Understanding Nux moschata

Dr Claudio C Araujo MD, FFHom (Lon.) et al.

This remedy has been used and is well known by its symptoms of drowsiness and mental confusion. They are the most characteristic symptoms of Nux-m. 

Vanishing of thought. One man had complete loss of memory of his past life, and did not recover it for a week. 

The sensorium is disturbed as much as the mind, and a state of staggering, helpless drunkenness is induced. Connected with this are the sleep symptoms of Nux m., which give the leading keynote of the remedy. Drowsiness. Nux m. is needed for drowsiness more frequently than Opium itself. When any complaint causes drowsiness or is accompanied by drowsiness, 

The mental disturbance may take all the protean forms of hysteria and even mania.

From the proving symptoms as from clinical observation present in the MM, all symptoms are pointing up to only one direction: our patient is at the same time exhausted and very confused. Alcoholism is mentioned, infectious exhaustive diseases as also mental strain and any physical exigence – like studying and working hard, also in pregnant women and before the menstrual period- these factors were quoted as trigger situations for the appearance of the mental symptoms. This combination of events – mental tiredness and maybe another situation like alcoholism or exhaustive diseases – will trigger the so-called Nux-m. mental symptoms like confusion, drowsiness and loss of memory.

The patient is now there - quiet, confused, looking into one´s surroundings not knowing where he is - feeling as if it is all part of a strange dream. He is not afraid, scared or any other sensation – he´s lost, confused and absent. Some symptoms coming from the proving can be compared to the sensation of the opium smokers. Spaced out, sleepy and prone to fell asleep at any time. Nux-m. appears in the rubric Mind, “Spaced out” in Synthesis repertory and we believe that this symptom embodies the whole understanding of the mental and neurological aspects of this remedy. There are not many symptoms related to his relationship with the others but his emotional and mental absence. Other external factors – like the cold wind and noise – are described as causal entities prone to throw our patient into this dreamy sensation. Also, it´s mentioned that some “typhoid” fevers that have progressed to a comatose state have been helped by Nux moschata.

But “where” is our patient now?

Surroundings seemed changed ; fanciful, dreamy images ; does not recognize the known street. 
The outer world had no existence for her ; automatically she attended to her household duties, and on awaking from this condition she had not the slightest recollection of what she had done ; if forcibly aroused she fell into violent convulsions ; if unmolested she would usually, after finishing her work, go to bed and fall into a quiet sleep, from which she awoke after forty-eight hours, invigorated and unconscious of what had happened. 

Due to some apparently unknown reason, this patient hid oneself from the world and have fallen inside a different reality, to the point of not knowing which “side” of life  is the real one.

But - underlining the symptoms of drowsiness and confusion, the commonest characteristic of Nux-m.- there is a personality division, and we believe that this is the deep mental estate of this patient.

Nux m. is one of the most profoundly active of psychical remedies in the Materia Medica, producing states of exaltation resembling hysteria, and the mesmeric state with exalted senses and consciousness of double personality.

But - apart of this mental division, providing the possibility of this patient may present a divided personality, we must understand who he is. Born sensitive to anything coming from the real world, Nux-m.  is lost in a strange place. He can´t recognize where he is, it seems to him that he never had been in this place before.

if forcibly aroused she fell into violent convulsions ; if unmolested she would usually, after finishing her work, go to bed and fall into a quiet sleep, from which she awoke after forty-eight hours, invigorated and unconscious of what had happened. 
Short time seems very long to her. 

After dinner, head felt strange as if in a dream; but he joined a small musical party, as he had intended. He seemed to be two persons, and his real, conscious self seemed to be watching his other self playing. He could not play well; and had to desist. He seemed lost, and when spoken to would come to himself with a start. Hearing for distant sounds much more acute than usual. 

Seemed to be two persons, his real conscious self seemed to be watching his other self playing (piano). Could not play well, struck false notes, and was obliged to give it up.

Seemed lost when spoken to, and would come to himself with a start.

Hallucination that she has two heads

A woman who ate several nutmegs with the idea of bringing on abortion had the hallucination that she had two heads. 

Our patient is confused, dreamy and divided. The proving does not specify what kind of division is happening within our patient, only says that, during a musical party, one side of his personality is criticizing the “part that is trying to play”, in some way impending him to hit the right notes at the piano keyboard to the point of stopping him to play. Could be our patient tormented by some sort of divided internal criticism? Is his funny part, the happy side of one´s personality subdued by the other, both living in a dreamy and confused state? Has our patient been stopped to feel or to live happy moments of his life due to a severe look or any form of self-criticism coming from his “other head”?

And - if this division has been present along our patient´s life, how is he feeling now? He is tired, confused, exhausted after being impeded by his “other head” from been happy, from hit the right notes in the piano´s keyboard. He has been fighting along all his life against this internal division. Maybe – and we say maybe – we may find this division present in his fight between his pleasantry part - the pianist who wants to enjoy the musical party – and his intellectual rational being, criticizing him, saying that he is not good at the instrument at all, to the point of impeding him from hitting the right notes, to the point of getting our patient paralyzed, confused and lost.

Listless and indifferent ; would go out in the night and not return till searched out and brought back ; he was disposed to talk, to laugh and sing songs. θ Mental disorders. 
Awakening as from complete absence of mind, does not know where he is nor what to answer. 

In our hypothesis we have also considered that this Nux-m. dreamy reality have being created and produced as a strategy to escape from some sort of mental and existential stressful sufferings, as if our patient have hid himself from any sort of painful impact coming over from the real world – and his sensitivity has been considered in our study as a probable reason of this “hiding out” strategy. 

Oversensitiveness of hearing. 
Oversensitiveness of smell;

The senses of sight and touch are exalted in the same way as hearing. 

Our patient must be someone with difficulties from being acting and living is this real world. 

Surroundings seemed changed ; fanciful, dreamy images ; does not recognize the known street. 
The outer world had no existence for her ; automatically she attended to her household duties, and on awaking from this condition she had not the slightest recollection of what she had done ; if forcibly aroused she fell into violent convulsions ; if unmolested she would usually, after finishing her work, go to bed and fall into a quiet sleep, from which she awoke after forty-eight hours, invigorated and unconscious of what had happened. 

Nux-m. symptoms are represented in the following rubrics in the repertory, given us further examples of the division inside his mind:

Will, contradiction.

Confusion of mind, duality, sense of.

Delusion, being double

Irresolution: acts, in

We will find someone that – apart of his drowsiness, memory loss and confusion – has been fighting all his life against the division he has created: his intellectual and objective part - who couldn´t never gave vent to the artistic delicate part of oneself - fighting over against his painful sensitiveness, who´s also the happy and pleasant part of his soul.  Besides his difficulties to deal with the surrounding reality due to one´s extreme sensitivity, a division has been developed as a survival strategy: as if this patient, suffering the hard impact coming from the world, would establish a protection, a division between his sensitivity and life´s hard existential experience. Nux-m. is having a hard time from being living in this world and, staying spaced out from time to time after being hit from reality may be his strategical solution to dealt with one´s own sensitivities. But then comes division and its consequences:

Never accomplishes what he undertakes, but remains standing in one place, absent-minded; appears quite changed to his companions. 

 

Nux moschata groups

Symptoms from Hering, Allen, Clarke & Kent

Dr. Claudio C Araujo MD, FFHom (Lon.)

WITH THE ENVIRONEMENT

The senses of sight and touch are exalted in the same way as hearing. 

Persons who easily faint away from sight of blood; from standing (as to have a dress tried on) and those who have faintness or fainting during or associated with evacuations; 

Aware of danger, but no apprehension. 

Surroundings seemed changed ; fanciful, dreamy images ; does not recognize the known street.

The outer world had no existence for her ; automatically she attended to her household duties, and on awaking from this condition she had not the slightest recollection of what she had done ; if forcibly aroused she fell into violent convulsions ; if unmolested she would usually, after finishing her work, go to bed and fall into a quiet sleep, from which she awoke after forty-eight hours, invigorated and unconscious of what had happened. 
Short time seems very long to her. 
Delirium tremens, slowness of senses, imaginary fancies ; awakens and knows not where he is ; laughter with stupid expression. 
Had no power to resist being led anywhere, in evening. 
Oversensitiveness of smell; loss of smell. 
Fright : causing trembling of heart, fear and sadness. 

Clairvoyancy

At times in a state of clairvoyance, answers questions accurately on subjects entirely out of her sphere, on returning to consciousness is ignorant of what she has said. 
Kent: The mental state is the keynote. Sometimes she is < in the morning, sometimes in the evening, or on waking. She performs all her duties and yet seems to be in a dream, she seems not to know her friends. The patient is sensitive to wind, to a draft, to damp air. She has a headache < walking against the wind; hoarseness from walking against the wind; she is so sensitive to cold weather that she comes home dazed and sleepy from walking against the wind; her mouth is dry but there is no thirst, she doesn't desire water (sometimes thirst is present). The patient may hold water in the mouth without desire to swallow it. Nux mos. holds ice water and succulent fruits in the mouth to relieve the sensation of dryness. Often there is a sensation of dryness when the mouth is moist.

In the extremities there is numbness, tingling, prickling, paralytic weakness; there is threatened paralysis; momentary hysterical paralysis; coming for a short time and then going away.

Aphonia with a dry mouth, in hysterical patients; when walking out of doors. This aphonia passes away on going into the house.

I took a broken nutmeg and put it in my pocket, and in the course of six hours, I had eaten half a one. Soon after I felt a dizziness and an unaccountable derangement of intellect, transient loss of memory, but a perfect consciousness of all that I said or did; I became remarkably loquacious and seemed to be neither in this world nor the other; I felt happy and free from any pain; I was truly in an indescribable state; I felt as I supposed one might feel that had been magnetized; my friends were greatly alarmed, and the doctor was sent for in great haste; bleeding was proposed, but as I thought I knew at least as much as any one, I was not willing to be bled; after keeping them laughing and crying till about 11 o'clock at night, I retired to bed, without anything having been done for me; I woke in the morning, and was well as usual, having never been sick a day in my life. Since this occurred, several cases have come to my knowledge in which persons having eaten nutmegs, were affected in the same way that I had been. Had I eaten a little more, I have no doubt it would have proved fatal, as I learn it has done in other cases, [68]. 

WITH ONSELF

The senses of sight and touch are exalted in the same way as hearing. 

The mental disturbance may take all the protean forms of hysteria and even mania. Vanishing of thought. One man had complete loss of memory of his past life, and did not recover it for a week. 

The sensorium is disturbed as much as the mind, and a state of staggering, helpless drunkenness is induced. Connected with this are the sleep symptoms of Nux m., which give the leading keynote of the remedy─Drowsiness. Nux m. is needed for drowsiness more frequently than Opium itself. When any complaint causes drowsiness or is accompanied by drowsiness, 

Vanishing of thought. One man had complete loss of memory of his past life, and did not recover it for a week. 

Stupor and insensibility ; unconquerable sleep. 
Unconsciousness : after mental excitement ; especially just before menses ; thoughts vanish with fainting ; seemingly to her of a half hour's duration, but really only momentary. 
Vanishing of thoughts while talking, reading or writing. 
Gradual vanishing of thoughts while reading, ends in falling asleep. 
Weakness or loss of memory. 
Never accomplishes what he undertakes, but remains standing in one place, absent-minded ; appears quite changed to his companions. 
Listless and indifferent ; would go out in the night and not return till searched out and brought back ; he was disposed to talk, to laugh and sing songs. θ Mental disorders. 
Awakening as from complete absence of mind, does not know where he is nor what to answer. 
Difficult comprehension. 
Sluggish flow of ideas. 
Gives answers which have not the least reference to questions put to him. 
Great incoherency on attempting to express her ideas. 
Uses wrong words, during headache. 
While writing he omitted letters, wrote in different alphabets against his will, and changed from one subject to another. 
Senselessness, intoxicated condition, with absence of mind. 
Delirium tremens, slowness of senses, imaginary fancies ; awakens and knows not where he is ; laughter with stupid expression. 

Imbecility. 
As if drunk and sleepy ; drunken feeling in head ; drunken appearance. 
While writing he omitted letters, wrote in different alphabets against his will, and changed from one subject to another (after six hours), [1]. [From the flowers.] 

The words he employed to express his sensations remarkable for their merit of being the opposite to what he should have used; on the third day his thoughts hardly submitted themselves to his control, unless by a consciously great effort. 
Inclination to laugh at everything, more in open air. 
Fitful mood, changing from deepest sorrow to most frolicsome behavior ; now grave, now gay. 
Fickle ; irresolute and wavering in his undertakings. 
Had no power to resist being led anywhere, in evening. 
After overtaxed mental powers : gastric complaints ; nervous irritation of intestinal canal ; hysteria. 

Staggers in walking ; falls often. 
Great languor. 
Lassitude, even talking tired him.
Drowsiness ; torpor ; lethargy. 
Completely distracted in the head, and as if intoxicated (in a pregnant woman, from ten pieces of the nuts), 

Causes intoxication and indolence,. 

The least exertion or mental excitement brought on somnolency. 
Fright : causing trembling of heart, fear and sadness. 

Restless, must move about. 

 At times in a state of clairvoyance, answers questions accurately on subjects entirely out of her sphere, on returning to consciousness is ignorant of what she has said. 
Difficult nervous affections springing from catarrh. 
Trembling : in hands ; from cold ; inner more than outer parts. 
Anxiety in body, with disposition to trembling. θ Typhoid fever. 
Nervous erethism. θ Mania a potu. 
Feels as if she had to gather up all her strength. θ Hysteria. 
Fatigue, feels as if he must lie down, after least exertion ; sleepy ; chilly, pale face. 
Sickly, faint sensation. 
Disposition to faint ; also from pains even when slight. 
Stiff and fainty, with palpitation of heart. 
Fainting, with palpitation of heart, followed by sleep. 
As if he had been electrified, it goes in a straight line from roof of mouth downward, towards his feet, afterwards diffused over whole body. 
Insanity 

Mental derangement,. 

She fell into a delirium, that lasted several hours, 

After a few hours, he was attacked with violent vertigo and delirium, so that he made remarkable gestures; then he used improper language in a loud tone, and could in no way be quieted or made to sleep until he had taken tea and been bled, after which he fell into a profuse perspiration, with deep sleep, from which he woke well,. [From three nuts of M. tomentosa, taken for diarrhœa and tenesmus.] 

They became foolish and delirious (in five soldiers). 

It causes foolishness. 

Unusually lively, laughing and bright, in the forenoon, . 

Felt foolishly happy, but could not talk; had no desire to talk (first evening). 

Everything provokes laughter, quite contrary to habit; this was especially noticeable on going into the open air. He stood still upon the street, made foolish gestures; between the attacks he sank into absence of mind, and on collecting himself everything about him seemed ludicrous. During this he looked foolish and childish, like an idiot. On being brought into the house he became somewhat better (first day). 

He seemed to himself to be remarkably lively, with constant throngs of joyous fancies, and he managed to see something ludicrous in everything, [1]. [Effects of the inunction of the tincture to the abdomen.] 

Great fear of death, at 5.30 P.M.

Weeping mood, with burning in the eyes, and lachrymation (first day), [5]. 

Præcordial anxiety, [60]. 

Reeling and great anxiety, [26]. [20.] 

Violent anxiety (second day), [63]. 

Extreme ill-humor (first day), [54]. 

Variable mood; at one time he wishes to do something, but when he is about to accomplish it changes his mind (first day), [6]. 

At one time mood more earnest, at another more inclined to laugh (first day), [6]. 

Felt perfectly careless; nothing could have offended me (first evening), [65]. 

Indifferent mood (first day), [4]. 

As soon as she lay down felt a sinking sensation, as though she were going to die, with no fear, however, being perfectly at ease in mind, and free from pain or any suffering; felt happy and unconcerned; sensation was not complete; faculties undisturbed up to this time, save in the expression of her ideas; knew all that was transpiring about her, but could not express herself clearly (ideas muddled, tongue thick, with coldness commencing in lower limbs), [76]. 

Many ridiculous or extravagant acts or expressions, like idiocy, while she seemed perfectly conscious, and at the next moment would appear chagrined at her conduct, and said she could not control her actions; *disposition to laugh or jest at everything; stupid look for a moment; changeable humor; one moment laughing, the next crying (after seven hours). 

He cannot comprehend what he is reading, does not know what he is reading (first day). 

Ideas were somewhat confused, [76]. 

Great incoherency on attempting to express her ideas (after seven hours), [64]. 

Great confusion of ideas, with strange feeling over the whole system (after four hours), [64]. 

Unfitted for any work (first day), [54]. 

Loss of memory, at 2 P.M., [62]. 

The preserved nuts, if eaten too frequently, destroy the memory,

It causes forgetfulness,

When writing, he had scarcely written half of the thoughts in his mind when everything vanished; the other part could be recalled only with difficulty, or frequently not at all; was first obliged to rest; commenced to write anew, but could write only a single word, when he had to stop and collect his thoughts (first day), [1]. [From the flowers.] 

Dizziness and vanishing of thought, and on forcibly arousing himself, he is first obliged to collect is thoughts, [6]. 

While reading he gradually sinks into absence of mind, which passes into sleep (after three hours), [1]. 

Before he could answer a question he was obliged to wait awhile and collect his thoughts; frequently in spite of everything he was unable to give a suitable answer immediately; a kind of slowness of ideas (after five hours), [1]. 

He staggered when walking, and when reflecting his mind ran upon one idea until all at once he woke from complete abstraction, and was obliged to collect his thoughts before he knew where he was (after five hours), [1]. 

Absence of mind, cannot think; great indifference to everything; scalp very much stretched, he laid down at noon to sleep for half an hour, but slept soundly for four hours; before falling asleep, boring pains in the root of a tooth; on falling asleep, some dull headache on the left side (after six hours), [54a]. 

He talks very little; confused images appear before his mind; whenever he wishes to say anything he is first obliged to collect his thoughts (first day),. 

He never accomplishes what he undertakes, but remains standing in one place, absent-minded; he appears quite changed to his companions,. 

It became difficult to recall to mind things learned shortly before; for many such things the mind seemed paralyzed for many days together, [1].

In a state of apparent unconsciousness. 

Dulness of sense and loss of control; she could have been led anywhere without resistance; loss of power (first evening). 

Total loss of consciousness, seemingly to her of a half hour's duration, but really only momentary, at 2 P.M.,. 

Senselessness,. 

Senselessness, intoxication condition, and absence of mind (first day),. 

After about an hour he was seized with drowsiness, that gradually increased to complete stupor and insensibility, and not long afterwards he was found fallen from his chair, lying on the floor of his chamber in the state mentioned; being laid in bed he fell asleep, woke a little from time to time, when he was quite delirious; he thus continued alternately delirious and sleeping for several hours; by degrees these symptoms diminished, so that in about six hours from the time of taking the nutmeg he had pretty well recovered. Although he still complained of headache and was somewhat delirious, he slept naturally, and the next day was quite well, [31]. [From about 2 drachms of the powdered nutmeg.] 

From eating three nutmegs, after a moderate dinner, he is taken with unconquerable desire to sleep; he passes the afternoon in delirious slumber, with pleasant, peaceful dreams; at half past 5 o'clock he went to the theatre, which was at some distance; the way seemed to have no end; he has perfect control over his limbs, but is lost each moment in fanciful images, from which he has to tear himself away, with great energy, in order to continue on his way. Although he was, at times, quite unconscious, his limbs did not fail to do their service; he went straight on, without recognizing the streets that crossed his way; he was most concerned about the time; he feared to come too late, but came to the theatre much earlier than he thought; during the entire play, fancy and reality battled with each other. 

It surely possesses narcotic and stupefying properties.

She fell into the deepest stupor, was deprived of all motion and sensation, 

She lay immovable and stupid the whole of the first day, as in coma. 

State of mind similar to that of the opium-eater, entertaining no apprehension of the result, although aware of the presence of some danger, 

Sleep at night disturbed by voluptuous dreams (first day), 

Irresistible sleep, frequently disturbed by vivid dreams, soon, [2]. 

Dreams of falling from high places; again, as if being pursued by persons seeking to harm her,.

Kent: This is a singular state of the mind sometimes found in hysterical women.

Sometimes it is impossible to find out what state of the mind is present she is so forgetful. She lies with the eyes closed and yet knows everything that is going on, but remembers nothing. She speaks with intelligence about the things of the moment, but knows nothing of the past. She prophesies, predicts with a sort of clairvoyance.

The mental state is the keynote. Sometimes she is < in the morning, sometimes in the evening, or on waking. She performs all her duties and yet seems to be in a dream, she seems not to know her friends.

Sleep: The Nux mos. patient is always ready to go to sleep; it is with great difficulty that she can keep awake. She falls asleep on all occasions, in season and out of season. The eyes look heavy; she cannot keep awake; falls into a profound slumber, sometimes into coma.

They give an answer that has no relation to the question asked, or, answer correctly. We find such a state in typhoid, in hysteria, after shock, after fear, blighted affections, or the loss of a friend. It is more suitable after shock ending in this kind of trouble than in typhoid.

It is also useful in typhoid, but where there is great weakness, sliding down in bed, and nervous trembling, Phos. ac. is a better remedy. Nux mos. does not relate so completely to the general image of a typhoid as does Phos. ac.

The sleepiness and the dazed state are two things combined, and when combined are difficult to cover by a remedy. This state is somewhat like Opium.

Faintness and even fainting when standing long, such as occurs in a nervous woman standing to have a dress fitted.

There is a dry mouth, the tongue cleaves to the roof of the mouth in all complaints. There is great sleepiness and automatic conduct, especially in nervous women. It has cured petit mal.

Clarke: 

Nux m. is one of the most profoundly active of psychical remedies in the Materia Medica, producing states of exaltation resembling hysteria, and the mesmeric state with exalted senses and consciousness of double personality 

A woman who ate several nutmegs with the idea of bringing on abortion had the hallucination that she had two heads. 

After dinner, head felt strange as if in a dream; but he joined a small musical party, as he had intended. He seemed to be two persons, and his real, conscious self seemed to be watching his other self playing. He could not play well; and had to desist. He seemed lost, and when spoken to would come to himself with a start. Hearing for distant sounds much more acute than usual. 

After second dose of half nutmeg head felt queer and dizzy, then head felt large, could not reply to questions, though eyes were open and seemed to understand. Pupils dilated, eyes staring, face pale, respiration laboured. Semi-conscious and had to be shouted at, but relapsed into semi-consciousness. Pulse at first small or rapid, but during unconscious period, irregular, fuller, and weak. When consciousness first returned kept hands to her head "to prevent it falling off"; was obliged to move her head with her hands, "it being too large and heavy for her body." Her chest felt as if in a vice. For some days was unable to use words properly, frequently obliged to stop in middle of a sentence and change it entirely from not being able to use appropriate words.

Exaltation of the senses and sensibilities runs through the remedy. One hypersensitive patient to whom I gave a single dose of Nux m. 30, said it seemed to put a coat of cotton wool over her. 

Here are some Sensations: As if drunk. Limbs as if floating in the air. Forehead as if as large again. Forehead as if pushed out. As if brain struck against side of head. Brain as if loose. Objects appear much too large. Pain as of a rough body in Eustachian tube. Pricking as of electric sparks on cheek. As if wind incarcerated in stomach. As if a piece of bacon were in throat. As if food had formed itself into lumps in stomach. As if a piece of wood stretched across small of back were pressing from within out. As if heart would be squeezed off. As if something grasped heart. As if heart were beating in a vacuum. As if it were difficult to move tongue. As if blood were rushing to heart, and then all over body 

As if left shoulder contained lead. 

As if a string were tied round arms. 

As of a grasping hand in upper arm. 

Pains as if bruised, sprained, wrenched; as if bones smashed. As if electrified. Pressure, throbbing, drawing, burning, are all common sensations. 

The sensitiveness of Nux m. comes out in the soreness of parts lain on. 

Mind.─Weeping mood with burning in eyes and lachrymation.─

Fickleness, with desire sometimes for one thing, at others for something else

Great inclination to laugh, to make a jest of everything, esp. when in open air, sometimes with a stupid look, as if imbecile.

Incessant flow of facetious ideas.

Everything about him seemed ludicrous.

Humour grave and gay alternately.

Mentally excited and exhilarated.

Facility of arguing.─After dining, head felt strange as if in a dream.

Seemed to be two persons, his real conscious self seemed to be watching his other self playing (piano). Could not play well, struck false notes, and was obliged to give it up.

Seemed lost when spoken to, and would come to himself with a start.

Transient loss of memory, but a perfect consciousness of all that I said or did.

Surroundings seem changed; fanciful, dreamy images; does not recognise well-known streets.

Weakness of memory; loss of memory.

Entirely lost memory of his past life.

Hallucination that she has two heads.─

Sense of impending dissolution; besought me piteously not to let her die.─

WITH THE OTHERS

Petulant and irritable, when roused. 

Disposed to be petulant

Useful in the coma of typhoid and intermittent fever. When aroused she remembers nothing; looks dazed; looks about and wants to know who the people are around and what they are doing. It is a state in which patients answer questions slowly after a long interval, and then look confused again.

CAUSALITIES

< mental effort

< mental exertion

Lassitude, even talking tired him. 
Feels as if she had to gather up all her strength. θ Hysteria. 
Fatigue, feels as if he must lie down, after least exertion ; sleepy ; chilly, pale face. 
Drowsiness ; torpor ; lethargy. 
Sickly, faint sensation. 
Disposition to faint ; also from pains even when slight. 
Stiff and fainty, with palpitation of heart. 
Fainting, with palpitation of heart, followed by sleep. 
Spasms of children ; better suited to those of feeble constitution and scrofulous diathesis, frequently troubled with diarrhœa from debility ; violent palpitation of heart. 
Hysteria : exhausted from least effort ; after intermittent ; after typhus abdominalis ; with disturbance in sexual functions ; with strangury ; catamenia too late and scanty, with sensation in sacral region as if a stick of wood was lying across, with headache, weariness, pressure in stomach, water running from mouth, and pain in liver ; blood from vagina thicker and darker ; leucorrhœa at right time of catamenia ; cardiac ; palpitation with fainting and insensibility ; with quickly changing mood, great sleepiness and disposition to faint ; with globus hystericus. 
Constant sleepiness ; skin cool and sensitive to exposure ; oppression of pit of stomach to chest, slow rattling breathing ; least exertion causes great weakness and sleepiness ; diarrhœa. θ Shock from injuries. 
Progressive locomotor ataxy, if disease was occasioned by exposure to cold and wet and in rheumatic subjects. 
Complaints cause sleepiness ; irresistibly drowsy ; sleepy, muddled, as if intoxicated ; coma, lies silent, immovable ; eyes constantly closed ; strange feeling on waking. 

< before menses

Unconsciousness : after mental excitement ; especially just before menses ; thoughts