Alumina is a unique remedy often under-appreciated by beginning prescribers. It is characterized by DELAYED ACTION both internally on the mental plane, and externally on the central and peripheral nervous systems. The idea is SLOWNESS of function followed eventually by PARALYSIS. This is a very slow onset. The patient may not realize that anything is wrong for a long time; she may feel a vague “heaviness” in the legs about which she doesn’t complain until it has developed into locomotor ataxia.
The most striking aspect of the mental picture is the great SLOWNESS of mind. She is slow to comprehend things, then slow in figuring out how to proceed to accomplish her task, and slow in its execution.
The slowness of mind results in a peculiar kind of confusion which is unique to Alumina. The ideas are very vague, and hazy, like undefined shadows. You may see a patient who has difficulty in swallowing. But when you ask her to describe the trouble, she becomes halting and indecisive. She thinks a long time, tries this word and that, struggling to find the correct word to describe what she is feeling. This difficulty in expressing what is happening is so peculiar to Alumina that it is like a keynote symptom. This is the type of patient whose descriptions are so vague that you may prescribe many remedies before realising that you have never really had a case to work from; once you recognize this peculiar kind of vagueness and confusion, then you will give Alumina and witness a good effect.
With time this confusion progresses to another peculiar mental state : when she talks, she thinks that someone else is talking. Or, even more strangely, the patient may say that she cannot hear except through the ears of someone else. This can be tricky, however, because the patient will not volunteer this information. This is the kind of symptom you must elicit by direct questioning. You may suspect Alumina on the basis of other symptoms so you ask about this symptom directly, and the patient says, “Oh yes, now that you mention it”.
By this stage of pathology, the patient comes to the conclusion that he or she is going insane. This is not actually a fear of insanity; it is more of an objective conclusion. It is a kind of confirmation of what was previously suspected. Alumina is not a prominent remedy for fear of insanity. In fact, if the patient displays a lot of fear of insanity, one would tend to turn away from Alumina. Finally, the patient falls into a deep sense of despair. She feels, “nobody can help me”. “Why am I not getting better”? She feels this over relatively minor ailments, and she goes from doctor to doctor trying to solve the problem; when she sees that no-one can help, then she falls into a despair of recovery. The Arsenicum despair of recovery arises from a tremendous fear of death. In Alumina, however, the despair is very deep, and it is real. She is very sick! The mental plane is confused, she is losing her identity. This can be an early symptomatology of schizophrenia.
It is important to remember that this progression from slowness of mind, to confusion, to loss of identity and despair of recovery, occurs very slowly and eventually the nervous system demonstrates degeneration as well. This is a process seen in broken down constitutions – whether by age or by frequent diseases; it is commonly prescribed in senile patients.
Next we consider the emotional plane. Alumina has a great sense of being hurried inside. Kent stresses this symptom greatly in his Materia Medica, yet Alumina is listed only in ordinary type in the Repertory. What Kent means to say, then, is that this is a sense that the patient cannot do things fast enough; she feels there is such a DELAYED ACTION in functioning that everything happening in the external world seems to move too slowly. This is the basis for the symptoms : “Times passes too slowly”. Even though an external observer would see the Alumina patient as being very slow, she feels inside that time is passing too slowly. A half an hour seems to be a whole day.
As the emotional pathology progresses, this sense of being hurried leads to apprehension that she won’t be able to finish everything in time. She tries her best, but she is so slow that she cannot actually finish, and this causes her to be apprehensive. At the very extreme of this state, she suffers from a pervasive fear that something bad will happen – an accident, a misfortune.
This process eventually progresses into depression, with suicidal impulses. Alumina has suicidal impulses upon viewing a knife, or seeing blood. Platina, Arsenicum and Mercury are other remedies having a similar symptom, but they mostly have the impulse to kill others. Alumina has the impulse to kill himself or herself. The Alumina depression can best be described as a “gloominess”. There is no light. She complains to the doctor, but in a nonburdensome way. She does not wail and moan and cling to the prescriber. She merely reports her symptoms in a heavy but nonnagging manner. She has the appearance of being RESIGNED to her condition. It has come on over such a long time and so insidiously that she has resigned herself to her condition.
This resignation, coupled with the vagueness and slowness of mind, sometimes gives the patient the appearance of merely “going through the motions”. You may observe her a bit and come to the conclusion that she has not really come of her own motivation. She seems to be feeling, “Why did I come here after all”? But then she opens up a bit and begins working with you. The theme of DELAYED ACTION pervades the physical plane thoroughly. There is a slowing of function at first; this progresses to weakness of muscles, and eventually to a kind of paralysis.
The weakness in Alumina applies peripherally. Just as we see when the patient is struggling so hard to express herself but simply cannot find the right word, she wills herself to function on the plane, but the response is delayed. the characteristic Alumina constipation is the prime example. Here is Kent’s description : “Now, so great is the straining to pass a soft stool that you will sometimes hear a patient describe the state as follows : When sitting upon the seat she must wait a long time, though there is fullness and she has gone many days without stool; she has the consciousness that she should pass a stool and is conscious of the fullness in the rectum, yet she will sit a long time and finally will undertake to help herself by pressing down violently with the abdominal muscles, straining vigorously, yet conscious that very little effort is made by the rectum itself. She will continue to strain, covered with copious sweat, hanging on to the seat, if there be any place to hang on to, and will pull and work as if in labour, and at last is able to expel a soft stool, yet with the sensation that more stool remains”.
The same thing is seen in the bladder. It takes a long time to get the urine started. In the oesophagus, there is the sensation that food is stuck, that it cannot go down.
The paresis which characterizes Alumina is focused primarily in the legs. The concept of the Alumina loss of identity applies even in this area. The extremities seem to go their own way; they cannot be controlled no matter how hard the patient tries. Thus, we see locomotor ataxia – a clumsy, aimless wobbling of the legs. The same is true of the bladder and rectum – loss of control.
Often a sensation of numbness affects the part before the onset of the weakness. In particular, there is numbness of the soles of the feet. This typifies the delayed conduction of nerve impulses from the periphery to the brain. As with Cocculus, Alumina displays delayed reflexes upon being pricked with a pin.
There is in Alumina a peculiar kind of vertigo which is frequently observed in neurological cases – vertigo upon closing the eyes. Upon closing the eyes, a patient who is standing will tend to fall over. This again is undoubtedly due to the fact that sensory stimuli from the periphery take too long to provide reliable information to maintain proper balance.
In this way, it is possible to study each system of Alumina and virtually predict what symptoms are seen in the provings. Once the essential themes are understood, the rest falls into place. For example, what kinds of symptoms might be expected in the sexual sphere? There is weakness and loss of control in Alumina, hence the sexual sphere displays diminished desire and, in the male, incomplete or absent erection when there is desire. The genitals are relaxed.
Alumina is known to be one of the main remedies for recurrent colds. How can we explain this? Undoubtedly, it is a relative paralysis of the nerves supplying the mucous membranes. This results in inadequate circulation, or sluggish response of the circulation, along with dryness of the membranes. Since the usual mechanisms whereby the defence mechanism protects against colds have been compromised, the patient becomes susceptible to colds. Basically, this weakness in reactive power is also the basis for pathology in other remedies having colds. Tuberculinum, Sulphur, Graphites, Silica, Mercury.
Some other characteristic physical symptoms : dimness of vision, probably due to weakness of eye muscles. The skin is extremely dry. There is itching without eruption. There are dry crusts on the skin eruptions, dry thick crusts in the nose, and dry granular crusts in the throat. There are catarrhal discharges from all membranes; nasal, urethral, vagina and easy suppression of discharge which then become recurrent. (There may be one-sided paralysis – usually on the right side).
Alumina has a definite time aggravation in the morning. She may then gradually improve during the day, or she may remain low all day. However, there is then a marked amelioration in the evening, once the sun has gone down (Medorrhinum, Lycopodium). Another striking characteristic in Alumina is aggravation from potatoes. There may also be intolerance to other starchy foods, wine, pepper and salt.
The idea of SLOWNESS PROGRESSING INTO PARALYSIS typifies the kind of response which can be expected once alumina is administered. To be certain of the response it is necessary to wait quite a long time with this remedy. This is especially true when there are organic changes involved. It takes a long time to cure the results of disease, just as it took a long time to develop.