Ambra Grisea. Ambergris.
AMBERGRIS is a greyish yellow, fatty, spongy substance which is found in and expelled from the intestinal canal of the sperm whale. It floats in water, softens or melts with heat and contains cholesterine-like bodies. This whale feeds on cuttle- fish, and it is of interest that a number of the symptoms of ambra recall those of sepia.
Reading Hahnemann’s pathogenesis of this drug reveals no clear picture of any named disease. One prover who took 30 gr. noticed “quickness of pulse, increase of muscular power and of sight and hearing; also greater activity of mind and of the sexual power.” (Cyclamen of Drug Path. sub voce). This concise statement supports the general view of its function as a nerve stimulant.
The cases for which ambergris (to be distinguished from amber) is indicated, are those where failure of mental and physical power is premature. There is a generally exhausted condition, worse in the mornings on awaking, with weariness and even painfulness of the limbs -a form of neurasthenia. These pains may be of a tearing character, are often one-sided but not showing decided preference for either side; or the limbs may be merely heavy or numb. That it is not part of an impending paralytic condition is shown by the relief from walking exercise. Similar pains-possibly described as rheumatic, but not definitely articular-are found in the limbs and on the trunk. The pains in the limbs are associated with coldness and relieved by local warmth, the patient, however, being easily overcome by hot rooms, &c.
Vertigo is a common feature in most provings, but it is emphasized in ambra cases-being described as “even dangerous”; with this lowered condition goes great liability to take cold.
Nervous System.-Even more important is the nervo-mental condition. There may be gradual impairment of powers and of special senses, such as sight or hearing, without obvious local lesion. On the other hand, there may be hypersensitiveness, e.g., to music; this may be an earlier stage in the history of a case. Forgetfulness is an earlier stage in the history of a case. Forgetfulness is a notable symptom and coupled with it in an extreme lack of power of concentration-late symptoms probably.
The patient may be quite loquacious, but turns rapidly from one train of thought to another, or after asking a question passes on without waiting for reply, as a fresh topic or side issue enters his mind. He also passes quickly from one morbid mental state to another, such as from depression to irritability- but not like pulsatilla patients from depression to gaiety, or from weeping to laughter. Weeping, however, may be present, and may be succeeded by passionateness or quarrelsomeness. Indifference, amounting even to melancholia, may characterize the case, but it is not so strong an indication as in sepia patients, for the sadness is more active-from anxiety it may become despair, or desire to die. Various other nervo-mental indications also should be chronicled-e.g., loss or “presence of mind”- of power to decide or act quickly, trembling and flushing; dwelling on disagreeables; morbid embarrassment in presence of others, especially during stool. Some patients develop transitory illusions or hallucinations-see or dwell upon “faces” or fancies.
The conditions described may be induced by a sudden shock or anxiety-business or domestic-especially in debilitated, loose- living subjects.
The student should be reminded that the picture drawn is a composite one, based on the observation of a number of patients under treatment, and appearing to be benefited by ambergris. No one patient ever exhibited all these symptoms, still less was such a condition produced as a whole by “proving” the drug. Interwoven with these general, nervous and mental states, are a number of local physical features which only require enumeration. For a full record of them the reader is referred (as usual) to the schematic records, or the day books of the experimenters.
The sexual sphere has been referred to. In women the action of ambra is chiefly superficial, and it is prescribed for (inter alia) soreness and itching of the vulva, with early appearance of the period, and in the intervals leucorrhoea-slimy, “bluish- white, or thick.” Inter-menstrual bleeding has been noted as easily brought on by walking or straining at stool. [As this symptom may be due to local lesions, some of serious import, it should be regarded as an indication for a careful local examination.
The men, itching and soreness of the glans penis, and burning internally, as if in the seminal vesicles, may be present; voluptuous sensations without erections, or the converse, waking a patient from sleep; all these are possible indications for ambra.
The urinary sphere has certain symptoms recalling the action of sepia-e.g., pyknuria, turbidity, or high colour of the urine, which may have an offensive sour smell on standing.
Digestive System-Sour eructations, worse after milk, heartburn; constipation with ineffectual urging and straining; aching in the hepatic region; distention of the abdomen (especially hypogastric); flatulent colic, waking the patient at midnight or coming on in the morning and relieved on rising; cold feeling in the belly; rectal tenesmus, and itching and shooting-these are the notable digestive symptoms.
Sleep.-The sleep of ambra patients may be disturbed in the early part of the night, or later on by frequent waking; by anxious dreams or dreams arising from digestive derangement, sexual irritation or business cares. Strong-smelling perspirations may occur at midnight or in the morning, with evening heat 7 to 8 p.m.
In conclusion.-A dry, spasmodic nervous cough, but without whoop, worse from talking, worse in the evening and accompanied in the morning by expectoration; asthma from exertion, from coitus, from excitement, from music, with cough and palpitation, this throbbing being felt all over the body; cramp in the calves at night; falling out of the hair; all these complete, as far as such a narrative can be complete, the account of the indications for ambra as a remedy in diseased states of the body.
1) Neurasthenia; lowered resistance to local cold, and to heat generally.
2) Hypersensitiveness or impairment of powers according to stage of malady; great liability of taking cold.
4) Coldness in the abdomen.
5) Paroxysmal cough without whoop; see the modalities.
6) The subjects most likely to benefit by ambra are excitable, nervous, emaciated girls or young women, and thin, nervous, old people.
From warm rooms, warm drinks, especially milk; in the morning; in company; after passing water (local); walking; straining at stool (haemorrhage); coitus; music; talking or reading aloud.
Open-air exercises; cold air, food and drinks; rising from bed.
Ambra grisea deserves more extended use, especially in certain nervo-mental states.