CASES

An excerpt from Emergencies of General Practice by Dr. Douglas Borland

Pages: 1 2

Essence of a lecture Dr. Douglas M. Borland gave in 1946

(Submitted by Marc VanWijk)

Arsenicum: – extreme fear, anxiety

– restlessness

– constant thirst for ice cold water

– extreme cardiac pressure, great weight on chest

– cannot get enough breath

– fear to die

– coldness

– anxious look

– sudden onset

Remarks: – use the highest potency you have with you

– the response to the remedy should be quick, if no response

within 15 minutes, it is not an Arsenicum patient.

– after the acute phase is gone, you should not repeat Arsenicum,

but look for the complementary remedy

Antimonium Tartaricum:

– tendency to cyanosis (finger nails, hands, feet…)

– down, hopeless and depressed

– no thirst

– < heat

– likes a fresh room but no stream of air

– tendency to edema of lower extremities

– tongue coated with thick white coat

– feeling of fullness in chest with rales in lower parts of chest

Carbo Vegetabilis:

– cold, sweaty skin

– mentally dull

– air hunger, want the air blowing on them

– paler rather than cyanotic

– great abdominal distension with flatulence

– < eating or drinking ; no thirst

– ice-cold extremeties

Remark: If a patient respond well up to a point on Carb-v, don’t go to a

higher potency to carry on the improvement. Look for a

complementary remedy.

Oxalic acid: – most intense exhaustion

– sensation of numbness, as if having no legs

– cold and clammy skin with mottled cyanosis

– wants to keep absolutely still

– sharp precordial pains

It’ s difficult to distinguish between snake poisons; the most common being Lachesis and Naja.

Lachesis:

– purplish, bloated appearance

– feeling of tightness or constriction

– sensitive to heat

– < after sleep

– suffocative attacks when falling asleep

– < when turned over on the left side

– tremor

– mentally becomes fogged, confused

Naja:

– mostly same symptoms but with a pronounced numbness of

mainly the left arm and hand.

Remarks:

– if stitching pain is more marked: give Naja

– if feeling of constriction is more marked: give Lachesis

Lycopus:

– heart is just starting to fail

– pulse becoming a little irregular

– pale appearance

– restlessness

– complains of a tumultuous sensation in cardiac region

– tendency to cough

– < when turned over to the right side

– dislike of any food, particularly the smell of food

Laurocerasus:

– picture of a congenital heart

– bluish-red appearance

– clubbed fingers

– extreme dyspnoea, < sitting up, > semi-prone position

Aconitum:

– absolutely overwhelming fear

– is certain he is going to die

– unable to keep still

– < any movement

Cactus:

– fear of being incurable and dying

– sensation as from a tight band round the chest

– feeling of increasing tension

Arsenicum:

– feeling of constriction in the chest

– anxious, worried

– very chilly

– burning sensation in the chest

Iodine:

– feeling of constriction and tension in the heart

– anxious

– uncomfortable in heat

– flushed appearance

– underweight

Spongia:

– progressive sensation of swelling in the heart region

– < lying down

– chilly

– numbness of left arm and hand

– face and neck look congested

Lilium tigrinum:

– symptoms as if angina but no cardiac lesion

– stabbing, radiating pains

– hyperesthesia of the chest wall

– depressed, irritable

– sensitive to heat

– < movement

– associated with pelvic lesion – history of gynecological illness

Aconitum:

– very sudden onset

– after he has been out in very cold north-east wind

– restless

– pains are violent, burning

– irritable, scared

– extreme tenderness to touch

Chamomilla:

- pain even more intense

– patient beside himself with pain

– cross and irritable

– nothing satisfies

Capsicum:

– tenderness over mastoid region

– ear looks more prominent

– redness of external ear

– acute stabbing pains

– slight amel by hot applications

– patient feels extremely sorry for himself

Magnesium phosphoricum:

– acute trigeminal neuralgia

– sharp stabs

– < any draught of air

– extreme superficial tenderness of nerve

– mostly right side

– > applied warmth

– > firm pressing

Colocynthis:

- same conditions but affecting the left side

Spigelia:

– sharp stinging pains (as from red hot needle)

– pains radiating along the course of the nerve

– pain is burning but after being touched, a strange cold sensation

is felt (only spigelia)

Magnesium phosphoricum:

– acute burning along the course of the intercostal nerve

Ranunculus:

- history of herpes

– sharp shooting pains

– very sensitive to touch

– conscious of any weather change

Mezereum:

– same pains and modalities as Ranunculus

– < wet weather

– affected area extremely sensitive to any cold draught; sensitive to

bathing with cold water

– < night

Magnesium phosphoricum:

– acute pain down sciatic nerve

– < any movement

– sensitive to cold

– > rest; warmth

– right sided

Colocynthis:

- same symptoms but left sided

Kalium iodatum:

– warm blooded

– < warmth

– > moving

Rhus toxicondendron:

– chilly

– sensitive to damp; cold

– > moving

Gnaphalium:

- if associated with marked numbness

– tenderness over sciatic nerve

Plumbum:

– numbness associated with pain over sciatic nerve

– extreme constipation

Useful in case of acute colic, renal, hepatic or intestinal.

Acontium:

– usually the first attack which is frightening, terrifying

– drives the patient crazy

– patient feels frightfully cold

– very anxious

– cannot bear a hot room

Belladonna:

– repeated attacks; short duration

– feeling of fullness in epigastrium

– < any fluids

– accompanied by flushed face and dilated pupils

– full, bounding pulse

Chelidonium:

- patient with liver problems

– fullness in right hypochondrium

– flatulence

– pains shoots through to the back, to angle of right scapula

– > very hot applications

– > drinking very hot water

Berberis:

– colics from renal or gallstone

– pain radiates in all directions

Magnesium phosphoricum:

– severe colic pain

– > external pressure (rubbing)

– > bending double

– > heat

– in distress from the intensity of the pain

– clean tongue

– result of exposure to cold

Colocynthis:

- severe colic pain

– > external pressure (steady, hard pressure)

– bending double

– irritable, frightened, impatient

– violently angry

– slightly coated tongue

– sometimes follows on an attack of anger

– from over indulgence of cheese

Dioscorea:

– violent, spasmodic colic

– sudden onset, rising up to the head, then subsiding

– > applied heat

– >hyper-extended position

Ipecacuanha:

– cutting pains

– accompanied with intense nausea

– clean tongue

– feels hot and sweaty

– < motion

Lycopodium:

– colic accompanied by abdominal flatulence

– irregular areas of distension

– pains likely to start on the right side

– < 4 to 8 pm

– rumbling and gurgling in abdomen

– tendency to eructations

– sour taste

Raphanus:

– colic accompanied by abdominal flatulence

– paralytic conditions after abdominal section; postoperative colic

– pain remains more or less localized in one area

– pockets of wind in irregular areas

– patient gets a little flushed

Opium:

– colic accompanied by abdominal flatulence

– paralytic conditions after abdominal section

– definite area of distension; everything is churned up to one point

– likely to be in the center of the abdomen

– patient becomes very flushed and hot

– paralytic ileus

– extreme hyperesthesia to noise during attack

Podophyllum:

-hepatic colics

– associated with diarrhea

– some degree of infection of the gall-bladder

– maximum temperature in the morning

– patient feels miserable, disgust of life

– pain in epigastrium as a whole

– < taking food

CASES