Naja tripudians, the cobra di capello, one of the hooded snakes. N.O. Ophidia. Family, Colubridae. The venom from the living snake is preserved in glycerine or received on milk sugar and triturated.
NAJA as a poison and a remedy very closely the other members of the family Colubridae. It causes less local damage than does the venom of the vipers.
It has been used in cholera, plague, diphtheria, angina pectoris and asthma, so-called ovarian affections, spinal “irritation” and other ill-defined neuroses. ColocynthisH.E. Deane, of the R.A.M.C., used it in an epidemic of plague by subcutaneous injection, which he found more effectual than by the mouth.
Naja shows many of the spasmodic or constrictive effects shown by lachesis-in the head, larynx, jaws, chest, heart and abdomen. Clarke in his “Dictionary of Materia Medica,” sub voce, lays stress on two features in the pathogenesis of the poison, both of which have been utilized clinically with success; one of them is the hot or burning character of the pains, and the other, sudden pain in the nape and occiput, as if the victim had been struck a violent blow on the head and neck.
The scalp is scurfy and sensitive to touch and there is alopecia.
Headaches are common and varied, and they are described as dull, aching, throbbing, constrictive; the commonest sites are the temples and the forehead. The right temple is a favourite position, and though pain over the left eye is recorded, left- sided predominance of symptoms does not obtain in the head.
The headache modalities are:(1) relief from smoking and taking alcohol, in the open air and in the afternoon; (2) aggravation from movement and at night; (3) coming on after cessation of a period; (4) associated with cold feet. Though asleep the patient may feel conscious of the pain.
Mind.-Sadness and irresolution, worse in the evening, are naja symptoms.
The naja patient is often forgetful, confused and absent- minded; he tends to brood over imaginary wrongs, over failure of sexual power on account of headaches, and because he fears “things are all going wrong .” The foregoing are symptoms of chronic ailments; in acute conditions, loss of consciousness or even coma may come on. With the insensibility the eyes may be wide open and the pupils irresponsive.
Eyes.-Heaviness of lids, ptosis, dilated pupils and deficient power of accommodation may be present.
Nose.-A thin, acrid coryza, with sore, hot nose comes on, or stuffiness, worse in the open air may be present; either nostril may be affected.
Face.-Most of the face and jaw symptoms are left-sided; the facial aspect will vary with the stage of a malady-heat, redness (sometimes patchy), relieved by washing, may be present in febrile or reactive states; or pallor, sallowness and a haggard look in poisoning or collapse. Toothache is worse on the left side and, if neuralgic, is relieved by taking food.
Mouth.-The tongue varies similarly.
Throat.-Dark red inflammation, tonsillitis, always on the left side (and not travelling over to the right as with lachesis) are noteworthy; choking feelings and dysphagia accompany the sore throat.
Digestive System.-The patient has indigestion, as if stones were in his stomach, with heartburn and hot, offensive risings. He craves alcohol, which makes him worse (except headache). Rumbling, colic, &c., are present, with much pain in the left hypochondrium and loin.
Sudden urgent attacks of diarrhoea come on with a tendency to dysenteric straining, griping, and heat and itching at the anus.
Sexual Organs-Increased desire and diminished power distress male sufferers. A stinging and burning along the right side of the penis, quite superficially, has been produced by naja, worse during the night and on rising; vivid dreams and emissions are followed by weakness and worry.
In women, pain in the left ovarian is quite noteworthy, extending up towards the cardiac region, and relieved by the onset of menstruation. When the pain is severe, the flow stops (plumbum) and the abdomen is tender to touch.
Respiration-Here right-sided pains may obtain (to right of sternum), also a dull pain in lower half of right chest assumes a stabbing character on deep breathing; it is so severe as to prevent coughing. It is relieved by lying on the affected (right) side, and worse when lying on the left.
Circulation-The pulse becomes slow and irregular, or small, irregular, and difficult to feel. In the reactive stag of a disease it may be rapid and soft, but full. Palpitation and cardiac collapse are met with.
Back and Limbs-The pains are mostly of a rheumatic type; aching, tearing, bruised, moving from one place to another, and worse from movement. Left-sided pains predominate, but the right thigh and fingers have been involved. Staggering gait from weakness and vertigo. Interscapular pain extending to scapulae is noticed.
The accident of site in the case of a snake-bite does not, of course, count in estimating the “elective affinity” of the remedy.
Febrile symptoms may be reactive, from a bite or during the reactive stage of an illness, ex. gr. cholera. Many symptoms catalogued under this heading are of nervous, circulatory origin- flushes, perspirations, &c. The left side feel’s them chiefly.
Named Diseases-The snake poisons are much used in India. In cholera during the collapse stage; in plague where rapid septic symptoms develop; in diphtheria it is used for left-sided cases, where; laryngeal symptoms are present-choking, constriction, ” grasping a the throat” ; in asthma and angina with dyspnoea; feeling of great weight pressing on the chest of a band round it; palpitation, cardiac pain, of a band round it; palpitation, cardiac pain, of a “hot iron” being run in; in menopausic flushing, disturbed sleep with unremembered dreams, or dreams of murders, fires, &c. It is in cardiac diseases that naja has made its reputation, chiefly in toxic cases and myopathies.
In dysmenorrhoea it is useful where the pain is left sided, is situated in the ovarian region, and shoots up or down and proceeds the flow for several days, being relieved by its in on set, and by lying on the right side.
Hay fever with asthmatic symptoms, where the dyspnoea is worse lying down, where thee coryza is followed by severe sneezing fits which relieve the breathing.
UNILATERAL SYMPTOMS- The following categorical list requires to be carefully consulted if the side affected is to be any real guide to the choice of the remedy.
It is obvious that left-sidedness of symptoms causes and cured by naja is not so exclusive as with lachesis.
Left-sided Symptoms-Chest (pain worse lying on left), pectoral muscles (pain in afternoon), scapula (shooting to left chest), hypochondrium and loin (severe pain), leg (rheumatic pain)_, shoulder (drawing pain), triceps (stabbing pain), ovary (aching and cramps), tonsil and throat (inflammation, pain, redness), teeth (gnawing neuralgia in sound teeth), lower jaw (pain in condyle, worse moving), upper jaw (shooting , worse after midnight), eye nasi (spots and soreness), ear (noises), eye (scalding pain above), temple (pain), orbit (pain extending tom occiput).
Right-sided Symptoms-Chest (relieved lying on right side), lower chest (stabbing, worse on inspiration), sternum (dull pain), limbs (rheumatic pains), thigh (pain in front of), penis (Burning), nostril (soreness), lower jaw (pain), head, especially temple (pain, aching, deep-seated), throat (numbness).
(1) Sensitiveness to cold.
(2) Depression, absent-mindedness,suicidal tendency.
(3) Relief from lying on painful side (bryonia)
(4) Aspect,. gait and manner as if intoxicated
(5) Loss of virility and consequent depression
(6) Purple, livid, numb spots on skin like threatening gangrene.
(7) Cardiac collapse.
(8) Great heat, with prostration: feeling as of a hot iron thrust into chest (alter infection on finger)
(9) Tonsillitis, dusky, left-sided.
(10) Foaming at the mouth.
(11) Left-sided preponderance, in certain localities without extension to right.
(12) Pre-menstrual left-sided pain.
(13) Palpitation, faintness, at menopause.
Morning (shoulder pain), afternoon, (cough, evening (colic), night (headache), after midnight (shooting in upper jaw), movement (head, limbs, jaw), walking and other exertion (general), touch (abdomen and pelvis), open air (nose,coryza), inspiration (lower right-chest pain), alcohol (except headache), lying on left side (cardiac pain and dyspnoea).
Alcohol (head only), smoking (head), open air (head), afternoon (head, temple), evening (depression), washing (facial pains), lying on right side and on affected side, sneezing relieves asthmatic breathing, onset of menstruation (1.ovarian pain).