dorsal region, the scapula, the shoulder, the upper right arm, in the thigh or knees, etc. When stooping, there may be a feeling as if the brain would fall forward, with a sensation of bubbling, as if all would prolapse from the forehead.
The third important characteristic in this remedy is the wandering nature of pain in the nerves and nerve sheaths. Little twinges are felt one moment in one place and the next moment in another.
Kent gives his own experience of this symptom:
‘As you sit by the side and talk to a gouty patient – “Ow, ” he will say. What does he mean by it? He has had one of those twitching pains. The next thing he knows it is in his knee; then it is in his toes; then it is in his head, all over him. In Berberis these twinging, tearing, stitching, burning pains are everywhere, they never remain in one place, but are always moving, and they are not often affected by motion. Whether he moves, or keeps still, they keep coming. In a few instances we have pains aggravated by motion, but a very few in proportion to the many pains in Berberis.
Further characteristics to be found in this remedy include the sensation of a skullcap. The patient has the feeling that his whole scalp is tight, or that he is wearing a hat. This is a rheumatic condition that can be felt in a number of ways; it may be experienced as numbness, enlargement of the skull, or a painful constriction of the whole of the skull. The patient may alternatively have, ‘a feeling in the head as if it were becoming larger’, or a peculiar puffy sensation in the head.
Another symptom to be considered for Berberis vulgaris is the extension of any pain from the abdominal area to the thighs.
Finally, mention should be made of the aggravation of mental symptoms at twilight, with apparitions and visions of imaginary forms.