Introduction

Spigelia is a vegetable remedy belonging to the Loganiaceae family of trees, which comprises several hundreds of species, some of which are lethal because of their high content of strychnine ( 1 ). In East countries, Spigelia was employed for headache, neuralgia, and as an expeller of intestinal worms ( 1 ).

In Homeopathy, Spigelia is known as a specific cardiac and neuralgic remedy (2 , 3 ). Here we discuss two cases observed in homeopathic surgery at the L. Sacco Hospital, University of Milan, which lead to an excellent outcome, in complete agreement with the natural essence of the remedy ( 2, 4 ).

Some authors do not agree with the view of basing a homeopathic prescription principally on physical symptoms, even when they fit the remedy’s nature. At the end, we will discuss this topic, in the light of homeopathic philosophy.

Case #1 Headache – April 2008

Interview with the patient:

O.M., a 62 year old male, came to homeopathic surgery. He has been suffering for 9 years with migraine, which was fully elucidated in the Cefalea Center and diagnosed as primary headache, tension-type ( International Classification of Headache Disorders )( 5 ). The patient suffered 2-4 attacks/month, lasting 24-48 hours which were poorly controlled by difmetre ( Solvay-Pharma ); indeed , the patient often used fans to fight the pain.

The patient contracted Poliomyelitis when he was 18 months old, which resulted in a left somatic paralysis. He was operated on for an inguinal hernia on the left side.

Q: You came to me primarily for headache, tell me more about your main disturbance.

A: I suffered from Cefalea (migraine headache) since 1999. All examinations made in Cephalea Center have excluded any severe neurologic problems, but I cannot control the headaches anymore, since it worsened in the last five years.

Q: How many episodes of cefalea do you have in a month?

A: I suffer 2-4 main attacks monthly, which last up to 48 hours in spite of the use of difmetre. The pain slowly decreases after 1-2 tablets of metacen.

Q: What about the pain’s intensity? Could you score the average pain intensity on 100 mm Visual Analogue Score ( VAS )?

A: (The patient scores 9 mm on VAS ( 6 ).)

Q: How do you describe your cephalea?

A: I feel the pain as a weight, I have to hold my head tightly. I feel better when I get around, better outdoors, for example when I walk in open air.

Q: Do you remember any health problems you had in the past ?

A: Yes, off course. Some years ago I had persistent fever accompanied by a thoracic stinging pain and I went to the emergency department. The doctors performed an echocardiogram which showed an acute pericarditis. I had to stay in hospital for 2 weeks.

Q: Have you had any disturbing consequence of poliomyelitis?

A: Sometimes my hands are swollen. I very often experience a tingling sensation in my hands, especially at night. My right leg muscles are often stiff and hard. It happens that my hands cannot hold anything and things drop from my hands.

Q: Do you notice any other recurrent problems?

A: I have had several episodes of blister eruptions on my left eye; my family doctor sent me to the ophthalmologist who made a diagnosis of herpes zoster ophthalmicus. These episodes were unbelievably painful.

Q: Other problems?

A: I ‘m always tired, I think weakness is another problem.

Q: What about your character?

A: I’m very impulsive, and I sometimes get angry. In spite of my handicap, I’m not a lazy person. I work with my body, I love sports especially if outdoors. I love walking in open air.

The patients said he is quite independent, not sensitive to people’s opinions or criticism. He loves to read and he is a chilly person. I was satisfied with the information provided by the patient and arrived at my prescription:

Spigelia Anthelmia 200k, 4 drops twice a day.

Repertorisation ( Radar 10 )

Head pain as a weight. (Spigelia 2°)

Head constriction band or hoop ( Spigelia 2° )

Head pain, walking in open air ameliorates. (Spigelia 1° )

Generals- walking in open air ameliorates. ( Spigelia 1° )

Generals- amelioration in open air. ( Spigelia 1° )

Face, eruptions, herpes. ( Spigelia 1°)

Extremities, swelling. ( Spigelia 1° )

Extremities, formication hands. ( Spigelia 1°)

Tingling sensation in the hands (Controlla). Spigelia 1°

Generals -neurological complaints. Spigelia 1°

Generals- on side left. ( Spigelia 2° )

Chest inflammation, heart pericardium. ( Spigelia 3°)

Eye pain neuralgic. (Spigelia 2° )

Mind Impatience. (Spigelia 1° )

Mind Anger. (Spigelia 2° )

Mind desires activity. (Spigelia 1° )

Moreover, you can note there is a left side predominance and Spigelia is a left side remedy ( 1, 2 )

First update one month later, May 2008

A: I’m surprised, doctor, my headache has improved very much, progressively in this month, and even my general health has improved!

Q: How many attacks did you have?

A: Only one, but less serious than before ( the patient signed a 4 mm VAS ), I did not take difmetre but only nimesulide.

Q: Tell me more.

A: I feel well, less tired and calmer than before.

Prescription Spigelia MK

July 2008

Patient: My big problem, the headache, is gone. I only had a mild attack one month ago then no more. I ‘m feeling very well, with good energy, more willpower. I feel quite calm, less impulsive.

Q: What about herpes?

A: I had one episode which resolved spontaneously in one day during the first month after starting the remedy.

Q: What about dropping things, motion and general stability?

A: I have improved, I feel stronger, stable when I walk and even my hands hold things firmly, I rarely drop objects.

Prescription – since remedy is confirmed, same potency, only one dose a day.

October 2008

Q: How do you feel?

A: Well, I had one mild cephalea attack since July which I resolved taking the remedy more often.

Q: The other problems?

A: I don’t know, I resolved my main problem…..In general I’m much better than before I met you. I started a special training to participate in a regional championship for disabled people.

I called the patient in Febraury 2009, the patient suspended the remedy and he reports he is very well and the headaches have disappeared. I called the patient again on November 2009 and he confirmed all the improvements. I therefore considered the patient definitively cured.