Read before the Onondaga County Homoeopathic Medical Society,

October, 1864, by C. W. Boyce, M.D., Auburn, N.Y.

To take a general view of the action of Spigelia upon the organism, it may be said to be manifested chiefly upon the nervous system of animal life. Spigelia is eminent among the remedies of our Materia Medica for the extent to which its action seems to be exerted upon the nerves themselves or their envelopes. Upon the substance of the nervous centres however, its action is probably very slight.

1. Spigelia excites the nerves of special sense in a marked degree, and this, without any clearly defined inflammatory affection of the organs of special sense. In this regard, it differs from Belladonna, Rhus, and other remedies which excite particularly the nervous system of animal life. But there is an exception to this statement. In the tissues of the eye Spigelia excites inflammation, its symptoms giving a well marked picture of rheumatic sclerotitis.

Spigelia exerts a marked action on the trifacial nerve, producing prosopalgia, which involves the orbit, the zygoma and the superior maxilla; also upon the nerves of the tongue; perhaps also upon the portio dura. The prosopalgia of Spigelia, is distinguished by sticking, burning pains with subsequent swelling and soreness of the parts affected. In this respect it closely resembles the prosopalgia of Colchicum, from which however it is distinguished by the remarkable exaltation of the special senses and by the general nervous erethism and excitement and intolerance of pain which characterize Spigelia, whereas Colchicum on the other hand has an equally remarkable tolerance of pain and patient, enduring disposition, with a general semi-paralyzed condition.

2. There is no evidence of any definite modification of the organic substance of any part of the body, unless such action upon the pericardium be inferred ex usu in morbis.

3. The sphere of action of Spigelia is not extensive. It embraces the nerves of animal life, and of special sense and the fibrous and perhaps the muscular tissues of the heart and of the smaller extremities.

The effect of Spigelia upon the heart's action seems to be due to a morbid condition which the drug excites in the pericardium, and hence its value in pericarditis.

4. The pains of Spigelia are sticking, tearing, and burning pressing. They are aggravated by motion and in the afternoon and at evening. They often prevent sleep. There is great lassitude and heaviness of the limbs. Great sensibility of the whole body to touch; the least touch on any part of the body, sends a shudder through the whole frame.

5. There is no marked periodicity in the symptoms. Let us now examine more closely the different parts of the body chiefly affected.

Head. - There is vertigo when looking down and when walking. The memory is impaired, and mental effort is very irksome.

The headache is very characteristic and presents a good picture of a form of so-called “nervous headache.” In general, the sensations are dullness, heaviness and pain in the head; the pain is much increased by shaking or jarring the head, as by walking, especially if one make a misstep or cough or sneeze; by moving the facial muscles, by speaking aloud or by any loud noise, as well as by touch or by a bright light. These things increase the pain so that it seems as though the head would burst; the patient is compelled to support it with the hand, or to bind it around. (Here we have headache with over-sensibility of the senses of sight, hearing and touch, with relief from binding the head. These symptoms resemble the headache of Silicea which has likewise exaltation of the special senses and relief from binding up the head, but it is to be carefully noted, as characteristic, that the relief to the Spigelia headache comes from the pressure of the bondage, while to the Silicea headache, the relief is from the warmth; for warmth relieves the Silicea headache, while it rather aggravates the headache of Spigelia.)

The pains are a heaviness, and feeling as of a load or weight in the head; a pressing from without inwards, aggravated by stooping forwards unless the forehead is supported by the hand; a sensation of swashing and surging of the brain within the cranium (compare China, and Rhus and Apis) at every step or on the least motion or when speaking loudly, and very severe when a false step is made or the body is jarred; relieved by repose. This swashing sensation is often accompanied by a tearing, digging pain in some small well-defined portion of the head; generally, semi-lateral, as, for example, in the left parietal region, or the space extending from the left occiput to the left forehead. As regards the localities affected, the pain is generally circumscribed and is often confined to one side; more frequently the left.

The occiput is the seat of many pains which extend into the nape of the neck causing stiffness and at the same time restlessness. In the forehead and in the frontal protuberances we find pulsating stitches; pressure from without inwards; boring and burning pains; the latter are probably superficial and seated in the super-orbital nerve. In the frontal protuberances tearing pain extending into the eye and aggravated by motion of the globe of the eye.

In the temporal region, we find pulsating stitches, pressure inwards and burning, extending into the zygoma.

We pass now to the Eyes which are acted upon not only as regards the tissues, especially the muscular and fibrous tissues, but also as regards the special sense of vision.

In addition to the affections of the eye proper, we find in the left orbit pressing neuralgic pains extending down to the zygoma and leaving on the zygoma a tumor which is sensitive to touch.

The conjunctiva is moderately inflamed. There is moderate pain as if sand were in the eye, a slight secretion of muco-pus and bland lachrymation.

The affection of the deeper tissues of the eye-ball is shown by the dull and flat aspect of the eye, the supra-orbital pains, redness and inflammation of the sclerotic with ptosis, pain in eye and brow; the eyeball is painful when moved and feels tense as if too large for the orbit (Paris quad.); sticking pain in the eye. The eye is painful when moved in any direction (Bryonia) an intolerable pressive pain, so great that, rather than endure it, the patient, when desirous of looking from side to side, moves the whole head, instead of merely the eyeball. Heat and burning in the eyes.

Vision. The sensibility of the retina is increased, inducing photophobia. It is likewise perverted, causing illusions, as if hairs or feathers were on the lashes, and these illusions are increased by wiping the eyes; sparks and a sea of fire. The pupils are dilated.

The sense of hearing is exalted in connection with the headache.

In the zygomatic region of the left side of the face, burning or tearing pressive pains which leave a dull sensation of swelling as the pain abates. There are stitches from the upper maxilla to the vertex.

We pass now to the symptoms of the thorax.

There are stitches in the chest in various parts; and on-both sides, most frequently the left. These stitches are generally from within outwards, and are aggravated by respiration (most by inspiration) and by motion. They occur under the nipple of either side, and, on the left side, are directed towards the scapula and left arm.

The following symptoms: violent stitch in the left side just under the heart recurring periodically; stitch in the diaphragm on the left side, so violent as to arrest breathing; dull stitches, synchronous with the pulse, in the region in which the heart's impulse is felt; stitches between this spot and the epigastrium; - these symptoms, together with those which denote modified action of the heart, viz.: very violent pulsation, audible to the patient and visible to the bystanders; violent palpitation and anxiety; tremulous motion of the heart; palpitation increased by sitting down and bending forwards, and by deep inspiration and retention of the breath; palpitation as soon as he sits down after rising in the morning, and, in the precordial region, a heavy painful pressing load causing constriction and anxiety with cutting and griping as from wind in the abdomen; - these symptoms all clearly point to an affection of the heart and pericardium, and, in such diseases, clinical experience has shown Spigelia to be of exceeding value.

Clinical Indications. - It is evident from our hasty and partial review of the symptoms, that Spigelia may be clearly indicated in cases, that would come under the following groups.

1. Headaches; generally semilateral, so-called nervous; accompanied by great exaltation of the special senses; (compare Silicea, Conium,) aggravated by motion, noise, light and thought; involving generally the left eye and orbit without congestion of the head. In such affections (if attended, as frequently, by nausea and vomiting they resemble “sick headaches ”) Spigelia, compares with Silicea, Belladonna, Apis Ignatia, Thuja, Sanguinaria.

2. In Sclerotitis. Also in nasal catarrh when the discharge is chiefly from the posterior nares into the pharynx, and attended by neuralgic affections of the pharynx and region of the ear and lower jaw provided always the general symptoms correspond.

3. Above all, in acute or subacute affections of the heart which present symptoms similar to those of Spigelia above quoted, it is an invaluable remedy; as for example, in acute pericarditis, with anxiety and weight in the precordia, stitches through the heart arresting respiration, oppressed and accelerated palpitation so forcible as to be audible and visible and excited or aggravated by change of position or by the slightest motion. In such cases, Spigelia compares with Aconite, Bryonia, Kalmia, Lachesis, Naja. [And with the new remedy Cactus grandiflorus.-D.]

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