Plumbum metallicum

Slow, insidious processes, having violent side symptoms; often of very changeable or incoherent character; coming in single parts, etc. Paralysis. Atrophied limbs with plump body; paralysed parts < touch. Sensitive to open air. Impulse to stretch. Exaggerates her condition. Retraction; anus, testes, navel, etc. Increasing slowness and apathy. Deep, bluish red sclerotic. Abdomen is drawn into uneven lumps (Ars. Ign.). Abdominal distress that impels her to stretch. Urination slow, yet profuse. VIOLENT CONTRACTION. Retraction. Lightning pains that extort cries. Boring. Cramps (periodical), convulsions or (flaccid) paralysis; with hæmorrhage or hyperæsthesia. Chronic epilepsy, with marked aura. Wasting of single (upper) parts, or of paralysed parts. Sclerosis. Gout. .................... Taciturn. Timid, restless and anxious. Fears assassins. Physical labor exhausts the mind. Stupidity. Melancholy. Delirium; nocturnal; alternating with colic or pains in limbs. Twitching of r. face. Yellow sclerotic and inside of mouth. Trembling tongue. Sticky saliva. Sweet taste. Aphthæ. Dysphagia. Foul or fecal eructations. NAVEL FEELS RETRACTED. Colic; accompanies many symptoms. Radiating abdominal pains, or boring, or as if forced through a narrow place. Tense abdomen. Hernia at navel. Anus feels drawn up, or painfully contracted. Stool, granular; of hard, black balls, like sheep dung; passed with an urging cramp. Stubborn constipation or colics of infants. Retracted testes. Pollutions. Bluish, red spots. Dry oversensitive skin. Dry, burning ulcers. Takes odd positions during sleep. Wiry pulse. Coldness from exertion. General cold sweat during stool. Feet cold, when walking only.

Clear weather. Open air. Exertion. Motion. Company. Grasping smooth objects. Touch.

Hard pressure. Rubbing.

CORD AND NERVES: MUSCLES. ABDOMEN. Kidneys. Navel. Blood-vessels. Blood.

Complementary: Rhus-t. Thallium. Related: Op.

Plumbum metallicum

Lead. The Metal.

Adapted to diseases from spinal origin (Phos., Pic. ac.. Zinc.).

Excessive and rapid emaciation ; general or partial paralysis; extreme, with anaemia and great weakness.

Muscular atrophy from sclerosis of spinal system.

Lassitude; faints on going into a room full of company.

Slow of perception ; intellectual torpor, gradually increasing apathy (in fevers, Phos. ac. ).

Weakness or loss of memory; unable to find the proper word (Anac., Lac c.).

Delirium alternating with colic.

Assumes strangest attitudes and positions in bed.

Complexion : pale, ash-colored, yellow, corpse-like, cheeks sunken; expressive of great anxiety and suffering.

Skin of face, greasy, shiny (Nat. m., Sanic.).

Distinct blue line along margin of gums; gums swollen, pale, show a lead-colored line.

Excessive pain in abdomen, radiating to all parts of body.

Sensation in abdomen at night, which causes patient to stretch violently for hours; must stretch in every direction (Amyl. n.).

Violent colic, sensation as if abdominal wall was drawn as if by a string to the spine.

Intussusception, with colic and faecal vomiting; strangulated hernia, femoral, inguinal or umbilical.

Constipation: stools hard, lumpy, black like sheepdung (CheL, Op.) ; with urging and terrible pain from spasm of anus; obstructed evacuation from indurated faeces, dryness of the excretions, paralysis or muscular atony; during pregnancy; from impaction of faeces; when Platina fails.

Bright’s disease : colic pain ; abdomen retracted ; rapid emaciation ; excessive debility ; contracted kidney.

• Feels a lack of room for foetus in uterus; inability of uterus to expand; threatening abortion.

Spasms: clonic; tonic; from cerebral sclerosis or tumor; epilepsy or epileptiform convulsions.

Yellow skin: dark brown “liver spots” in climacteric years; jaundice, the eyes, skin and urine yellow.

Pod. in retraction of navel ; Nux in strangulated hernia ; Pod. the vegetable analogue.

The bad effects of Plumbum are antidoted by Alum., Petr., Plat., Sulph. ac.. Zinc.

Aggravation. — At night (pains in limbs).

Amelioration. — Rubbing; hard pressure.

Lecture LX — Plumbum and Stannum

Plumbum Metalucum.

( Belladonna, Platina, Nux vomica, Cuprum, Opium.

Plumbum. < < Opium.

( China. ^ ( Alumina.

The symptoms of Plumbum, or lead, may be studied from its main property, that is, its tendency to cause contraction of muscular fibre, both voluntary and involuntary. It will cause this contraction of muscles, and it will also cause contraction of the bloodvessels, because it affects the involuntary or non-striated muscular fibres. The first symptom that usually follows poisoning by lead, whether taken by the stomach in small doses, as in case of drinking water impregnated with it, or whether by inhalation, as in the case of painters, is lead colic, and this consists of horrible griping cramp-pains, with retraction of the abdominal walls, making the abdomen concave rather than convex. There is understood to be spasm of the recti muscles; as these are contracted, of course they draw the abdominal walls in. Pain radiates in all directions, generally following the course of the nerves, sometimes causing delirium when extending to the brain, dyspnoea when involving the chest, retraction of the testicles when extending in that direction, and violent cramps in the legs when reaching the nerves there. With this colic there is obstinate constipation, and in some cases, even stercoraceous vomiting.

The colic is antidoted by Alumina, Alume?i, Platina, Opium, Nux vomica, Arsenicum, Colocyntk, Sulphuric acid, Zincum, or Belladonna, and is prevented by alcohol.

Next the symptoms of Plumbum that are of a paralytic character. The first characteristic symptom here is wrist-drop from paralysis of the extensor muscles of the wrist. This Plumbum has cured when it has arisen from other causes than lead-poisoning. This paralysis extends to other parts of the body, always involving extensor muscles in preference to flexors. There appears on the border of the gums a blue line, known as the gingival line of lead poisoning. It is caused by the sulphur that exists in the tartar on the teeth combining with the lead in the bloodvessels, and forming a deposit of insoluble sulphide of lead. As I have said, the paralysis extends and involves other parts of the body, and then it is characterized by atrophy of the affected parts, which is therefore due to true organic changes. Thus you find Plumbum indicated in paralysis from disease of the spinal cord when that nervous structure has undergone fatty degeneration or sclerosis. Plumbum suits very nicely that disease known as multiple cerebrospinal sclerosis. It is indicated by this symptom: tremor, followed by paralysis.

We often find Plumbum indicated in paralysis with contracture. Progressive muscular atrophy may also call for Plumbum. Plumbum tends to produce non-development of the uterus. We may, therefore, find it indicated in cases of tendency to abortion. The foetus in utero increases in size, but the muscular fibres of the uterus do not develop in proportion, hence the uterus is no longer able to accommodate the growing foetus and abortion ensues.

Sometimes we find Plumbum indicated in delirium, very much like that of Belladonna; the patient bites and strikes at those near him; but it differs from that of Belladonna in this: there is tremor of the head and hands, and yellow mucus collects about the mouth and teeth. The delirium, moreover, alternates with colic, which is not the case in Belladonna .

Other cerebral disturbances from lead-poisoning are not common, but still the following may be met with: insomnia, severe headache, either occipital or frontal, with or without vertigo; noises in ear; disordered vision; diplopia; amaurosis; contraction of pharynx, though liquids are swallowed in gulps and greedily; mind weak, morose, and sad; preceded by albuminous urine.

Plumbum has frequently caused epilepsy. The characteristic symptoms which indicate it are paralytic heaviness of the legs before the attack, and paralysis and prolonged snoring sleep afterwards. It is especially indicated in convulsions from cerebral sclerosis or tumor. In constipation you may use Plumbum when the retraction of the abdomen already mentioned is present, and when there is marked spasm or contraction of the sphincter ani. There is urging to stool, and the patient complains of a sensation as though a string were drawing the anus up into the rectum.

It may be mentioned in passing that Baryta carbonica has a colic with retraction of the umbilicus like Lead. Thallium has the same symptom as an accompaniment of violent lancinating pains through the stomach and bowels, following each other rapidly like electric shocks. This remedy has relieved the fulgurating pains of locomotor ataxia. In its action on the kidneys Plumbum produces granular degeneration or cirrhosis of those organs. There is very little dropsy or albuminuria, but a marked tendency to uraemia and consequent convulsions.

Stannum.

( Causticum.

Stannum. \ Phosphorus, Sulphur.

Sepia, Pulsatilla, etc.

\ V Pulsatilla.

f Exhaustion.

Paralysis.

Nerves. < .

bpasms.

^ Neuralgia.

Mucous membranes.

Fevers.

Organs.

Stannum is a drug that has not many symptoms; hence it can be disposed of very quickly. Its complement is Pulsatilla. The Stannum patient is usually sad and lachrymose, just like Pulsatilla. Crying usually makes the patient worse. This low-spiritedness is found in the lung troubles for which Stannum is your remedy. This is rather different from the usual mental state of consumptives, who, you all know, are generally hopeful, almost to the last hour of life. Stannum is particularly indicated when they are low-spirited, hence it is rarely indicated in true tuberculosis. The woman for whom Sta?mzim is indicated is also nervous and weak; so nervous, irritable, and weak is she, that she becomes anxious and has palpitation of the heart, even from so little exertion as giving directions concerning her household affairs. She complains of a sensation of goneness in the stomach and chest. This nervous exhaustion is exhibited in various ways; it is particularly induced when the patient goes down stairs, more than when ascending. She feels as if she could not walk down stairs, or as if she had not sufficient strength in her limbs. This exhaustion may be exhibited in another way: the patient does not complain much about walking, but on trying to sit down she fairly drops into the chair. This is not an imaginary symptom. You will meet it in uterine affections.

In the mental symptoms you may compare Stannum with Natrum mur., Pulsatilla, and Sepia. Natrum mur. has melancholy, sad, weeping mood, but consolation seems to aggravate. On trying to comfort him, he becomes enraged.

The Pulsatilla patient is of a mild, tearful, yielding disposition. She rather likes consolation. She has scanty, delayed menses, while

Mental depression. Fear of being assassinated. Quiet melancholy. Slow perception; loss of memory; amnesic aphasia. Hallucinations and delusions. Intellectual apathy. Memory impaired (Anac; Baryta). Paretic dementia.

The great drug for general sclerotic conditions. Lead paralysis is chiefly of extensors, forearm or upper limb, from center to periphery with partial anæsthesia or excessive hyperasthesia, preceded by pain. Localized neuralgic pains, neuritis. The blood, alimentary and nervous systems are the special seats of action of Plumbum. Hematosis is interfered with, rapid reduction in number of red corpuscles; hence pallor, icterus, anæmia. Constrictive sensation in internal organs. Delirium, coma and convulsions. Hypertension and arteriosclerosis. Progressive muscular atrophy. Infantile paralysis. Locomotor ataxia. Excessive and rapid emaciation. Bulbar paralysis. Important in peripheral affections. The points of attack for Plumbum are the neuraxons and the anterior horns. Symptoms of multiple sclerosis, posterior spinal sclerosis. Contractions and boring pain. All the symptoms of acute. Nephritis with amaurosis and cerebral symptoms. Gout (Chronic).

Worse, at night, motion. Better, rubbing, hard pressure, physical exertion (Alumen).

Delirium alternating with colic. Pain as if a ball rose from throat to brain. Hair very dry. Tinnitus (Chin; Nat salic; Carbon sulph).

Pale and cachetic. Yellow, corpse-like; cheeks sunken. Skin of face greasy, shiny. Tremor of naso-labial muscles.

Pupils contracted. Yellow. Optic nerve inflamed. Intraocular, suppurative inflammation. Glaucoma, especially if secondary to spinal lesion. Optic neuritis, central scotoma. Sudden loss of sight after fainting.

Gums swollen, pale; distinct blue lines along margins of gums. Tongue tremulous, red on margin. Cannot put it out, seems paralyzed.

Contraction in œsophagus and stomach; pressure and tightness. Gastralgia. Constant vomiting. Solids cannot be swallowed.

Excessive colic, radiating to all parts of body. Abdominal wall feels drawn by a string to spine. Pain causes desire to stretch. Intussusception; strangulated hernia. Abdomen retracted. Obstructed flatus, with intense colic. Colic alternates with delirium and pain in atrophied limbs.

Constipation; stools hard, lumpy, black with urging and spasm of anus. Obstructed evacuation from impaction of feces (Plat). Neuralgia of rectum. Anus drawn up with constriction.

Frequent, ineffectual tenesmus. Albuminous; low specific gravity. Chronic interstitial nephritis, with great pain in abdomen. Urine scanty.

Tenesmus of bladder. Emission drop by drop.

Loss of sexual power. Testicles drawn up, feel constricted.

Vaginismus, with emaciation and constipation. Induration of mammary glands. Vulva and vagina hypersensitive. Stitches and burning pains in breasts (Apis; Con; Carb an; Sil). Tendency to abortion. Menorrhagia with sensation of string pulling from abdomen to back. Disposition to yawn and stretch.

Cardiac weakness. Pulse soft and small, dichrotic. Wiry pulse, camp-like constriction of peripheral arteries.

Spinal cord sclerosed. Lightning-like pains; temporarily better by pressure. Paralysis of lower extremities.

Paralysis of single muscles. Cannot raise or lift anything with the hand. Extension is difficult. Paralysis from overexertion of the extensor muscles in piano players (Curare). Pains in muscles of thighs; come in paroxysms. Wrist- drop. Cramps in calves. Stinging and tearing in limbs, also twitching and tingling, numbness, pain or tremor. Paralysis. Feet swollen. Pain in atrophied limbs alternates with colic. Loss of patellar reflex. Hands and feet cold. Pain in right big toe at night, very sensitive to touch.

Yellow, dark-brown liver spots. Jaundice. Dry. Dilated veins of forearms and legs.

Compare: Plumb acet (painful cramps in paralyzed limbs; severe pain and muscular cramps in gastric ulcer; locally, as an application (non- homeopathic) in moist eczema, and to dry up secretions from mucous surfaces. Care must be used, as sufficient lead can be absorbed to produce lead poison, one to two drams of the liquor plumbi subacetatis to the ounce of water; also in pruritus pudendi, equal parts of the liquor plumbi and glycerin). Plumb iodat (Has been used empirically in various forms of paralysis, sclerotic degenerations, especially of spinal cord, atrophies, arterio-sclerosis, pellagra. Indurations of mammary glands, especially when a tendency to become inflamed appears; sore and painful. Indurations of great hardness and associated with a very dry skin. Lancinating pains of Tabes). Compare: Alumina; Plat; Opium; Podoph; Merc; Thall. Plectranthus (paralysis, spastic, spinal form); Plumb chromicum (convulsions, with terrible pains; pupils greatly dilated; retracted abdomen;); Plumb phosph (loss of sexual power; locomotor ataxia). Antidotes: Plat; Alum; Petrol.

Third to thirtieth potency.

Plumbum Metallicum

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.

Uraemic coma. Uremia. Perhaps it will fix it in your mind if I tell you something clinical about it. Some years ago a physician came to me in regard to his wife. She had been unconscious for two days and had passed no urine for days and the catheter showed there was none in the bladder. She had quite an array of symptoms but they were common symptoms.

She had had the slowness for days before, and complained of a sensation of a continual pulling at the navel, as if a string were drawing it back to the spinal column, and then the coma came on. In the middle of the night this doctor came to me in great distress. He said she was pale as death and breathing slow. A single powder of Plumbum high was given, and she passed urine in a few hours, roused up and never had such an attack again.

Violent spasmodic palpitation of the heart, worse lying on the left side, with marked anxiety in the cardiac region. Hypertrophy and dilatation of the heart. Stitching pain in the heart.

Hysterical diathesis hysterical contractures; cramping of the fingers; hysterical motions convulsions of parts, hands, feet, whole body; an apparent delirium; cardiac pains; numbness in parts - all hysterical phenomena.

Plumbum produces an inclination to deceive, to cheat. The Acetate of lead produced in a woman, who took a little of it for suicide, a confirmed hysterical state. She would be in a hysterical condition for hours when any one was looking at her. When she thought no one was near she would get up, walk about, look in the glass to see how handsome she was, but when she heard a foot on the steps she would, he on the bed and appear to he unconscious.

She would bear much pricking and you could scarcely tell she was breathing. Plumbum establishes a hysterical state in the economy; an inclination to deceive, to feign sickness; to exaggerate one's ills; and it goes to the root of the evil providing the symptoms agree. Changeable; continually changing from one thing to another, from one group of imaginations to another, from one group of emotions to another. The whole remedy is intensely emotional. While the intellect is slowed down, yet most of the symptoms are emotional.

Plumbum cures kidney affections with albumen and sugar in the urine. The urine is dark, scanty, and of high specific gravity. Retention of urine from lack of sensation that the bladder is full. Apoplexy. Stupor, when Opium is sufficiently similar to remove the cerebral congestion which always surrounds the apoplectic clot, Plumbum may follow. Plumbum, Phosphorus and Alumina are three sheet anchors.

They conform to the symptoms often when the first state as been like Opium. The paralysis of muscles, the paralytic weakness of one side of the body, or single parts of the body, show its relation to such cases.

There is another feature of the upper part of the body, of the head and mind, which is not clear in the books and which is worthy of your attention. The mental symptoms, the emotional symptoms, and the head symptoms are greatly exaggerated by any exertion, especially exertion in the open air.

While walking in the open air the patient becomes hot in the head, pale in the face, and cold in the extremities, hands and feet cold as ice, as if dead; and if he continues the exertion the face becomes fairly cadaveric. Persons cannot exercise and continue it without cold extremities.

An irritable brain; pain in the base of the brain, back of the neck, in the nerve centers. Cold extremities from exertion; yet can do considerable mental exertion without becoming cold. It is from physical exertion like walking in the open air. Paroxysmal pain in the limbs, evening and night; better by pressure and worse from motion. Lightning-like pains. Jerking and trembling of all the limbs.

The Plumbum patient is cold and emaciated, needs much clothing even in warm weather, not about the head, but over the body. Extremities cold, blue, numb and emaciated. Sweat on the extremities, and on the feet it is stinking. Feet and toes withered like a washerwoman's hands. Toes blistered; blisters between the toes, smarting. Ulcerations. Molecular death and even gangrene of the skin of the fingers and toes. Calluses about the feet, corns and bunions. With the chronic affection of the head there is contraction of the muscles of the back and neck; drawing and twitching indicating meningeal troubles; spasmodic jerking.

"Swelling of the submaxillary and sublingual glands."

Convulsions often like tetanus, with lockjaw. "Distinct blue line along the margins of the gums."

"Gums pale, swollen, show a lead-colored line; blue, purple, or brown; painful with hard tubercles."

"Tongue dry, brown, cracked; coated yellow or green; dry, red, glazed in chronic gastritis." Breath foetid, dryness of mouth, ulceration, aphthae.

"Sensation of a plug in the throat; globus hystericus."

"Paralysis of throat and inability to swallow," a paralysis of the oesophagus.

The stomach has no ability to digest food. Assimilation is also destroyed. Pains in the abdomen, tearing, like colic, doubling the patient up. Constant sensation of pulling at the navel as by a string; as if the abdomen were drawn in. At times the abdomen does become concave, as if the abdomen and back were too close together. Constipation is a common and well known feature. The constipation, colic, and abdominal symptoms are commonly associated.

"Constipated stools, hard, lumpy like sheepís dung; with urging and terrible pain from constriction or spasms of anus; knotty faeces in form of balls."

No matter how much straining he cannot expel the stool.

"Constriction of intestines; navel and anus violently retracted."

"Excessive pain in abdomen radiating from thence to all parts of the body."

"Severe colic; contracted abdomen; bends backward, motor nerves most affected." Rumbling and flatulence. Impaction of faeces. Vaginismus in keeping with the spasmodic action.

"Inclination to take strange attitudes and positions in bed."

"Anemia, chlorosis, emaciation, muscular atrophy, wandering pains, dropsical swellings, yellow skin, jaundice."

Burning in ulcers is in keeping with the remedy everywhere.