OF NUX VOMICA WITH SPECIAL 

                            REFERENCE TO CHILDREN 

                                                            JONATHAN SHORE JAIH. VOL.83, 4/1990 

Nux vomica as a broad polychrest is well known in its action.  The introductory passage in BOERICKE1 gives a clear description of the classical type.  “Nux is pre-eminently the remedy for many of the conditions incident to modern life.  The typical Nux patient is rather thin, spare, quick, active, nervous, and irritable.  He does a good deal of mental work; has mental strains and leads a sedentary life, found in prolonged office work, over study, and close application to business, with its cares and anxieties.  This indoor life and mental strain seeks stimulants, coffee, wine, possibly in excess; or again, he hopes to quiet his excitement, by indulging in the sedative effects of tobacco, if not really a victim, to the seductive drugs, like Opium, etc.  these things are associated with other indulgences; at table, he takes preferably rich and stimulating food; wine and women play their part to make him forget the close application of the day.  Late hours are a consequence; a thick head, dyspepsia, and irritable temper are the next day’s inheritance.  These conditions produce an irritable, nervous system, hypersensitive and over-impressionable”.  The psychological “essence” delineated by VITHOULKAS accords well with this description, restating it in 20th century terminology.  Ambitious, driving, competitive, with a great emphasis on efficiency and fastidiousness.  These descriptions, however, give us no indication of the evolution of the remedy image in time, of the “staging” of the remedy. 
This concept of staging may need a few words of explanation.  A remedy image may be thought of as a pattern, a pattern of symptoms, a pattern of events.  These pattern may be seen to exist not only in space but also in time.  It is a mistake to think of all the symptoms of a remedy as being connected in a one dimensional fashion.  Events in nature have beginnings, middles and endings.  Thus remedies are like the people they suit, they have their manifestations of youth, of adolescence, middle and old age.  Looking at things from a certain viewpoint we could conceive that in the life of any person all their possibilities are contained and inherent in their genes and in their energy body at the time of conception, and that these possibilities are gradually filled out and made manifest by stages.  The same principle may be applied to our understanding of remedy patterns.  All the possible symptoms are contained in the configuration of the remedy, and are “filled out” or emphasized dependent upon many factors.  These factors include influences of culture, social milieu, geography, the age and vitality of the patient and the stresses to which they are subject.  Thus the frequency of use of certain remedies varies in different parts of the world and in different centuries. 

In children, for example, we see a somewhat different pattern of symptoms from the adult.  The essence or thread is the same, but the manifestation is different corresponding to the different stresses which bear down upon the organism and the different possibilities for the expression of symptoms.  I have been struck by certain similarities in the psychological presentation of the Nux vomica children I have seen, and will attempt to clarify this image.  The repertory2offers some indications.  Though only four rubrics are to be found dealing directly with children, they point us in a definite direction. 

  JEALOUSY, children, between 
  OBSTINATE, headstrong; children 
  SENSITIVE, Oversensitive; children 
  SHRIEKING, screaming, shouting; children, in 
As expected the emphasis lies in an irritability of the nervous system.  Children are, in general, more healthy than adults.  They have more vitality and have not been deadened and suppressed by the restrictions and vicissitudes of life.  Thus we might expect their expression to be more free, more spontaneous, less conditioned by social expectations.  Given this we do not expect to find many Nux vomica children, as the etiologies described in the introduction do not really apply to children, and when we do see them we might expect to see strong expressions and anger and irritability. 
My experience is that neither of these suppositions holds true.  With respect to the etiology, the great increase, not only in the pace of modern life, but also in the use of substances designed to alter the functioning of the organism in general, have very definite deleterious effects upon the nervous systems of the parents as well as on the fetus in-utero and the young infant.  Implicated here are not only the illegal drugs, but especially the legal ones, ranging from vitamins through tobacco and coffee to the myriad over-the counter and prescription drugs consumed by the large majority of the adult population of North America.  Nux vomica is quite a common remedy as will be seen from Table 1. 
Table 1.  Percentage of Pediatric (and all) Prescriptions for the five Main Groups of Pediatric Remedies. 
1.  Calc. phos. 6% (2.2% of all prescriptions) 
2.  Carcinosin  5.5% (3.5% of all prescriptions) 
3.  Sulph., Nat-m., Mercurius, Puls., each about 4.5% 
4.  Nux-v., Sanic., Sil., Tub., each 3.5% 
5.  Med., Calc., Bell., Caust., Rhus-t., each 2.5% 
The above remedies comprise about 57% of all pediatric prescriptions. 

As regards the emotional expression of these children, whilst it is true that they can be very irritable, and very demonstrative in the expression of this irritability, there exists a polarity, in which the anger, although present, is more contained and internal.  These are sullen, unlikeable, non communicative individuals who appear to have “a chip on their shoulder”.  They seem to dislike people and resent their interference.  Their attitude suggests the inner feeling that life has been unjust to them, that it has not given them all they deserve.  This sentiment was directly stated in two cases as “Life is unfair” and “People are against me”.  Younger children express this somewhat differently in that they say that people are ugly.  This state is well represented in the repertory by the following rubrics: 

AVERSION; persons, to certain; to all3 Absin., Calc., Chin., Merc-ac., Nux-v., Phos., Staph., Sulph. 
SULKY; MOROSE, cross; DISCONTENTED, displeased, dissatisfied; HATRED; SUSPICIOUS, mistrustful; REPULSIVE mood; DELUSIONS; persecuted, that he is; DELUSIONS; pursued, thought he was; enemies, by; DREAMS; pursued by, of being. 
Both of the polarities may exist simultaneously, in varying degrees of admixture, or in their pure form. 
The case which best illustrates the sullen presentation is Case 1: Christopher P.  If we take the observations of the prescriber: not a likeable child, adult and sullen; skin has yellowish caste; very irritable in office because he was being spoken about (2);contradicts mother constantly (2); and add to this some of the other symptoms: loner, not popular at school; deceitful (1); and devious; we can get a feel for the state of this child.  He is reserved, unfriendly, disagreeable and sullen.  A quarrelsome child with few friends.  A misanthrope.  Case 2:  Stephanie S. is another example of a clear polarity.  Case 3: Lauren G., a three year old, shows these same tendencies: Cannot approach her, will not be friendly, pushes and hits everyone saying “Go away, you are ugly.”  The expression here falls within the limitations of a three year old, yet her inner state is quite easy to imagine. 
Less obvious but still along the same lines is the expression of Case 4, Zoe T., age 18 months.  Here we see an infant with an unusual degree of hardness, of lack of caring for the opinions of others and an aggressivity which is brought  out when approaching her.  In this instance we have to use more imagination to justify our assumptions.  The biting itself is not as important as the context.  She does not go out of her way, it is only when the examiner tries to relate to her, to make contact, that she becomes aggressive.  There is hardness, an obstinacy, and a mischievousness (Mind; MISCHIEVOUS; Agar., Anac., Ars., Calc., Cann-i., Cupr., Hyos., Lach., Merc., Nux-v., Stann., Stram., Tarent., Verat.), a sort of meanness and disrespect for people.  Of course these prescriptions were not made only on the above symptoms.  The basis for the prescriptions is given at the end of each case.  It is the correct and deep action of the remedy which justifies the retrospective analysis of the emotional state. 

In general the fears of Nux vomica are not a very prominent feature of the pattern.  There is one fear which I have observed both in children and in adults, but more strongly in children, and have been unable to find in any of the related rubrics of the repertory and that is fear of, or at least a definite dislike of, the dark.  My sense of this is that it is not so much the dark itself, or imaginations about the unknown, but rather a feeling of presences or of other energies in the room when it gets dark.  I have no direct evidence for this in the children but the combination of two adult cases and some other features of the nature of this remedy have led me to this speculation. 
Nux  vomica is one of a group of substances which have their center of gravity of action on the nervous system like Ignatia and Strychninum (strychnine being the active ingredient of the materia substance in all three remedies).  The sensitizing of the nervous system, leads not only to irritability but also to an increased capacity for the reception of other energies.  This idea finds support in the combination of two rubrics; Sympathetic, and the amelioration from Magnetism or Mesmerism.  The former indicates an openness to the ambient emotional energies, while the latter speaks to a sensitivity to electromag etic or vitalistic forces. 
The first case which brought this idea to my attention was a 40 year-old woman who revealed during the third or fourth interview that she had a fear of psychic attacks (2) or ghosts (1).  She felt that certain forces or spiritual entities were encroaching upon her.  This sense was especially strong while alone at night (1) and in a dark room (2).  She was rather a coarse woman with no pretensions to any form of spiritual or psychic development.  Nux vomica was given on other aspects of the case and although it did not act very deeply it almost completely removed the fear of psychic attacks and of the dark.  The other case is one in which Strychninum was given after struggling for many years to find the true simillimum.  At the time of administration of this remedy she was in her mid thirties and afflicted with great fears of disease, insanity and death in addition to a myriad physical complaints.  Some three weeks later she reported that the severe anxiety attacks she was having at night (they would begin in fact as soon as it began to get dark) had been replaced by a different type of experience.  Instead of the panic, she felt as if she were transported back in time to the age of between five to seven years old.  It was as if she were that age again, standing alone in the living room of the house and feeling that there was somebody or some thing in the room with her.  Something which frightened her and which she did not like at all.  Three months later she reported that all the anxieties and fears had subsided and that for the first time in her life she feels really “strong and courageous”. 
  The question of whether this remedy or person for that matter, may have the possibility for a direct experience of certain “other worldly” energies as opposed to simplify impressions resulting from an over active imagination, is a fascinating one, however, which will be left as being beyond the scope, of this Journal to address.