In all the complaints of Helleborus stupefaction occurs in greater or less degree. Sometimes it is a complete stupor, sometimes a partial stupor, but it is always stupefaction and sluggishness.
Hellebore is useful in affections of the brain, spinal cord, the general nervous system and mind, but especially in acute inflammatory diseases of the brain and spinal cord and their membranes, and in troubles bordering on insanity. There is a peculiar kind of imbecility or stupefaction of the our water and mucus. A feeling of anxiety in the stomach. Cramping in the stomach after food a body and mind. The extreme state is unconsciousness. Complete unconsciousness in connection with cerebral congestion, or inflammation which has gone on to hydrocephalus, cerebrospinal meningitis, or inflammation of the brain, with stupefaction. Even early in the disease Hellebore lacks the wildness and acute delirium found in Stramonium and Belladonna. It is passive. Again, it fits in after the wildness of the delirium has passed away and the patient has settled down into a state of stupefaction. The patient lies upon the back, eyes partly open, rolling the head, mouth open, tongue dry, eyes lusterless, staring into space. Staring at the individual talking. Waiting a long time to answer, or not answering at all.
Violent attacks of brain trouble frequently come to a sudden end, but those that are more passive linger, and that is where Hellebore comes in. The Hellebore case will linger for weeks and sometimes months in this state of stupefaction, gradually emaciating. He lies upon the back with the limbs drawn up; he looks pale and sickly. When questioned he answers slowly. The text says: "Stupefaction bordering on insensibility." Another common expression is: "Diminished power of the mind over the body." The muscles will not act; they will not obey the will. It is a sort of paralytic state, but "stupefaction" expresses it. Cannot project ideas; cannot rivet the attention; cannot concentrate the mind. The patient appears semi-idiotic.
Delirium is not common, and when present it is muttering. There is more stupefaction, more "do nothing," more "say nothing," than delirium. Yet there is evidently confusion of mind; he cannot think. In many instances, very late in the disease, the patient can be roused up, and he will act as if he were attempting to think, as if he were attempting to answer, attempting to move. But he simply stares at the doctor with eyes partly open, with a dazed expression on his face, and picks his finger ends.
When questioned the Hellebore patient is not able to tell you what he has in mind, unless considerably aroused and agitated. But when so aroused he will talk about spirits, or say that he sees devils. He sees in his imagination, those images that he has read about, or seen pictured, as the devil, with horns and a tail. A young person who has never heard of the devil, or of spirits, would not have that form of hallucination in his delirium. The hallucinations are shaped in accordance with what he has been taught to imagine.
Hellebore has a peculiar quasi-hysterical condition-a form of insanity. She imagines she has sinned away her day of grace. Like Aurum, she believes that she is doing wrong, that she is committing an unpardonable sin. That is as near as the remedy approaches to insanity.
"An old woman having been accused of theft by the women around took it so much to heart that she hanged herself. This suicide produced such an effect on the women of the village that one after another accused herself of having caused the death of the old woman."
The most striking type in Hellebore is the sick child. It comes in especially in children between two and ten years of age. The staring-lying on the back and staring with half-closed eyes-is typical of the remedy. Sometimes the lips move without any sound. The lips move as if the child wishes to say something, but on further questioning the words he wished to speak are lost, forgotten.
In hydrocephalus there is a sharp scream, the brain cry. The child will cry out in sleep. He will carry the hand to the head and shriek, like Apis. But the Apis hydrocephalus is far more active and acute. The Apis patient kicks the covers off; this patient does not mind the covers, he does not mind anything. He is not easily disturbed. He lies upon his back with the limbs drawn up; often making automatic motions with the arms and legs. Sometimes one side is paralyzed, but the other keeps up automatic motions.
Hellebore is useful in the low form of disease known as "apathetic typhoid." These same symptoms guide to the remedy. Indifferent to all external impressions. Rarely much disturbed by being touched, or by being covered too warmly, or by not being covered at all. He does not seem to be sensitive to heat, or cold, or pricking, or handling or pinching. Listlessness. What is called in the text "stubborn silence" is more an apathetic silence, an inability to speak. It appears as if he refused to answer, but he does not; he does not know how to answer; he cannot think.
Fixed ideas in persons who are said to be just a little "off their balance," a little queer. And that fixed idea will stay; there is no use trying to argue him out of it. The woman gets a fixed idea that she is going to die on a certain day – and nothing can get it out of her head. This is not like Aconite, because there is no fear of death. Aconite has fear of death and fixes the time of death. Fixed idea that she has committed some sin, which she will at times name and describe, or perhaps only mention vaguely – but, it is very real to her.
When able to be about the patient appears to be sad, because she sits and says nothing, and seems to be in a woeful mood. But there is not that great lamentation, with walking the floor and wringing the hands, that we find in Aurum. It is an apathetic state; she appears sad and melancholy, whereas perhaps she does little thinking. Any attempt at consolation, so long as the patient is able to think, only aggravates the trouble. Like Natrum muriaticum, the complaints are aggravated by consolation, but the complaints of Natrum muriaticum are not at all like these. If the Hellebore patient is able to meditate upon his symptoms, they seem to grow better.
Sometimes there are convulsive motions in this remedy, but they are more likely to be automatic. Motions that seem to have nothing to do with the will. He simply makes motions, like one moving in an absent minded state.
The Helleborus patient is benumbed everywhere. The whole sensorium is in a benumbed state, a stupefaction, a blunting of general sensibility. The text says: "Vision unimpaired." Nevertheless he sees imperfectly; he does not regard the object his gaze is fixed upon; that is, his range of vision appears to be correct, yet if questioned a little as to what he saw, he has no recollection of it; it has made no impression upon his memory or his mind.
Vertigo, with nausea and vomiting. Vertigo from stooping. With the general stupefaction the head rolls and tosses. The child lies upon the back and rolls the head from side to side. The eyes are partly open, and he keeps boring the back of the head into the pillow. This is partly unconscious and partly to relieve the drawing in the muscles of the back of the neck. These muscles keep shortening, as the disease progresses, just as they do in cerebrospinal meningitis; until the head is drawn back as far as it can go.
There is burning heat in the head; shooting pains; pressive pains in the head from congestion. Violent occipital headache. Dull aching in the occiput; benumbed feeling in the occiput. A feeling like wood; fullness, congestion and pressure. The headaches, the motions of the head and the appearance of the face are those occurring in congestion of the brain. I have seen children, after passing through a moderately acute but rather passive first stage, lie in this stupid state, needing Hellebore for weeks before they received it. When it was given, repair set in; not instantly, but gradually. The remedy acts slowly in these slow, stubborn, stupid cases of brain and spinal trouble. Sometimes there is no apparent change until the day after the remedy is administered or even the next night, when there comes a sweat, a diarrhea, or vomiting-a reaction. They must not be interfered with no remedy must be given. They are signs of reaction. If the child has vitality enough to recover, he will now recover. If the vomiting is stopped by any remedy that will stop it, the Hellebore will be antidoted. Let the vomiting or the diarrhea or the sweat alone, and it will pass away during the day. The child will become warm, and in a few days wilt return to consciousness-and then what will take place? Just imagine these benumbed fingers and hands and limbs, this benumbed skin everywhere. What would be the most natural thing to develop as evidence of the rousing up of this stupid child? It is necessary for you to know this. It is not really a part of the teaching of the homeopathic materia medica, but you must know what to expect after giving this remedy. It is a clinical observation which you will see if you see Hellebore cases, and Zincum cases. Zincum is, if possible, even more profound in its dreadful state of stupefaction than Hellebore. Well, that child’s fingers will commence to tingle. As he comes back to his normal nervous condition, the fingers commence to tingle, the nose and ears tingle, and the child begins to scream and toss back and forth and roll about the bed. The neighbors will come in and say, "l would send that doctor away unless he gives something to help that child;" but just as sure as you do it you will have a dead baby in twenty-four hours. That child is getting well; let him alone. You will never be able to manage one of these cases if you do not take the father into a room by himself and tell him just how the case will proceed. Do not take the mother; do not tell her a word about it, unless she is an unusually excellent mother, because that is her child, and she is sympathetic, and she will cry when she hearts that child cry; she will lose her head and will insist upon the father turning you out of doors. But you take the father aside beforehand and tell him what is going to happen; explain it to him so he will see it for himself; and tell him that if this is not permitted to go on, that if the remedy is interfered with, he will lose his child.
It is not so much the awful pains, but it is the itching, tingling and formation that cause the appearance of extreme agony. Sometimes in every part of the child’s body it is a week before all these symptoms go away of themselves-but they will go away, if left alone.
All this will make you nervous. Do not stay and watch the case too long, because if you do you will change the remedy. I never heard of one solitary cure like these in the hands of an Old School doctor.
The face has a very sickly appearance; sunken; gradually emaciating. It has a sooty appearance, just as if soot had settled in the nostrils and in the corners of the eyes. You will say that the patient is going to die. Quite likely-without Hellebore. The remedy fits the kind of cases that the allopath knows nothing about and has no remedy for. His prognosis is always unfavorable. The face, of course, expresses the mental symptoms. Wrinkled forehead, bathed in cold sweat. Paleness of the face and heat of the head. Twitching of the muscles of the face. We find that knitting of the brow and wrinkling of the forehead in just this kind of brain trouble. We find a similar kind of wrinkling in Lycopodium, but the trouble is in the lungs. In this remedy the nostrils are dilated and sooty. Not much flapping, but extremely dilated. The eyeballs are glassy and the lids sticky.
There is violent thirst in these fevers, and unusual canine hunger. The nausea and vomiting are nondescript. In the early part of the proving there are diarrhea and dysentery; with copious white gelatinous stool; stool consisting solely of pale tenacious mucus. And then comes paralytic constipation and these prostrated, emaciated brain cases, such as described, will lie for days without stool, or any action of the bowels. After a day or two they will not even respond to injections. Little, hard, dry stool. Again, when reaction comes, it very commonly comes with a diarrhea, or a sweat, or vomiting; perhaps with all three of these conditions.
The urine is retained or suppressed; sometimes it dribbles away – passes unconsciously. Urine passed in a feeble stream; bloody urine.
The patient lies on the back, with his limbs drawn up; or slides down in bed. Great debility; great relaxation; the muscles refuse to act. Convulsions of sucklings. Epilepsy with consciousness. Traumatic tetanus. Constant somnambulism; cannot be roused to full consciousness. Soporous sleep.