Spigelia Anthelmia

[PINK-EOOT. NATUEAL OEDEE, LOGANIACEiE. ]

A native of the West Indies and South America. It was first in- troduced as a drug by Dr. Browne in 1751. It is known in the books as the Demerara pink-root. Its action is similar to the spigelia mari-

796 SPIGELIA ANTHELMIA.

landica or Caroline pink-root. In collating the symptoms of spigelia Hahnemann uses indiscriminately both varieties.

Spigelia acts upon the nerves of special sense and of animal life, without producing a marked effect upon the nervous centers them- selves or causing a well-defined inflammatory condition of the organs of special sense ; the organ of vision forms an exception, for spigelia causes well-marked inflammatory symptoms in the eye. Pink-root affects also the fibrous tissues of the heart and of the smaller ex- tremities. In poisonous doses the mariland pink-root operates as a cerebro-spinal or narcotic agent, giving rise to vertigo, dimness of vision, dilated pupils, spasms of the facial muscles, and sometimes even to general convulsions. Spasmodic movements of the eyelids have been observed among its most common effects.

CEPHALIC GROUP.

Spigelia has the following: Vertigo, when sitting, standing, walking — it is felt least in a recumbent posture ; his head inclines backward, with a sensation of nausea in the region of the palate, and a feeling of malaise in the abdomen and in the chest ; in the former he experiences a pinching pain, with a sensation as if he must go to stool, during which he loses his senses. A fine, digging, tearing pain in the brain, particularly violent in the left parietal bone, very much aggravated by motion, by walking, by a jar, toward evening.

Digging and digging-tearing pain in the occiput, in the left parietal bone, and in the forehead, with aggravations from sim- ilar causes and from opening the mouth to speak. Dullness of the head ; pressive pain, from within outward, in the forehead. Burst- ing headache, relieved by pressure. Heaviness in the head, pressure from without inward, worse from stooping, unless the forehead is supported by the hand.

Swashing sensation in the brain, accom- panied by tearing, digging, circumscribed pain ; generally semilateral with a preference for the left side. These symptoms justify the use of spigelia in

NERVOUS HEADACHES, generally semilateral, with dullness of the head, vertigo, depression of spirits, and corresponding with the symptoms given. Redness and irritation of the eyes are fre- quently present. •

A man, twenty-five years old, of sanguine-bilious temperament, of strong constitu- tion, had an attack of headache three years ago, which was repeated two years ago and again this year. Symptoms: Continuous violent pain, at times jerking and lacerating (ssegend) as if fine instruments were lacerating the nerves; this attack is located in the right forehead and temple, but affects also the right eye and the

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superior maxillary. The right eye is quite inflamed ; there is considerable lachryma- tion, and a feeling as if the eye were being forced out of its socket, with sensitiveness to light. Burning heat in the affected parts and in the face. The temporal arteries are full, pulsate strongly.

There is coryza, restless sleep. Belladonna and others did no good. The pain became perfectly excrutiating and communicated itself to the teeth. Prescribed spigelia80.

After half an hour, violent perspiration, which continued through the night ; he found himself well in the morning. (Romig in Correspondenzblatt, No. 6.)

Spigelia causes fine, stinging pains within, and along, the tracks of various nerves, twitching in the shoulder-joints, crampy pains in the balls of the thumbs, twitching and tearing pains in the thigh, run- ning into the lower leg ; heaviness and stiffness of the legs. Great sensitiveness of the parts to touch. The pains are aggravated by motion, and in the afternoon and evening ; worse also during damp weather. There is no periodicity in the pains.

NEURALGIA, presenting such a group of symptoms, comes

within the curative range of this drug.

M. L., aged thirty years, has suffered greatly during the past two years from fre- quent attacks of neuralgia which, at first of short duration and comparatively slight, have steadily increased in severity and now last as long as three days. The attacks are always preceded by a roaring in the left ear as ol a great wind. The severest pain is in the left upper arm.

Sometimes preceding, and sometimes accompanying, the pain in the arm, is a pain in the left chest, in the cardiac region, which describes a semicircle corresponding to the border of the right half of the left mamma, and con- tinuing from the upper part of the mamma, in a direct line to the front of the left shoulder; it is there continuous with the pain in the arm. The pain about the heart is sometimes attended with a constrictive sensation. The pain in the arm commences above the left elbow, in front, apparently in the bone, and runs in a line up the anterior part of the arm, and in front of the shoulder joint, ascending in a direct line to the mastoid portion of the temporal bone.

A streak of pain dips into the left ear. Of lat.e, the pain has gone around the left side of the occiput, and has reached the crown of the head. There is obscuration of vision, especially in the left eye during the paroxysms ; the pain increases and diminishes without apparent irregularity. The left upper arm, shoulder and left side of the neck feel as if a great heat were radiating upon them, which are superficially so sensitive that the slightest covering increases the suffering.

When the pain is greatest the head is repeatedly jerked to the left side. When she attempts to raise her arm, it seems to be drawn down to her side. During the pain there is much sweating, which does not relieve. The hands and feet are always very cold.

She is worse at night ; the pain prevents sleep. Has had severe attacks both in wet and in dry weather, and during all seasons, but the pains have been worse during an approaching thunder-storm — rather easier after the rain has begun to fall. At the menstrual periods the attacks are aggravated apparently from increase of the pain about the heart, but the suffering has not been peculiar to this period. She is worse when sitting up ; from application of cold water and from the heat of a fire.

There is no amelioration from warm water. She cannot, of course, lie on the painful side. Her menses have been somewhat premature and profuse. Her digestion is not good; she drinks much water at a meal; unless she does this, she has continued hiccough until the food is thrown up.

She received spigelia, which broke np the neuralgic pains and improved her general health. She had left some rheumatic pains in the right shoulder and arm. (Dr. Hamilton Ring in Ohio Med. and Surg.

Reporter, March, 1868.)

OEBITAL GROUP.

Spigelia has developed eye symptoms which recommend it as a useful agent in various inflammatory conditions of this organ. We

798 SPIGELIA ANTHELMIA.

Bote : Pain of the eyeballs during motion, as if too large. Intoler- able pressure in both eyes, worse when turning them. Inflamma- tion of the margins of the lids, with ulceration and smarting soreness. Inflammation of the sclerotica, with turgescence of the vessels, also with heaviness of the lids and inability to open them.

Burning in both eyes, obliging one to close them, attended with an apprehension that he will not be able to open them again, followed by an appear- ance of blood-red fire before the eyes which obstructs the sight ; the sight returns after a profuse flow of tears and considerable dilatation of the pupils. The eyes look dim and faint. The upper lids hang down as if paralyzed. Dilatation of the pupils, even from the smallest dose.

Vanishing of sight, when looking at anything. In- distinctness of sight as if the eyes were full of water, or as if a mist were before the eyes, or as if little hairs were hanging from the eye- lashes. Scintillations. Passing amaurosis.

These symptoms render spigelia of possible value in amaurotic and amblyopic conditions, more particularly in the case of rheu- matic and arthritic individuals ; also, in

BLEPHAEOPHTHALMIA SOKOFULOSA, when existing alone or as a symptom of some general scrofulous or arthritic irritation of the eyes ; also in iritis and in accommodative asthenopia, with ansemia of the optic nerve from excessive tea drinking. (Lilienthal.)

In all these conditions keen, sharp, sticking, stabbing pains are prominent symptoms; these pains run from the eyeball into the head, radiate, following the course of various nerves, and cause at times excrutiating suffering. There is redness of the eye ; profuse lachrymation ; pressure upon the eyeball as if it would start from its socket ; the ball feels too large ; exquisite sensitiveness to motion. Feeling as if feathers were lying on the eyelashes. Aggravations from motion and touch.

A girl of eight years was nearly blind on the left eye and had strabismus conver- gens on the same side. Examination revealed nothing, but some dilatation of the pupil, with lessened mobility (?), but she was greatly troubled with worms. Spigelia cured every symptom in two months. (Clotar Mueller in Horn. Vierteljahrs, vol. x., 3.)

FACIAL GROUP.

Spigelia acts more or less characteristically upon the nerves which are distributed over the cheeks and dorsum of the nose. It causes, for instance, a titillating sensation on the dorsum of the nose, or as if a light current of air were passing over it ; this sensation was felt for a long while. Pale, disfigured face, with yellow margins around

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the eyes ; the face looked swollen on rising in the morning. Pressure in the malar hones. Jerking-tearing, or tearing, with pressure, in the malar hones, particularly in the right one. Burning in the malar bones, particularly the right one. Sticking or drawing- sticking in the cheek, also extending from the jaw to the vertex.

PEOSOPALGIA. — Hence we infer that spigelia must be useful in prosopalgia, where these peculiar pains constitute pathognomonic indications. v

.A woman of thirty-two years of age, of icteric color, emaciated, with an expression of great suffering, had been tormented since her sixteenth year with this neuralgia, which was sometimes diminished for a few weeks, absent for several days, and then raging with full force for several months at a time. The patient had become per- fectly desperate and had often contemplated suicide. She had been married for six years and is the mother of two healthy children. Of late years the pain commenced in the morning, soon after rising, and reached its height in four or five hours.

After some diminution there was another exacerbation toward evening, which lasted one or two hours, or nearly all night, and was followed by profound sleep. The pain commenced at the parotid, and gradually extended over all the branches of the facial nerve with increasing violence. During the absence of the paroxysm the patient was attacked by a peculiar asthma, with oppression, anxiety and violent palpitation. Of late years the patient's memory was seriously affected ; she was unable to conduct her household affairs and was much occupied with thoughts of self-destruction.

Spigelia was ordered, ten drops of the 6th decimal dilution, in one ounce of water, half a teaspoonful every half hour ; to begin in the morning with the attack. During that and the six days following the paroxysms were very light, and in six weeks they had disappeared entirely with the other morbid symptoms. During this time the writer used the 6th and 12th dilution and finished the cure in the 3d. (Dr.

Gross in Allg. Hotn. Zeitg., March, 1859. Trans, by Dr.

Hoffendahl in the N. A. Jour, of Horn., May, 186 1.

DENTAL GROUP.

TOOTHACHE. — The action of spigelia upon the jaws and teeth shows that it may prove useful in some cases of toothache, especially when decayed teeth are affected with painful jerks and the pain is aggravated by cold water or by the contact of cold air ; or it may be given for pressing pain in the teeth from within outward, most violent when lying on the right side, intermitting while eating and drinking, but commencing again immediately after, and frequently waking one at night.

CHYLO-POIETIC GEOUP.

Spigelia causes a flatulent distention of the abdomen, followed and relieved by loose stool ; the stool is mingled with a yellowish mucus, and may occur several times a day. The provers have experienced a crawling and itching sensation at the anus and rectum as from ascarides ; nausea, waterbrash, abnormal changes of taste and appetite, and thirst, are likewise present. One pvover (Stapf) reports : "On waking in the morning, his mouth feels exceedingly

800 SPIGELIA ANTHELMIA.

dry ; it seemed as if the mouth were full of pins, and as if glued together, although full of saliva, and without thirst." Pinching pains in the bowels are very common effect of spigelia.

ASCARIDES. — These symptoms have confirmed homoeopathic practitioners in the use of spigelia for ascarides ; it is likewise used for lumbrici. In the United States Dispensatory it stands at the head of anthelmintics. Alloeopathic physicians give the powdered root in doses of from ten to twenty grains to children three or four years old, and from one to three drachms to adults. This dose is repeated morning and evening for several days, and then followed by a brisk cathartic. It is often combined with calomel.

URINARY GKOUP.

All the provers of spigelia report an increased secretion of urine. Hahnemann himself reports the following characteristic symptoms : Ten emissions of urine in one night, attended with a painful pressure on the bladder which passed off as soon as the urine had been voided. Another symptom, reported by Hahnemann, reads : In the afternoon, on rising from his seat, there occurs a sudden and involuntary dribbling of five or six drops of urine ; this takes place four times in succession ; each dribbling is succeeded by a burning in the anterior portion of the urethra.

NOCTURNAL ENURESIS.— It is doubtful whether these irri- tations of the mucous lining of the bladder and urethra occur independently of similar irritations of the intestinal lining mem- brane. They might indicate spigelia in the nocturnal enuresis to which children afflicted with worms are so often subject. In

CATARRHAL DISCHARGES from the urethra, resulting sym- pathetically in consequence of intestinal irritations, spigelia may likewise be required. These symptoms may possibly occur in con- sequence of an inherent weakness of the parts, represented patho- logically and anatomically by venous engorgements.

THORACIC GROUP.

Spigelia has a marked action upon the chest. It causes a violent pressure on the chest below the left clavicle, and a sense of constric- tion in the muscles of the chest accompanied with a feeling of anguish. Also, a tearing sensation with constriction in the lower part of the chest ; afterward, this pain shifts to the upper part of the chest, accompanied with palpitation of the heart..

Spigelia causes an unusually strong beating of the heart, so that

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the walls of the chest are raised. The palpitation of the heart which spigelia causes increases by sitting down and by bending the chest forward. Above the region where the beating of the heart is felt, the prover experiences a painful oppression as from a load ; at the same time a cutting and digging-ap pain is felt in the abdomen, as if caused by incarcerated flatulence, which continues longer than the palpitation.

Guided by these symptoms, homoeopathic practitioners have used spigelia in various affections of the heart, more particularly for pal- pitation of the heart, accompanied by a feeling of constriction across the chest ; or for an affection of the heart characterized by a sense of tearing and constrictive oppression in the region of the heart, violent palpitation, dyspnoea, cutting pain in the abdomen.

"Clinical experience tends to prove the value of spigelia in inflam- matory and organic diseases of the heart. * * * At present we only know that spigelia acts curatively in advanced endocarditis, in valvular disease, hypertrophy and dilatation of the heart. The fol- lowing physical signs indicate its use : Percussion yields a normal sound, somewhat muffled in case of very great dilatation ; the heart- beat is increased in force, raising the wall of the chest with each beat, so that it can be seen and felt, but not synchronous with the radial pulse ; noises (geraeusche) instead of the normal sounds are heard in various parts of the heart, during both the systole and dyastole." (Clotar Mueller, Allg. Horn. Zeitg., xxvii., 57.)

"When a person who suffers from heart disease, especially women who menstruate too often and too profusely, complain about light- ness of the head, have an anxious expression of the countenance, lose control of themselves when they are hurried, have violent palpi- tation of the heart from every emotion or quick movement, while the stethoscope reveals nothing abnormal in sound or form ; when, at the same time, the patient is of an anxious and retired mood, avoids society, or, if forced into society, perspires and has trembling of the hands — small doses of spigelia often give prompt relief. (Schroen, Hygea, xxiii, 271.)

Violent stitch in the left side, just under the heart, recurring periodically ; stitch in the diaphragm on the left side, so violent as to arrest respiration ; dull stitches synchronous with the pulse in the reo-ion in which the heart's impulse is felt ; stitches between this latter spot and the epigastrium. These symptoms, together with the following, which denote modified action of the heart, viz. : very

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violent pulsation of the heart, audible to the patient and visible to the bystander ; violent palpitation and anxiety ; tremulous motion of the heart; palpitation increased by sitting down and bending forward, and by deep inspiration and retention of breath ; palpita- tion as soon as he sits down after rising in the morning ; and in the prsecordial region a heavy, painful pressing load, causing constric- tion and anxiety, with cutting and griping as from wind in the abdomen. These two series of symptoms point clearly to an organic affection of the heart or pericardium, such as clinical experience has proved to find its curative agent in spigelia. (Dunham, Lectures on Materia Medica.)

In pericarditis, endocarditis, hypertrophy of the heart with insuffi- ciency of the bicuspid valve.

A boy of twelve years, formerly strong, well nourished, has had carditis. After several months a " lifting up " of the ensiform cartilage was noted. Then the lowest four true ribs and the sternum were raised in the same manner, with palpitation, brought on and increased by motion. There was also a spinal curvature.

After two years of allceopathic treatment I found the following symptoms : He cannot move in bed without suffering from great difficulty of breathing; he cannot sleep on less than three pillows and must lie on the right side. By placing the ear over the heart, a noise like the purring of a cat could be heard. The cheeks and the lips were of a bright red; sometimes they looked very pale. The carotids beat with an even, trembling motion; occasional stitches in the heart.

Small appetite; hardly any thirst. The least effort at stool brought on a swoon ; he also fainted in a warm room. Talking caused oppression, shortness of breathing and a marked increase of the red- ness of the cheeks and lips. He took cold very easily and, if so, had a fluent coryza, with soreness of the nostrils.

From time to time he had attacks of fever, presumed to be of rheumatic origin. Prescribed spigelia30. After five hours, aggravation of all the symptoms ; during the following night sleep ; on the following day he walked a few steps in the room and rode out. On the fifth day the peculiar " cat-like purring" had disappeared and the sternum and ribs stood out less prominently.

Soon after, he ceased to have trouble at stool. After four weeks some illusions demanded hyoscy- amus and in six weeks he received a dose of calcarea for his cold. Discharged cured. (Giuseppe Mauro in Archiv., x., I, 159.)

A woman, twenty-six years old. She had, after her fourth confinement, spasmodic symptoms, which attacked the chest. After a long course of allceopathic treatment she presented the following symptoms : Constant burning, pressure of painful feel- ing of " being bruised " in the chest. Shortness of breath and seeming suffocation upon motion, so that she dare not leave the bed.

Sensation of constant trembling in the chest and temples, aggravated by every motion of the hand, even knitting, and enforcing absolute idleness. The most violent symptoms are, however, produced when she raises the arms to the head. It causes a feeling as if something was being torn in the chest, with suffocation and anxiety. Touching the chest causes rush of blood to the face with perspiration.

Consequently she cannot wear clothes and is only lightly covered with a shirt. There is often a sensation of a spasm which com- mences in the lower abdomen, extends upward and stops her breath. Again, violent action of the heart, with a sensation as if the heart were compressed ; again, a feeling of trembling and pain. At other times it seems as if everything in the chest were too short or were loose and tumbling about.

She is consequently very cautious when moving, and quick motion of other persons makes her nervous. The head is pressed down upon the chest, whether she is lying down or sitting up. An attempt to hold it up is followed by anxiety and a feeling as if something in ihe ehest was tearing, with spasmodic inspirations, during which there is spasmodic action of the whole chest; cyanosis of the countenance; stormy action of the heart. Pulse synchronous

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in all the arteries. When reclining, So per minute ; sitting up, 92 per minute, and not synchronous with the beat of the heart. The hand detects a feeble, indistinct action of the heart. The ear, especially with the aid of the stethoscope, distinguishes the difference between the systole and diastole by a wavy motion rather than by the distinct beat.

Prescribed spigelia30, followed by an aggravation of symptoms ; on the following day improvement commenced ; she could move the arms without difficulty and even walked a little. On account of some little aggravation the remedy was repeated, followed by a cure. She remained well and soon became pregnant. (Bethmann in Allg.

Horn. Zeitg., iii., 109.)

A boy, ten years old, had muscular rheumatism three years ago ; he took cold, and had a similar attack with pains in the bowels and palpitation of the heart, later, dropsy. Symptoms: Violent aching in the extremities ; the hands are stiff ; cannot be moved ; especially the fingers. Pressing cutting pain in the lower bowels, under the lower ribs ; terrible action of the heart ; every beat is audible, causing severe pain in the back. Periodical, cutting pains in the shoulders, head and arms ; diffi- cult breathing; breathing is so short, that he feels as if he did not get any air at all, with great dyspnoea and anxious perspiration.

Extreme emaciation ; must eat very cautiously, otherwise the pains will be greatly intensified. Prescribed on December 4th, three doses of spigelia30, one dose every three days. December 29th He is much stronger ; rheumatism too-thirds better ; the violent action of the heart has im- proved a good deal, the attacks now are not very severe.

Breathing easier. Can walk out of doors. Prescribed spigelia every eight days. The case resulted in an early and complete recovery.

(Weber in Arch., xvi., I, 52.)

ANGINA PECTOKIS.— The same group of symptoms (viz.: severe stabbing stitches in the heart at every beat, with excited action of the heart, -worse from motion) indicates the use of spigelia in angina pectoris, in which disease the remedy has made a good record.