Sepals four to five. Petals three to five, concave or unguiculate, sometimes by absorption few or none. Stamens numerous ; authers retrorse. Style short ; stigma simple. Carpels one to eight, folli- cular, many-seeded. Sp. char. Kacemes very long; leaflets ovate oblong, incisely toothed ; staminodia slender, two-forked. Root thick and knotted, with long fibres. Stem three to eight feet high, glab- rous, furrowed, leafy near the middle. Leaves three, ternate ; leaflets two to three inches long. Racemes branching, six to twelve inches long ; pedicles three to four lines in length, bracteate. Flowers very fetid. Sepals caducous, greenish white, concave. Staminodia four to eight. Carpels globose ovate, glabrous. Seeds seven to eight, compressed and angular. (Torray and Gray, Flor. of North Amer- 724 CIMIOIFl'GA RACEMOSA. ica.) Stamens about 100 to each flower, giving the raceme the ap- pearance of a long and slender plume. (Wood.) This plant is abundant in open woods and on hill-sides throughout the United States, flowering in June and July. It is known by dif- ferent names, among them the following, viz., snake root, squaw root and black cohosh, are most common. The first two are derived from the Indians, with whom the root has ever been a favorite medi- cine in the cure of snake-bites and who use it freely in facilitating child-birth. The same plant is also known as the macrotys racemosa. (Rafinesque) and the actaea racemosa (Linne). The root is the medicinal part of the plant. It should be collec- ted late in summer or in the early fall. Dried, it is composed of a rough, tuberculated head, with numerous radicles, from four to seven inches long, black externally and white internally. The taste is bit- ter and astringent, remaining in the mouth for a long while ; the odor is feeble and earthy. Oimicifuga acts upon the cerebro-spinal system, affecting, through its agency, the entire uervous system, the muscular system and the female generative organs. Shooting, darting, muscular pains, here and there, and a nervous, irritable state of mind, especially in diseases of women, are valuable characteristics of the drug. CEREBRO-SPINAL GROUP. Oimicifuga has caused : Heaviness, dullness ; acute pain over the eyes, (left or right, or both). Headache through the temples, as if the head would burst ; pain in the eyeballs, even in the very centre of the eyes ; the brain felt too large for the cranium ; pressure in the head ; redness of the face and eyes ; the eyes feel as if swollen ; the eyes looked very much congested ; headache with pressure outward and upward, unbearable in its nature ; pain over the eyes, extending along the base of the brain to the occiput ; severe pain over the left or right eye, extending to the eye and to the base of the brain, with dejection of spirits. Severe remitting headache of long standing, occurring every day at the same hour ; severe pain in the forehead, extending to the temple and vertex, with fulness, heat and throbbing ; when going up-stairs, sensation as if the top of the head would fly off ; headache, relieved in the open air. HEADACHES. — These symptoms indicate the use of oimicifuga in headaches of a rheumatic origin and in those severe headaches of women, who labor under menstrual or uterine disorders. Pain in the back and along the spine are important concomitant symptoms. CIMICIFUGA. BACEMOSA. 725 Especially adapted to weak, nervous, hysterical persons ; of value in the treatment of headaches brought on by a debauch or by close and long-continued study. Miss L. aged twenty-seven years, of dark complexion, nervo-bilious temperament, has suffered for a year past with severe frontal headache, usually over one eye and in the eyeball. The eyes looked red and congested. The headaches came on a few days before menstruation and hardly ever left her until the second or third day after the discharge had ceased. Menstruation was attended by severe, drawing pains all over the body, occasionally darting, quickly changing location, but usually confined to the small of the back. There was considerable tenderness in the spine. She was perfectly regular and the menstrual discharge was usually scanty and dark. The headaches were increasing in intensity and in duration. Cured in two months by cimicifuga3. CEREBRO-SPINAL MENINGITIS.— Cimicifuga becomes of value in the treatment of this disease, when distressing rheumatic or neuralgic complications exist; it is of little service in the true in- flammatory type. Dr. E. M. Hale gives the following indications : Delirium like mania-a-potu, with nausea, retching, dilated pupils, tremor of the limbs ; quick, full pulse, and wild look out of the eyes. Intense throbbing pain, as if a ball were driven from the neck to the vertex with every throb of the heart. Tongue swollen ; breath offensive ; pharnx dry ; dysphagia ; roughness and hoarseness of the voice. Pain in the back, of a drawing, tensive character, or dull and heavy, with tenderness on pressure. Nausea and vomiting attend the pain in the head. Alternate tonic and clonic spasms, night and day. Spasmodic jerkings, like chorea. Rigidity of the muscles of the neck and back. Intense aching pains in the back, head and all the joints of the extremities, like the pains which accompany the fever of variola. Eruption of white pustules on the face and neck ; some- times large, red and papular. IRRITABILITY OF THE SPINE is a prominent symptom of this remedy and has been cured under its exhibition. MENTAL GROUP. Inability to fix the attention ; a sort of delirium, with an incli- nation to run over the subject, which he was reading. Miserable, dejected feeling ; feels grieved and troubled with sighing. Delirium with nausea, retching, dilated pupils. Vertigo, impaired vision, diz- ziness ; apprehensiveness and sleeplessness ; incessant talking. Dr. Dunham reports as a clinical symptom : Sensation as if a heavy black cloud had settled all over and enveloped her head, so that all was darkness and confusion, wThile at the same time it weighed like lead upon her heart. Cimicifuga is a most important remedy in the treatment of those 726 CIMICIFUGA RACEM0SA. mental diseases, which arise from serious disturbance in the nervous system, depending upon either of the following primary causes : loss of vital fluids by excessive haemorrhage or by nursing infants; nervous disorders of pregnancy or of the climacteric period ; exces- sive care and anxiety, too close application to business or to study ; derangements in the sexual sphere, from excesses, with irritation of the nerve-centres, tenderness along the spine and shifting rheumatic pains. A young lady, aged twenty-three years, suffered from a second attack of acute mania of an hysterical character, accompanied with excessive nymphomania. This condition had lasted for several months, and the only improvement by the remedies given was a diminution of the extreme violence of her actions, as many as six persons having previously been required to hold her. She was, however, not much improved in mind, complained of constant chilliness with tremoi's, yet without desire for heat in the room or warm clothing; cold hands and feet; incoherent talking; restless nights; constipation; suppressed leucorrhcea; pulse quick, weak and frequent. Cimicifuga2 completely cured her in about a week. (Dr. Koch, Hahn. Monthly, Vol. iii, No. 10.) A tall and corpulent man, aged forty years, married, came to my office complain- ing of great nervousness ; picked constantly at the chair while talking to me ; was so nervous as to be obliged to come three times before he was able to finish telling me what ailed him; felt always as though something dreadful might happen ; was on the verge of insanity ;• unable to attend to his business; nights sleepless; pulse irregular; face of a dark red hue; grayish circles around the eyes; chilly feelings. After using cimicifuga for a week, he could attend to his business as well as ever and is now per- fectly well. NERVOUS GROUP. As previously stated, the effect of this drug upon the nervous sys- tem is well marked. Its primary effect is to excite the nervous system ; when the organism reacts, we get the secondary effect, prostration. It acts both upon the nerves of sensation and of motion, producing shifting, darting neuralgic pains in the former, and twitching, spasmodic jactitations and tremors in the latter. CHOREA. — Cimicifuga has been used, with fair success, in the treatment of chorea, accompanying or depending upon rheumatic difficulties, menstrual and uterine disorders. The mental symptoms should be examined painstakingly. Shifting, darting, neuralgic pains, depending upon causes and accompanied by constitutional symptoms which point to this remedy as homoeopathic to the case. We have seen that black cohosh exerts a decided effect upon the nervous structure of the eye. We get intense, persistent pain in the eyeballs, sensation of enlargement of the eye, neuralgia of the eye- balls, etc., without any structural change. Hence we use this rem- edy in the treatment of VIOLENT PAIN IN THE EYE with various visual disturb- CIMICIFUGA RACEM0SA. 72? ances, but without any symptoms of inflammation or marked congestion. DELIRIUM TREMENS.— It is well known that a terribly destructive effect is produced upon the nervous system by the im- moderate use of alcoholic stimulants. When this culminates in delirium tremens cimicifuga may become to the pain-racked patient a very messenger of mercy. Few remedies present in their patho- genesis so great a similarity to that form of delirium tremens, which depends Upon a constantly increasing accumulation of nervous dis- turbances, produced and re-produced daily, until the whole nervous system finally gives way to the destroyer of its vigor and health. A few drops of the tincture of the black cohosh will often relieve with wonderful promptness. The opium or morphine habit also is productive of the most serious disturbances of the nervous system. Cimicifuga is a close simile in such cases, especially in the utter despondency which is alike charac- teristic of the drug and of the permanent ill-effects of opium. By removing many of these effects, the patient is not only made com- fortable, but is enabled to make a persistent effort to save himself from a continuance of this destructive habit. INFLAMMATORY GROUP. Your attention has been called to the use of cimicifuga in non- inflammatory diseases of the eye. It is also a valuable remedy in rheumatic and other inflammations of the eye, either of the eyeball itself or of the muscular appendages, with increased secretion of tears, stinging pain in the eyes and swollen eyelids, pain in the very center of the eye ; weakness of vision and congestive headache. PNEUMONIA. — Cimicifuga has caused dry and hacking cough ; acute pain in " the right lung, aggravated by every inspiration; lancinating pains in the left side, along the cartilages of the false ribs ; soreness of the chest ; neuralgic pains of the chest. These symptoms might justify its use in pneumonia, with strongly marked rheumatic symptoms ; or rather in PLEURODYNIA, especially of the right side ; the pain is worse from motion, extorting screams; articular rheumatism of the lowrer extremities, with much swelling and heat of the affected parts* (Raue.) In CATARRH OP THE LARYNX AND BRONCHIAL TUBE, cimicifuga is often a useful remedy. Dr. Ingalls gives the following- indications: Hoarseness; unpleasant fulness in the pharynx; con- 728 CIMICIFUGA RACEMOSA. stant inclination to cough, caused by a tickling sensation of the larynx in the evening; an attempt to speak is followed by an inclina- tion to cough; dry cough caused by tickling; hoarseness in the evening; fluent coryza of whitish mucus during the day; aching pain in the head; very profuse greenish and slightly sanguineous Coryza ; fulness of the pharynx and constant inclination to swallow ; great sensitiveness to cold air. ANGINA PECTORIS. — Oimicifuga may be called for in angina pectoris. The remedy can be of occasional use only, i. e., in cases of a purely nervous origin. The following symptoms belong to cimicifuga : Rheumatic pains in the muscles of the neck and back ; stiffness ; rheumatic pains in the joints, with heat and swelling ; excessive muscular soreness ; all these symptoms are worse from motion. The remedy is said to affect the belly of the muscle. We prescribe cimicifuga in RHEUMATIC AFFECTIONS, depending upon over-exertion and exposure, and affecting the various muscles of the body, includ- ing the uterus and heart. We usually find much soreness; little, if any fever ; nausea, loss of appetite ; severe headache ; uneasiness and restlessness; gloomy anticipations of trouble in the future; the symptoms are aggravated from motion. SMALL-POX. — Before leaving this group, mention should be made of the use of cimicifuga in small-pox. The remedy, in its provings, has not developed any remarkable skin-symptoms. In the case of one patient, some writer tells us, the internal use of the 3d dilution produced a burning and itching eruption on the skin. Many symptoms of small-pox, however, suggest cimicifuga, such as the severe and often excruciating pain in the hack and in other parts of the body, the headache, the pain in the eyes, and the mental symptoms. Drs. B. L. Hill, Holcombe and others have seen its use followed by excellent results. URINARY AND SEXUAL GROUP. We have no important urinary symptoms ; pro vers have noted an increase in the secretion, the urine being of a pale, yellow color. It is presumed that this symptom is due to the action of the drug upon the nervous system. We have drawing pains in the (right) sper- matic cord ; some tenderness in the testicle. The sexual organs of women are affected in a marked manner; the effects are due to the action of the drug upon the nervous system and, through it, upon the muscles. We find, sensation of weight CIMICIFUGA KACEMOSA. 729 and bearing down in the uterine region, with heaviness and torpor in the lower extremities. Irregularity, tardiness and suppression of the menstrual How. Shooting pains in the uterine region, from side to side. Shooting pains in the ovarian region, running upward. Bearing-down pains in the uterine region and small of the back, with heaviness of the limbs; severe aching in the lumbar and sacral regions, down the thighs and through the hips, with heavy pressing- down; prickling sensation in both mammae; leucorrhoea with bearing- down pains. DYSMENORRHEA.— Cimicifuga may be used in the following diseases of women : Dysmenorrhea, with labor-like pains in the uterus ; weight and bearing down in the abdomen ; colicky pains ; tenderness of the hypogastric region ; heavy ache low down in the back and in the hips, thighs and limbs; rheumatic diathesis, or, like gelsemium, with a sickT-headache history and a tendency to prolapse. (Dr. J. 0. Sanders.) AMENORRHCEA, with rheumatic paina in the limbs, headache, nervous excitement, peevishness, irritability. Miss W., aged about twenty-six; black eyes; dark complexion, with varying chlo- rotic hues; at uncertain times, cold fingers, with blue nails; spells of physical weak- ness ; palpitation of heart and panting after exercise ; melancholy ; complains at home of being forsaken ; menstrual flow has been suppressed six months " certainly," she thinks longer. Prescribed cimicifuga tincture, three drops in a little water three limes a day. Nineteen days later, return of menstrual flow, with cheerfulness.