This drug illustrates a doctrine of Hahnemann: the doctrine of attenuation.
Generalities: When you think of the insolubility of lead, and then think of it as spread on the wall of a room, and then remember how many become sick from sleeping in a newly painted room, you will then wonder how much lead it took to make them sick.
Many patients cannot sleep in a newly painted room – they come down with lead colic or the acute affections of lead. Many people are sensitive to lead. This sensitivity is more marked than is observed in painters, who may use it for years with impunity, but all at once become susceptible to it.
You wonder how much he gets, given off in the air. It is too attenuated to be examined by the microscope and yet enough to make him sick.
We have no measure by which to find out how much he gets. We make use of such susceptibility, the lead palsy of lead workers, the lead colic in painters – these things add to the proper proving and give a well-rounded image of Plumbum.
General paralytic state: If we study the whole symptomatology of Plumbum, we will be struck with the general paralytic state in this remedy.
The activities of the body, the functions of the organs, are slowed down in pace. The nerves do not convey their messages with the usual activity. The muscles are slow in action, sluggish. There is first paresis and finally paralysis, of parts first and finally of the whole.
The mind is impaired, slow. Perception is slow. He memorizes with difficulty. Comprehension is difficult. He cannot recall words to express himself. The operations of the mind are slow. When in conversation with such a patient you will wonder what he is thinking about while making up his mind to answer.
There is sluggishness also in the skin. You may prick him and a second later he says, “Oh”, showing the slowness in feeling. You would expect him to feel the prick instantly. When you begin to conclude that he does not feel at all, his limb will jerk.
Anesthesia of the skin. There is a state of hyperesthesia in the acute affections, but the chronic affections are characterized by loss of sensation. Numbness of fingers and toes, soles, and palms, and this extends to the skin, towards the spine.
The trophic functions are slow in that they do not keep up with the waste, and so we see emaciation until the patient becomes almost a skeleton. The skin is wrinkled, puckered, shriveled, and drawn over the bones. The emaciation is sometimes local.
When local it is generally associated with a painful part; the painful part withers. Pains down the sciatic nerve; burning, shooting; as if the bone were being pulled out of place; as if being scraped and the limb emaciates. Pain down the arm, in the shoulder; violent pains in the brachial plexus and the arm withers.
Neuralgia of one side of the face and that side withers. Paralysis of single muscles and these muscles wither. There is, paralysis of both extensors and flexors, but especially extensors. The paralysis begins in the extensors, so that we have wrist drop. He cannot raise or lift anything with the hand. Extension is difficult. This occurs in piano players; they cannot lift their fingers sufficiently rapid to keep up the pace, while flexion is all right. Curare is another remedy which corresponds to this state in piano players; a paralysis from overexertion of the extensor muscles.
When the muscles become fatigued from playing fixed exercises, scales, etc., for hours at a time, when the player has to do the same thing over and over again, Rhus comes in, but it is an acute remedy and only holds for a short time.
It is especially a Rhus condition when certain muscles become overused and the patient takes cold and a weakness sets in; after a cold bath or plunge the muscles take on paresis; getting wet when tired brings on the Rhus state.
For the chronic state which follows, Plumbum and sometimes Curare will be indicated.
Paresis of the intestines; constipation; cannot strain at stool. The patient can use the abdominal muscles, but the rectum is in a state of paresis and he cannot expel the faeces.
The bladder is also paretic; cannot expel the urine, the muscles do not cooperate to void the urine and there is retention. Plumbum has both retention and suppression of urine.
The paralyses are found in the chronic state. In the acute we have the fever, the colic, the sudden constipation; tearing pains in the intestines; indigestion with vomiting. Everything eaten turns sour.
Violent vomiting of everything eaten. Chronic gastric catarrh with vomiting of albuminous mucus and sweetish substance. Vomiting of stercoraceous matter, blackish blood and green fluid. Sour eructations.
The remedy is slow and insidious; it works continuously; it does not leave the economy but holds on and establishes a miasm of its own. It, therefore, suits slow and insidious chronic cases, with no tendency to recovery. Progressive muscular atrophy; progressive paralysis. Chronic constipation; chronic retention of urine; chronic giving way of the mind.
Aside from the slowness of the mind, which is a general, the remedy is full of melancholia, sadness, feeling as if something terrible would happen; that she has sinned away the day of grace; that she has committed the unpardonable sin. The body and mind are weak.
“Deep melancholy with timidity and restlessness,”
In the mental state, while he is slow to think, yet in this slow thinking he does a great amount of thinking; he makes an effort to think. His thoughts trouble him all night and prevent sleep. Insomnia; sleepless from the continual effort to think.
The mind will not operate, yet the patient is full of imaginations and emotions. Inability to comprehend and to remember. Now, this progresses from periods of insomnia to periods of coma and this coma is associated with suppression of urine.