Plumbum Metallicum | Materia Medica by J. T. Kent
This drug illustrates a doctrine of Hahnemann—the doctrine of attenuation. 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.
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. Anaesthesia 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, shrivelled, 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 co-operate 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. Uraemia. 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 lie on the bed and appear to be 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 has 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 sheep’s 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.” Anaemia, chlorosis, emaciation, muscular atrophy, wandering pains, dropsical swellings, yellow skin, jaundice.”
Burning in ulcers is in keeping with the remedy everywhere.