CHINA


Homeopathic remedy China from A Manual of Homeopathic Therapeutics by Edwin A. Neatby, comprising the characteristic symptoms of homeopathic remedies from clinical indications, published in 1927….


      Cinchona calisaya: Peruvian bark. N.O. Rubiaceae. Cinchona and Quinine. Preparations from the bark and derivatives.

INTRODUCTION

      QUININE, one of the alkaloids obtained from cinchona bark, affords a good example of how the primary and secondary effects of a drug may be utilized, on opposite principles, for therapeutic purposes.

PATHOGENESIS.

      (1) QUININE is primarily a stimulant of protoplasm in general, and secondarily it exhausts and paralyses it. The movements of lowly organisms are first stimulated as are those of cilia; subsequently they become slower, less vigorous, and finally cease. These effects are induced by the direct application of solution of 1 in 20,000. If the solution is stronger the primary stimulus is less marked and shorter, the paralysing effect rapidly ensuing; if weaker the converse occurs. In the ordinary doses used for experimenting it is the secondary or depressing influence which is conspicuous, and the same action is utilized (antipathically) in many cases in its therapeutic employment.

(2) Action on Cells of Blood and Body.-The leucocytes soon become spheroidal and motionless in contact with a solution of quinine. The usual diapedesis of the white corpuscles of the frog, seen when the mesentery is examined under the microscope, is checked by the subcutaneous injection of quinine, the cells become granular and motionless. “Suppuration” is thus said to be prevented. By the doses required to effect this the phagocytic and antidotal power of the leucocytes is lessened and the resisting power of the organism to sepsis is diminished. The other cells of the body are probably affected similarly.

(3) Muscle tissue, both plain and striped, is first stimulated and then depressed, that is, the contractions are first increased and then diminished, arterioles are first constricted and then dilated.

(4) Circulatory System.-The pulse-rate is first increased and then diminished. Blood-pressure becomes lowered, followed possibly by the death of the subject. Besides the effect on the blood-cells noted in paragraph 2, haemorrhages in various parts have been noted as due to quinine, e.g., purpuric spots, and bleeding from mouth and vagina occur, also haemoptysis, though the heart and lungs are healthy (C.D.P.).

(5) Metabolism.-Even here the same order is observed, the predominant effect, however, being depression. The effect on tissue change is best seen by urinary analyses; after a slight temporary increase the phosphates, sulphates, chlorides, urea and uric acid are all diminished. The total solids may be lessened by as much as 40 percent., and the effect of a single dose may be seen in a fall of nitrogen excretion lasting as much as three days. The absorption of oxygen and the elimination remain unchanged. Coincident with the changes in metabolism is the influence on the body temperature.

(6) Temperature.-Experiments on animals show that the temperature is first slightly raised and then considerably lowered. These experiments furnish an interesting confirmation of those of Hahnemann, who found that his own temperature was raised by taking doses of cinchona bark, and that a condition was induced resembling a malarial attack. This experiment was made deliberately by Hahnemann with the object of ascertaining the action of “bark” in ague, and as a deduction the action of drugs on disease in general. After confirmatory experiments Hahnemann re-affirmed the fact as a rule for the selection of drugs in disease, similia similibus curentur. The secondary effect of quinine, its most obvious effect in large doses, is not due to increased loss of heat but to diminished production. The depression of temperature is proportionate to the lessened excretion of nitrogen. The pyrexial effects of quinine, to which we have already alluded, are usually unaccompanied by inflammation of any particular organ or structure.

Definite lesions are, however, sometimes met with, which will be referred to presently.

Intermittence has been noticed without repetition of the dose, but this did not occur in Hahnemann’s experiments on himself. He had to repeat the dose to induce a fresh febrile manifestation. this recurrence of the febrile condition may be daily or every second day, commencing chiefly in the evening or afternoon. During the stage of shivering there is commonly no thirst, but headache, vertigo, nausea, feeling of fulness in the head, pallor of face and coldness of hands and feet are present.

In the hot stage there are the usual headaches of fever, with red, burning face, dryness of mouth and lips, full, quick pulse and possibly some wandering. The relationship of the thirst to the stages of the fever must be noticed. It is rarely felt during the heat and still less during the cold stage, but mostly before the chill starts and during the perspiration. There may not be the regular stages of an ague fit; perhaps only a chill with cold feet and hands, inability to get warm in bed, but with heat of the head-all worse in the evening. Or heat only may be pronounced, with headache, abdominal and hepatic symptoms, or cough and stitches in the chest; heat without thirst-a striking and unexpected symptom.

Respiratory System.-Hoarseness, from mucus in the larynx, soreness and raw feeling there; choking, paroxysmal cough in the evening or at night mark the influence of chinchona on the larynx. The cough may be worse after midnight, from cold air, on awaking, from talking or laughing, and better from sitting propped up in bed (hyoscy., puls. and lycopod.). Or the irritation may extend lower in the chest, when the cough my be accompanied by retching, wheezing and oppression on the chest, with expectoration of mucus or muco-purulent and bloodstained sputum. Haemoptysis without lung disease may also occur. The breathing may be loud and stertorous and only possible when sitting erect, worse after eating, drinking, moving about and trying to breathe deeply.

Pressure in the chest, as from a weight on it, may be felt after a meal.

Urinary Organs.-China causes frequent micturition and burning at the urethral orifice. The urine varies with the site of chief impact of the poison. It is turbid and scanty, depositing a yellowish or brick-dust sediment in gastric catarrh; if jaundice is present it will be dark and contain bile-pigment. It is also accused of producing albuminuria, haematuria and haemoglobinuria. “This haemoglobinuria so resembles.. blackwater fever… that it has been contended that blackwater fever is really quinine poisoning occurring in malarial subjects. But this view is now abandoned, the fact is that chronic malaria and quinine can both cause haemoglobinuria (a parallel of deep significance to the homoeopathist), and although quinine sometimes seems to provoke this symptom when given in chronic malaria, it can also cause it to disappear…” (Wheeler, op. cit.).

THERAPEUTICS.

      The chief importance of quinine is centred in its use in malaria. Here we do not propose to go into the question of the use of that drug in the routine treatment and prevention of malaria. Its nodus operandi may be twofold-that of a parasiticide and that of a stimulant of body resistance. Indeed, even its parasiticidal action may be via the body-resistance route, for it is stated that a strength of quinine which, given per os, will kill malarial parasites, will allow them in vitro to live and multiply. It is still a point, unsettled by experts, whether the daily prophylactic dose of 5 gr. is desirable or not. Some observers denounce it as useless or dangerous and liable to predispose to blackwater fever, others regard it as an essential in malarial countries. Experience seems to show that the regular use of quinine in doses of 5 gr. daily does in most cases ward off attacks of ague and may banish blackwater fever from districts where it is prevalent. Irregular dosing, with sudden large doses when an attack of fever is threatening, is to be deprecated. Quinidine, a cinchona alkaloid isomeric with quinine, reduces the conductivity of the heart’s muscle, especially of the auricle, and thereby increases the time of the “refractory period’ in the auricular pulsations. This property is made use of in the treatment of extrasystolic paroxysmal tachycardia and auricular fibrillation, all of which irregularities it controls.

The indications for the homoeopathic use of cinchona (“china”) in malaria may be summarized as follows. Immediately before the paroxysm there is much thirst and increased appetite, with restlessness, sneezing, palpitation and nausea. The chill is pronounced and is not accompanied by thirst, nor (and this a “keynote”) is the heat; the intense heat is worse from movement; the patient wants to throw off the clothing but he gets chilly if uncovered. There are general aching pains and irritating cough.

In the sweating stage thirst returns. The sweat is exhausting and is worse during sleep, on movement, when covered up, and on the parts lain upon.

In the interval there will be debility, yellowish skin, abdominal distension and probably enlarged spleen. The tongue is thickly coated, the taste is too acute, there are bitter taste and eructations, turbid, scanty urine and absence of thirst, except just before a paroxysm. General aggravation ensues from draughts, mental exertion and drinking milk, and improvement from rest and warmth. China is chiefly indicated (homoeopathically) in benign cases, it is usually a day-time attack. Absence of thirst during the heat is one of its outstanding indications.

Edwin Awdas Neatby
Edwin Awdas Neatby 1858 – 1933 MD was an orthodox physician who converted to homeopathy to become a physician at the London Homeopathic Hospital, Consulting Physician at the Buchanan Homeopathic Hospital St. Leonard’s on Sea, Consulting Surgeon at the Leaf Hospital Eastbourne, President of the British Homeopathic Society.

Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,