Cactus grandiflorus. Night-blooming cereus. N.O. Cactaceae. Tincture prepared from the young and tender branches and flowers.
PATHOGENESIS AND THERAPEUTICS.
THREE have been no laboratory investigations of cactus, and our knowledge concerning it has been gained from the provings of Dr. Rubini and his wife, and a few later provings, and from clinical use. Its sphere of action is limited, but well defined, as is also its therapeutic application. It will be more convenient, and will avoid repetition, to consider together the symptoms of the provings and the diseases in which cactus has been used medicinally.
Cactus causes violent congestions of blood in many parts, but especially in the head and chest, and the congestions are accompanied with severe pressing and constricting pains in the part affected. Constrictive sensations may be so general that the whole body feels as if caged, each wire being twisted tighter and tighter.
Head.-A rush of blood to the head causes vertigo; there are violent pulsation in the head, and pressure outwards in the temples, ears and eyes, heat and a sensation as it the skull would burst. Pressive pains occur in the parietal regions, mostly on the right side, which are made worse by the sound of talking and by a bright light. A sensation of great weight is felt on the vertex, as if the skull is being pressed in, but which, nevertheless, is relieved by hard pressure. There may be a constant dull pain in the occiput, which is aggravated by pressing on the pillow, and relieved by turning the head to one side, or the head feels as if covered with a tight cloth which is being squeezed tighter and tighter.
Face, &c.-With these conditions of the head the face is red, hot and inflamed, or it may be deeply congested and have a purple or bluish appearance (chronic states). The eyes are intolerant of light, and there is momentary dazzling before them, or circles of red light are seen that obscure the sight. Rushing noises and pulsations occur in the ears.
These kinds of headache often come on as a result of menorrhagia, or are associated with the menopause; cactus will relieve them. There is intense heat in the head and the headache is made worse from movement and talking, the voice seems to go through the head. Cactus relieves heat and pressure in head, brought on by mental exertion, and the similar condition arising from the attempt to leave off coffee by those addicted to taking it in excess. It has been used in threatened apoplexy.
Chest.-Even more characteristic of this drug than the congestive headaches are the symptoms it causes in the chest and heart, the well-known constrictive sensations. It causes a feeling of constriction in the throat, which prevents freedom in speaking, the voice is low and hoarse. There is oppression of breathing, as from a great weight in the chest, a sensation as though someone was pressing it and holding it tight; the patient feels that he cannot expand the chest, and there is a sensation of painful constriction, as of a cord tied tightly round the false ribs, or “constriction of the lower chest as high as the fifth rib, as if it is encircled by a hot iron cincture pressing more and more till respiration is most distressing and difficult.” There may be a dry cough or a cough with mucous expectoration, which may be blood-stained.
Heart.-With these symptoms, referable to the chest wall, are cardiac symptoms which accentuate the respiratory difficulty. Acute pains are felt in the cardiac region and a sensation of constriction “as if an iron band prevented the movements of the hear,” or as if the heart were alternately clutched and released by an iron hand. Very acute, painful stitches are felt in the cardiac region, with prolonged oppression of breathing and much mental anxiety, with fear of approaching death. A heavy pain may be felt over the heart, which is aggravated by pressure. Strong heart beats and pulsations are experience in the upper part of the the chest in the subclavian regions , which are stronger when the patient is lying on his back than when on his side. Or the palpitation consists of small, irregular beats, with desire to breathe deeply; it is excited by any little emotion, active thought or sudden movement, and is aggravated by walking and by lying on the left side. The heart symptoms are better from standing still and breathing deeply. The pulse is usually very irregular, hard and quick, it may be lost during the periodical attacks of suffocation, with fainting and cold sweat on the face. Associated with the cardiac conditions is numbness of the left arm, or it is numb, weak and tingling and the left hand is swollen.
Cactus has been much used in heart troubles occurring with inflammatory rheumatism when the above symptoms are present; in acute myocarditis, endocarditis and pericarditis; in valvular affections; in distress arising from hypertrophy of the heart; in all overactions of the heart, whether functional or due to organic disease; when rheumatism leaves the joints and goes to the heart in chronic palpitation and lastly, angina pectoris, to which the symptoms of cactus present a striking resemblance.
Cactus in low dilution as recently been used for mountain sickness with excellent result. It is a remedy for hypostatic congestion of the lungs, secondary to cardiac weakness, and for epistaxis and haemoptysis, due to hyperaemia of the head and chest, associated with overaction of the heart.
The drug is useful in what as been called rheumatism of the diaphragm, were there is severe constrictive pain round the chest at the level of the attachments of the diaphragm and sharp stitches through the chest at that situation.
Pains.- Cactus causes various rheumatic pains of a cramping or tearing character, ex. gr., “a sensation of constriction in the shoulders so that he could not move,” sharp, tearing pains in the scapular regions, in the arms, calves and soles, and a severe pain in the spine in the lumbar region, pressing down through the glutei to the lower limbs. There are great weariness and a sensation of weight in the limbs, and transient, tearing pains in the joints. When the heart is much embarrassed there may be oedema of the feet and legs-cardiac dropsy.
digestion.-The characters of congestion and constriction that distinguish cactus are displayed also in the alimentary sphere. The patient is thirsty and drinks much water, he has nausea and complete loss of appetite, the throat feels constricted and causes him frequently to swallow his saliva, there may be globus hystericus, and the oesophagus is constricted, making it difficult to swallow.
In the stomach he feels oppression and weight which impedes breathing and he eructates a sour, acrid fluid. Throbbing occurs at the scrobiculus cordis and a sense of constriction which extends to the hypochondrium, there are wandering pains in the umbilical region which cease and recur periodically and a sensation of insupportable heat is felt in the abdomen, as though something internal were burned, and at the same time the abdominal parietes feel hotter when touched than the rest of the body. A distressing feeling has been described “as if a serpent were twisting about in the bowels.” Violent pain in the bowels which almost causes faintness may be present. As a rule there is diarrhoea, which is bilious, watery, mushy or mucous, and is preceded by pain and borborygmus. The anus feels swollen or there is a sensation of a weight pressing on it with ineffectual desire to evacuate. There are bleeding piles.
Cactus has been used in congestions of the bowels and for haemorrhoids that bleed freely and are accompanied by constriction of the anus; these conditions would generally be secondary to cardiac disorders.
Urinary System.-The spasmodic, constricting action of this drug is shown in the urinary sphere by the great delay in the ability to pass water, although there may be an urgent desire to do so; when the sphincter at last relaxes the urine flows freely and abundantly, or it may be passed only in drops with much straining and with burning in the urethra at night. There is frequent desire to micturate and a copious flow each time. There may be blood in the urine, which on account of its rapid coagulation forms clots that block up the urethra and render urination difficult; or retention may occur from contraction of the sphincter vesicae.
Sexual.-In women, menstruation comes on too soon, is scanty and is often preceded by or accompanied with palpitation; pulsating pains are felt in the hypogastrium, which recur and extend to the thighs. Menstruation is very painful, “as if a tape were tied round the sore and congested uterus,” meaning probably a constricted feeling at the level of the hypogastrium or possibly in the vagina; it causes the patient to cry out and weep; the pain immediately precedes and accompanies the flow, which ceases while lying down. The discharge forms large clots which are expelled spasmodically, and which while retained in the vagina may press on the urethra and hinder the passage of urine. Suffocating fainting attacks and constrictive pains in the heart frequently accompany menstruation. Cactus is useful for this kind of dysmenorrhoea occurring in young, vigorous, plethoric women and also in inflammation of the uterus.
Sleep.-The cactus patient is sleepless at night, especially in the early part, he is talkative in his sleep and seems to be semi-delirious; when aroused he speaks unconnectedly or he wakes suddenly from sleep in a fright. His dreams are full of excitement and are often of falling.
Fever.-Cactus can cause fever. Dr. Rubini in his proving had a short rigor at p.m., ending in a slight sweat at 4 p.m. In the evening he had another rigor lasting three hours, so severe as to make his teeth chatter, not relieved by lying down and covering himself with blankets: it was followed by great heat, dyspnoea and restlessness which lasted for twenty hours and ended in a copious sweat. A female prover after leaving off the proving had a quotidian intermittent fever which recurred for several days. There occurred at 10 p.m. a slight rigor, then burning heat, dyspnoea, and severe pulsating pains in the uterine region, terminating in slight sweat, till by noon next day there was complete apyrexia. Cactus has been used for intermittent fevers of congestive type. It cures periodical neuralgic headache. Its periodicity is said to be at 11 a.m. and 11 p.m. Intermittent neuralgias frequently precede or follow the attacks of intermittent fever and are relieve by this drug.
Mental.-The state of mind in subject who is under the influence of cactus is one of unusual and unaccountable melancholy which may amount to profound hypochondriasis. He believes he is developing an incurable malady and thinks he will die. He is inclined to weep and is irresistibly sad. He desires solitude and avoids people who want to comfort him. He specially dislikes the sound of the human voice, shuns all talking and is himself continuously taciturn. He is restless and feels hurried in his actions (arg. nit.), seems to be always too late and the day too short for his work.
(1) Constricting sensations and pains throat, oesophagus, stomach, chest, heart, uterus, bladder, anus, and generally.
(2) Congestions of blood; in head, chest, abdomen, uterus,
(3) Haemorrhages; from hyperaemia or from passive congestion secondary to cardiac affections.
(4) Palpitation, pulsations, worse before menstruation.
(5) Painful heart affections, with constrictive pains in chest and cardiac region.
(6) Congestive headaches that are relieved by hard pressure. Vertex headaches at climacteric.
(7) Dysmenorrhoea: painful spasms, clots; menses cease when lying.
(8) Strangury from contraction of sphincter vesicae.
(9) Febrile attacks 11 a.m. and 11 p.m.
from lying on back (palpitation), sudden movement (palpitation), after eating (weight stomach), from lying on left side, from noise, light, heat sun’s rays, exertion, damp; at 11.am. and 11 p.m.
From turning head to one side (occipital headache), standing still and taking a deep breath (cardiac spasm); pressure (headaches in vertex).