COCCULUS [Cocc]:
- M.L.Tyler.
Introduction:
OF Cocculus indicus HAHNEMANN says: "This vegetable substance, hitherto only used for destroying some noxious vermin and stupefying fish so that they may be taken by the hand, was (like Staphisagria) first employed by myself as a medicine (after I had first ascertained its dynamic effects on the healthy human body.) It possesses many curative virtues, as the following symptoms produced by it show; and the tincture prescribed according to the similarity of effect in high attenuation and potency is indispensable for the cure in many cases of common human diseases; -more especially in some kinds of lingering nervous fevers; in several so-called spasms in the abdomen, and so-called spasmodic pains of other parts, where the mental state is one of extreme sadness, particularly in the female sex; in not a few attacks of paralysis of the limbs, and in emotional derangements resembling those that Cocculus can itself produce." HERING (Guiding Symptoms) says: "Tincture of the powdered seeds is used, which contain a crystallizable principle, Picrotoxin, a powerful poison. "Cocculus was used by the ancients as a poison for fish, stupefying them, and rendering it easy to catch them. "It has been, and still is" (So he says) " extensively used for adulterating malt liquors." A pleasant idea! Perhaps, if this use persists, it may account for some of the symptoms of beer drunkenness. The attitudes and mentality of the reeling and roaring monstrosities one used to meet in the streets-anyway before the war, when beer happily became more costly and more difficult to obtain-are very suggestive of Cocculus poisoning: the difficult, uncertain gait; the difficult speech and articulation; the noisy, quarrelsome mood of the reeling, roaring songsters-no wonder that "one of the remedies for the diseases peculiar to drunkards" is Cocculus. But, as Tennyson has it, "Bygones may be come-agains", and we may yet see the good old days back now that beer is blatantly preached from all the great hoardings, "Beer is good for you!" with all the other brewers' slogans. As an American journal pointed out in regard to patent medicines, these are put on the market and advertised not for tender love of the dear people, or for their relief and salvation, but solely for the juggling purpose of extracting money form their pockets. However, all these things spell "Industry" and "Dividends": and the revenue from beer is increasing, which must be very gratifying to the Chancellor of the Exchequer. Only-there is the other side to the question; appetites whetted; habits difficult, once formed, to eradicate, and as always, temptations for the weak and wavering at every street corner. But it is a free country; or was supposed to be till "DORA" came along-and stayed; and so long as the Boisterous Britisher only gets drunk and not too disorderly or obstructive in the streets, and drinks only before a certain "witching hour of night", the kindly police will not cause him over much inconvenience. And meanwhile we homoeopaths can see Cocculus in the spasticity and loss of power of the inebriate's limbs and his clumsy attempts at progression: and learn how to remember its peculiarities and apply them for healing. Among the mental symptoms, highly suggestive, are:- Speech: difficult in reading and thinking. Thinks and answers correctly, but takes a long time in reflecting. Slowness of comprehension: cannot find the right word: forgets himself: cannot talk plainly: or is irritable, speaks hastily, cannot bear the least noise or contradiction. Great talkativeness: witty joking: irresistible desire to sing. A kind of mania. Melancholy and sad: sensitive to insults, slights and disappointment. Easily affronted. A trifle makes him angry. Cannot accomplish anything at her work: cannot finish anything. Frightened look. Little concern for his own health; very anxious about others' sickness. (Ars., Phos., Sulph.) Fear of death and unknown dangers. In regard to Picrotoxin, the alkaloid of Cocculus, and to its effect on fish, CLARKE (Dictionary) tells us that "When Picrotoxin is added to water in which fish are swimming, they make winding and boring movements of the body, alternating with quiet swimming, open their mouths and gill-caverns frequently, fall on their side, and rapidly die of asphyxia." And he tells of a doctor who proved Picrotoxin on himself with such alarming symptoms that he had to resort to Opium and Camphor to antidote. He experienced "nausea with tendency to vomit; violent intestinal pain and purging; dysenteric diarrhoea and excessive secretion of urine; cramps and paralytic sensations. Pain in bowels and sensation as if bowels would protrude at left inguinal ring." (Cocculus or Picrotoxin has been found useful in left sided inguinal hernia.) Of Cocculus he says: " It has cured a case of delirium at onset of menses; the patient said, `I always see something alive, on walls, floor, chairs, or anywhere, always rolling, and will roll on me." (Cocculus is one of the remedies of troubles and irregularities of menstruation- the rest of the symptoms agreeing.) And he tells of a cure of enlargement of the liver by the great Lippe: it was after parturition, the indication being "The liver was more painful after anger." And, with Cocculus, the least jar is unbearable (Bell.). HUGHES (Pharmacodynamics) quotes a case of poisoning by Cocculus related by Hahnemann (in Hufeland's Journal). "Coldness: paralytic stiffness of the limbs with drawing pains in their bones and in the back, and sullen irritability, with anxiety, were the prominent symptoms. The patient said that his brain felt constricted as by a ligature. He wished to sleep, but a frightful sensation, as of a hideous dream, came over him directly he closed his eyes, and made him start up again. He had great repugnance to food and drink. This is a frequent symptom of Cocculus, and very characteristic of it." Hughes also says," The experiments lately made on animals with the alkaloid contained in Cocculus, Picrotoxin show that convulsions, both tonic and clonic, are a special characteristic of its action. The latter present many of those singular features which have been observed as results of injury to the crura cerebri, as semicircular and backward movements, and rolling over on the axis of the body. With these there is great slowness of pulse and respiration, indicating disturbance at the origin of the vagus." Again, "Cocculus thus appears to influence the motor nervous tract throughout the cranio-spinal axis. To such action is referable, I think, the whole range of its curative influence. It is of great service in certain kinds of vomiting. These, when analysed appear to be of cerebral rather than gastric origin. They are such as occur in sea-sickness, and in some persons from riding in a carriage or any similar motion; they have another instance in the vomiting of migraine, or cerebral tumours in the former Cocculus has no rival." And he talks of "vertigo, where Cocculus is a principal remedy and of the abdominal spasms, accompanied by flatulence, not the product of fermentation. FARRINGTON (Comparative Materia Medica) says in regard to "Cocculus, whose active principle is Picrotoxin, bitter poison. "We shall find under Cocculus symptoms that are under many other drugs, but in no other drug do they hold the same relation as they do here. "The general effect of Cocculus is its well-known action on the cerebrospinal system: here it produces great debility. It causes a paralytic weakness of the spine, and especially of its motor nerves; thus we find it a certain or frequent remedy in paralysis originating in disease of the spinal cord especially in the beginning of the trouble, whether from functional or severe organic disease irritation, softening of the cord, or locomotor ataxia. It is especially indicated where the lumbar region of the spine is affected, with weakness in the small of the back gives out when walking. Weakness of legs: knees gives out when walking; thighs ache as if they had been pounded; soles of feet feel as if asleep; first one hand and then the other goes to sleep, or the whole arm falls asleep, and hands feel as if swollen. "There is a concomitant symptom almost always associated with these- a feeling of hollowness in some of the cavities of the body-head, chest, or abdomen. It is more than a weakness; it is an absolute feeling as though the parts were hollow. "The debility is of spinal origin: especially is it apt to follow loss of sleep: the patient cannot sit up even one or two hours later than usual in the evening without feeling languid and exhausted throughout the entire day following. "The abdomen is greatly distended and tympanic: this tympanites under Cocculus is not the same as under Cinchona, Carbo-veg., Colchicum, Sulphur, or even Lycopodium. "There are several origins of tympanites. It may come from the blood-vessels, from the air swallowed with the food, from changes in the food itself, and also from the retention of flatus. The later condition is the cause of the tympany under Cocculus indicus. It is not to be thought of as a remedy when flatus results from decomposition of food. That calls for Carbo veg." In regard to the occipital headache of Cocculus, Farrington has some interesting contributions. "Some years ago there was an epidemic of spotted fever in the city. During that epidemic many children, died, especially in its earlier days. After a while there was discovered a symptom characteristic of the epidemic, and that was intense headache in the occipital region, and in the nape of the neck. Children in a stupor would manifest it by turning the head back, so as to relieve the tension on the membranes of the brain; others who were conscious would put their hands to the back of the head; while still others complained of pain in the back of the head, as if the part were alternately opening and closing. That symptom was under Cocculus. There were very few fatal cases after Cocculus was used. Occipital headaches are hard to cure. This is NASH's little summary of Cocculus: Weakness of cervical muscles, can hardly hold the head up. Weakness in small of back, as if paralysed: gives out when walking; can hardly stand, walk, or talk. Hands and feet get numb; asleep General sense of weakness; or weak, hollow, gone feeling in head, stomach, abdomen, etc. Worse by loss of sleep or night watching. Great distension with flatulent colic; wind or menstrual colic; crampy pains; inclined to hernia. Modalities; (<) sitting up, moving, riding in carriage or boat, smoking, talking, eating, drinking, night watching:-(>) when lying quiet. To epitomize KENT, who is, as usual, the most illuminating of all:-"Cocculus slows down all the activities of body and mind, producing a sort of paralytic weakness." Behind time in all its actions. All the nervous impressions are slow in reaching the centres. As (he says) if you pinch the patient on the great toe, he waits a minute and then says "Oh", instead of saying it at once. Answers slowly, after apparent meditation. Weak: tired. First this slowness and then a sort of visible paralytic condition, and then complete paralysis-local or general. But there are causes:-Nursing: night nursing: worn out by anxiety, worry and loss of sleep. Cocculus, he says, from the time of Hahnemann to the present time has been a remedy for complaints from nursing; not professional nursing, for Cocculus needs the combination of vexation, anxiety, and prolonged loss of sleep. At the end of it, prostrated in body and mind, cannot sleep, has congestive headaches, nausea, vomiting and vertigo. That is how a Cocculus case begins. The instant Cocculus gets into a wagon to ride, sick headache, nausea, vertigo come on. Cocculus cannot endure motion: worse talking, motion, motion of eyes, riding. Wants plenty of time to turn the head cautiously to see things. Wants plenty of time to move; wants plenty of time to think; wants plenty of time to do everything. Is slowed down: inactive. Then the incoordination, the numbness. He says it has been used with good effect in locomotor ataxia. In regard to the STIFFNESS of Cocculus. Kent makes this clear and rememberable. "Such a strong symptom, and quite peculiar to Cocculus-as to some nerve diseases. Limbs straightened out and held there for a little while can only be flexed with great pain. Persons prostrated with anxiety will lie down on the back, straighten out the limbs, and can only get up with great difficulty. The doctor comes, discovers what is the matter, bends the limbs and she screams; but is relieved after the bending, and can get up and move about." Kent says, "You cannot find that anywhere else. It is entirely without inflammation: a sort of paralytic stiffness, a paralysis of the tired body and mind. A man will stretch out his leg on a chair and he cannot flex it till he reaches down with his hands to assist. Now with all this slowing down of the thoughts and activities, the patient remains extremely sensitive to suffering and to pain." Spasms like electric shocks: convulsions after loss of sleep. Tetanus, chorea, attacks of paralytic weakness with pain. Paralysis, eyes, face, muscles, limbs-everywhere. Kent gives a case of paralysis of both limbs after diphtheria in a little girl, which was considered hopeless; but one of the big old men, looking through the case, gave Cocculus cm and "it was not many days before the child began to move the legs and the condition was perfectly cleared up", "and I have never ceased to wonder at it", says Kent. (Here, and in other of the aspects of Cocculus, one is reminded again and again of Gelsemium. Both paralyse the eyelids and the throat, producing ptosis and paresis of deglutition; the limbs: and both may help and cure paralysis after diphtheria. One may compare also with Plumbum which, as Nash has pointed out, has hyperaesthesia with loss of power:-a brilliant and fertile hint, as one has experienced; notably in a case of Landry's disease, "ascending paralysis", where the condition caused great anxiety as it progressed, and the hyperaesthesia was such that the hospital nurse had to give up taking the pulse. Rare doses of Plumbum in high potency sent her back to useful war-work. It was the sort of case that one does not forget. But Cocculus has spasticity with loss of power, and should be useful in spastic paraplegias.) Kent says further: In the extreme Cocculus state, there is the appearance of imbecility, the mind seems almost a blank, He looks into space, and slowly turning the eyes towards the questioner answers with difficulty. Prostration and nervous exhaustion accompany most of the complaints of Cocculus. Then, as to the vertigo and nausea: A Cocculus case cannot look out of the car window, cannot look down from the boat and see water moving, without nausea immediately. Headaches and nausea, with giddiness and gastric symptoms. Cannot accommodate the eyes to moving objects. Headache as if the skull would burst, or like a great valve opening and shutting (or, as we have heard, mysterious feeling as if the head were hollow and empty) prostration and nervous exhaustion accompany most of the complaints of Cocculus. You go to the bedside and ask the nurse, "What have you been feeding the patient?" and the patient gags. The thought of food makes the patient gag. The nurse will say, every time she mentions food the patient gags. The thought of food or the smell of food in the other room or the kitchen will nauseate the patient. (Colchicum:-but also Ars. and Sep.) Kent also draws attention to: Sensation as though a worm were crawling in stomach:-("Something alive inside" reminds one of Thuja and Crocus) and Kent ends with "Slightest loss of sleep tells on him." Working through Cocculus, as mirrored in the experience of different prescribers, is extremely interesting and instructive, and one remembers with regret cases where Cocculus might have been useful. As a matter of fact one's most frequent experience with Cocculus has been helping persons worn out with prolonged night nursing and loss of sleep: where "Glamis hath murdered sleep and therefore Cawdor Shall sleep no more; Macbeth shall sleep no more.".
BLACK LETTER SYMPTOMS
(i.e. those which Cocculus most notably causes and cures) THOUGHTS are fixed on a single disagreeable subject: absorbed in thought and notices nothing about her. Sits in deep reverie. Ill effects of anger and grief. Sudden extreme anxiety. Easily startled. Time passes too quickly. Stupid in the HEAD. Cloudiness of the head, chiefly after eating and drinking. Vertigo as if intoxicated, with dullness in forehead: as if a board across head: on rising from lying: had to lie down again. Vertigo: as if intoxicated: with confusion: with nausea: things whirl from right to left. With flushed, hot face and head: then palpitation. Headache as if eyes would be torn out. Headache with nausea and inclination to vomit. Sick headache from riding in carriage, boat, train, cars, etc. Seasickness. Dimness of SIGHT Dryness of oesophagus. Loss of appetite with metallic taste. Unusual NAUSEA and inclination to vomit, while riding in a wagon. Extreme aversion to food, caused even by the smell of food, although with hunger. Frequent empty eructations. When he becomes cold, or catches cold, there is inclination to vomit, causing a copious flow of saliva. Inclination to vomit in connection with headache, and a pain as if bruised in the bowels. Violent spasm in the STOMACH, clutching in the stomach. Spasm in the stomach: squeezing in the stomach. Griping in epigastrium, taking away the breath. Thirst especially for beer. Great distension of the ABDOMEN. Flatulent colic about midnight; awakened by incessant accumulation of flatulence, which distended the abdomen, causing oppressive pain here and there; some was passed without remarkable relief, whilst new flatus constantly collected for several hours; he was obliged to lie on one side for relief. Painful inclination to a hernia, especially after rising from sitting. Watery urine. Itching in scrotum MENSTRUATION seven days, too early, with distension of abdomen and cutting, contracting pains in abdomen on every motion and every breath, together with contraction of rectum. Tensive constriction of right side CHEST, which oppresses the breathing. Very violent tickling in larynx, wakes him at 11.30 p.m., causes cough, with expectoration of much tenacious mucus. Expectoration of much viscid albuminous mucus. PARALYTIC SYMPTOMS. Weakness of cervical muscles, with heaviness of head. In shoulder joint and muscles of upper arm, single stitches when at rest. Stitches in right upper arm. Numbness and paralytic feelings in arms. Now one hand, now the other is numb, as if asleep. Sometimes one hand, sometimes the other is alternately hot and cold. Hand trembles while eating, and the more the higher it is raised. Knees sink down from weakness; totters while walking and threatens to fall to one side. Cracking of the knee when moving. Soles of both feet go to sleep, while sitting. At one time the feet are asleep, at another the hands. (And, in italics Weakness in limbs as if paralysed). Trembling from excitement, over-exertion and pain. Sensation of seasickness. Hysteric complaints with sadness. Convulsions after loss of sleep. Attacks of paralytic weakness with pain in back. Here and there in the limbs an acute paralytic drawing, continuous and in jerks, as if in the bone. Cracking and creaking in the joints. Painful stiffness of the joints. Falling asleep of feet and hands alternately, in short paroxysms. Tendency to trouble. Great exhaustion of the body, so that it was an exertion to him to stand steady. Slight perspiration over the whole body on slightest exertion. Cocculus excites shooting pains and heat in cold glandular swellings, at least when they are touched. All the symptoms and sufferings, especially in the head, are aggravated by drinking, eating, sleeping, and speaking. Intolerance of cold and warm air. SLEEP disturbed by excessive anxiety and restlessness. Sleepless from long continued nursing; from night watching. Anxious, frightful dreams. Ill effects from loss of sleep and night watching. FEVER SYMPTOMS. Chill frequently alternating with heat. Flushes of heat, with burning heat of cheeks and cold feet. Insidious nervous fevers, particularly in cases which have been produced by frequent fits of anger, or are accompanied by great disposition to anger.
PECULIAR CHARACTERISTIC SYMPTOMS
Great excitement after two glasses of beer. His accustomed beer caused headache. Thirst, especially for beer. Great sensitiveness of mouth and fauces, so that rinsing the mouth caused cough and vomiting thick masses of mucus. Loud speaking or brushing the teeth caused cough and vomiting. Constant desire to spit, with sweetish metallic taste. Pain in liver after anger. Pain in tendo achillis-only when walking. No tenderness: limped when walking in street: obliged to turn foot outwards: to stop and hold foot up to relieve the pain. Ascending steps was especially painful. Pain, redness and swelling of great toes, like gout. Left great toe especially affected: with fine pricking as from splinters of glass, beneath nail, and at tip of toe. Coldness of stomach: as if cold air were blowing in it. Spasmodic internal heaving in epigastrium. Nausea, felt in head: seems to be mostly in mouth. Hollowness in head: in chest: in abdomen. Shivering over mammae. Chilly feeling through teeth. Rolling of eyeballs, eyes being closed. Sleep aggravates all symptoms, especially of head. Colic as if there were sharp stones rubbing against each other in abdomen. Occipital headache, occiput alternately opens and shuts. (Vertex opens and shuts. Cann. ind.) Time passes too swiftly (too slowly). In regard to the places where nausea is felt, one is constantly adding to them: Nausea felt in head and mouth, Cocc. In rectum, Ruta. In ears, Dios. Besides the more usual localities, stomach, chest, abdomen.
Introduction:
OF Cocculus indicus HAHNEMANN says: "This vegetable substance, hitherto only used for destroying some noxious vermin and stupefying fish so that they may be taken by the hand, was (like Staphisagria) first employed by myself as a medicine (after I had first ascertained its dynamic effects on the healthy human body.) It possesses many curative virtues, as the following symptoms produced by it show; and the tincture prescribed according to the similarity of effect in high attenuation and potency is indispensable for the cure in many cases of common human diseases; -more especially in some kinds of lingering nervous fevers; in several so-called spasms in the abdomen, and so-called spasmodic pains of other parts, where the mental state is one of extreme sadness, particularly in the female sex; in not a few attacks of paralysis of the limbs, and in emotional derangements resembling those that Cocculus can itself produce." HERING (Guiding Symptoms) says: "Tincture of the powdered seeds is used, which contain a crystallizable principle, Picrotoxin, a powerful poison. "Cocculus was used by the ancients as a poison for fish, stupefying them, and rendering it easy to catch them. "It has been, and still is" (So he says) " extensively used for adulterating malt liquors." A pleasant idea! Perhaps, if this use persists, it may account for some of the symptoms of beer drunkenness. The attitudes and mentality of the reeling and roaring monstrosities one used to meet in the streets-anyway before the war, when beer happily became more costly and more difficult to obtain-are very suggestive of Cocculus poisoning: the difficult, uncertain gait; the difficult speech and articulation; the noisy, quarrelsome mood of the reeling, roaring songsters-no wonder that "one of the remedies for the diseases peculiar to drunkards" is Cocculus. But, as Tennyson has it, "Bygones may be come-agains", and we may yet see the good old days back now that beer is blatantly preached from all the great hoardings, "Beer is good for you!" with all the other brewers' slogans. As an American journal pointed out in regard to patent medicines, these are put on the market and advertised not for tender love of the dear people, or for their relief and salvation, but solely for the juggling purpose of extracting money form their pockets. However, all these things spell "Industry" and "Dividends": and the revenue from beer is increasing, which must be very gratifying to the Chancellor of the Exchequer. Only-there is the other side to the question; appetites whetted; habits difficult, once formed, to eradicate, and as always, temptations for the weak and wavering at every street corner. But it is a free country; or was supposed to be till "DORA" came along-and stayed; and so long as the Boisterous Britisher only gets drunk and not too disorderly or obstructive in the streets, and drinks only before a certain "witching hour of night", the kindly police will not cause him over much inconvenience. And meanwhile we homoeopaths can see Cocculus in the spasticity and loss of power of the inebriate's limbs and his clumsy attempts at progression: and learn how to remember its peculiarities and apply them for healing. Among the mental symptoms, highly suggestive, are:- Speech: difficult in reading and thinking. Thinks and answers correctly, but takes a long time in reflecting. Slowness of comprehension: cannot find the right word: forgets himself: cannot talk plainly: or is irritable, speaks hastily, cannot bear the least noise or contradiction. Great talkativeness: witty joking: irresistible desire to sing. A kind of mania. Melancholy and sad: sensitive to insults, slights and disappointment. Easily affronted. A trifle makes him angry. Cannot accomplish anything at her work: cannot finish anything. Frightened look. Little concern for his own health; very anxious about others' sickness. (Ars., Phos., Sulph.) Fear of death and unknown dangers. In regard to Picrotoxin, the alkaloid of Cocculus, and to its effect on fish, CLARKE (Dictionary) tells us that "When Picrotoxin is added to water in which fish are swimming, they make winding and boring movements of the body, alternating with quiet swimming, open their mouths and gill-caverns frequently, fall on their side, and rapidly die of asphyxia." And he tells of a doctor who proved Picrotoxin on himself with such alarming symptoms that he had to resort to Opium and Camphor to antidote. He experienced "nausea with tendency to vomit; violent intestinal pain and purging; dysenteric diarrhoea and excessive secretion of urine; cramps and paralytic sensations. Pain in bowels and sensation as if bowels would protrude at left inguinal ring." (Cocculus or Picrotoxin has been found useful in left sided inguinal hernia.) Of Cocculus he says: " It has cured a case of delirium at onset of menses; the patient said, `I always see something alive, on walls, floor, chairs, or anywhere, always rolling, and will roll on me." (Cocculus is one of the remedies of troubles and irregularities of menstruation- the rest of the symptoms agreeing.) And he tells of a cure of enlargement of the liver by the great Lippe: it was after parturition, the indication being "The liver was more painful after anger." And, with Cocculus, the least jar is unbearable (Bell.). HUGHES (Pharmacodynamics) quotes a case of poisoning by Cocculus related by Hahnemann (in Hufeland's Journal). "Coldness: paralytic stiffness of the limbs with drawing pains in their bones and in the back, and sullen irritability, with anxiety, were the prominent symptoms. The patient said that his brain felt constricted as by a ligature. He wished to sleep, but a frightful sensation, as of a hideous dream, came over him directly he closed his eyes, and made him start up again. He had great repugnance to food and drink. This is a frequent symptom of Cocculus, and very characteristic of it." Hughes also says," The experiments lately made on animals with the alkaloid contained in Cocculus, Picrotoxin show that convulsions, both tonic and clonic, are a special characteristic of its action. The latter present many of those singular features which have been observed as results of injury to the crura cerebri, as semicircular and backward movements, and rolling over on the axis of the body. With these there is great slowness of pulse and respiration, indicating disturbance at the origin of the vagus." Again, "Cocculus thus appears to influence the motor nervous tract throughout the cranio-spinal axis. To such action is referable, I think, the whole range of its curative influence. It is of great service in certain kinds of vomiting. These, when analysed appear to be of cerebral rather than gastric origin. They are such as occur in sea-sickness, and in some persons from riding in a carriage or any similar motion; they have another instance in the vomiting of migraine, or cerebral tumours in the former Cocculus has no rival." And he talks of "vertigo, where Cocculus is a principal remedy and of the abdominal spasms, accompanied by flatulence, not the product of fermentation. FARRINGTON (Comparative Materia Medica) says in regard to "Cocculus, whose active principle is Picrotoxin, bitter poison. "We shall find under Cocculus symptoms that are under many other drugs, but in no other drug do they hold the same relation as they do here. "The general effect of Cocculus is its well-known action on the cerebrospinal system: here it produces great debility. It causes a paralytic weakness of the spine, and especially of its motor nerves; thus we find it a certain or frequent remedy in paralysis originating in disease of the spinal cord especially in the beginning of the trouble, whether from functional or severe organic disease irritation, softening of the cord, or locomotor ataxia. It is especially indicated where the lumbar region of the spine is affected, with weakness in the small of the back gives out when walking. Weakness of legs: knees gives out when walking; thighs ache as if they had been pounded; soles of feet feel as if asleep; first one hand and then the other goes to sleep, or the whole arm falls asleep, and hands feel as if swollen. "There is a concomitant symptom almost always associated with these- a feeling of hollowness in some of the cavities of the body-head, chest, or abdomen. It is more than a weakness; it is an absolute feeling as though the parts were hollow. "The debility is of spinal origin: especially is it apt to follow loss of sleep: the patient cannot sit up even one or two hours later than usual in the evening without feeling languid and exhausted throughout the entire day following. "The abdomen is greatly distended and tympanic: this tympanites under Cocculus is not the same as under Cinchona, Carbo-veg., Colchicum, Sulphur, or even Lycopodium. "There are several origins of tympanites. It may come from the blood-vessels, from the air swallowed with the food, from changes in the food itself, and also from the retention of flatus. The later condition is the cause of the tympany under Cocculus indicus. It is not to be thought of as a remedy when flatus results from decomposition of food. That calls for Carbo veg." In regard to the occipital headache of Cocculus, Farrington has some interesting contributions. "Some years ago there was an epidemic of spotted fever in the city. During that epidemic many children, died, especially in its earlier days. After a while there was discovered a symptom characteristic of the epidemic, and that was intense headache in the occipital region, and in the nape of the neck. Children in a stupor would manifest it by turning the head back, so as to relieve the tension on the membranes of the brain; others who were conscious would put their hands to the back of the head; while still others complained of pain in the back of the head, as if the part were alternately opening and closing. That symptom was under Cocculus. There were very few fatal cases after Cocculus was used. Occipital headaches are hard to cure. This is NASH's little summary of Cocculus: Weakness of cervical muscles, can hardly hold the head up. Weakness in small of back, as if paralysed: gives out when walking; can hardly stand, walk, or talk. Hands and feet get numb; asleep General sense of weakness; or weak, hollow, gone feeling in head, stomach, abdomen, etc. Worse by loss of sleep or night watching. Great distension with flatulent colic; wind or menstrual colic; crampy pains; inclined to hernia. Modalities; (<) sitting up, moving, riding in carriage or boat, smoking, talking, eating, drinking, night watching:-(>) when lying quiet. To epitomize KENT, who is, as usual, the most illuminating of all:-"Cocculus slows down all the activities of body and mind, producing a sort of paralytic weakness." Behind time in all its actions. All the nervous impressions are slow in reaching the centres. As (he says) if you pinch the patient on the great toe, he waits a minute and then says "Oh", instead of saying it at once. Answers slowly, after apparent meditation. Weak: tired. First this slowness and then a sort of visible paralytic condition, and then complete paralysis-local or general. But there are causes:-Nursing: night nursing: worn out by anxiety, worry and loss of sleep. Cocculus, he says, from the time of Hahnemann to the present time has been a remedy for complaints from nursing; not professional nursing, for Cocculus needs the combination of vexation, anxiety, and prolonged loss of sleep. At the end of it, prostrated in body and mind, cannot sleep, has congestive headaches, nausea, vomiting and vertigo. That is how a Cocculus case begins. The instant Cocculus gets into a wagon to ride, sick headache, nausea, vertigo come on. Cocculus cannot endure motion: worse talking, motion, motion of eyes, riding. Wants plenty of time to turn the head cautiously to see things. Wants plenty of time to move; wants plenty of time to think; wants plenty of time to do everything. Is slowed down: inactive. Then the incoordination, the numbness. He says it has been used with good effect in locomotor ataxia. In regard to the STIFFNESS of Cocculus. Kent makes this clear and rememberable. "Such a strong symptom, and quite peculiar to Cocculus-as to some nerve diseases. Limbs straightened out and held there for a little while can only be flexed with great pain. Persons prostrated with anxiety will lie down on the back, straighten out the limbs, and can only get up with great difficulty. The doctor comes, discovers what is the matter, bends the limbs and she screams; but is relieved after the bending, and can get up and move about." Kent says, "You cannot find that anywhere else. It is entirely without inflammation: a sort of paralytic stiffness, a paralysis of the tired body and mind. A man will stretch out his leg on a chair and he cannot flex it till he reaches down with his hands to assist. Now with all this slowing down of the thoughts and activities, the patient remains extremely sensitive to suffering and to pain." Spasms like electric shocks: convulsions after loss of sleep. Tetanus, chorea, attacks of paralytic weakness with pain. Paralysis, eyes, face, muscles, limbs-everywhere. Kent gives a case of paralysis of both limbs after diphtheria in a little girl, which was considered hopeless; but one of the big old men, looking through the case, gave Cocculus cm and "it was not many days before the child began to move the legs and the condition was perfectly cleared up", "and I have never ceased to wonder at it", says Kent. (Here, and in other of the aspects of Cocculus, one is reminded again and again of Gelsemium. Both paralyse the eyelids and the throat, producing ptosis and paresis of deglutition; the limbs: and both may help and cure paralysis after diphtheria. One may compare also with Plumbum which, as Nash has pointed out, has hyperaesthesia with loss of power:-a brilliant and fertile hint, as one has experienced; notably in a case of Landry's disease, "ascending paralysis", where the condition caused great anxiety as it progressed, and the hyperaesthesia was such that the hospital nurse had to give up taking the pulse. Rare doses of Plumbum in high potency sent her back to useful war-work. It was the sort of case that one does not forget. But Cocculus has spasticity with loss of power, and should be useful in spastic paraplegias.) Kent says further: In the extreme Cocculus state, there is the appearance of imbecility, the mind seems almost a blank, He looks into space, and slowly turning the eyes towards the questioner answers with difficulty. Prostration and nervous exhaustion accompany most of the complaints of Cocculus. Then, as to the vertigo and nausea: A Cocculus case cannot look out of the car window, cannot look down from the boat and see water moving, without nausea immediately. Headaches and nausea, with giddiness and gastric symptoms. Cannot accommodate the eyes to moving objects. Headache as if the skull would burst, or like a great valve opening and shutting (or, as we have heard, mysterious feeling as if the head were hollow and empty) prostration and nervous exhaustion accompany most of the complaints of Cocculus. You go to the bedside and ask the nurse, "What have you been feeding the patient?" and the patient gags. The thought of food makes the patient gag. The nurse will say, every time she mentions food the patient gags. The thought of food or the smell of food in the other room or the kitchen will nauseate the patient. (Colchicum:-but also Ars. and Sep.) Kent also draws attention to: Sensation as though a worm were crawling in stomach:-("Something alive inside" reminds one of Thuja and Crocus) and Kent ends with "Slightest loss of sleep tells on him." Working through Cocculus, as mirrored in the experience of different prescribers, is extremely interesting and instructive, and one remembers with regret cases where Cocculus might have been useful. As a matter of fact one's most frequent experience with Cocculus has been helping persons worn out with prolonged night nursing and loss of sleep: where "Glamis hath murdered sleep and therefore Cawdor Shall sleep no more; Macbeth shall sleep no more.".
BLACK LETTER SYMPTOMS
(i.e. those which Cocculus most notably causes and cures) THOUGHTS are fixed on a single disagreeable subject: absorbed in thought and notices nothing about her. Sits in deep reverie. Ill effects of anger and grief. Sudden extreme anxiety. Easily startled. Time passes too quickly. Stupid in the HEAD. Cloudiness of the head, chiefly after eating and drinking. Vertigo as if intoxicated, with dullness in forehead: as if a board across head: on rising from lying: had to lie down again. Vertigo: as if intoxicated: with confusion: with nausea: things whirl from right to left. With flushed, hot face and head: then palpitation. Headache as if eyes would be torn out. Headache with nausea and inclination to vomit. Sick headache from riding in carriage, boat, train, cars, etc. Seasickness. Dimness of SIGHT Dryness of oesophagus. Loss of appetite with metallic taste. Unusual NAUSEA and inclination to vomit, while riding in a wagon. Extreme aversion to food, caused even by the smell of food, although with hunger. Frequent empty eructations. When he becomes cold, or catches cold, there is inclination to vomit, causing a copious flow of saliva. Inclination to vomit in connection with headache, and a pain as if bruised in the bowels. Violent spasm in the STOMACH, clutching in the stomach. Spasm in the stomach: squeezing in the stomach. Griping in epigastrium, taking away the breath. Thirst especially for beer. Great distension of the ABDOMEN. Flatulent colic about midnight; awakened by incessant accumulation of flatulence, which distended the abdomen, causing oppressive pain here and there; some was passed without remarkable relief, whilst new flatus constantly collected for several hours; he was obliged to lie on one side for relief. Painful inclination to a hernia, especially after rising from sitting. Watery urine. Itching in scrotum MENSTRUATION seven days, too early, with distension of abdomen and cutting, contracting pains in abdomen on every motion and every breath, together with contraction of rectum. Tensive constriction of right side CHEST, which oppresses the breathing. Very violent tickling in larynx, wakes him at 11.30 p.m., causes cough, with expectoration of much tenacious mucus. Expectoration of much viscid albuminous mucus. PARALYTIC SYMPTOMS. Weakness of cervical muscles, with heaviness of head. In shoulder joint and muscles of upper arm, single stitches when at rest. Stitches in right upper arm. Numbness and paralytic feelings in arms. Now one hand, now the other is numb, as if asleep. Sometimes one hand, sometimes the other is alternately hot and cold. Hand trembles while eating, and the more the higher it is raised. Knees sink down from weakness; totters while walking and threatens to fall to one side. Cracking of the knee when moving. Soles of both feet go to sleep, while sitting. At one time the feet are asleep, at another the hands. (And, in italics Weakness in limbs as if paralysed). Trembling from excitement, over-exertion and pain. Sensation of seasickness. Hysteric complaints with sadness. Convulsions after loss of sleep. Attacks of paralytic weakness with pain in back. Here and there in the limbs an acute paralytic drawing, continuous and in jerks, as if in the bone. Cracking and creaking in the joints. Painful stiffness of the joints. Falling asleep of feet and hands alternately, in short paroxysms. Tendency to trouble. Great exhaustion of the body, so that it was an exertion to him to stand steady. Slight perspiration over the whole body on slightest exertion. Cocculus excites shooting pains and heat in cold glandular swellings, at least when they are touched. All the symptoms and sufferings, especially in the head, are aggravated by drinking, eating, sleeping, and speaking. Intolerance of cold and warm air. SLEEP disturbed by excessive anxiety and restlessness. Sleepless from long continued nursing; from night watching. Anxious, frightful dreams. Ill effects from loss of sleep and night watching. FEVER SYMPTOMS. Chill frequently alternating with heat. Flushes of heat, with burning heat of cheeks and cold feet. Insidious nervous fevers, particularly in cases which have been produced by frequent fits of anger, or are accompanied by great disposition to anger.
PECULIAR CHARACTERISTIC SYMPTOMS
Great excitement after two glasses of beer. His accustomed beer caused headache. Thirst, especially for beer. Great sensitiveness of mouth and fauces, so that rinsing the mouth caused cough and vomiting thick masses of mucus. Loud speaking or brushing the teeth caused cough and vomiting. Constant desire to spit, with sweetish metallic taste. Pain in liver after anger. Pain in tendo achillis-only when walking. No tenderness: limped when walking in street: obliged to turn foot outwards: to stop and hold foot up to relieve the pain. Ascending steps was especially painful. Pain, redness and swelling of great toes, like gout. Left great toe especially affected: with fine pricking as from splinters of glass, beneath nail, and at tip of toe. Coldness of stomach: as if cold air were blowing in it. Spasmodic internal heaving in epigastrium. Nausea, felt in head: seems to be mostly in mouth. Hollowness in head: in chest: in abdomen. Shivering over mammae. Chilly feeling through teeth. Rolling of eyeballs, eyes being closed. Sleep aggravates all symptoms, especially of head. Colic as if there were sharp stones rubbing against each other in abdomen. Occipital headache, occiput alternately opens and shuts. (Vertex opens and shuts. Cann. ind.) Time passes too swiftly (too slowly). In regard to the places where nausea is felt, one is constantly adding to them: Nausea felt in head and mouth, Cocc. In rectum, Ruta. In ears, Dios. Besides the more usual localities, stomach, chest, abdomen.
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