PULSATILLA NIGRICANS [Puls]:

– Pierce W.I.

MEADOW ANEMONE-WIND FLOWER-PASQUE FLOWER.

Introduction
(Pulsatilla-pulsar, to beat or strike) Pulsatilla nigra, is the European Pulsatilla and is not to be confounded with the American variety (Pulsatilla Nuttalliana, named after Thomas Nuttall, an American scientist), as the action of the latter differs in certain respects from the one we are going to speak of. It is called Wind Flower because it was supposed not to open its flowers until blown upon by the wind, and pasque flower because it flowers about Easter (the French word for Easter being Pasques). Pulsatilla was first proved by Hahnemann, who advises its use in the 30th. It was dismissed from the last (1905) U.S. Pharmacopoeia. We will never dismiss it from our materia Medica, for we now of its great value; its field if usefulness covers a wide range and with its many pronounced characteristics, we have a remedy not only of frequent use, but one most readily forgotten.
Symptoms
Its most extensive action is on mucous membranes, the eyes, ears,nose and entire respiratory tract,the whole digestive tract and the genito-urinary apparatus of both sexes. There is a general aggravation towards evening,from rich greasy food (5) and from warmth (8); there is amelioration from cold and great longing or and relief while in the open air (9). There is also an absence of thirst (189), an aggravation from laying on the 1.side (8) and in general, relief from lying on the painful side (8). The characteristic Pulsatilla patient has light hair and blue eyes (88) and is of a timid or submissive and clinging temperament. She, for it is remedy especially useful for girls and women, is easily influenced b her surrounding and the people she happens to be with at the time; there is nothing positive or assertive about her, and the last person who sees, or advises with her, is the one whose opinion she accepts. Farrington speaks of the plant’s name, Wind flower, as being in keeping with the Pulsatilla character, as it is as changeable as the wind. laughter and tears are both very near the surface with our patient, and are apt to succeed each other as do sunshine and shadow on a typical April day. She is very tender-hearted and her feeling are very easily hurt, but she is never sullen and never mopes. She is inclined to be fretful and too full of care, and if she has no trouble of her own, she is ready to condole and weep with any of her friends who may be afflicted, but she craves and needs sympathy in her troubles to someone, even when she knows that the recital of her real or fancied wrongs, and the receipt of the sympathy that she longs for, will make her cry. When she is blue she will tell you that she feels as if a good cry would make her feel better; and it will. Oliver Wendell Holmes unconsciously described the Pulsatilla temperament when he spoke of a woman who was “subject to lachrymose cataclysms.” As this disposition, modified more or less, is an almost constant accompaniment,of any disease calling for this remedy, it is seldom safe, in these days of family medical books, to tell your patient that you have given her Pulsatilla. Pulsatilla hold a prominent position as a catarrhal remedy, Any portion of the mucous membrane may be affected and the discharges are, as a general rule, profuse, thick,yellow and purulent, as well as bland or non-excoriating. In the eyes it will be found of frequent use for catarrhal conjunctivitis, whether due to cold (73) or after measles; the lids will be found agglutinated in the morning, but without any especially redness or other evidence that the discharges has caused irritation. It is of value for pustular conjunctivitis (76) and for inflammation and fistula (125) of the lachrymal duct. In ophthalmia neonatorum it follows well after Argentum nit with thick , bland discharge that tends to collect over the cornea and may be removed by wiping. the general inflammatory conditions in the eyes would have relief from cold applications or when in the open air. There is a general tendency to stays, especially affecting the lower lid, and many physicians use Pulsatilla as a prophylactic against their recurrence (183)., (I have had much better success with Staphisagria as a preventive.) In the ears it is of value for catarrhal and other inflammations from cold, with pains darting, tearing and shifting, involving even the face and teeth. the pains are worse evening and night and relieved by cold applications. the discharges from the ears are thick, purulent or bloody, not especially offensive and seldom excoriating (63), associated with deafness and feeling as if the ears were stopped, and involvement of the Eustachian tube (63)., It is frequently indicated in deafness due to cold or following measles or scarlet fever (63). Pulsatilla ‘is one of our most frequent remedies for an ordinary cold in the nose” (allen) when it reaches the catarrhal stage. The nose may be sore and swollen and the discharge is profuse and thick; it is easily removed on blowing the nose and does not excoriate. The discharge may alternate from one side to the other, with stoppage of the opposite side and the discharge is more profuse and the stoppage (40) more pronounced in evening and when in a warm room. In these conditions there is usually loss of smell (170), rarely of taste, and aggravation late in the afternoon and evening. The mucus from the nose is more or less offensive and is likened in odor to that of an old catarrhal 9143). it is useful on ozaena (148) with offensive mucus, and in catarrh of the antrum of Highmore (117),with orange-colored discharge of a urinous odor, especially from the r. nostril. (The cough and other catarrhal conditions will be spoken of in their proper order.) vertigo, as if intoxicated (297), I a frequent accompaniment of other pulsatilla symptoms and is usually associated with nausea and gastric disturbances or with suppressed menses. there is vertigo on rising from bed (297) forcing one to lie down, and when stooping (207) so that she could hardly rise again,but it is especially noticed on looking upward (297), and worse while sitting or lying. Pulsatilla is of value for headaches involving the forepart of the head, usually associated with the thought of having eaten too much (97),or with regret at having taken dessert, and accompanied by qualmishness and disgust at even hering the name or any fat food or pastry (6). The headaches and facial neuralgias calling for the remedy are frequently due to disorders of digestion (97) or to some irregularity of the menstrual function (95) and in general are worse towards evening and during the night, worse in a close room (95) or from the warmth of the bed, better from pressure (92), from cold applications (92) and when in the open air (92); there is also relief when walking slowly (93. Allen, in the Handbook, speaks of “supraorbital neuralgia of the r. side” (76) and “infraorbital neuralgia of the left side, with profuse secretion from the left nostril,” but as a usual thing Pulsatilla has no decided preference for either side. It is useful for headache associated with nausea and vomiting, and relieved in the open air, headache preceding or during menstruation (95) or due to suppression of the menses Pulsatilla is often indicated in neuralgic toothache and for the toothache of pregnancy (188), always worse in the evening until midnight and in a warm room (187), relieved when walking about (187) and will holding cold water in the mouth (187) and casing entirely in the open air (187). I well recall a case of neuralgic toothache, with these symptoms of amelioration, that I thought called for Coffea. Not having the 30th with me, I gave Pulsatilla 1st as the next best, intending to bring he Coffea the following day. had no need for it, a Pulsatilla had cured before my return. In orders of digestion and especially that form which according to early foreign literature,a nd Americans suffer from, dyspepsia from eating pie, Pulsatilla is a valuable remedy. Whether we call it dyspepsia, atonic dyspepsia (178) or plain indigestion there is , in general, an aggravation from and a disgust for, rich, fat (6) or greasy foods, fried food, buckwheat cakes, pastry of all kinds, and ice-cream, if the richness of the cream is the cause of the trouble. There are eructations tasting of the food, waterbrash (179), nausea,aversion even to the thought of meat or any rich food, no thirst, a more or less greasy,m bilious taste in the mouth (186), and a heavily furred tongue. there is distention of he abdomen (13), rumbling and gurgling of flatus (11) and may be colic, especially when associated with menstrual troubles (138),but a hot-water bag over this region would be distasteful and afford no relief. Frequently there is a feeling of distress in the lower apart of the oesophagus, as if some of the food had lodged there is instead of descending in to the stomach, a condition often referred to as a sensation of a lump or load in the stomach (179). An important point to keep in mind in reference to Pulsatilla is that the gastric and abdominal troubles, eructations, heartburn (179) distention, etc., are not noticed directly after eating but come on an hour (177) or more after eating and last until it is time for the next meal. For this reason patients will some tunes think that eating relieves the distress. It is of value for the vomiting of pregnancy(153), where we have as the extreme picture, our light-haired, blue-eyed, doll faced wife, with aggravation towards evening or at night and general relief while in he open air. There is in Pulsatilla a desire for acids (9) and sour things. In the abdomen we have rumbling and gurgling (11) from the moving of flatus from on part of the intestines to another and with more or less pain,and it is to be thought of in colic from cold, from fruit and right food, as well as in menstrual cold (138). Pulsatilla is to be thought of for haemorrhoids associated with gastric derangements;there is a good deal of itching (159) worse evening and night and they usually bleed easily *85) especially after the stools. It is of value for intestinal catarrh, with burning in the abdomen and mucous stools, for diarrhoea that alternates with constipation (58) and for diarrhoea from fright (5)_, from pastry and ice-cream (589). The movements are of green mucus (59) or green as from bile, and watery, with aggravation at night and from being in a warm room; they are preceded by rumbling and griping in the abdomen, and with pain in the small of th back. Hahnemann, in a food-note, says:’These kinds of nocturnal diarrhoea are characteristic of Pulsatilla, and are hardly met with in such marked manner in any other medicine: (Mat. Med. Pura). Pulsatilla is to be thought of in nocturnal enuresis (198) as well as an involuntary maturation on coughing (52), emitting flatus or when walking (198). It is useful in catarrh of the bladder from taking cold, from gonorrheal extension or during pregnancy, with frequency desire, incontinence if they have to wait and a great deal of mucous sediment (199). It is of frequent use in enlarged prostate (155), with the above bladder symptoms and in the e latter stage of gonorrhoea, with profuse, slimy, bland discharge. It is at times indicated when the urine is loaded with ammonium urate, especially in young children. In the male sexual organs in it frequently indicated. In orchitis, due to taking cold, injury or to a suppressed gonorrhoea (188) and in epididymitis (188), with dragging pain and soreness, pains in the small of the back, chilliness and nausea. It is also of value for neuralgia of the testicle (188), with tearing, lancinating pains, but in altheas conditions we must remember, that it Pulsatilla is the remedy, there is no relief from warm applications, but rather an aggravation from their use (188)., In disorders of the female sexual organs this is a remedy of prime importance. Someone has well said that if Hahnemann had done nothing more than to discover the virtues of Pulsatilla,m women would be justified in mentioning his name every night in their prayers. its pathogenesis covers a filed to which they are especially or exclusively susceptible and our clinical experience has so enlarged its sphere that it seems as if there were no limit to its usefulness. To follow them from before the time of sexual activity to the full period of maternity we notice first that this remedy is of value for chlorosis (17) n young girls, with chilliness and sluggish circulation, hot flushes at night, and tearful moods and a longing for fresh air. Pulsatilla is an antidote to quinine (158) and to a less degree, to iron and Farrington calls particular attention to its value when the chlorosis has been complicated by the abuse of both iron and quinine, saying that in such cases it will frequently be the4 first, if not the only remedy needed. On reaching the age of puberty, the menstrual function of the Pulsatilla patient does not assert itself (134), or the menses appear victoriously (138), especially as nosebleed and we have headache, backache, indigestion, tears and general chilliness. We also have the menses suppressed for that month (134)., 0r unduly delayed, with dysmenorrhoea, and use to catching cold unduly delayed, with dysmenorrhoea, and due to catching cold (134) or getting her feet wet (134) just before the menstrual period. Menstruation under Pulsatilla is too late (136) too scanty and of to short duration, Lilienthal giving additional prominence to the symptom, :” flow more in daytime and while walking about, very little at night” (134), Hahnemann saying: “It is particularly suitable for females when their menses usually come on some days after the proper time” (Mat. Med. Pura). There is a leucorrhoea before the time of puberty (126), and preceding the delayed menses (126), which like other catarrhal discharges calling for the remedy is profuse (126) which, like other catarrhal discharges calling for the remedy is profuse (126) and bland. It is a remedy useful in prolapsus of the uterus (203), “with pressure in abdomen and small of back, as from a stone” (Hering,) aggravation when lying down and from heat, better when walking in the open air. Many disorders of pregnancy , including nausea and vomiting (153) and false labor pains (153), call for Pulsatilla, all with the characteristic symptoms and the relief while in the open air. Many disorders or pregnancy, including nausea and vomiting (153) and false labor pains (153), call for Pulsatilla, all with the characteristic symptoms and the relief while in the open air. it is a remedy that seems t have special power of the gravid uterus in preserving and causing harmonious action and contraction, and many physicians give it during the last month of pregnancy, not only top keep the uterus in tone (153) but also to facilitate proper action of the pains at tie of labor. In cases of abnormal presentation, it detected by the e end of the eighth month, the use of Pulsatilla will often correct it, be full term, top one of normal presentation. This may be a strong assertion,but Allen, with all his conservatism and care in making pronounced statements, says: “Testimony on this point is so strong that its power to rectify abnormal on this point is so strong that its power to rectify abnormal presentations seems undoubted. It is quite probably hat some of you who have had no particularly experience with our remedies, that you when certain statements are made in this college, will shake your head and say “that will have to be taken “cum grano salis:” but I venture to any that you, at the end of five years of practice will be able to make statements as to results that you have obtained, that your old school friends will feel need of a whole bag of salt to permit of easy deglutition. Pulsatilla is to be thought of for phantom tumors anywhere, and in young girls we may have lumps in the breasts and even secretion of a thin, milk-like fluid. In nursing women there his frequently ;’suppression, of , or very scanty supply of milk (Hering) (146). the cough of Pulsatilla is loose and the expectoration easy, with relief in the open air and aggravation from heat (41) or the warmth of the bed. Frequently the cough is dry at night an loose during the day (45). Often with the cough, or in asthma (19) of children, there is a sensation of suffocation (25) at night, with necessity o sit up in bed (41). In haemoptysis (27) we should find a sensation of suffocation,with soreness of the lungs, both relieved as soon as one gets in the open air. There is a general sluggish circulation in Pulsatilla, with chilliness, “fitting chilliness: or “chills in spots’ (Hering), soft pulse and palpitation worse when thing on the 1.side (111). It value for phlebitis and varicose veins and ulcers (205), having, beside s the usual ameliorations and aggravations, the general characteristic of coldness of the part affected,with chilliness. The backache of Pulsatilla , which starts in the sacrum or hips and travels upward to the small of the back,consists especially of a sprained sensation or stiffness, worse when lying on back, better lying on sides and usually better from change of position (128) and when walking. This from of backache occurs delayed or suppressed menstruation, prolapsus of the uterus and during pregnancy., In spinal irritation (171), along with this stiffness,the small of the attack feels as if bandaged (165). It is a remedy to be thought of for paralytic symptoms, especially with suppressed menstruation, , with bruised pa in in numbness of the extremities (146). The rheumatism calling for Pulsatilla is seldom of a highly inflammatory character. The joints may be swollen, with sharp, stinging or tearing pains,but like all the pains of the remedy, they are erratic and not to be depended upon to continue in any particular spots for any length of time, for they constantly shift from place to place (149), frequently leaving the one place free from pain when they attack the other., The pains are better from pressure or when lying on the affected side (8). when moving about slowly (10) and from cold applications (160); worse from warmth and in the evening and at night. it is useful for gonorrhoeal rheumatism (161) and for gouty symptoms due to indigestion. Pulsatilla has, as the result of eating too rich food, an itching and burning of he skin that is worse at night and after becoming warm in bed (122), and during the day after becoming overheated,a s from walking, and from scratching (122). The Pulsatilla patient is apt to be sleepy in the evening but after getting into bed she is restless and fussy 9169), feels to hot and throws off the covers or puts here arms out to get relief; while sleeping the favorite position is one the back with her hands above the head. In intermittent fever Pulsatilla, would be indicated by the predominating chill or chilliness (121). chill at 4 p.m., no thirst but with distressing desire for fresh air, followed by fever and sweat. during the fever there are frequently heat of one part and coldness of another. Sweat is usually profuse the rest of the night. Another indication would : “Paroxysms of increasing severity and ever changing symptoms; no two attacks alike ” (Hering. The principal antidote to Pulsatilla is Coffea. I use Pulsatilla 1st.