====== INTERCOSTAL NEURALGIA WITH SPASMS====== 

{{anchor:s2}}BY PROF. DR. J. HOPPE, OF BASLE.

{{anchor:s3}}Dr. Hoppe, a distinguished Professor of Physiology in the University of Basle, has, for a number of years, been investigating the subject of Homoeopathy. {{anchor:s4}}To the <span grade2>Allgemeine Homoeopathische Zeitung</span> he has contributed, while expressly disclaiming the position of a Homoeopathist, a number of very valuable papers upon the homoeopathic law, the <span grade2>modus operandi</span> of remedies and the efficacy of infinitesimal doses. {{anchor:s5}}He does not hesitate to admit the power of high potencies and, assuming to be an impartial observer and not an Homoeopathist, he distinctly affirms that the strict Hahnemannian Homoeopathists have higher claims to a scientific status and to success in practice than those Homoeopathists who use only the lowest potencies, and who seek to harmonize Homoeopathy with the Physiological School of Medicine. {{anchor:s6}}The following case is interesting not merely from its practical bearings, but also from the physiological views which Dr. Hoppe uses it to illustrate. {{anchor:s7}}— Ed.

{{anchor:s8}}Mrs. H. K., 36 years old, of medium stature, well-nourished and rosy-cheeked, was confined four weeks ago and nursed her child. {{anchor:s9}}For the last fourteen days she had sticking pains in the lumbar region of the back. {{anchor:s10}}These had increased and extended since yesterday evening, and since noon to day (May 7) the pains had reached a very high degree of severity. {{anchor:s11}}I was called in the evening, after the patient had suffered agony from noon till evening. {{anchor:s12}}I found a very desperate state of things. {{anchor:s13}}The woman was sitting in bed and her husband crouched near her, supporting her at the back. {{anchor:s14}}The pain continually darted through the patient and on each occasion the body was spasmodically drawn backward with a wild cry: The room was full of persons who had run together thither and who stood staring around the bed. {{anchor:s15}}This scene had continued since noon, sometimes with the greatest intensity, then for a while somewhat moderated. {{anchor:s16}}There were convulsions such as we see in traumatic tetanus; nevertheless in the jaw and elsewhere, there were no tetanic symptoms. {{anchor:s17}}When the patient was sharply spoken to, there was a brief cessation of the storm, and the patient hastily gave us to understand that she had stitches in the back, which were the cause of this outcry and of these spasmodic movements; with every stitch a cry and a spasm. {{anchor:s18}}Hardly had the patient said this, when she went off as before in violent outcries and jerking spasmodic opisthotonos. {{anchor:s19}}Her husband must not only hold the patient at her back, but also press upon the back; this pressure gave relief. {{anchor:s20}}After this explanation, I was able to survey the scene with better courage and to picture to myself how it was that once on a time people could talk of being bewitched and such like.

{{anchor:s21}}Were the stitches so violent that the patient was compelled to thrash about so fearfully; or rather did she thrash about thus fearfully because there lay something tempestuous in her whole manner of thought and sensation? {{anchor:s22}}The latter was certainly true in no slight degree. {{anchor:s23}}The outcry too relieved the patient. {{anchor:s24}}She therefore screamed without stint. {{anchor:s25}}Pressure relieved and so the husband had to press, and the patient herself, with the impetuous bending backward of the body, pressed her back against the pressing hand of her husband, And all this happened with such a stormy rapidity that the jerking bending backward of the body appeared involuntary. {{anchor:s26}}That it was voluntary, however, I think, one could see from the aspect of the man who was at work supporting his wife's back. {{anchor:s27}}He certainly perceived that the pressure was voluntarily modified, and he drew consolation from this fact — consolation and perhaps something more, for his countenance was very different from that of those who stood around the patient full of astonishment and terror.

{{anchor:s28}}The tongue was white, the epigastrium very sensitive on pressure, the pulse rather full and pretty strong, the face red and dripping with sweat. {{anchor:s29}}There was, therefore, a so-called gastralgia caused by too early exertion after confinement, by milk-diet and by taking cold. {{anchor:s30}}The cataplasms upon the back, which had been prescribed before I was sent for, had increased the suffering. {{anchor:s31}}I ordered a mustard plaster and three drops of tincture of Aconite in nine powders, one powder to be taken every two hours. {{anchor:s32}}I forbade milk.

{{anchor:s33}}May 8th. {{anchor:s34}}After the mustard plasters which were applied upon the stomach and back, the patient improved and she slept pretty well. {{anchor:s35}}After waking, however, the pain came on again. {{anchor:s36}}Now, however, the patient could lie down. {{anchor:s37}}She screamed and was convulsed; the convulsion was of such a character that the patient jerked downward and thus pressed the back against the bed. {{anchor:s38}}This feature was not so continuous as yesterday. {{anchor:s39}}The seat of the sticking pain was now under the left scapula, and it radiated thence toward both sides along the ribs as far as the hypochondria. {{anchor:s40}}The pain was more severe on the left side and occurred both spontaneously as well as on every movement, and inasmuch as motion excited the pain the spasmodic convulsions also necessarily excited pain, so that the patient, by her behavior, kept working herself up to a higher degree of pain, until she became exhausted and thereby got a little repose. {{anchor:s41}}Pressure on the epigastrium caused severe pain which extended through to the back. {{anchor:s42}}Though the tongue was coated, the appetite was good. {{anchor:s43}}Pulse 88; warmth of the skin, and sweat.

{{anchor:s44}}I now prescribed Bryonia<sup>12</sup>, twenty-four drops in eight powders, one powder every two hours. {{anchor:s45}}I ordered the gastric region to be covered; during the raging of the patient it had remained uncovered.

{{anchor:s46}}The patient took Bryonia, and two hours after the first powder the storm was calmed. {{anchor:s47}}The patient now lay quiet in bed, and though she still felt some sticking pain on the left side about the lower ribs, she could sit comfortably again and could lie as she pleased.

{{anchor:s48}}On the 9th of May, in the morning, the patient perceived only occasionally a little sticking pain under the left scapula. {{anchor:s49}}Covering the gastric region warmly was agreeable; pressure on the epigastrium was still somewhat painful and the tongue was somewhat coated as before. {{anchor:s50}}In the evening the patient was out of bed.

{{anchor:s51}}The reader of course understands that it is not proposed here to treat of a radical cure, but only to depict the striking instantaneous action of Bryonia; yet nevertheless the patient received from it a good enduring effect, for up to this day, middle of August, she has remained free from every kind of stomach trouble and to all appearances well. {{anchor:s52}}That effect was however, in fact, very striking. {{anchor:s53}}In two hours the whole morbid picture was changed; still more, from the very moment of taking the first powder, all the by-standers became immediately aware of the change which was in progress. {{anchor:s54}}Indeed the cure was almost too quick for the patient and for her relatives; for the latter were compelled to say to themselves, "if the malady was really so terrible as it appeared to be, how could it vanish so quickly, and if it was not so very bad, why did the patient act so extravagantly" The people are not capable of rightly appreciating a rapid Cure, and it must be confessed this has Its difficulties for physicians too.

{{anchor:s55}}Bryonia accomplished it however, and this in the twelfth, therefore in a high dilution. {{anchor:s56}}Why Bryonia? {{anchor:s57}}Why Bryonia the twelfth? {{anchor:s58}}And by what process was this effect brought about? {{anchor:s59}}Not otherwise by any possibility than through the action of Bryonia upon the vessels. {{anchor:s60}}But when the apparent spasmodic attacks of the patient had vanished, her raving and screaming had ceased, and the pain had become reduced to a very moderate degree of discomfort. {{anchor:s61}}All this after taking the Bryonia. {{anchor:s62}}All the subjective phenomena still remained unchanged. {{anchor:s63}}The tongue, the pulse and the sensibility of the epigastrium were just the same as before.{{anchor:s64}}%%*[%% Whoever has watched a severe case of pneumonia or of pleurisy run its course under homoeopathic treatment, and has carefully noted, day by day, the physical signs, must have observed the same mot to which Dr. Hoppe here calls attention, viz.: the rapid and almost complete subsidence of pain, cough, fever and all subjective symptoms long in advance of any marked change in those objective symptoms which make up the physical signs of the disease. {{anchor:s65}}The same thing is observed in all diseases, under homoeopathic treatment, which present at the same time, both subjective and objective symptoms.{{anchor:s66}}D.] How, then, could the Bryonia have brought about a cessation of the pains, while yet the entire stomach-catarrh out of which the stomach-pain and the associated intercostal pains proceeded, still continued to exist as before!

{{anchor:s67}}The reply to this question is not a difficult one. {{anchor:s68}}Indeed it is quite frequently the case that the patient already perceives an improvement in his condition, before any change in the objective phenomena of his disease can be detected, and that amelioration obtained from remedies does not at all accord (in point of time) with the objective changes. {{anchor:s69}}In all violent pains, which are caused by vascular irritation, it depends upon the tension of the vascular muscles; in these cases, the vessels are swollen and, in this swollen condition, their muscles are extended and tense — facts which experiment attests.

{{anchor:s70}}Not only does a greater quantity of blood in consequence stream through the vessels to the tissues, but the blood in the overfilled small vessels is also driven with increased force to the overflowed tissues and this very increased tension of the vascular muscles, this stormy acceleration of the blood-waves in the vessels, is the hostile element. {{anchor:s71}}If now a remedy exercises a healing, quieting influence upon these morbidly active vessels in such wise that the latter return to the normal condition, then first of all the increased tension of the vascular muscles is relaxed, and this affords the patient great relief even without the tangible part of his morbid condition having as yet undergone any change. {{anchor:s72}}A vessel-remedy, however, can only bring back to a normal state the function of the vessel; everything else, subsequent to this, is a result of this restoration of the vascular function to its normal condition.

----

====== DOCUMENT DESCRIPTOR ======

^ Source: | The American Homoeopathic Review Vol. 04 No. 05, 1863, page 213-217 |
^ Description: | Intercostal Neuralgia With Spasms |
^ Remedies: | Bryonia alba |
^ Author: | Hoppe, J. |
^ Year: | 1863 |
^ Editing: | errors only; interlinks; formatting |
^ Attribution: | Legatum Homeopathicum |