions of Nux vomica the mind is not affected.
In this respect of profoundly affecting the organs and functions of nutrition and locomotion, while the mind and senses are but little affected, Nux vomica resembles Veratrum, Camphor and the poison of Asiatic cholera.
The reflex function of the spinal marrow is unquestionably the great seat of action of Nux vomica, as the symptoms of convulsion or of semi-paralysis in the limbs and trunk, together with the spasmodic affections of the face, jaws, throat, oesophagus, intestinal and urinary tracts, and the respiratory organs, particularly the larynx, plainly show.
It is an error, however, to regard the action of Nux vomica as restricted to this region. It acts with hardly less vigor upon the organic substance of the body; and this more particularly in the entire intestinal tract and in the urino-genital organs, modifying the secretions in both quantity and quality, and causing not only perversions of function but also changes of structure, as we see in the aphthae and in the haemorrhoids which it produces and cures.
The sphere of action of Nux vomica will be seen thus to be quite extensive, involving most of the functions and organs of animal and vegetable life. The sensorium is not deeply affected, save secondarily. The skin, bones and glands are not primarily affected by Nux vomica.
PERIODICITY. There is a well-marked periodicity in the action of Nux vomica. As a general rule, it may be stated that its symptoms are aggravated in the morning.
PECULIARITIES. Among the peculiarities attending almost all the symptoms, and which serve as characteristic indications, are the following:
The symptoms are worse in the morning; they are made worse by motion and by exertion, and by exposure to cool air, being ameliorated by repose and by warmth. In all these respects Nux vomica is the opposite of Pulsatilla.
The sleep of Nux vomica is peculiar. Instead of being wide-awake in the evening, as under Pulsatilla, the prover falls asleep in his chair, is very heavy, and on going to bed sleeps immediately. On the other hand, an hour or two before day-break the prover wakens and then cannot sleep again, or, rather, he dozes after a while in a semi-conscious state, and then wakens more tired and inert than before he dozed.
Under Pulsatilla there is difficulty in falling asleep in the evening, but the sleep is sound till morning, and, on waking, the patient is languid.
Many of the symptoms occur or are aggravated immediately after eating; whereas under Pulsatilla they did not occur or were not aggravated until several hours after eating.
The symptoms are aggravated by mental exertion or by sedentary habits, to which, nevertheless, the Nux vomica patient is disposed.
The disposition is irritable, choleric, impatient. If there be despondency it is of the impatient kind.
Hahnemann says in the introduction to the proving: "There are a few medicines, the greater part of whose symptoms are analogous to the principal and most common diseases to which mankind is subject, at least in Europe, and which, consequently, are most frequently employed in homeopathy. The term polychrest may be applied to them.
To this class Nux vomica especially belongs. The use of it was formerly dreaded because it had been tried only in very large doses; and in cases with which it did not correspond it could not fail to injure. But in a moderate dose it is the mildest and most precious of medicines in instances where its symptoms accord with those it excites in healthy persons.
Nux vomica is chiefly successful with persons of an ardent character, or a temperament disposed to anger, spite or deception. If the catamenia occur several days too early, or are too abundant, Nux is perfectly adapted to meet the consequences."
In this respect Calcarea carbonica is similar to Nux vomica. Pulsatilla and Sulphur are opposites.
This medicine (Nux vomica), taken some hours before going to bed, acts more mildly than at any other time of day. Any case of immediate necessity must of course be excepted.
It is best for very sensitive persons not to take it fasting in the morning or on first waking, because its most powerful symptoms are then called out. Also, it should not be taken immediately before or after a meal, or when the head is much exercised, nor should the patient, after taking this (or any other) medicine, directly employ his faculties in writing, reflecting, or reading, or reciting. He must wait at least two hours to avert ill consequences.
Among the diseases in which Nux vomica is especially efficacious are many chronic affections; for instance, those caused by excess of coffee or wine, especially in persons of sedentary habits; or those proceeding from too protracted literary application. It is also a remedy for many epidemic disorders and acute fevers, chiefly those in which cold is preceded or accompanied by heat. It frequently prevents the bad effects of chills.
It is more particularly suitable when the patient is worse in the morning than at any other time of day; when he awakes about three A. M., and remains wakeful with a multitude of ideas crowding his mind, and when, just at day-break, he falls involuntarily asleep, filled with busy dreams, from which he wakes tired and indisposed to arise. It is also adapted to persons who, several hours before bed-time, fall asleep in their chair."
Vertigo ... Headache.... Gastralgia.... Flatulent colic .... Constipation .... Diarrhoea ... Dysentery .... Haemorrhoids ... Hernia .... Coryza.... Bronchitis ... Laryngesimus ... Asthma.... Bad effects of coffee and wine... Intermittent fever.