This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol1", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
As a mere stimulant to the stomach, in ordinary dyspepsia, though probably equally efficient with the simple bitters, nux vomica has no advantage over them, while any accidental abuse of it would be attended with inconveniences to which they are not liable. Hence they should, as a general rule, be preferably employed in this complaint. But, when there is reason to think that, from want of due nervous influence, the muscular coat of the stomach is unable to perform efficiently its share in the process of digestion, nux vomica may be resorted to with the hope of special benefit. In nervous disorder of the gastric sensibility, connected with debility of stomach, it is decidedly indicated, and has been found highly beneficial. Hence its use in pyrosis, and that most painful affection denominated gastralgia or gastrodynia.
Upon the same principles exactly it may be employed in bowel complaints. In constipation dependent on torpor of the peristaltic muscles, it proves often of great service, especially in connection with tonic laxatives, such as rhubarb or aloes. In obstinate flatulence from the same cause, it would probably be among our most efficient remedies. We now and then meet with cases of excessive accumulation of flatus, amounting to tympanites, especially in debilitated states of the system, and in nervous persons, and wholly independent of any discoverable lesion, which resist all ordinary remedies. Some of these may depend on a certain laxity or torpor of the muscular coat, and would be very likely to yield to nux vomica. When the flatulence is attended with copious discharge of air, whether from the stomach or bowels, it may possibly arise from an extrication of gas from the mucous tissue itself, owing to insufficient innervation; and here too the remedy is indicated. In en-teralgia or neuralgic pains of the bowels, connected as this often is with debility of the parts, nux vomica has been used advantageously; as also in colica pictonum, and in pure nervous colic independent of the poison of lead. The remedy has been recommended in diarrhoea and in dysentery, having been employed in the latter complaint particularly by the German physicians, some of whom speak highly in its favour. These complaints are sometimes connected with a relaxation of the bowels, in which a defect of innervation is probably concerned, permitting an excess of secretion from the flaccid vessels, or deranging the due relation between the contents of the bowels and the expulsive power. In such cases the medicine may sometimes prove useful; but, as a general rule. little good can be expected from it in these complaints, and it would probably often do harm by adding to the existing irritation of the mucous membrane.
The medicine has been little used in complaints of the chest; but M. Homolle has recently recommended it in the asthmatic paroxysm, and in suffocative catarrh, believing that, in both these affections, the difficulty lies in a want of proper contractility of the bronchial tubes and perhaps the air-vesicles, and that nux vomica operates by restoring this contractility. (Ann. de Therap. par Bouchardat, 1854, p. 18.) Though not disposed to admit the pathological view of M. Homolle, I am quite willing to hope that the therapeutic advantages claimed for the remedy may prove well founded on future trial. If nux vomica does good in these complaints, it is probably, in asthma, by so affecting the nervous centres as to overcome the existing spasm of the tubes, and in the suffocative catarrh, by giving increased tone to the mucous membrane, and thereby checking the excess of secretion poured out from the relaxed vessels.
In defect of the generative function, M. Trousseau was inclined to make a trial of nux vomica, from having observed its effects in producing erections, and exciting the venereal propensity. He has found it useful in impotence in both sexes. (Trait. de Therap., 4e ed., i. 714.) It has also been employed with supposed advantage in spermatorrhoea.
In general nervous debility, manifested by tremulousness, and unconnected with positive cerebral lesion, and particularly when dependent on previous excesses, as from intemperate drinking, abuse of opium, or excess in sexual indulgences, good may be expected from nux vomica in supporting the nervous functions, while the patient is endeavouring to regain health by abstinence from the cause. Any apparent good which might arise from it, without an abandonment of the indulgences referred to, must be merely temporary, and might indeed do harm by still further exhausting the excitability of the centres.
In chronic states of debility connected with the various cachexies, as in atonic gout, scrofula, atonic dropsy, etc., good may result from the use of nux vomica as of most other tonics; but, unless a special indication exist in some functional defect of nervous power, it would be better to trust the case to medicines less liable to produce serious injury if abused. It has been recommended in albuminuria. (Ann. de Therap., 1863, p. 65).
The asserted efficacy of the medicine in different forms of nervous disease, not paralytic, must be referred to the same tonic influence over the nervous centres, either directly stimulating them to a more energetic exer-cise of their function, or strengthening them against irritating influences calculated to throw them into disorder. Spasmodic asthma has already been referred to. The remedy is asserted to have proved effectual in neuralgia in the face, and may be employed against this affection wherever seated, whether externally or internally, with some hope of benefit. In hysteria, chorea, and epilepsy it was lung since used, hut attracted little attention until recently revived as a remedy in the two latter of these complaints. M. Trouseau. and MM. Fouilboux and Rougier, about the year 1841, simultaneously announced the great efficiency of this medicine in chorea; and since that period it has come to be one of the remedies most relied on in this affection among the French physicians. (Trousseau et Pidoux, Traite de Therap., 4e ed., i. 715.) In chorea, the involuntary movements are not dependent on excess of action in the nervous centres, but upon irregularity of action, which is often connected with debility. It may, therefore, be readily understood how a medicine may prove efficient in its cure, by elevating the powers and actions of these centres. But it is not so easy to explain the asserted usefulness of nux vomica in epilepsy. Bayle speaks of it as having been used advantageously in this disease; and in the N. Y. Medical Times for April, 1855 (iv. 229), Dr. Elisha Harris has reported several cases, in which it appears to have acted very favourably. As the epileptic irritation is in the brain, while nux vomica acts specially on the spinal marrow, we can conceive that the remedy may prove useful by a revulsive influence from the former to the latter; but great care should be taken, before using it, to ascertain that the system is not plethoric, and, as a cerebral irritation superadded to that already existing might result in serious consequences, to begin with it very cautiously, lest it might, as it sometimes exceptionally does, act upon the brain. A case of epilepsy is recorded in which paralysis and death followed the use of strychnia. (Pereira, Mat. Med, 3d ed., p. 1492.) Headache, mental dejection, hypochondriacal feelings and notions, and general or local uneasiness of a nervous character, when connected with general debility, may be treated with nux vomica with a reasonable hope of benefit. Perhaps the asserted usefulness of the medicine in bronchocele, may be traced to its action on the nerve-centres.