FOR the ordinary acute attack of indigestion due to an indiscretion in diet, Nux is almost a specific, especially if the indiscretion has been particularly marked. Time and again, when a patient who has had a large and too rich dinner with alcoholic liquor to wash it down, takes a dose of Nux-quite low potency- before going to bed, he will get up next morning feeling perfectly well instead of liverish, headachy and bad-tempered.
Similarly on the day after the indiscretion, when they are feeling absolutely rotten. There is the common Nux story of sleeplessness during the greater part of the night, particularly round about 3 a.m. (the usual Nux sleepless period), and then falling asleep about 7 a.m. when they should be getting up. It was extremely difficult to wake when it was time to get up, and they have a beastly head, a foul taste in the mouth, feel sickish and are generally off colour. That is the common Nux story, and a dose of Nux will wipe out the whole thing in twenty minutes or half and hour.
When this acute picture is firmly understood, it gives also the key to the chronic Nux case. The patient who has been persistently overdoing it-and the overdoing need not necessarily be a dietetic error, it may be overwork, too much anxiety, too much stress-can get into very much the same state. He has disturbed nights, does not sleep well, and then, falling into a heavy sleep in the latter part of the night, awakes feeling perfectly awful it is time to get up.
One of the outstanding Nux characteristics is that the patients say they have the feeling that if only they could vomit they would be better. It does not matter whether that feeling arises in the course of an acute digestive attack or in a chronic condition, the statement is always the same : the patients say they feel as if their stomachs were loaded up. In actual fact, they are better immediately after they have vomited.
Another constant factor is that process of vomiting is very difficult. They retch and strain, and then bring up a quantity of material which is very bitter, sour and scalding. Added to this mighty effort of vomiting is the Nux characteristic disturbance of peristaltic movement. It occurs throughout the whole of the hollow viscera.
The patients are liable to be very constipated and any effort seems to increase their constipation. They have intense straining to get their bowels to act. When they do act, there is the feeling that the action is incomplete-it feels as if there were some stool left behind-and the patients go on straining to try to expel this; and the more straining they do, the greater the spasm of the sphincter.
There is exactly the same kind of disturbance in connection with the bladder. There is extreme difficulty in passing urine, and the more effort made the more difficulty there is; if the patients just wait quietly, the urine flows away but if they make an effort, the sphincter seems to close down and they cannot pass urine at all.
This is the general description of the kind of digestive upsets the Nux patients get. The condition may go further. With the history of overdoing things in a dietetic way, they are apt to get a good deal of congestion of the liver. There may even be definite enlargement of the liver with a constant feeling of distension in the upper abdomen; and actual attacks of jaundice and even the development of gall-stones, with acute hepatic colic.
The Nux make-up is typical and these patients either are, or tend to be, rather underweight. They are a highly nervous type, and are very much strung up. They are very irritable, and liable to fly into a rage; they are hard to please, touchy and extremely difficult to satisfy either in business or at home-conditions are never quite right for them. Occasionally, in extreme states, you get a patient who is definitely malicious and spiteful. No Nux patient can stand contradiction.
That is the typical case, but occasionally you come across a Nux patient who does not appear to be so much on wires, who is much more quiet and sullen, and very definitely dislikes being spoken to; he is rather surly and has an aversion to doing anything or talking at all. It is not the type associated with Nux vomica, but I have seen such cases. In dealing with this type of patient, Nux helps them up to a point but you have to follow up with Sepia.
Typical Nux patients are exceedingly sensitive to any external impressions. They are very sensitive to noise, smell, light, music and, especially, to pain.
As regards particular foods, Nux patients are liable to be upset by any very rich food. They are upset by coffee, tea, stimulants and tobacco; and very much upset by over-eating. You will find that, if the typical Nux patient is worried or chivied about, his digestion is at once affected and he cannot digest his food.
So far as desires for food are concerned, Nux patients always have a craving for something with a marked taste-some definitely stimulating type of food-although it makes their digestion worse. They do not really mind what the food is, so long as it has a bite about it.
As a rule, these patients complain of a nasty feeling of distension which sometimes comes on immediately after a meal but more usually two or three hours after food. The distension is so extreme that they have to loosen their clothes, and it is very often accompanied by acute colicky abdominal pains. With these colicky pains coming on as digestion proceeds, there is often a typical Nux sudden urging to stool.
Another common Nux characteristic: while having a good meal- particularly one of their favourite stimulating meals-the ordinarily pale Nux patients are liable to flush up, become hot and sweaty. Often after a meal, they are very sleepy and heavy.
Nux patients need a sound night’s sleep. The Nux condition may develop due to the fact that the patient has not been having good nights, either from stress or worry; and you will find that any persistent loss of sleep is liable to produce the definite Nux condition. One of the difficulties of these patients is that under condition of stress they become sleepless. When they are sleepless, any noise in the neighbourhood is enough to keep them awake; or they just lie awake and worry about their daily business.
All Nux patients are intensely chilly and very sensitive to cold-cold draughts, cold air. They feel miserable in cold weather, and are apt to become much more irritable if chilled. Yet, in spite of their acute chilliness, many become faint in a hot, stuffy atmosphere.
There is one strange Nux condition which does not appear to indicate Nux at all : during a very good meal, particularly if accompanied by a good deal of alcohol and heatened in a very hot room, Nux patients sometimes develop acute gastric distension. They get a feeling of severe gastric oppression, as if their clothes were too tight, accompanied by acute abdominal colic; a feeling as if they were going to have violent diarrhoea, and followed by a sensation of extreme faintness.
Remember, therefore, that a diner who becomes rather dusky, has obvious abdominal flatulence, is growing faint and wants to loosen his clothes, does not necessarily need Carbo veg. Many need Nux which acts much more quickly, is almost instantaneous, and in a moment or two the patient becomes perfectly comfortable.
Sometimes there are indications for Nux in ordinary pregnancy morning sickness, particularly if it is associated with the typical Nux sleeplessness. It is a very nondescript morning nausea with headache. When this is associated with the typical Nux constipation-the feeling that the bowels are never completely emptied-it will very often control the morning sickness, even in patients who are not typically Nux.
The Nux type of constipation is often stressed, but the cases do suffer from very troublesome diarrhoea as well. It is a very painful, colicky diarrhoea, and the characteristic thing is the actual stool. There is great urging to stool, the passage of the stool is very difficult, and the stool consists of a quantity of water in which there are a number of hard lumps usually covered with mucus and it appears to be a case of acute irritation superimposed on a chronic constipation.