Borland Painkillers

8/10/2019 Borland Painkillers

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PAIN KILLERS

The next problem I want to touch on is the patient suffering from acute pain.

Pain illers are a little !ifficult to s"stemati#e$ an! I thought probabl" the most helpful wa"woul! be to consi!er the cases of acute pain which one meets with in general practice$ an!these I thin one can classif" to a certain extent. %ne gets acute neuralgias$ acute

inflammation of one of the serous membranes$ an! acute colic. I thin that more or less co&ersthe or!inar" con!itions one meets with in general practice.

To tacle these from the homoeopathic stan!point is not &er" !ifficult. If one consi!ers theacute neuralgias from the prescribing point of &iew one taes the character of the pain an! thecircumstances which mae it better or worse$ an! to a lesser extent its situation. It is on thesethat one mainl" prescribes' in other wor!s on the character of the pain an! the mo!alities. It isexactl" the same as regar!s serous inflammations( again it is partl" on the situation but muchmore on the character of the pain an! the circumstances which mo!if" it that one prescribes.)ith colic e*uall"( an! it !oes not matter whether it be gallstone$ intestinal or renal colic$ onepa"s a little attention to the situation but &er" much more to the character of the pain an!what mo!ifies it.

)oring on these lines it is possible to tae up the three groups an! gi&e the in!ications forthe lea!ing !rugs which "ou must ha&e at "our finger en!s.

+ut before taing these up in !etail I shoul! lie to touch on another &er" painful con!itioncommonl" met with in general practice$ namel"$ A,-TE EARA,E.

A,-TE EARA,E

If "ou go to a patient who is suffering from &iolent earache$ acute stabbing pain in the ear$an! ten!erness o&er the mastoi! region$ when "ou first loo at it from the homoeopathicstan!point "ou are completel" lost. After a little experience "ou fin! that these cases are &er"satisfactor"$ "ou get "ou relief astonishingl" *uicl"$ an! often a case which a "ou exceptwoul! re*uire incision of the membrane$ within the next few hours *uicl" subsi!es an! thepatient is comfortable when "ou to bac in the e&ening. This is the sort of thing "ou shoul! beable to !o in these acute con!itions.

In cases of acute otitis with &iolent pains all roun! the mastoi! region there are three orfour !rugs I want to consi!er.

Supposing "ou tae the case which has come on &er" su!!enl"$ with a histor" of thepatient ha&ing been out in a &er" col! north/east win!$ he is intensel" restless$ the pains are&er" &iolent$ usuall" burning in character. e is irritable$ a bit scare!$ with all the signs of arising temperature$ an! extreme ten!erness to touch. )ith that histor" after a few !oses ofA,%NITE the acute inflammator" process which is 0ust staring will ha&e entirel" !isappeare!.That it is the t"pe that one hopes for$ an! which one sees &er" often in winter.

1ou will get another case/usuall" in chil!ren/where there is not the same !efinite histor" ofchill$ although that ma" be present$ but where the pain is e&en more intense an! where thepatient is practicall" besi!e himself with pain$ will not sta" still$ is as cross an! as irritable ascan be$ again with extreme ten!erness$ an! "ou get the impression that nothing that thefrien!s !o satisfies him. 1ou gi&e him a few !oses of the ,A2%2ILLA an! again the wholeinflammator" process will rapi!l" subsi!e.

The next case has gone a little further( there is much more ten!erness o&er the mastoi!region$ possibl" a little bulging$ an! the ear begins to loo a little more prominent on theaffecte! si!e. The external ear is &er" re!$ often much re!!er than on the opposite si!e. Thereare &er" acute stabbing pains running into the ear$ the con!ition is a little comforte! b" hotapplications$ an! the patient is extremel" sorr" for himself$ miserable$ wanting to be

comforte!$ probabl" a little tearful$ but without the irritabilit" of ,hamomilla an! ,APSI,-2almost alwa"s clears it up.

In a!!ition to the three !rugs which I ha&e consi!ere!$ one alwa"s has in min! the


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possibilit" of a Pulsatilla chil! re*uiring a !ose of Pulsatilla for the con!ition. An! also one notinfre*uentl" sees as case gi&ing in!ications for 2ercur" or epar sulph.$ but these I ha&e notime to !o more than mention.

Then to go on to t"pical acute neuralgias$ facial neuralgias$ or acute sciaticas$ or things ofthat sort where "ou want to get imme!iate relief. Again "ou can use prett" well routinemetho!s for relie&ing these cases.

Let us consi!er the acute facial neuralgias$ for these con!itions. It !oes not reall" matterwhich branch of the ner&e is in&ol&e!$ "ou tae a case a lie that$ with &iolent pain coming insharp stabs$ or twinges of pain running up the course of the ner&e$ coming on from an"mo&ement of the muscles of the face$ &er" much aggra&ate! b" an" !raught of air$ withextreme superficial ten!erness o&er the effecte! ner&e$ which is much more comfortable fromwarmth$ applie! warmth$ an! also from firm supporting pressure. That case$ particularl" whenit in&ol&es in&ol&es the right si!e$ almost alwa"s respon!s to 2A3. P%S / nine out of ten willso respon!. Inci!entall" this !ose not appl" to !ental neuralgia$ these are much more !ifficultan! the" run to *uite a number of !ifferent !rugs.

If "ou ha&e the same con!ition$ with practicall" the same s"mptoms$ the same mo!alities$affecting the left si!e$ it generall" respon!s to ,%L%,1NT.

The si!e usuall" !etermines the choice$ but occasionall" either !rug ma" relie&e neuralgiasin&ol&ing the opposite si!e.

)here "ou get an orbital neuralgia$ with much more sharp stinging pains$ 4as if a re! hotnee!le were stuc into it4 is a &er" common !escription in these cases$ an! the pains ten!ingto ra!iate out o&er the course the ner&e$ in the ma0orit" of cases$ "ou get relief from SPI3ELIA.

There is one &er" useful point about Spigelia$ an! that is that "ou sometimes get thestatement that$ in spite of the burning character of the pain$ after it has been touche! there isa strange col! sensation in the affecte! area. That is Spigelia an! Spigelia alone.

These are three !rugs which I fin! much the most useful in a routine wa" for facial

neuralgias.

As a rule I use high potencies$ but I !o not lie to go too high because sometimes in these&er" painful con!itions the &er" high potenc" aggra&ates the pain for the time being$ for tenminutes or so$ an! thus unnecessar" suffering$ so in these cases with acute pain I sel!om gohigher than a 56th potenc". P%ST/ERPETI, NE-RAL3IAS

There is another group of con!ition of the same t"pe$ the post/ herpetic neuralgias$ whichare sometimes &er" troublesome. 1ou now the or!inar" shingles neuralgia where the patientcomes with acute burning pain along the course of the intercostal ner&e an! gi&es a histor"that he has ha! a small crop of shingles$ &er" often so slight that he pai! little or no attentionto it. )ell$ if "ou can get the same mo!alities as "ou got in the facial neuralgias un!er 2ag.phos. that reme!" with often reli&e. 2uch more commonl" "ou fin! that these post/herpeticcases respon! to RAN-N,-L-S. The particular features for this !rugs are the histor" of herpes$the &er" sharp shooting pains exten!ing along the course of the intercostal ner&e$ that thepainful area is &er" sensiti&e to touch$ that the pain is in!uce! or aggra&ate! b" it$ an! "ouma" get the statement that the patients is extremel" conscious of an" weather changebecause it will cause a return of the neuralgia again. )ell$ that t"pe of case respon!s in almoste&er" instance to Ranunculus.

1ou will get a few of these cases which ha&e not respon!e! to Ranunculus$ with much thesame !istributions of pain$ an! the same mo!alities$ but without the mare! aggra&ation inwet weather. where the affecte! area is extremel" sensiti&e to an" col! !raught$ particularl"sensiti&e to an" bathing with col! water$ an! where the pain are liel" to be &er" troublesomeat night$ an! with a mare! h"peraesthesia o&er the affecte! area. An! these cases usuall"

respon! to 2E7ERE-2.

S,IATI,A


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Then "ou get another t"pe of neuralgia/the sciaticas. An! there again "ou can get helpfullea!s. In cases of sciatica$ pure sciatica$ in which I can get no in!ications at all but the or!inar"classical s"mptoms of sciatica$ that is to sa"$ acute pain !own the sciatic ner&e$ which isaggra&ate! b" an" mo&ement$ is &er" sensiti&e to col!$ more comfortable if ept *uite an!warm$ then it !epen!s which leg is in&ol&e! what !rug I gi&e. If it is a right si!e! sciatica I gi&e2A3. P%S.$ but if it is a left si!e! I gi&e ,%L%,1NT. An! "ou woul! be astonishe! how oftenone gets almost imme!iate relief from either 2ag. phos. or ,oloc"nth.

Some sciatica patients are frightfull" uncomfortable the longer the" eep still$ the" ha&egot to start mo&ing$ an! there are two !rugs which seem to co&er the ma0orit" of these cases.If the patient is warm/bloo!e!$ an! the sciatic pains ten! to be more troublesome when warm$particularl" warmth of be!$ an! rather better when mo&ing about$ in the ma0orit" of instancesone gets relief from KALI I%8.

If on the other han!$ "ou ha&e &er" much the same mo!alities with a chill" patient$particularl" if he is sensiti&e to !amp as well as col!$ an! again more comfortable when mo&ingabout$ R-S will clear the ma0orit" of such cases. Then there are one two o!! in!ications whichsometimes help "ou in a sciatica where "ou can get no other !istinguishing s"mptoms. 9orinstance$ if "ou get a sciatica which has$ associate! with the acute sciatic pain$ mare!numbness$ there are two !rugs which co&er most of "our cases. %ne is 3NAPALI-2$ which

has this sensation of numbness associate! with the pain an! ten!erness o&er the sciatic ner&emore mare! than an" other !rug in the 2ateria 2e!ica.

The secon! !rug which has this numbness associate! with pain an! ten!erness of thesciatic ner&e is PL-2+-2$ an! the main in!ication which suggests this reme!" is that I ha&ene&er seen a sciatica gi&ing in!ications for Plumbum which was not associate! with extreme$constipation as well as the pain an! numbness. A,-TE ,%LI,

In cases of acute colic$ renal hepatic$ or intestinal$ one can gi&e *uic relief b" fairl"snapshot prescribing. )hen "ou go to such a case an! now that morphia an! atropin willreli&e the spasm$ it is &er" tempting to us them. If "ou cannot get "our homoeopathic !rug in asnapshot wa" I thin "ou are boun! to gi&e the patient relief with "our h"po!ermic. To m" min!the !isa!&antages of this proce!ure are twofol!. 9irst$ there is the !isa!&antage that after such

relief$ it is necessar" to begin to treat that case now mase!$ if not actuall" complicate!$ b" theaction of the morphia. Secon!l"$ there is alwa"s the !anger that in an acute case of this in!the morphia ma" conceal the !e&elopment of surgical emergenc" which in conse*uence ma"be misse!. Suppose "ou ha&e a hepatic colic$ it is *uite liel" !ue to a stone pressing !own intothe bile !ucts$ which ma" perforate. If morphia has been use! it is *uite possible/one has seenit happen/that owing to the se!ati&e$ in!ications of the perforation are not !etecte! for hoursafterwar!s. The clinical picture is mase!$ an! "ou are exposing the patient to a &er" gra&eris. So if there is a metho! of !ealing with these colics apart from morphia I thin it is wise touse it. +ut$ as I sa"$ "ou are onl" 0ustifie! in using it if "ou are getting relief$ because thesecon!itions are so painful that it is not fair to let the patient suffer merel" because "ou woul!prefer using a homoeopathic !rug to a se!ati&e. 9ortunatel" the in!ications in these colics areusuall" prett" !efinite.

If "ou ha&e a case of a first attac of colic$ whether it be hepatic or renal$ it is a &er"!e&astating experience for the patient an! he is usuall" terrifie!. The pains are usuall" extremean! nearl" !ri&e the patient cra#"$ an! if$ in a!!ition$ the patient feels frightfull" col!$ &er"anxious$ faint whene&er he sits up or stan!s up$ an! "et cannot bear the room being hot$A,%NITE will usuall" gi&e relief within a couple of minutes.

1ou will sel!om get in!ications for Aconite in repeate! attacs. The patients somehow beginto reali#e that although the con!ition is frightfull" painful it is not mortal$ so the mental anxiet"necessar" for the a!ministration of Aconite is not present$ an! without that mental anxiet"Aconite !oes not seem to act.

Another case ha&ing repeate! attacs$ each short in !uration$ !e&eloping *uite su!!enl"$

stopping as su!!enl"$ associate! with a feeling of fullness in the epigastrium$ an! where theattacs are in!uce!$ or &er" much aggra&ate!$ b" an" flui!s$ an! accompanie! b" flushing ofthe face$ !ilate! pupils an! a full boun!ing pulse$ +ELLA8%NNA relie&es them almostimme!iatel".


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,onsi!er another patient who has ha! li&er s"mptoms for some time$ 0ust &ague!iscomfort$ slight fullness in the right h"pochon!rium$ a goo! !eal of flatulence$ intolerance offats$ an! who is losing con!ition$ becoming sallow an! slightl" "ellow. e !e&elops an acutehepatic colic$ with &iolent shoot of pain going right through to the bac$ particularl" to theangle of the right scapula$ which subsi!e an! lea&e a constant ache in the hepatic region$ an!then he gets another &iolent colic" attac. These attacs are relie&e! b" &er" hot applications$

or the !rining of water as hot as it can be swallowe!$ ,ELI8%NI-2 relie&es these attacs inthe most astonishing wa".

In these case :/ra"s usuall" re&eal a number of gallstones. An!$ in contrast with whathappens with morphia an! atropine treatment$ subse*uent :/ra"s after ,heli!onium has beengi&en fre*uentl" shows that one or more of these gallstones ha&e passe! almost painlessl". Sowith ,heli!onium "ou are well un!er wa" with "our treatment of the gallstones$ whereas withmorphia an! atropine "ou merel" relie&e the acute attac of pain. In other wor!s$ "ou ha&ealrea!" taen a long step in the treatment of the patient towar!s clearing the con!itionaltogether. That is one point to be sai! in fa&our of "our homoeopathic treatment rather thanthe merel" se!ati&e relief.

There are *uite a number of other !rugs for these colics$ some of them hepatic$ some renal$

an! same intestinal$ an! the" all ha&e their own in!i&i!ual points which are &er" eas" to picup at the besi!e. If one memori#es them in this wa" it is astonishing the east of "our wor inacute cases. 1ou see I am not gi&ing "ou the full !escription of these !rugs$ I am picing outonl" the points which appl" to this t"pe of case. That is how "ou ha&e to !o it in practice$ but"ou must remember that these !rugs I am gi&ing "ou for these con!itions are the commonones$ an! that e&er" now an! then "ou meet a case which appears to call for one of these!rugs an! "et the patient !ose not respon!. There ar certain homoeopathic ph"sicians whosometimes call me out in consultation for acute cases an! I now perfectl" well before I lea&em" room that it is no use m" thining of these !rugs as the" will alrea!" ha&e been gi&en$ an!what I ha&e to get is something that is not common but our of the wa". I remember seeing acase of gallstone colic with one of our &er" goo! ph"sicians. It was an el!erl" woman$ an! sheha! that t"pical ,heli!onium picture. %f course she ha! ha! ,heli!onium alrea!"$ but withoutbenefit. The !octor sai!$ 4I !ont un!erstan! this case at all' I thin she must ha&e a malignant

li&er.4 I ase! wh"$ an! he sai!. 4+ecause she has all the ,heli!onium in!ications an! she !oesnot respon!.4 That is the sort of o!! case "ou will meet with. so if that shoul! happen to be"our first one !o not thin therefore that omoeopath" !oes not wor' "ou will fin! that as timegoes on "ou get more an! more cases that !o wor an! the exceptions are fewer an! fewer. Asa matter of fact that particular case respon!e! to a !ose of one of the Snae Poisons$ but Iha&e ne&er seen another case that ha! a Snae Poison for that con!ition$ an! one ga&e itpurel" because she ha! alrea!" ha! her ,heli!onium( ha! I seen the case in the first instance Ishoul! certainl" ha&e gi&en ,heli!onium. In spite of the o!! cases it is worth while gettingthese or!inar" !rugs at "our finger en!s so that when cases crop up "ou can prescribe easil"on the few in!ications of the acute con!ition as presente! to "ou.

There are one or two other !rugs that I can touch on which "ou will fin! &er" helpful inthese colics.

9or instance$ +ER+ERIS$ which is extremel" useful in colics whether renal or gallstone. Theoutstan!ing point about the +erberis colic$ no matter its situation$ is that from one centre thepain ra!iates in all !irections. Suppose "ou ha&e a renal colic/an! when +erberis is in!icate! Ithin it is more commonl" on the left si!e than the right/"ou will fin! that where "ou getin!ications for +erberis the colic" pain starting in the renal region$ or in the course of theureter$ there is one centre of acute pain$ an! from that centre the pain ra!iates in all !irections.If "ou ha&e a hepatic colic "ou get the centre intensit" in the gallbla!!er$ an! from there thatpain ra!iates in all !irections$ it goes through to the bac$ into the chest$ into the ab!omen.That is the outstan!ing point about these +erberis colics.

In a!!ition to that$ where "ou are !ealing with a renal colic "ou almost alwa"s get an acute

urging to urinate$ an! a goo! !eal of pain on urination. )here "ou are !ealing with a biliar"colic$ it is usuall" accompanie! b" a &er" mare! aggra&ation from an" mo&ement$ this ispresent to a slight extent in the renal colics$ but it is not so mare!( an! in both the patient is&er" !istresses$ an! has a pale$ earth" looing complexion. The pallor$ I thin$ is more mare!


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in the renal cases$ an! where there has been a pre&ious gallstone colic "ou ma" get a0aun!ice! tinge in the hepatic cases.

It is a &er" useful !rug$ an! I !o not now an" other which has the extent of ra!iation ofpain that "ou get in +erberis. It is surprising wi!esprea! the area of ten!erness can be which isassociate! with a +erberis colic$ so much so that in gallstone attacs "ou get so muchten!erness an! resistance that "ou are &er" afrai! of a perforate! gallbla!!er$ "ou get such a

resistant right upper rectus$ an! "ou ma" be &er" suspicious of a peri/ renal abscess in therenal cases$ again because of the extreme resistance of the muscles on the si!e of theab!omen.

In a +erberis renal case the urine is as a rule rather suggesti&e. 2ore commonl" it is notbloo!/staine!$ but contains a *uantit" of gre"ish/white !eposit which ma" be pure pus$ butmostl" contains pus an! a *uantit" of amorphous material usuall" phosphates$ sometimesurates. Although it is a &er" !irt" looing urine it is surprisingl" inoffensi&e.

There are two !rugs !rugs which one alwa"s thins of for colics of an" in!$ an! the" are,%L%,1NT an! 2A3. P%S. It !oes not matter where the colic is( when "ou ha&e an acuteab!ominal colic of an" in! one alwa"s thins of the possibilit" of either ,oloc"nth or 2ag.phos. +oth reme!ies are often useful for colic in an" area$ uterine$ intestinal$ bile !ucts$ or

renal/it !oes not matter which it is. The point about these !rugs is the the" are almosti!entical$ that alwa"s in their colics the pain is &er" extreme$ an! the patients are !ouble! upwith pain. In both cases the pains are relie&e! b" external pressure$ an! b" heat. In 2ag. phos.there is rather more relief from rubbing than there is in ,oloc"nth$ which prefers stea!"$ har!pressure.

The next thing about them is that their colics are intermitting. The patients get spasms ofpain which come up to a hea! an! then subsi!e.

There are one or two !istinguishing which help "ou to choose between ,oloc"nth an! 2ag.phos. )ith ,oloc"nth$ in the attacs of colic "ou alwa"s fin! the intensel" irritable. e isfrightfull" impatient$ wants something !one at once$ wants imme!iate relief$ an! is liable to be&iolentl" angr" if the relief is not forthcoming. In 2ag. phos. there is not the same !egree of

irritabilit"$ an! the patient is !istraught because of the intensit" of the pain rather than&iolentl" angr".

Another point that sometimes helps in "our selection is that ,oloc"nth ten!s to ha&e aslightl" coate! tongue$ particularl" if it is the !igesti&e tract is upset$ whereas when 2ag. phosis in!icate! it usuall" is clean.

+oth these !rugs ha&e a mare! aggra&ation from col!$ a little more mare! in 2ag. phos.than in ,oloc"nth. 9or instance$ 2ag. phos. is excee!ingl" sensiti&e to a !raught on the area$whereas ,oloc"nth$ though it lies hot applications$ is not so extremel" sensiti&e to col! air inits neighbourhoo!.

Another !istinguishing point between the two is that in ,oloc"nth there is apt to be aten!enc" to gi!!iness$ particularl" on turning more especiall" to the left$ but this is not presentin 2ag. phos.

)here "ou ha&e a report that the colic/an! I thin this applies much more commonl" touterine than to intestinal colic/has followe! on an attac of anger it is almost certainl",oloc"nth "ou re*uire.

If the colic is the result of o&er/in!ulgence in cheese it is ,oloc"nth in!icate!$ not 2ag.Phos. If the pain is the result of exposure to col!$ either a !"smenorrhoea or an ab!ominalcolic$ it is much more liel" to be 2ag. phos. than ,oloc"nth.

These are two of the most useful !rugs in the 2ateria 2e!ica for colics$ an! it is surprising

the relief "ou can get$ e&en in cases of intestinal obstruction$ from the a!ministration of,oloc"nth or 2ag. phos. I ha&e seen cases of intestinal carcinoma with partial obstruction inwhich the patients were suffering from intense recurring colic" pain coming to a hea! an!then subsi!ing$ where 2ag. Phos. has gi&en the most astonishing relief. Less commonl" in


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such cases where there has been mare! irritabilit" in a!!ition to the local s"mptoms.,oloc"nth has also !one won!ers. ;er" often one or other of these !rugs has ept a patient in asurprising !egree of comfort till !eath super&ene!. In these malignant colics I ne&er go high' a56th potenc" is sufficient. In an or!inar" acute colic$ sa" !"smenorrhoea$ I gi&e a


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there is eructation the patients usuall" complain of a &er" sour taste in L"copo!ium cases.

In L"copo!ium "ou usuall" ha&e a somewhat emaciate! patient with a rather sallow$ palecomplexion.

There are one or two points that lea! "ou to %PI-2 instea! of the other tow. In %pium. as Isai!$ there is apt to be a !efinite area of !istention$ an! the patient ma" sa" that he gets a

feeling as if e&er"thing simpl" churne! up to one point an! coul! not get past it$ or as ifsomething were tr"ing to s*uee#e the intestinal contents past some obstructing ban!$ or as ifsomething were being force! through a &er" narrow opening.

Another point that lea!s to the selection of %pium is that with these attacs of colic the%pium patient ten!s to become &er" flushe! an! hot$ feels the be! abominabl" hot$ wants topush the blanets off$ an! after the spasm has subsi!e! ten!s to become &er" pale$ limp$ an!often stuporose.

The area of !istension in %pium is liel" to be in the centre of the ab!omen rather than inthe right iliac fossa$ an! it is one of the most commonl" in!icate! !rugs in a paral"tic ileus.

Another point that sometimes puts "ou on to %pium is that when the pains are !e&eloping

up to a hea! the %pium patients !e&elop an extreme h"peraesthesia to noise. I remember onepatient who ha! a paral"tic ileus after an ab!ominal section an! as he was woring up toanother attac of &omiting he ha! that h"peraesthesia to noise more mare! than I ha&e e&erseen it. If the nurse in the room happene! to 0angle the basin into which he was going to besic he nearl" went off his hea! an! he turne! an! fairl" curse! her. That h"peraesthesia tonoise mae me thin of %pium$ an! it completel" controlle! his attac an! the whole con!itionsubsi!e!. This h"peraesthesia is worth remembering as it is so !ifferent from the sluggishcon!ition in!uce! b" the a!ministration of %pium in material !oses.

The RAPAN-S t"pe of post/operati&e colic is again slightl" !ifferent. Instea! of getting theright si!e of the ab!omen !isten!e! as in L"copo!ium$ or the swelling up in the mi!!le as in%pium$ in Raphanus "ou get pocets of win!$ a small area coming up in one place$ getting*uite har!$ an! then subsi!ing$ followe! b" fresh area !oing exactl" the same. These pocets

of win! ma" be in an" part of the ab!omen. In the acute attacs of pain the patients ten! toget a little flushe!$ but not so flushe! as the %pium patients$ an! the" !o not ha&e theten!enc" to eructation that one associates with L"copo!ium$ in fact the" !o not seem to beable to get ri! of their win! at all either upwar!s or !own war!s. +ut it is these small isolate!pocets coming up in irregular areas throughout the ab!omen which gi&e "ou "our main lea! inRaphanus cases$ an! I ha&e seen *uite a number of them now$ post/operati&e cases$ an! it isastonishing how *uicl" after a !ose of this reme!" the !isturbance subsi!es an! the patientbegins to pass flatulence *uite comfortabl".

In post/operati&e cases I usuall" gi&e L"copo!ium in ?66th potenc". In Raphanus I alwa"suse the ?66s$ ha&ing foun! this potenc" wore! I ha&e stuc to it. In %pium I usuall" gi&e ahigher potenc" because these cases are prett" extreme.

There are$ of course$ en!less other !rugs which ha&e colic$ but I am tr"ing to pic out thosemost useful in emergencies. There is one other which "ou ought to now$ P%8%P1LL-2.Po!oph"llum "ou will fin! useful in hepatic colic mainl"$ It is helpful in intestinal colicsassociate! with !iarrhoea$ I mean with acute !iarrhoea$ but then "ou prescribe it much moreon the !iarrhoea s"mptoms than on those of the colic. +ut "ou !o get in!ication for it in hepaticcolics purel" on the local s"mptoms.

I thin in these cases where "ou ha&e Po!oph"llum in!icate! in hepatic colic "ou alwa"sha&e !egree of infection of the gallbla!!er$ an! one of the first things that maes "ou thin ofthe possibilit" of Po!oph"llum is the fact that the maximum temperature is in the morning an!not in the e&ening. It has a @ ocloc on in the morning pea temperature.

In a!!ition to that$ the Po!oph"llum patients are &er" miserable an! !epresse!$ almost!isguste! with life.

There is alwa"s a !egree of 0aun!ice in the gallbla!!er cases$ an! it ma" be prett" mare!.


8/8

In the ma0orit" of these cases the pain is not !efinitel" locali#e! in the gallbla!!er area$ it smore in the epigastrium as a whole$ an! ten!s to sprea! across from the mi!!le of theepigastrium towar!s the li&er region. The pains are twisting towar!s the li&er region. The painsare twisting in character$ an! the" are much aggra&ate! b" taing foo!.

In these Po!oph"llum cases when the acute pain has subsi!e! there is a horrible feeling of

soreness in the li&er region$ an! "ou fin! these patients l"ing stroing the li&er$ which gi&es agreat sense of comfort. )hen I see an infecte! gallbla!!er with a morning temperature instea!of an e&ening one I imme!iatel" thin of Po!oph"llum. It is astonishing how often one gets hisin!ication$ an! then "ou generall" see the patients l"ing in be! stroing the li&er region. Ine&er" case where the morning temperature an! that relief forms stroing ha&e put me on toPo!oph"llum I ha&e foun! that the other s"mptoms fitte! in.

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Borland Painkillers