By Dr. E. Schlegel, Tucbingen
About ten years ago, in springtime, I had to treat two children who had been poisoned by eating the young shoots of Tragopogon (Goat’s beard), which are dug up here in April by children on account of their sweet juice. One of them was a five-year-old boy in the neighboring V., from whose mother I then heard that another child was taken sick from the same cause and with the same symptoms; another child, a girl thirteen years old, was sick from the same cause in a more distant village of the Black Forest. Both the former children were taken sick, soon after eating the “Goat’s-beard,” with headache and vomiting, fever, tonic convulsions, paralysis of the extremities (paretic conditions) and of the eyes, disability to swallow, drawing back of the head, somnolence and unconsciousness. Both the children recovered after several weeks’ illness; the girl lay ill for six weeks.
The symptoms in all these cases so much resembled an attack of sub-acute cerebro-spinal meningitis that I was strongly reminded of them when this severe disease lately appeared in its epidemic form. I am sorry that I am unable at present to find my written observations as to the case of the young girl, which I made at the time. On inquiring of my colleague, Dr. Stiegele, Jr., whether he knew of any similar cases with respect to Tragopogon, he was so kind as to send me the following notice; “With respect to tragopogon, I found the following in Lewin (Lehrbuchder Toxologie), page 320, among the poisonous plants (Composite); Tragopogon Tourn. The buds and the upper leaves of the Goat’s-beard are much relished by children. A boy who had eaten a quantity of it was taken ill with headachee, swelling of the face, amblyopia, and finally with amaurosis which continued for several days, and vertigo. On the seventh day there appeared tonic convulsions; these were followed by recovery. (Schaal, Wuertemberg Correspondenzblatt, 1891, page 230.) It may be that parasitical fungi on the Goat’s-beard caused the poisoning.” This latter supposition must be given up, when we learn of a number of such cases; then also parasitical fungi are found least frequently in the spring-shoots of plants. It must, therefore, be assumed that Tragopogon pratensis must contain a particular exciting substance which with men (especially with children, who are more particularly exposed to the various forms of meningitis) exercises a corresponding poisonous effect on the central nervous system. Hahnemann, in his valuable “Apothekerlexicon,” does not know anything of this effect of Goat’s beard, but he mentions the long established use of the root in troubles of the kidney and in urinary troubles, he also specially mentions tragopogon porrifolius, also with a white sweet juice, which is used for cough, dyspnoea. Stitches in the side, and in consumption. It is closely related to the oyster-plant, of which Hahnemann also mentions a similar use in convulsions and epilepsy. The use of the these remedies reaches back into antiquity; we find it mentioned already in the excellent Botany of Tabernamontanus, who cites authorities for a similar purpose. That the poisonous effect on the central nervous system is not mentioned does not prove anything; it may only affect a small number of men, as we also know that not all are equally susceptible to the virus of diseases.
Our provings, which are useful in Homoeopathy for unlocking medicinal powers, should make use of this peculiar power and it would then be determined in what particular manner Tragopogon corresponds to the irritation and diseases of the meninges. Perhaps these lines may serve to give an impulse in that direction.
I take occasion here to enter somewhat farther on the disease in question, which will be justified by the general attention turned at present in this direction, owing to the frequency of this disease at the present time both in Europe and in America. I am well aware that the image of the disease as it is formed by an exact observation of the many cases of the epidemy must form the basis for what homoeopaths would call the epidemiology of the disease. I have not as yet observed any cases during this epidemy; yet there is a great general agreement of all the cases in a locally specific respect. The organic systems and organs seized are always the same. The image of the disease in the various individuals is very similar; by which we would not, however, say that the varieties found in the individual cases are not of the greatest importance to homoeopathic therapy. The present epidemic of cerebro-spinal meningitis seems to have a peculiar tendency to draw the central sphere of the senses into participation, especially the sense of vision, which also finds a farther analogy in the action of Tragopogon. But before we have a symptomatology of the president epidemy elaborated by homoeopaths, it is of no use to recommend any particular medicines; still we might let our remedies pass through a brief review. And in this review I would put in the front rank two remedies which have lately been proved:
Cytisus laburnum and Saponiari (soapwort).- Both of them have a decided toxical effect on the central nervous system.
Cytisus.- Great depression of the strength, sensation of heart failure, constriction of the throat, stiffness of the neck, pain in the neck, tearing pains extending from the neck into the occiput, lusterless eye; aggravation in the afternoon and evening, and on the left side. The convulsions and the cerebral symptoms have been observed in cases of poisoning.
Saponaria has great similarity.- Weakness, sensation of weakness in the heart, depression of high degree with somnolence, dull indifference, violent pains in the eyes, also glaucomatous appearances and ciliary neuralgias, supraorbital neuralgia, retarded pulse; poisoning with well developed meningitis.
A third remedy of most general importance is Tuberculin. We must not leave this remedy out of mind in cases of epidemical meningitis, for we must look especially to the symptoms, not to the often defective classification of the cases. Tuberculin (Bacillin) was given with success by burnet in meningitis with children; its symptomatology as collated by Nebel, according to Koch, shows numerous organs, even extending to delirium, coma, collapse, fever and subnormal temperatures as also serious implication of the visional organs. Also Kent emphasizes in Tuberculin; headache, even in old persons; intermittent fever tendency to periodicity, sleeplessness with tormenting thoughts, loquacity during the fever, excitement, restless tossing about of the body, soreness of the whole body, fornication, perspiration of the head, thirst for large quantities of cold water, muscular twitching. Tuberculin should be especially kept in mind in the case of weakly children from consumptive families.
Another remedy rarely used in Europe in this serious disease should not be overlooked; Veratrum viride. It is characterized by strong febrile fluctuations also with subnormal temperatures, and congestion’s; its action is especially on the full-blooded; delirium, headache, starting from the neck, vertgo, dullness of vision, distended pupils (Weakness of the heart with swooning and blindness), fullness in the head, pulsations, increased acuteness of hearing, buzzing in the ears, meningitis with violent fever, rolling the head about, vomiting, a perturbed expression of the face and retarded pulse; pains in the neck and the shoulders, the muscles of the back are contracted, the head bent back heat and redness of the spine, opisthotonos, twitching and distortion of the body, trembling of the body, paralysis. A red streak in the middle of the tongue. This remedy is also suitable in very acute cases, where the a dynamic element, which mingles with the congestive, is prominent in distinction from Belladonna.
We would particularly recommend these less known remedies to the student. I will now merely briefly review the customary and often proved treatment of meningitis, according to the manuals and from my own experience, which also shows some cures of meningitis tuberculosa:
According to farrington there are cases which from the commencement show a stupid condition without reaction; the patient is cold, cyanotic, pulse very weak. Here Ammonium carb. Is first indicated as causing a reaction. Else in the initiatory stadium with prominent irritation, congestion, redness, starting up, fright, guashing of the teeth, incomplete depression. Belladonna is the recognized remedy.
In the progress of the disease with quick, weak pulse, cool feet, heat irregularly distributed, with a befogged sensory and somnolence: Lachesis.
Or we may row follow up, especially in cases where an eruption has been suppressed, with Sulphur, one dose. This I have twice used successfully in tubercular meningitis.
Also Apis may follow after Belladonna, where there is shrill screaming, nervous restlessness, an excited activity pointing to an inflammatory exudation.
In similar cases with anxious changing of the position, great fearfulness weakness, and restlessness: Arsenicum.
On the other hand, in sharp pains in the head (as if the head was being split open), sensitiveness of the stomach, slight setup faction, dark red face, lips chapping, chin moving, hasty thirst, motionless while lying down, stiffness of the neck, and also after an eruption has been forced back: Bryonia.
Sometimes there is found with it squinting, but the senses are not as much disturbed as with Apis and Helleborus.
Helleborus shows an even worse condition, loss of all reaction, a frowning forehead, enlarged pupils, squinting, automatic motions, dark, smooth nostrils and show pulse.
In the latter symptom, with sparing urine containing albumen, Digitalis agrees. This also has: Beating frontal headache, delirium shining fiery balls, amaurotic congestion of the retina, enlarged pupils, coma, prostration, coldness of the body with profuse perspiration. In congestion of the brain and in meningital symptoms after mental emotions and after-insolation, with painful stiffness of the neck and formication of the spine, Aconite is superior to Belladonna as well as to Glonoin.
Glonoin is useful in congestion’s, in painful pulsations, screaming, in sensation as if the head was enlarged, and in convulsive vomiting.
Hyoscyamus has pulsating undulations in the head. Sitting with the head bent forward. Easier when shaking the head (in contradistinction to Glonoin), stupor, into which he immediately sinks back again, rolling the head about, string eyes, murmuring.
Mercurius resembles Apis in the red face, the swelling of the glands, tendency to diseases of the mouth, perspiration which does not improve.
Cuprum has loud screaming, violent convulsions, the thumb bent inwards, paleness with blue lips, rolling of the pupils.
Aincum. Screaming, starting up affrighted, restless motions of the feet, also unconsciousness; blue hands and feet, with coldness; this is especially adapted to anaemic children that are too much exhausted to have any exanthems, and with irritation of the brain, trembling.
In Helleborus and in Zincum Kent remarks that the reaction often sets in with vomiting or trembling and twitching of the extremities, probably only the day after taking the medicine, and that those around the patient should first be prepared for it.
When the visible progress of the improvement comes to a stop, another dose of medicine should be given; but no palliative should be given with it. And we must simply wait for the end of the reaction much as the restlessness and pain may urge us. (In this matter I have no experience.)
Gelsemium. – Complete loss of all muscular strength, dull pains in the occiput, disinclination to everything, heaviness, passive congestion, vertigo, confused vision, the head feels too large, raving, buzzing of the ears, pains in the eyes. This remedy should be especially thought of in and after influenza this may also suggest its use in epidemic attacks.
In a similar manner Cimicifuga deserves consideration. This influenza remedy also causes violent headaches, pains in the eyes, stiffness of the back, tonic and clonic convulsion, raving, sensation of enlargement of the brain, or as if the teguments of the head flew away; the tongue is swollen.
Some additional remedies to which the study of individual cases may lead, or which may prove useful in a whole epidemy, are the following:
Argentum nitricum. – In confusion, sensation of swooning, vertigo, feverish haste, melancholy, congestion headache with a sensation of enlargement of the head, disturbance of vision, fullness and tingling in the ears, disturbances of coordination, convulsions, paralyses, trembling pains in all the limbs, aggravations in the morning and before midnight.
Opium. – Deep. Slow respiration. Very quick or very slow pulse, the occiput feels as heavy as lead, somnolence and snoring respiration, stupor after waking up, raving; the eyes are wide open there is a sensitiveness of the hearing, tendency to take fright, convulsions with tossing the limbs about.
Stramonium. – Babbling raving, desire to flee away, anguish when waking up talking, singing, versifying, glittering eyes, staring eyes, sore lips; wants light, hates to be alone. The meningitis of the brain much predominates.
Cicuta. – The face is bluish, bluated; there is photophobia, starting up, enlarged pupils. Gnashing of the teeth, thirst, inability to swallow, convulsive drawing backward of the head.
Arnica.- Pain in all the limbs, as if sore; exudation’s of blood under the skin; a numb, apathetic state, great weakness of the muscles of the neck (under similar Circumstances with a tendency to putrescence, perhaps also Baptisia).
Crotalus. – Dreadful headache, reddened face, pain in all the limbs, weak heart-beat, red spots on the body.
Chininum sulph.- The eyes close involntarily from weakness, pulsating headache, redness of the face, vertigo, pain of the dorsal vertebrae when pressed upon.
In a case which came under my treatment a short time ago the latter symptoms in a young girl was most prominent. Chininum 3 left me in the lurch: there was headache, as from a worm in the upper part of the head, then there appeared increasing unconsciousness, with enlarged pupils without any reaction, retention of urine and repeated involuntary cachination. A dose of Sulphur was also without effect, but after Tuberculinum 30 there was a rapid turn towards recovery. The patient is still growing better. Two of her sisters are suffering from tuberculosis of the bones.
Although my list of remedies has become already almost too large for easy survey, nevertheless nature is still richer in substances which cause and cure cerebro-spinal meningitis; also Lycopodium is to be considered in cases where there is raving and numbness, twitching of the limbs, headache extending even into the occiput. Acid picricicum is recommended in meningitis with priapism.
Many other might be adduced. But I will here close with the remark that physicians following the method of Rademscher state that they have had good success from Natrum nitricum with Nicotiana and from Cuprum with Nicotiana.