Lolium temulentum

A European grass (Gramineæ/Poaceæ) whose seeds, when ergotised or otherwise tainted, have long been known to produce “temulence”—a drunken, ataxic intoxication with giddiness, staggering, visual confusion and tremors; older medical writers attributed this to intrinsic narcotic principles and/or contaminating fungi [Hughes], [Clarke]. The homœopathic tincture is prepared from the ripe seeds; triturations are also used [Allen], [Clarke]. The toxic picture furnishes the pathogenesis: cerebellar vertigo, staggering gait, diplopia, dilated pupils, numbness and formication, gastric irritability with vomiting and diarrhœa, and sudden prostration, often worse from motion and light, better at rest—a likeness repeatedly observed in provings and poisonings collated by Allen, Hering and Clarke [Allen], [Hering], [Clarke], [Boericke].

Primary data arise from [Toxicology]—accidents after eating contaminated meal—and smaller provings and clinical notes in the American school. Constant features: staggering as if drunk, vertigo with oscillation of objects, double vision, dilated pupils, numbness/tingling of limbs, tremulous weakness, nausea with vomiting, purging, and collapse; worse motion, worse turning the head, worse bright light and reading, better lying still [Allen], [Hering], [Clarke], [Boericke], [Boger]. Early [Clinical] verifications include vertiginous ataxia, functional amblyopia/diplopia, choleraic diarrhœa with cramps, and post-alcoholic temulence [Clarke], [Hughes], [Farrington].

Lolium temulentum is the darnel-drunken picture: the world rolls and wavers; steps miss; the patient must clutch something to avoid falling. The eyes betray him—diplopia, blur, mydriasis—and the stomach mutinies with nausea, retching, and often watery stools. Heat, light and effort overset him; motion is the enemy: turning the head, stooping, attempting to walk, even closing the eyes while upright—all augment the unsteadiness. He is best lying quite still in a darkened room, with cool air to the face; after vomiting he gains a short truce. This is the cerebellar–vestibular stamp, a kinetic disarray echoed in the hands that tremble, knees that fail, and calf cramps that dart with effort. The mental state is bewildered and heavy, not angry or fearful; the tongue tastes foul, the mouth is pasty, and the pulse soft and compressible during storms. Compare Gelsemium when drowsy droop and soft pulse dominate; Agaricus where ataxia is friskier and twitching; Cocculus for seasick nausea without the oscillating visual field; and Nux-vomica when the temper, not the sensorium, is the louder note. In gastric–choleraic rushes, Veratrum outstrips it in collapse and cramp, and Arsenicum in anxiety and burning; Lol. remains chosen when temulent gait and diplopia are the reliable concomitants of the purge.

The pace is paroxysmal; the aetiology often includes spoiled grain, alcoholic excess, reading strain, travel on water, or damp cold. Prescribing pivots on three pillars: (1) Ataxic vertigo “as if drunk” with oscillation of objects; (2) Ocular paresis—diplopia, dilated pupils, reading impossible; and (3) Gastric–intestinal irritability—nausea/vomiting, watery diarrhœa, prostration—all worse by motion and light, better by rest, dark, cool air, and after vomiting. Recovery is tangible: the room steadies, the eyes hold the line of print, the hands write without tremor, the bowels quieten; the patient rises without clutching and can cross a room unaided.

• Cerebellum and vestibular apparatus—ataxic gait, staggering, vertigo “as if drunk,” objects seen to oscillate; the keynote of the remedy (see Head/Eyes/Generalities) [Clarke], [Allen], [Boericke].
• Ocular motor system & optic nerve—diplopia, blur, mydriasis, wavering focus; reading aggravates (see Eyes) [Allen], [Clarke].
• Peripheral nerves & cord—formication, numbness, shooting pains; tremulous weakness, tendency to paresis (see Extremities/Skin) [Hering], [Boger].
• Gastric–intestinal mucosa—nausea, vomiting, watery diarrhœa with cramps and prostration; choleraic facsimile (see Stomach/Rectum) [Allen], [Clarke], [Boericke].
• Cortex–sensorium—confusion, difficulty coordinating speech and movement, dull heavy head (see Mind/Head) [Clarke], [Hughes].
• Cranial nerves—glossopharyngeal/laryngeal reflex—choking or tightness in throat on swallowing; voice uncertain (see Throat) [Allen].
• Vascular/autonomic tone—pallor, cold sweat, weak pulse during gastric–nervous storms (see Fever/Generalities) [Clarke], [Boger].
• Muscles—cramps (especially calves), twitchings; exertion increases tremor (see Extremities) [Allen], [Boericke].
• Renal/urinary—secondary oliguria in collapse states; irritability without fixed lesion (see Urinary) [Clarke].

Confusion with bewildered heaviness of intellect, as if the room moved and thoughts slid away; answers are slow, speech uncertain, and the patient dreads movement lest the giddiness return—which tallies with the better-for rest and dark already noted [Clarke], [Allen]. There is an anxious sense of insecurity in space: fear of falling, clutching objects, aversion to crowds or crossing open places (Mind ↔ Generalities/Head). Irritable from nausea and the blur of vision; yet after vomiting he becomes quieter and even sleepy for a short interval. Memory seems treacherous during attacks; he misplaces words as eyes and head oscillate together. The temper is not violent, as in Nux-v.; it is the dull confusion of intoxication and temulentia. Fright or sudden noise exaggerates tremor and choking (Mind ↔ Throat/Extremities) [Hering]. With improvement the mind clears as steadiness returns.

Drowsy after fits of vertigo and vomiting; sleep unrefreshing; on waking, dulness and return of giddiness if he rises quickly (Sleep ↔ Head). Dreams confused, of falling or losing the way.

Of staggering, missing steps, falling from height; awaken with a start and swimming head. Terrifying dreams after heavy supper or alcohol.

Lolium temulentum centres on temulentia—a drunken ataxia with vertigo, staggering, diplopia/mydriasis, formication–numbness, gastric irritability (nausea, vomiting), and watery diarrhœa with prostration—worse every motion or head-turning, worse bright light and reading, worse alcohol, cold drinks, exertion, better lying perfectly still in a darkened room, better after vomiting and from cool air to the face [Allen], [Clarke], [Boericke], [Boger]. It sits between Gelsemium (heaviness, diplopia, drowsy weakness) and Agaricus (ataxia like drunkenness with twitchings); Lol. adds marked gastric irritability and positional vertigo with oscillation of objects. In choleraic facsimiles compare Veratrum (cold sweat, collapse, violent cramps) and Arsenicum (burning, restlessness); Lol. has more cerebellar signs and less burning anxiety. The direction of cure is from rolling instability to steadiness, from blur/diplopia to single focus, and from watery stools with collapse to quiet stomach and firm step; the power to rise without clutching signals recovery.

Little true fever; rather chilliness with cold sweat during gastric–nervous storms; later slight heat of face; pulse soft and fast [Clarke], [Boger].

Chill with trembling, then transient heat, ending in sweat; heat of room aggravates; cool air face relieves (Chill/Heat/Sweat ↔ Modalities).

Giddiness with a sense of rolling and pitching, as on a ship; worse motion, worse turning the head, worse closing the eyes when standing, and better lying still—the cerebellar signature [Allen], [Clarke]. Dull, heavy ache in occiput and vertex; band-like pressure as if the scalp were tight. The room oscillates; on attempting to walk the patient staggers and must seize support. Nausea accompanies the vertigo; cold applications soothe the brow. The headache is not throbbing but stupid, heavy, as if from bad beer—temulent. Heat of room and reading aggravate. After vomiting or a short sleep, the head is briefly clearer (Head ↔ Stomach/Sleep).

A leading sphere: diplopia; objects waver or seem double; pupils dilated, vision blurred, letters run together on attempting to read [Allen], [Clarke], [Boericke]. Focusing is painful; the eyes ache and feel weakened as if the muscles would not coordinate (ocular ataxia). Bright light aggravates; the dark room comforts (echoing modalities). In walking, walls sway; on closing one eye the picture steadies somewhat, but general unsteadiness persists (Eyes ↔ Head/Generalities). Functional amblyopia in drinkers or after strain has been noted [Clarke]. Lachrymation slight; it is coordination, not inflammation, that defines Lol.

Roaring or rushing noises in vertiginous fits; ear fulness with staggering; turning quickly aggravates. Seasick feeling on boat or train; a vestibular quality links to the cerebellar theme (Ears ↔ Head/Generalities) [Clarke].

No decided coryza; tip cold during gastric faintness. Smell perverted or dull with temulent heaviness; odours nauseate.

Pale, sometimes dusky during gastric–nervous storms; lips tremulous; expression bewildered and anxious (Face ↔ Mind). Sweat beads on forehead with nausea, relieved by air.

Thickly coated tongue, pastelike mouth, bad taste—beerish or nauseous; salivation not marked [Allen], [Clarke]. Speech uncertain; words slur when the eyes blur and head swims (Mouth ↔ Mind/Eyes). After vomiting, taste cleaner for a little.

No constant dental pathology; gnashing or jaw trembling in violent vertigo is occasionally noted.

Sensation of constriction or choking on swallowing; the act of drinking may start a fit of giddiness with retching—this tallies with the worse after cold drinks [Allen], [Clarke]. Tight collar intolerable; voice lacks steadiness.

Oppression as if the chest worked irregularly with the head; sighing during nausea; palpitations from weakness (Chest ↔ Heart/Generalities). No constant cough; voice uncertain like the gait.

Pulse soft, compressible, sometimes rapid and feeble in gastric–nervous storms; palpitations on exertion or fright [Clarke], [Boger]. A faint, sinking sensation accompanies diarrhœa or vomiting. Heat of room aggravates; cool air to face relieves faintness (Heart ↔ Fever/Modalities).

Breathing shallow with giddy nausea; fear to move lest suffocation and vomiting ensue. Fresh air eases; stuffy rooms increase faintness (Respiration ↔ Generalities).

Nausea with retching and vomiting, often of watery or bilious matter; emptiness with sinking at epigastrium; worse after eating, worse cold drinks, better after vomiting (Stomach ↔ Modalities) [Allen], [Clarke]. Appetite variable; craving for bland, warm sips. The stomach rebels at motion; the least attempt to walk sends the head round and the stomach up. Pressure of hand over epigastrium relieves retching for a moment.

Griping about the navel with borborygmi; colicky pains precede stool. Abdomen sensitive to jarring; in some, a sense of coldness within (Abdomen ↔ Rectum/Chill) [Allen]. Gas passes noisily after attacks.

Diarrhoea watery and sometimes profuse, with cramps and prostration; stools may be pale or bilious; the onrush resembles a choleraic effort in miniature [Allen], [Clarke], [Boericke]. Tenesmus slight; the urgency is from weakness and intestinal hurry. After stool the patient feels faint, knees tremble, and giddiness increases on rising (Rectum ↔ Generalities). In other cases, constipation alternates with loose days in nervous persons.

Urine scanty during collapse; later increased and pale. Frequent urging with tremulous weakness; no constant burning. In dizzy states, dribbling from poor control may occur [Clarke].

Aversion to alcohol; cold drinks aggravate; desires bland warm sips (broths) [Clarke]. Rich foods and coffee provoke nausea and blur.

Sexual sphere not primary; transient impotence of fatigue in chronic drinkers; emissions in students exhausted by vertiginous headaches. Improvement parallels nervous steadiness.

Nervous vertigo around menses; visual blur and nausea; better lying quiet in dark. Diarrhœa at menses has been noted in sensitive women [Clarke].

Dorsal weakness; must lean back or lie; cervical muscles tire holding the swaying head; lumbar aching after diarrhœa (Back ↔ Rectum/Generalities).

Staggering gait, knees knock, hands tremble; fine work impossible (Extremities ↔ Head/Eyes) [Allen], [Boericke]. Formication in hands and feet; numbness of fingers; cramps of calves, especially at night or with diarrhœa. Great prostration, worse on rising; must sit to prevent falling. Warmth to limbs comforts.

Creeping, crawling, pins and needles; cold, clammy sweat in gastric attacks [Hering], [Allen]. Flushes alternate with pallor; no fixed eruption.

Aetiology—Drunken/temulent states & post-alcohol

• Nux-v.: irritable, gastric over-stimulation, hyperæsthesia; less diplopia/ataxia; more staggering with ocular incoordination. [Kent], [Clarke].
• Gelsemium: heavy-eyelid diplopia with drowsiness; soft pulse; adds oscillopsia, seasick vertigo, worse closing eyes standing. [Farrington], [Clarke].
• Agaricus: reeling as if drunk with twitchings; more choreic playfulness; more gastric and light-aggravated diplopia. [Hughes], [Boericke].

Vertigo/ataxia (cerebellar–vestibular)

• Cocculus: motion-sickness, emptiness, nausea, worse loss of sleep; fewer ocular diplopia signs; has double vision and mydriasis. [Clarke].
• Tabacum: deathly nausea, cold sweat, prostration; less diplopia; oscillatory vision and ataxic gait prevail. [Farrington].
• Bryonia: vertigo worse motion with dryness; but eyes steady, prefers pressure; adds diplopia and seasick roll. [Kent].

Ocular—Diplopia/amblyopia

• Nux-mosch.: dreamy blur, dryness; not the stagger; Ataxic with oscillopsia. [Clarke].
• Belladonna: hot red face, throbbing, photophobia, mydriasis; pale, cold-sweating, gastric. [Hughes].

Gastro-intestinal—Choleraic purge

• Verat-alb.: violent cramps, icy coldness, collapse; less extreme, more vestibular signs. [Clarke], [Boericke].
• Arsenicum: burning pains, restlessness, great anxiety; dull confusion, ataxia, better after vomiting. [Hering].
• Ipecac: persistent nausea, clean tongue; little vertigo/ataxia; Lol. starred by staggering and diplopia. [Farrington].

Tremor/paresthesia

• Zinc.: fidgety feet, spinal atony; Lol. More acute temulent picture. [Boger].
• Phos-ac.: paretic weakness after losses; without seasick oscillation; Lol. is motion-provoked. [Kent].

• Complementary: Gelsemium—shares ocular paresis and weakness; Gels. in drooping drowsy states; Lol. when oscillation and seasick vertigo dominate. [Farrington], [Clarke].
• Complementary: Cocculus—for motion-sickness residua when diplopia/ataxia remain to be removed by Lol. [Clarke].
• Follows well: Nux-v.—after gastric excess (alcohol, coffee) when a temulent, ataxic stage persists. [Kent], [Clarke].
• Follows well: Ipecac.—if stubborn nausea yields but diplopia with staggering remains. [Farrington].
• Precedes well: Verat-alb.—if diarrhœa collapses towards icy sweat and violent cramps. [Boericke].
• Related (compare): Agar., Gels., Coccul., Nux-v., Bell., Tab., Bry.—see differentials.
• Antidotes (states): Coffee and stimulants often aggravate; Nux-v. is the medicinal antidote in gastric–nervous over-excitations; quiet, dark, fresh air antidote the environment. [Clarke], [Kent].
• Inimicals: None recorded in the classics; avoid alternation without fresh totality. [Kent], [Boger].

• Vertigo with ataxic gait and diplopia—post-alcoholic or vestibular; Lol. 3X–30C every 2–4 hours initially, then lengthen as steadiness returns [Clarke], [Boericke].
• Motion-sickness with oscillopsia (rolling horizon, double images), worse head-turning, better lying still in dark—prefer Lol. over Cocculus when diplopia is present [Clarke], [Farrington].
• Choleraic diarrhœa with cramps and temulent giddiness—use Lol. when neurological signs accompany the purge; escalate to Verat-alb. if icy collapse appears [Allen], [Boericke].
• Functional amblyopia in drinkers/readers—letters run together, pupils dilate; regimen (abstinence, dark rest) + Lol. often restores steadiness [Clarke], [Hughes].

Mind
• Confusion of mind with giddiness—cannot think when room rolls; choose when temulent head predominates. [Clarke], [Allen].
• Anxiety from sense of insecurity in space—fears falling, clutches furniture. [Clarke].
• Slowness of speech from incoordination; words slur during vertigo. [Allen].
• Irritability from nausea and light; seeks the dark. [Clarke].
• Startled by noise → trembling—noise renews fit. [Hering].
• Better quiet company; reassurance steadies. [Hering].

Head
• Vertigo—worse motion, turning head; better lying still—cardinal. [Allen], [Clarke].
• Vertigo—worse closing eyes while standing—cerebellar sign. [Allen].
• Sensation as if on a ship; everything rolls—seasick rubric. [Clarke].
• Headache, dull, heavy, stupefying—temulent. [Clarke].
• Band-like pressure about head—tight scalp feeling. [Allen].
• Cold applications to head ameliorate—practical bedside note. [Clarke].

Eyes
• Diplopia—letters run together; cannot read. Signature rubric. [Allen], [Boericke].
• Vision oscillates; objects waver—oscillopsia. [Clarke].
• Pupils dilated (mydriasis) with vertigo. [Allen].
• Photophobia; bright light aggravates—seeks dark. [Allen].
• Amblyopia functional in drinkers—letters blur; steadies with rest. [Clarke].
• Eye-muscle incoordination—ocular ataxia. [Clarke].

Stomach / Abdomen / Rectum
• Nausea and vomiting, better after vomiting—short truce. [Allen].
• Vomiting from motion—seasick stomach. [Clarke].
• Diarrhœa watery with cramps and prostration—choleraic facsimile. [Allen], [Boericke].
• Worse after eating; worse cold drinks—gastric modalities. [Clarke].
• Cramp in calves with diarrhœa—concomitant. [Allen].
• Faintness after stool; knees tremble—post-stool collapse. [Allen].

Extremities / Neurology
• Gait staggering; must clutch—cannot walk straight. [Allen], [Clarke].
• Trembling of hands—fine work impossible. [Boericke].
• Formication of hands and feet—pins and needles. [Hering].
• Numbness of fingers—paretic trend. [Hering].
• Cramps in calves, especially at night. [Allen].
• Weakness on exertion; stairs impossible—knees fail. [Boericke].

Generalities / Modalities
• Worse—motion of any kind; better—rest, lying in dark—master modality set. [Allen], [Clarke].
• Worse—bright light, reading—ocular strain rubric. [Allen].
• Worse—alcohol; worse—coffee (in sensitive). [Clarke].
• Worse—damp cold, fog—weather aggravation. [Boger].
• Better—cool air to face—practical aid. [Clarke].
• Heat of room aggravates; sweat with faintness—autonomic sign. [Clarke].

Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–1879): toxicology/proving—vertigo as if drunk, diplopia, gastric irritability, modalities.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879–1891): clinical confirmations—staggering gait, formication, cramps, choleraic diarrhœa.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): full remedy portrait—temulent intoxication, ocular and vestibular signs, regimen and comparisons.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—diplopia, staggering, nausea, watery stool; relationships.
Hughes, R. — A Manual of Pharmacodynamics (late 19th c.): historical toxicology of darnel; nervous and gastric effects; therapeutic analogies.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): generalities—weather, motion, autonomic features; remedy comparisons.
Farrington, E. A. — Clinical Materia Medica (1890): vertigo/ocular differentials—Gels., Coccul., Tab.; gastric–neurologic links.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): comparisons—Nux-v., Bry., Agar.; selection by modalities and sensorium.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): practical hints—post-alcoholic states, vertigo management.
Dewey, W. A. — Practical Homœopathic Therapeutics (early 20th c.): motion-sickness and choleraic diarrhœa; sequencing.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (20th c.): condensed keynotes—tremor, ataxia, gastric aggravations.
Tyler, M. L. — Homœopathic Drug Pictures (20th c.): vignettes—temulent patients, ocular strain, environment management.