Spigelia anthelmia. Pink root. N.O. Loganiaceae. An annual plant found in the West Indies and South America. Tincture of freshly dried plant.
SPIGELIA first irritates and then depresses the brain and spinal cord; its chief influence is on the cord. It also depresses both the circulation and the respiration. Its irritation of the spinal cord is shown in the motor sphere by spasmodic movements of the facial muscles, strabismus, protrusion of the eyeballs and subsultus tendinum; in the sensory sphere by violent neuralgic pains, which may occur in any nerve of the body, but are most common in the trigeminus, in the nerves of the scalp and in the cutaneous nerves of the chest and cardiac region. It also affects the fibrous tissues, especially those of the eyes and heart.
Mind.-The provings confirm the above physiological results and amplify the symptoms, while also disclosing their modalities. They show that spigelia produces a highly sensitive state of mind and body, a general hyperaesthesia, so that the pains it causes distress the sufferer exceedingly, and seem to him very intense; he is overcome by them. Delirium is not common, but when present is manifested by wild and incoherent talk, alternate fits of laughing and crying and distortion of the countenance. A peculiar mental symptom is a fear of pointed things, such as pins, scissors, &c.
Nerves.-The neuralgic pains may be anywhere, but are mainly in the head, face eyes, teeth, neck and cardiac region. They are violent in character, burning, jerking, tearing, stitching and cutting, and they radiate from the point first attacked. Their direction is from within outwards and from below upwards. They are aggravated by noise, jar, movement, bending forward, change of weather, especially by stormy weather, and by tobacco. The body is very sensitive to touch, the part touched feels chilly, or touch sends a shudder through the whole body (kali carb.). The subjects for whom spigelia is specially suitable are usually anaemic, debilitated people of rheumatic diathesis, who have light hair, and are pale, thin and weak, with yellow, wrinkled, earthy face.
Head.-Pains in the head are mostly on the right side, are sharp and extend forwards to the right eye, but they may be on either side; they are cutting, pressing, flying pains, worse from movement,jar, stepping and pressing at stool. Another more characteristics headache is in the occiput; it extends over the vertex and forehead to the left eye or down the neck to the shoulders. In all cases movement or jar of any kind aggravates. Vertigo occurs from looking downwards and from movement of the eyes; this may be due to strabismus and disturbance of accommodation.
Eyes.-In the eyes spigelia causes inflammatory redness and lachrymation, swelling of the lids and a sensation as of hairs on the eyelashes; the pupils are dilated, accommodation is disturbed and there is spasm of the internal recti, causing internal strabismus. The pains are severe, sharp and shooting and radiate to the frontal sinuses and forehead, or are stabbing backwards into the brain. They are aggravated by the least movement of the eyeballs. Sometimes there is a feeling of the eyes being too large for their sockets, or as if they are being forced out of the head. Spasmodic twitchings of the lids occur.
The face is often flushed and swollen, but is usually pale when trigeminal neuralgia is present. There is a tickling sensations as of hair on the dorsum of the nose and mucus collects in large quantities in the posterior nares and causes choking at night.
Digestion.-The teeth become sharp, brittle and break off; there are throbbing and tearing pains in them, which are worse from holding cold water in the mouth, from cold air and after eating. Smoking may bring on toothache. The tongue is pointed, tremulous and coated. The patient loathes food and the throat is full of mucus, and there is a sensation of a worm rising in the throat. spasmodic contractions occur in the entire length of the oesophagus. There is nausea and possibly vomiting of sour acrid, frothy matter in the morning before taking any food. Pressing pains are felt in the pit of the stomach, and there are griping, pinching, constricting pains in the abdomen associated with borborygmi and diarrhoea of soft stools. Itching and tickling occur in the rectum and anus.
Respiration.-Spigelia slows the respiration and causes a constrictive, suffocating sensation in the chest, which is the seat of stitching pains that are worse from movement and breathing. Dyspnoea and suffocating attacks occur from being moved in bed, and the patient must lie on his right side with the head high.
Circulation.-Violent palpitation of the heart is a frequent symptom. It is so violent as to be visible beneath the garments to the bystanders and may even be audible. It is worse when bending forward, on sitting down, and on rising from bed in the morning. Aching occurs in the region of the apex, as if a dull- pointed knife were driven through it, or a cutting, tearing pain is felt below the left nipple, which extends to the region of the left scapula and upper arm and is worse during deep breathing. A purring sound over the cardiac area has been described as well as a gurgling feeling. There is a desire for air. The pulse may be accelerated; or feeble, slow and irregular; it does not correspond in strength to the apparently forcible beat of the heart.
Head,-Spigelia is very useful in neuralgic headaches with the symptoms already described, also for migraine beginning in the left eye (sanguinaria right, sil. both sides). It is very valuable for neuralgias of the trigeminal nerve in one or more of its branches, especially the supra-orbital branch, when the eyeball is also involved. The left side is the more usually attacked. It often begins in the morning, is worse about noon, and ameliorates towards evening. The pain is made worse by stooping, light noise, movement or jarring and is relieved by lying down and temporarily by bathing with cold water, but is worse from it afterwards.
Eyes.-Spigelia is the chief remedy for ciliary neuralgia and is useful for rheumatic ophthalmia and glaucoma, in short, for all kinds of inflammation of the eyes when the characteristics neuralgic pains are present. The sensation of the eyes being protruded, in association with heart symptoms, would suggest this drug for consideration in some cases of exophthalmic goitre. It is a remedy for strabismus, for esophoria and exophoria, The action of this drug in disordering the function of the ciliary and orbital muscles makes it very useful when a similar condition occurs in nervous subjects. Such cases are difficult to suit with spectacles and the drug may make the task easier by helping to restore muscular balance.
Nose, &c.-Spigelia is useful for the toothache described above and for post-nasal catarrhs associated with supra-orbital neuralgia.
Circulation.-Probably the sphere in which it is most often used is in affections of the heart, both organic and functional. It is one of the principal medicines for rheumatic endocarditis and pericarditis and is indicated by stabbing pains at the apex, radiating towards the chest, back and left arm, that are worse sitting up bent forwards and are often associated with violent palpitation, great dyspnoea, and a quick, feeble, irregular pulse. It is also indicated by a sensation of the heart being squeezed with the hand. A blowing, systolic murmur may be heard at the apex. It is equally useful for simple nervous palpitation without organic disease, for cardiac neuralgias and even for angina pectoris.
Many of the symptoms of spigelia are similar to those occurring in the subjects of worms, such as irritability of temper, dilated pupils, strabismus, itching of the nose and anus, facial twitchings, tickling sensations in the posterior nares and throat, dry, hollow cough and pinching abdominal pains and borborygmi. Spigelia is equally useful for lymbricoides and oxyurides (cina), as also for the same symptoms occurring when there are no worms.
When it is desired to give it as a direct vermicide it should be given in doses of 1 to 2 drachms of the fluid extract preceded and followed by a purge.
(1) Sharp, cutting, stabbing pains that radiate from a point.
(2) Neuralgias of head, face and eyes, especially left-sided.
(3) Ciliary neuralgia; rheumatic neuralgia of eyeball.
(4) Headaches increase or decrease with the height of the sun.
(5) Organic and functional disease of the heart with violent pains and palpitation.
(6) Painful sensibility of the body to touch, general hyperaesthesia. Afraid of sharp pointed things, ex. gr., pins, needles, &c.
(7) The longer the pain lasts, the more sensitive the patient becomes to it.
(8) Pale, weakly anaemic people, the subject of neuralgia.
(9) Children affected with worms.
From noise, jar, movement, change of weather, especially stormy weather, tobacco, touch, pressure of clothes (firm pressure relieves neuralgia), shaking head, moving eyes, rising, stooping, bending forwards, immediately after eating, cold washing (except neuralgia, temporarily), morning on waking.
From rest, lying with head high and on the right side (cact., spong.), open air (headache), cold applications (neuralgia, temporarily), firm pressure (neuralgia).