Pulsatilla, including P.paratensis. P.nigricans, and P. anemone vel. P. nuttalliana, the last an American variety. N.O. Ranunculaceae. Syn. : Meadow anemone. Pasque flower. Wind flower. Tincture o the entire fresh plant when in flower. The plant pulsatilla contains a crystalline alkaloid, anemonin, which is present in greater amount in P. nigricans than in P. nuttalliana.
In experiments on animals, 9gr. of anemonin killed rabbits in three or four hours. The heart’s pulsations were diminished in strength and frequency and respiration was slowed; finally, diarrhoea, stertorous breathing, sinking of temperature, semiparalysis of the lungs and death in stupor occurred. at post- mortem the heart walls were relaxed and the heart full of black, clotted blood; there were congestion and oedema of the lungs, and marked hyperaemia of the membranes of the brain and cord, especially in the neighborhood of the medulla oblongata.
Our knowledge of the range of action of pulsatilla has been obtained from the provings on healthy human beings. It acts on all the mucous membranes of the body and produces thick, bland discharges. it acts also on the synovial membranes, on the veins, causing varicosis, and on the generative organs of both sexes. It affects the special organs of sense, the eyes and ears-causing inflammation of those organs-and produces an itching eruption on the skin. The influence of pulsatilla on the organism is extensive but not lethal, and its inflammations do not progress to deep, destructive lesions.
General characteristics.- Pulsatilla has a wide range of action and ranks as a polychrest. It is nevertheless a medicine of marked individuality, and seems to have been a favourite with Hahnemann, who has very carefully defined its place as a drug. He laid special stress on the mental and emotional alterations in the patients for whose complaints it is suitable. He notices that in these patients there is ” a timid lachrymose disposition, with a tendency to inward grief and silent peevishness, or, at all events, a mild and yielding disposition. It is therefore specially adapted for slow, phlegmatic temperaments… It acts best when there is a disposition to chilliness and adipsia.” it is particularly suitable for “women whose periods are habitually some days late, and where evening aggravations are prominent, and the patient cannot fall asleep for some hours after going to bed. It is useful for the ill-effects caused by eating pork.” In this passage hahnemann gives several of the leading characteristic of pulsatilla, but others may be added. We may, for instance, note the changeableness of the pulsatilla symptoms, viz., changeable mood, waywardness, the pains shift their place, are now here, now there, the patient requires to change his position frequently, the stools very in colour and consistency, pain and swelling leave one rheumatic joint and go to another, gonorrhoeal discharge will leave the urethra and epididymitis or orchitis will develop, there may be metastasis of mumps to the testicles or mammae, the dry night cough changes in the morning to one that is loose with profuse expectoration, hemorrhages stop and come on again. In keeping with this is restlessness with desire to keep moving about, and the patient is relieve by movement provided it is slow and gentle; vigorous movement aggravates.
Another characteristic of pulsatilla is venous engorgement, and a general relaxed state of the veins, from which varicosis results; haemorrhages are dark and passive, and mucous discharges are copious, thick, bland, and of yellow-green colour. This condition of venous relaxation seems to be the cause of another characteristic of this drug, viz., that the patients cannot bear warmth, and are better from cold air and cold applications. Warmth increases the relaxation of the veins, while cold braces them up. The pulsatilla patient will never sit over a fire, wants the windows open, and loves to go for a walk on a cold day, and to bathe in cold water. However, with all his preference for cold he feels chilly, but warm clothing and a warm room do not relieve him; he gains relief from slow walking in the open air, as the venous circulation, the sluggishness of which is the cause of his chilliness, is stimulated thereby.
The pulsatilla patient tends to be fat, lethargic, and easily perspires on exertion. The sweat has a musty odour, and may be partial or one-sided. Pains are drawing or tearing, and flit from place to place, or they are bursting or expanding, and are then relieved by firm pressure. A patient typically hypersensitive to pulsatilla, as far as bodily appearance goes, is one with fair hair, blue eyes, pale face and inclined to embonpoint.
Bearing the above characteristics in mind, we can now proceed to consider for that complaints pulsatilla is likely to be suitable prescribed.
Mind.- In states of melancholia it will be indicated when the disposition is timid and gentle, with great inclination to weep when the patient is telling his symptoms, when he is fearful in the evening, anxious and irresolute, and when the mood alternated between mildness and ill-humor and discontent. The corporeal symptoms indicative of pulsatilla should be present with the above mental state for it to be a certain remedy for melancholia. Epilepsy, when the fits have depended on absence or irregularity of the menses, has often been cured with pulsatilla, and it is equally useful for chorea, and for pseudo-paralysis arising from disturbance of the sexual organs. Other mental disturbances for which it should be considered are puerperal insanity, the weak-minded state after acute confusion, adolescent instability, sexual obsession and early dementia praecox.
The headaches for which pulsatilla is the remedy are congestive headaches, usually associated with stomach disorders, or occurring in connection with menstruation. They are mainly in the forehead, temples and sides of the head, and are often unilateral. The pains are mostly constrictive or bursting, pressing outwards, with vertigo and feelings of heat; they are aggravated by moving the eyes, looking upwards, from stooping, lying and sitting quietly, and ameliorated by the application of cold, by pressure, such as bandaging, and by moving about slowly in the open air. When the headache precedes menstruation, as it often does, it is relieved by the onset of the flow. Those arising from stomach disorders are caused by eating rich food, cream, pork, or form overloading the stomach, and they are often accompanied by sour vomiting
Eyes.- Pulsatilla is a well-established remedy for conjunctivitis when the discharge is profuse, thick, yellow and bland, and agglutinates the eyelids at night, with burning itching of the lids, provoking rubbing and scratching, and when there are lachrymation and dimness of vision, as from a fog or veil before the eyes. It is useful for styes, especially for those of the upper lid, and for twitching of the eyelids. The eye affections are better from bathing, whether with warm or cold water and from open air, but cold air and wind cause lachrymation. It has been used for ophthalmia neonatorum and strumous ophthalmia when there is not much photophobia and the discharge is bland and profuse.
Ears.- In the ears pulsatilla causes a stopped-up feeling, with dulness of hearing or a sensation as if the membrana tympani were being forced from within outwards, or there are shooting pains. Various snapping, whistling, roaring and ringing sounds re heard. it is very useful for inflammations of the middle ear, whether acute or chronic, with or without perforation of the drum, for earache in children, worse in the evening and on going to bed, and for catarrhal inflammation of the meatus, with bland, itching, purulent discharge.
Nose.- The coryza for which pulsatilla is indicated is when there is frequent sneezing, loss of smell and taste, the nostrils are sore and the alae nasi raw, the discharge is yellow-green and may become offensive. The nose becomes stopped up in the evening, and in a warm room. There may be epistaxis. In chronic cases there is blockage of the posterior nares, and hawking of masses of thick mucus and crusts in the morning. The patient feels better in the open air, can breathe better there, he sneeze much in a warm room. Nasal catarrh occurring with every menstrual period, and epistaxis before or during the menses, or when they are suppressed, require this remedy. The blood, when there is epistaxis, is dark, almost black, thick and clotted. Pulsatilla may be called for in hay-fever, when the coryza alternates with menstrual disorders.
Digestion.- In has great influence on the mucous membrane of the alimentary tract, which it inflames, and on this account is a frequently employed remedy for gastric catarrh, especially when caused by overloading the stomach with unsuitable food, such as pastry and food containing much fat or fruit. There are nausea and a flow of sweetish saliva into the mouth, and a flat, bitter, acid, sweetish or slimy taste. The tongue is coated with a dry, white fur, it smarts at the edge and there is a sensation in the middle of the dorsum of the tongue as if burned. An offensive odour arises from the mouth. Food, especially bread, tastes bitter. Sharp, shooting pains occur in the teeth, or a drawing and jerking, “as if a nerve were put on the stretch and then suddenly let loose”; the toothache is worse in the evening and at night, from the warmth of the bed (cham.) and when eating, is better in the open air, from throwing off the bedclothes, and from holding cold water in the mouth.
The throat feels dry, with a sensation of rawness and scraping, or as if a worm were in the throat. Taste is perverted or lost. Appetite is usually lost, and there is aversion from meat, butter, fat food, especially the fat of meat, and from milk, bread, pork and smoking. The patient craves sour, refreshing things, and often thinks he cannot digest, such as cheese, herrings, pastry, spiced and pungent food. he feels bloated after eating, and desires to loosed his clothing, a sensation of qualmishness is present, he has eructations tasting of the food eaten, and there is heartburn and possibly waterbrash of sour or foul-tasting fluid. he frequently omits, often food that has been taken many hours before and has lain undigested in. the stomach. Digestion is slow, and pain, as of a weight, occurs, in the stomach, or cramping pain at the epigastrium, which is tender and cannot bear pressure. Sometimes there is a gnawing distress in the stomach, as from hunger, which comes on one hour after eating. There is seldom thirst with all these symptoms, though the mouth is dry. Jaundice may occur secondarily to catarrh of the duodenum.
The abdomen is distended with flatulence, which moves about with rumbling and gurgling, especially in bed in the evening, it is sensitive, and there are pressing pains and forcing down towards the pelvis. The stools are usually loose, preceded by rumbling,and are soft and slimy, mixed with green mucus, and vary in colour and consistence; they occur mostly in the evening and during the night. Occasionally there is constipation. with difficult evacuation of whitish stools or of dysenteric stools that are scanty, bloody, green and watery, and are evacuated with a little spurt. Painful, protruding, blind piles are produced which itch, smart, and are sore. When the above symptoms are present pulsatilla is a very frequently used medicine for gastric disorders, for acute and chronic dyspepsias, for mucous diarrhoea, such as occur in measles and chicken-pox, and in febrile affections of children.
Urine.- Pulsatilla usually causes scanty, acrid urine, with copious deposit of urates, phosphates and urate of ammonia. There is burning during micturition and afterwards at the orifice of the urethra (can. sat., canth.) and frequent urging and cutting pain. Involuntary micturition and afterwards at the orifice of the urethra (can.sat., canth.) and frequent urging and cutting pain. Involuntary micturition may occur at night in bed or from any sudden exertion, such as coughing or lifting. This remedy is useful for incontinence in little girls of pulsatilla temperament. The scanty, high-coloured urine sometimes alternates with profuse, clear urine (apis, apocy., argent., calc., berb.) that is passed very frequently. The desire to urinate is worse when lying on the back, whether it is scanty or profuse.
Sexual.- In the male sexual organs pulsatilla causes drawing pains in the spermatic cords and a dull, distressing pain in the testicles. The testicles swell, as does also the right side of the scrotum. Sexual desire is increased. It is very useful for epididymitis and orchitis, whether arising from exposure to cold, metastases from measles and mumps, or from extension of gonorrhoeal inflammation from the urethra. The discharge. It is also a reliable medicine for inflammation of the prostate. It has cured hydrocele.
We now come to the female generative system, in which pulsatilla has its chief sphere of action. It is especially indicated when the menses are delayed or suppressed from catching cold, especially from getting the feet wet. For several days before the flow commences the patient feels chilly, is depressed, languid, puffy about the face and distended in the abdomen, with pressing down as though the menses would appear. When they arrive they are usually scanty, but may be profuse, are of dark colour and are accompanied by sharp constricting pains in the suprapubic region, mostly on the left side, which compel the patient to toss about and bend double. There is also a pain like a stone in the small of the back. The flow is free in the day-time while she moves about and the bowels are more loose than usual. The flow may stop for a few hours and then return (actaea). Sometimes mill appears in the breasts during the period and the breasts are swollen and tender (con.). Pulsatilla is equally useful for delayed first menses in delicate, undeveloped girls and will promote their natural onset. There is often a thick, bland, green-yellow leucorrhoea, or it may be cream-coloured, with swelling of the vulva, and is worse when lying down.
Pulsatilla is a useful remedy for many of the discomforts of pregnancy when the temperament and symptoms indicate it, and to help labour when pains are deficient in strength, irregular and changeable and, although the passages are relaxed, are not effectual. There is good evidence that it can rectify abnormal presentations, which it must do by regularizing and co-ordinating the contraction of the uterine muscle. It will promote the flow of milk during lactation when it is insufficient and will check its appearance in non-pregnant women and in girls at puberty. It will also disperse the small lacteal tumours that sometimes occur in the breasts of children before puberty. Pulsatilla is indicated in gonorrhoea in women (after the first few days), and is the most usually suitable remedy when the discharge is bland and green.
In respiratory diseases pulsatilla is indicated for a dry cough in the evening and at night which becomes loose with expectoration in the evening and at night which becomes loose with expectoration in the morning. Tickling and scraping in the larynx excite the cough, which is accompanied by lachrymation and comes on directly the patient lies down in bed, it ceases if he sits up but returns when he lies down again (hyos.), and in this way the cough keeps him awake the first part of the night. There are many sharp, stitching pains in the chest, especially in the left side, and pressive pain in the centre of the chest. Vicarious haematemesis of dark blood may occur from suppressed menses. Expectoration is difficult and of yellow mucus, scanty, tenacious and of bitter or salt taste, or it may be profuse, especially in the morning. There is considerable dyspnoea and oppression of the chest, the patient wants the windows open and is better from walking quietly in the open air. Pulsatilla useful in bronchitis and also for asthma and hay-fever, for bronchitis following measles, and for catarrhal phthisis in anaemic girls.
Circulation.- Dyspnoea and palpitation from lying on the left side, and catching pains in the cardiac region, relieved by the pressure of the hand, are cardiac symptoms that often accompany the menstrual irregularities for which pulsatilla is the appropriate medicine.
Back.- A pain in the small of the back, as from long stooping or as if sprained,is a prominent pulsatilla symptom and often accompanies menstruation and labour pains. The backache is worse from lying on the back, better from lying on the side and from change of position. Cold shivering, as of cold water being poured down the back, not relieved by sitting near a fire, is another characteristic.
Limbs.-pulsatilla causes drawing, tearing pains in the limbs, which shift rapidly from place to place, are worse at night and from warmth and are better from uncovering. The pains in the limbs are relieved by slow motion. Pains in the fingers and the tips of the toes, in the joints, especially the hip- joint, and about the ankles are common. The feet burn and the patient may put them out of bed to cool (sulph.). There is restlessness of the legs. The veins are varicose and burn and are relieved by cold applications. Pulsatilla very useful for varicose veins and varicose ulcers and for rheumatism and gout when the joints are moderately swollen, subacutely inflamed, and with a tendency for the swelling to go from joint to joint and with relief from uncovering and cold. Numbness occurs in parts that have been lain on.
Skin.- Pulsatilla causes itching of the skin and a red rash all over the body, but mostly on the chest and abdomen, which appears in points and blotches. An eruption may occur on the ankles which itch much at night and may extend up to the knees. The character of the eruption, the mousy odour from the skin, the affections of the eyes and ears, the coryza, the laryngeal catarrh and cough, and the mucous catarrh of the alimentary tract, which are all characteristic of pulsatilla, cause this medicine to present a closer similarity to measles than is afforded by any other drug, and it should always be prescribed in that complaint unless there is an exceedingly good reason for giving another medicine.
Chill, &c.- Chilliness is a characteristic of the pulsatilla patient; he feels chilly even in a warm room and with the pains, yet he cannot bear warmth and is less chilly in the open air. He may feel intolerably not in bed, with distended veins and burning hands and feet that seek a cool place. The heat is without thirst. Sweat is often profuse in the morning; it may be one sided.
Sleep.- The pulsatilla patient is sleepy in the afternoon and early evening, but later on is wide awake and cannot get to sleep for a long time after going to bed, he sleeps late into the morning and does not want to get up. His position in sleep is often on the back with the hands over the head. Pulsatilla antidotes the result of overdosing with iron and quinine.
(1) People of mild, easy-going, wayward, tearful disposition.
(2) People with light hair, blue eyes, inclined to adiposity.
(3) Changeableness of symptoms and mood.
(4) Amelioration from cold and open air, and aggravation from warmth.
(5) Mucous discharges are greenish-yellow and bland.
(6) Venous relaxation, varicosis.
(7) Symptoms are ameliorated by slow movement.
(8) Menses scanty and delayed, delayed first menses.
(9) Metastases of mumps and gonorrhoea.
(10) Increased inclination to micturate, and backache both worse when lying on the back.
(11) Occurrence and aggravation of symptoms in the evening and first part of the night.
(12) Tendency to loose stools, especially at the menses.
(13) Bursting or expanding pains and sensations relieved by pressure.
(14) Palpitation from lying on the left side.
(15) Chilliness, but worse from warmth.
(16) One-sided sweats.
(17) Affections from abuse of iron and quinine.
(18) Ear affections, especially in children.
(19) Inflammation and eruptions tend to be of a purplish colour.
(20) Measles and chronic sequelae of measles.
(21) Absence of thirst.
(22) Gastric disorders from fat, rich food-pork, fruit and pastry.
(23) Cough : dry at night, loose in the morning, worse lying down.
From warmth, warm room, in the Spring, at the oncoming of warm weather; from resting long in one position; from fat and rich food, pork, fruit and pastry, hot food; in the evening and until midnight; lying on the left side; a close room, wind, damp, especially getting the feet wet, lying down.
From cold, cold applications, open air, slow movements, cold food and drink (phos.), lying on the painful side, pressure, sitting up (cough), uncovering.