Sepiae succus. Tincture from the inspissated juice.
THE inky juice of the cuttle fish was introduced as a remedy by Hahnemann, and is still extensively used by his followers and by them alone. It is difficult to imagine its being used on any other than the homoeopathic basis.
The chief source of our knowledge of its effects, pathogenic and curative, is clinical, i.e., is due to the observations of its effects on the sick. This has been confirmed by a proving in 1874, carried out on thirty observes by the American Institute of Homoeopathy. Laboratory testing of this substance as a drug seems to be lacking.
(1) GENERAL EFFECTS.-Clinical experience has abundantly supported the claim made for it by the early homoeopaths. Its effects on the healthy were explained as inducing general and local congestions. It seems probable that modern science would attribute the general symptoms to a widespread influence on metabolism. The prover becomes chilly, seems to”lack vital heat,” flushes or faints, or feels faint under a variety of different circumstances, is very sensitive to extremes of heat and cold, and becomes sad and timorous; he has itching and sallowness of the skin, mostly patchy, and scanty high-coloured urine; his (or her) sleep becomes restless and is disturbed by dreams like nightmares, .
(2) LOCAL EFFECTS.- The foregoing symptoms are associated with disturbed digestion abdominal distension, combined with a feeling of sinking and epigastric emptiness, constipation, piles, disturbed menstruation and “bearing down,” itching of the skin and sallow,k yellowish-brown spots on the face and trunk, and with scanty high-coloured urine, frequently passed, and depositing sticky urates.
It may be that the digestion is the cause of the general symptoms which we have referred to as of metabolic origin, but this is a matter of explanation, and its accuracy or inaccuracy in no way invalidates the use of these symptoms groups as valuable therapeutic guides.
It is to this group (printed in italics) that we chiefly look for guides to the selection of the remedy, or perhaps we should say in a case, for example, of piles or prolapsus uteri, we must look to the combination of the two. Piles or prolapsus are not by themselves a sufficient indication for the use of sepia. Associated with the foregoing general group they are a reliable guide; in short, Hahnemann’s totality of symptoms” must here (at any rate) be invoked. To this group with its refinements and modalities some attention must be paid.
(1) “Deficient vital heat” or “poor circulation” means more than “cold hands and feet.” It is sensitiveness to temperature- variations, to draughts, to either extreme of heat or cold but especially to cold air. This is a persistent condition, manifest to the patient and associated with ready liability to “catch cold,” and is independent of the temporary temperature of the hands and feet, which , however, are usually cold, especially the feet. It is a valuable evidence of the lowered body resistance present in cases calling for sepia. E.B.Nash in his “Leaders,”., says, “If the feet are hot the hands are cold and vice versa.” This conjunction of phenomena would be a confirmatory indication.
(2) Fainting and flushing are in this case evidences of lessened resistance to stimuli. The fainting is usually a question of feeling faint rather than of actual syncope. It is induced by slight wet, or by various emotions. In this last case the flush may followed by perspiration, more or less general and it has been used as an indication for sepia in the flushing of the menopause. This has sometimes, in our experience, proved itself a useful guide.
(3) Extremes of Temperature.- Sepia is one of the few remedies stated to be useful for sensitiveness to either extreme. There are long lists of drugs for one or either. As it is a common symptom in patients sepia will often present itself for consideration as a remedy.
(4) Mental symptoms always where striking rank high in indication value those of sepia are all on the side of depression, weeping easily, sadness, different expressions being naturally used by different patients. They are not of great value as indications unless notably increased during the illness under treatment. Exception may be made in the case of two symptoms. Indifference to life, to usual occupations, to relatives and friends to whom the patient (usually a woman) was previously attached, lack of interest in general this may call for the consideration of sepia, and has proved reliable. It must be a new symptom or be markedly aggravated to have full value. The timorousness, which dreads being along yet dreads meeting even old friends, is a feature of some sepia cases and may be equally present in either sex. It is liable to be associated with symptoms of the pelvic organs. “Melancholia,” “stupor” and confusional states “sum up sepia conditions.
(5) Skin symptoms are of general value. The itching is not confines to one part of the body, though it is most conspicuous in the genital organs (both sexes). it has the feature that it is not relieved by rubbing or scratching, after which it changes to burning.
Yellow patches, or yellowish-brown discolorations have a metabolic significance. They may occur on the trunk, but when occurring on the face and forehead are regarded by some as very important indications for sepia. The yellow “saddle” across the nose and upper part of the cheeks has also been considered an important one. When recent and when associated with other general or local symptoms they are useful confirmations.
Other spots , such as papules, or even pustules, may be present, as also scaly symptoms, ex. gr., herpes circinatus; but these are not of any value as indications.
Perspiration of offensive odour has been induced and though not common in sepia cases may easily form a feature in the disease picture. It occurs in the axillae, .
(6) The urinary must be regarded, in the main as symptoms indicative of general rather than local origin and value; at nay rate the striking change in the urine was evidently due to some chemical change from a distance. This causes us to classify it as a general symptom, and in any case it is one of the utmost value, and we have not seldom proved its reliability clinically. The urine is faithfully described in the textbooks – it is scanty, frequently passed, decidedly acid, deposits urates, which adhere closely to the side of the vessel; the odour of it is very offensive; it is foetid-not like the hippuric acid type of horses’ urine and that found in benzoic and nitric acid cases. It is strongly suggestive of the need for sepia.
Other urinary symptoms may be local, but are mentioned here to save subsequent reference. There are frequent micturition (in pelvic cases) and incontinence of urine during the early part of the night (children), and in any form of straining (women). These are of much less importance of straining )women). These are of much less importance than the state of the urine.
(7) Sleep is disturbed at night, chiefly in the early part of anxious dreams, which wake the patient in a fright with screaming out; or she may talk in her sleep. She is correspondingly sleepy during the day.
The foregoing can hardly be disassociated from the more local conditions to which reference must now be made. We have placed them first, in a separate category, to emphasize their greater importance as clinical indications.
(a) Digestive Symptoms.-These again are evidences of lowered functional activity, variously expressed, according to the lowered resistance of the particular portion of the tract affected or sometimes in accordance with the pictorial powers of the narrator.
Constipation is usually present in sepia cases, and by itself is not very indicative; when combined (in chronic cases) with straining it is of more value (nux). The stool is hard. Evacuation is preceded by pain or by the sensation of fulness above the anus, which is not relieved by an action. When that is the case the sensation may be due to piles or even to prolapse of the uterus or vaginal walls. Passing along the digestive tract we find nausea-the thought (nux vom.), sight and smell of food, causes a feeling of sickness; the tongue is coated, but is not characteristics; in some cases milk disagrees. With abdominal distention due to flatulence is a contrary sensation of emptiness in the epigastrium, described as “sinking” or an “all-gone” sensation, which may be alarming in young and delicate persons who have not learned to understand its import. It is probably due to hyperacidity and is relieved by an alkaline drink. Its only association with pelvic disorders (to be mentioned) appears to be that such maladies are commonly accompanied by some from of dyspepsia. The most common time of the occurrence of this symptom is about 10 or 11 o`clock in the morning or in the evening after food, according to the patient`s habits; it is usually not relieved by food (compare Sulphur).
Oozing of secretion from the anus (with piles, chronic proctitis or fissure) does not contra-indicate sepia.
(b) Generative Organs in Women.-Much stress has been laid on the importance of sepia in “congestive” conditions of this sphere and in traumatic conditions. It is useful in correcting delayed or scanty period. The character of the menstrual discharge is usually dark and may be unpleasant. Prolonged menstruation may be remedied by it in case of subinvolution with the general symptoms described. Menorrhagia with bright, hot blood, however, is no indication for sepia. Leucorrhoea, thin and acrid, may follow the period and is quite compatible with a sepia case. Much exaggerated language has been used concerning the spectacular effects of sepia in “uterine prolapse”. Where there is a sensation of “bearing down” (meaning thereby ” a feeling as if `the inside’ were trying to force its way out at the front passage”) with no measurable degree of prolapse or retroposition and no demonstrably excessive pelvic-floor projection when the patient strains, as if for an action of the bowels, sepia may entirely remove the symptoms and hence has great value. After traumatism during childbirth, with vaginal walls which have never recovered their tone, with subinvolution of the uterus and the cervix close to or protruding from the vaginal orifice, the case seem outside the sphere of drugs. Just where their influence ceases to produce obvious local improvement it is hard to say. They may remove subinvolution, they may fill out the overstretched and thinned broad ligaments to a certain extent. Where, however definite lacerations have taken place and have healed a plastic operation is called for . A drug, sepia or other, may be indicated of course, and will be of great value in improving health and so aiding the success of operations, before and after.
We sound this note of warning to prevent unnecessary disappointment.
Some retro-flexions and version without obvious prolapse afford more scope for drugs. In such cases, with a good quantum of the general symptoms described, with the lumbo-sacral pain common to drug and disease with painful menstruation and leucorrhoea the use of sepia will usually repay the patient, even if it fail to replace her uterus “Bearing down” or “Labour -like” pains may be an indication here as in prolapse, also stitches from the uterine region upwards to the umbilicus or epigastrium.
Sepia should never be relegated to the category od women`s remedy IN so far as laundresses ailment frequently call for it this due to the physical labour of their calling and especially to long hours of. frequently call for it this due to the physical labour of their calling and especially to long hours of standing.
The claims for its beneficial effects on cervical catarrh and erosion are better substantiated, but to reply upon it alone in epithelioma would in our judgment be a serious error.
Sepia has been recommended for gonorrhoea in women.
In the acute stages other treatment would be called for.
IN chronic cases, with vulvitis, thin leucorrhoea, pruritus vulvae et ani-again let it be repeated with a basis of “generals”-it may prove useful.
Dryness of the vagina and vulva after menstruation (as nat. mur.) should call attention to sepia.
In pregnancy sepia has been used for nausea and toothache.
(c) Generative Organs in Men.-Sepia has some reputation in a sticky, yellowish discharge “gluing up the orifice of the urethra”. This was in subacute cases where pyknuria and burning on micturition were present; or it may be valuable in chronic gleet, with want of tone of the genitalia, emissions of thin semen, with deficient prostatic fluid and aching in the rectum, due to prostatic congestion or chronic prostatitis. Genito- urinary symptoms are less common in sepia cases in men than in women.
(d) The headaches of sepia are often one-sided, especially the left, with heaviness of the eyelid or lids, and a tendency to ptosis; pain from the left eye over the head to the occiput. Some types of sepia headache are relieved by lying down-these are sudden, severe cases of hemicrania chiefly during menstruation with spots or “a veil” before the eyes or coloured appearance round artificial lights 9? early glaucoma).
Other sepia headaches of a burning of a bursting character are relieved by external pressure and by continued hard motion. The scalp is tender in all cases, and with chronic and menopausic headache the hair falls out a good deal.
(e) Coryza in chronic cases, with swollen nose and ulcerated nostrils, may be a feature in sepia cases; thick crusts are blown or hawked from the nose and there is loss of taste and smell; more acute coryza (“cold in the head”) sometimes calls for it when unilateral or changing quickly from one nostril to another .
Sepia is complementary to nat. mur which it closely resembles; it is inimical to lachesis and should not be given before or after it.
Have been sufficiently clearly indicated in the narrative, and need not be repeated.
From extremes of temperature, slight physical or mental exertion, getting wet, sitting still too long (headache, &c.). stooping (headache), after eating (headache), after menstruation ((various symptoms), towards evening, warm moist weather.
Warmth, general and local, lying down (megrim, prolapsus), eating (pain renewed or increased after eating [see Hering, gastralgia and “sinking”, tickling in larynx), pressure (sacral pain), vigorous exercise.