Ignatia amara. Strychnos ignatia. St.Ignatius’ bean. N.O.Loganiaceae.
THE St.Ignatius bean belongs to the same natural order as the vomit nut or bean (nux vomica), which, however, contains a smaller proportion of strychnine, the active principle common to the two. The strychnine effects of the two have a close resemblance, and reference should be made to the article on nux vomica for the gross effects of the alkaloid. In its finer actions, brought out by provings, ignatia, like nux vomica, is a pathogenic and therapeutic entity.
PATHOGENESY AND THERAPEUTICS.
Its action is beat seen in sensitive, excitable subjects of mild disposition, quick to perceive and to act, and the drug brings out these very traits of character and temperament. Such patients are often of dark complexion. They become alert and apprehensive, and suffer acutely in mind and body; this disposition, and the sufferings of a prover are aggravated by the drug. coffee, tobacco and alcohol (especially spirits) make the ignatia patient worse, and tobacco, though usually enjoyed, becomes distasteful, and may cause headache. The muscular system (through the spinal cord) is irritated, muscles become rigid and twitching, or else they tremble.
Rapid changes of symptoms take place, and in many instances contrary or opposing symptoms are manifest. Of this interesting feature the following instances are given by H. C. Allen’s “Keynotes” : ” Roaring in the ears is relieve by music; piles are relieved when walking; sore throat feels easier when swallowing; empty feeling in stomach not relieved by eating; cough worse the more he coughs; cough on standing still during a walk; spasmodic laughter from grief; thirst during a chill” (see carbo veg.) not during hot stage of a fever. ” A frontal headache may be relieved by stooping” (T. Allen’s ” Primer”).
Mind.- The rapid changes are as prominent in the mental sphere as anywhere-from joy to sorrow, laughing to weeping, grave to gay; a hysterical condition develops. The prover or patient is extremely sensitive and is easily offended, annoyed or angered by criticism or contradiction; is impatient; but these evidences of weaknesses make him angry with himself. There is a kind of hyperconscientiousness, almost of fear, that he is unworthy or has committed a crime; there is an apparent quarrelsomeness due to the rapid changes of disposition, temper or outlook- irresoluteness.
These sensitive subjects are made ill by the depressing effects of grief, anger, shame or disappointment (love or other); concentrated and protracted anxiety or grief may result in mental and physical exhaustion, involuntary sighing. The sufferer feels life is too much for her (or him), wishes to be left alone, and broods in silence over troubles, real or sometimes imagined or exaggerated. The temperamental peculiarities are accentuated or brought out by illness, a quiet, pleasant person in health being easily irritated or disturbed when ill.
Some children display these symptoms, being easily upset by opposition or scolding; they may be made quite ill, or have convulsions.
In adults relief may come from being able to unburden the mind to a sympathetic hearer.
Something of this sensitive, changeable, in consistent disposition may display itself, if looked for, even when the ailment complained of is chiefly a local one. In technical terms the drug is useful in “adolescent instability,” in hysteria which is not bad enough to take a patient to a mental hospital or where loss of self-control is complete.
Head.- The most striking headache of ignatia patients is a sharp or a boring pain in a very small area, like a nail being driven into the skull-the classical clavus hystericus (hepar); the side of the pain may change rapidly, or alternate with pain in a distant area. Lying on the painful part gives relief. Pressure as from without inwards, especially frontal, and worse in the morning on waking, is another form of headache. Coughing, alcohol (especially spirits), noise, odours and tobacco smoke, aggravate all the headaches, also coffee drinking increases the tendency to headaches, though a strong cup of coffee may relieve a particular attack of the pain. The head may be bent backwards with the pain.
Eyes.- Photophobia an instance of ignatia hypersensitiveness; it may be so great as to cause convulsive movements of the lids, or take the form of bright zig-zag flickerings or flashes before the eyes, Irritation of the conjunctiva-like sand in the eye-under the upper lid, with sticking together of the lids at night may be present.
Ears, nose and throat are all somewhat irritated-itching in the meatus auditorius, noises in the ears and over-sensitiveness to noises, catarrh and itching in the nostrils; sticking pain and feeling of constriction in the throat relieved by swallowing, and globus hystericus-“a lump rises from the stomach which she must swallow down, but it constantly returns.”
These are illustrations of the effects of ignatia.
Digestive Symptoms.- Hunger relieved only for a short time by eating-sudden and early satiety but soon returning hunger; hunger worse in the evening; vomiting of food at night; stitches and empty sensation in stomach-all these are relieved by eating. Hiccough may be produced by eating, drinking or smoking. Extreme flatulence in hysterical patients or localized distension here and there, and pulsation in the hypogastrium are ignatia indications. Constipation, with a good deal of straining and with sharp pains in the rectum, which shoot upwards, sometimes severe enough to cause a patient to dread attempting to get an action,is common in ignatia subjects. Much carriage riding and heavy coffee drinking are alleged to be causes of constipation of ignatia type. The straining seems to come from high up in the belly, although there are (as stated) pains in the rectum and also itching (as from worms) and piles which readily prolapse. Prolapsus ani occurs with very moderate straining,especially if the stool is loose, which is sometimes the case after fright or emotion, when it may even be involuntary. Straining with either diarrhoea or constipation may (as with nux vomica, &c.) prove ineffectual, and the two may alternate.
Urinary Symptoms.-The voiding of a large amount of clear, pale urine sometimes marks the end of an ignatia type of headache, and sometimes burning and smarting in the urethra are felt during micturition.
Genital Organs.-The symptoms in this sphere are not real affections of the gonads. The skin about the genitals itches and may perspire; this is worse in the evening and is quickly relieved or driven elsewhere by scratching. Menstruation may be black, offensive and clotted, and be brought on prematurely by emotional causes. Disturbances of digestion during pregnancy; nausea and sinking in the epigastrium, relieved by eating, or functional spasms or convulsions from excessive pain or fear-not being true toxic eclampsia-these may require ignatia. Lack of sexual reciprocity in women, and languor during menstruation are also ignatia indications.
Respiratory System.-Inflammatory lesions are absent here as elsewhere. Dry, irritable cough from tickling in the throat or larynx, which can be controlled by great effort of will, and worse after lying down in the evening (hyoscy.), is a feature of ignatia patients. The more they cough the more they must cough. Inspiration is oppressed but expiration is easy. There is also a morning cough on waking, excited by epigastric tickling and relieved by getting up a little mucus from (apparently) the windpipe. Palpitation comes on at night, either with or apart from respiratory disturbances.
Back and Extremities.-Here again most of the symptoms are of nerve origin; such are the following: Twitchings and jerkings of various muscles or groups, worse at night on falling asleep-in the deltoids and forearm muscles. There seems to be a disturbance of muscular sense, the legs being raised too high in walking, causing an ataxic gait. There are also sharp, shooting or cutting pains from the lumbar region through the legs, and pain in the sacrum, worse when lying on the back in the morning. The neck may be stiff and spasms of the back muscles bring about a tendency to arching of the back (opisthotonos).
Skin.-Nettle-rash may be present, but the chief cutaneous symptom is itching. It is worse from becoming heated and in the open air, and is relieved by scratching, but it then appears in another place.
Sleep.-Usually the ignatia patient sleeps lightly and is restless; the limbs twitch on going to sleep. There is excessive yawning in the day-time. The patient dreams on one subject repeatedly.
Fever.-During the chilly (early) stage of febrile conditions the patient is not relieved by warmth and is thirsty, whereas thirst is not present (as would be expected) during the heat (see carbo veg.); must be uncovered during the heat (opposite of nux). The skin does not sweat except on the face. The face is red during the chill (ferr.). There is surface heat with some redness of skin and intolerance of external warmth.
The heat without thirst is the most characteristic symptom. There is a tendency to periodicity in ignatia cases, the symptoms returning each day at the same hour.
The named diseases are diseased conditions treated by ignatia are not many. Hysterical manifestations most frequently call for it, and twitchings, spasms or even convulsive attacks in children during teething and from fright, with the ignatia disposition, or convulsions in women from fright, bad news or severe pain (ex. gr., during labour). Headaches of the type described, clavus, &c., relieved by lying on the painful part, are successfully treated by the remedy.
(1) The ailments are superficial and nervous rather than inflammatory.
(2) Sensitive, excitable subjects of mild disposition.
(3) Changeable mood uncontrolled laughter alternates rapidly with tearful sobbing and sadness-sighing.
(4) Symptoms are contradictory-the unexpected happens-ex. gr., thirst during chill; roaring in ears, relieved by music; sore throat, relieved by swallowing, &c.
(5) Ailments from anger, grief, shame, disappointment, physical exhaustion; or from being scolded (children).
(6) Feeling of unworthiness or sinfulness in people of blameless lives-a form of inferiority-complex.
(7) Wishes to be left alone with his sorrows, broods over them.
(8) Headache (“clavus”), site changes rapidly, relieved lying on painful side; frontal, forcing outwards.
(9) Hunger pain, relieved only briefly by eating.
(10) Hysterical symptoms; sobbing “globus,” flatulent distension in parts of abdomen; polyuria; pale, clear urine.
(11) Twitchings of various parts, going on to convulsions.
From coffee-drinking habit,tobacco smoking (though usually enjoyed) and spirits, in the morning, drinking water (globus), in the open air, and external warmth, after stool (piles).
From lying on painful part (head), while eating (retching, gastralgia), and from change of position, swallowing (sore throat).