CINA. Several species of Artemisia levantica. “Wormseed.” N.O. Compositae. Tincture from flower heads (so-called “seeds”).
INTRODUCTION
SANTONIN. (C15 H18 O3). A neutral principle derived from the unexpanded flower heads of various species of artemisia, which, when freshly prepared, occurs in colourless crystals that turn yellow on exposure to light. Santonin is insoluble in water but is dissolved by alkalis with the formation of santoninates. It is to the santonin present in its seeds that cina owes its physiological properties.
PATHOGENESIS.
Santonin is absorbed to some extent from the stomach and thereby cayuses constitutional symptoms. The most peculiar effect of santonin is its influence on colour vision. Objects appear yellow. The violet end of the spectrum is not perceived, so that blue and violet appear black, and compound colours, of which either of these is a constituent, undergo modification. This phenomenon is considered to be due to a specific action of santonin on the retina that prevents the regeneration of the substance in the retina which appreciates violet rays. By some the xanthopsia produced by santonin is thought to be due not to a local specific action on the retina, but to irritation of the centres of vision in the brain, and they adduce in support of this opinion the undoubted irritating effect it has on the cerebrum. It causes general twitching of the muscles of the head, frequently beginning on one side, rolling of the eyes, grinding of the teeth, flexion and extension of the neck and rotation of the head from side to side; later on regular epileptiform convulsion occur, which begin with opisthotonos on which follow clonic spasms of the limbs and trunk. The convulsions are interrupted by intervals of repose, during which momentary contractions of all the muscles of the body are noticed. Respiration is embarrassed during the convulsions but otherwise is not affected. With smaller doses nausea and vomiting occur, presumably of cerebral origin, and in some cases the senses of taste and smell were deranged, and in one that of hearing. Aphasia has also been noticed.
Santonin affects the brain rather than the spinal cord, the convulsions are probably due to irritation of the cortex cerebri, and the sudden contractions in the intervals to a similar action on the basal ganglia. The medullary centres of respiration are not affected.
Santonin undergoes some oxidation in the tissues, and is excreted in the faeces and urine as oxysantonins. The urine is profuse, of a pale yellow colour, and becomes milky on standing. There is frequent desire to pass water. PROVINGS of Cina have elicited some symptoms which have helped to afford indications for its therapeutic employment. Circulation.-The pulse is small, regular, contracted and somewhat slowed, and this is followed by general sweat and a stronger pulse. Great heat and redness of the face alternate with pallor, or the heat and redness are coincident with markedly white lines about the nostrils and mouth, or the face is pinched and sickly- looking.
Noisy delirium occurs, alternating with quietness, and there are hallucinations of vision, smell and taste. The mind becomes very sensitive and makes the patient touchy, easily upset, refusing to be pacified, restless, ill-humoured and disliking to be looked at (antim. crud.).
Digestion.-Thirst for ice-water; nausea, retching, abdominal pains and diarrhoea of thin, white stools are observed. Capriciousness of appetite, the desire for many and different foods and great hunger not satisfied by food, but recurring soon after a meal are characteristic. The senses of taste and smell are exaggerated or perverted.
Respirations.-An incessant hoarse cough that is accompanied with a feeling of something coming up into the throat which has to be swallowed down, is a marked symptom.
Skin.-The skin is rendered hypersensitive, the scalp can bear no touch or pressure, and the integument over the shoulders and the upper part of the trunk feels sore as if bruised. Irritation of the orifices, especially of the nose, which the patient picks, is present.
Sleep.-Sleep is very disturbed, frightening dreams of dogs, phantoms, &c., wake the patient and seem so real that they are prolonged into the waking hours. There is grinding of the teeth during sleep.
THERAPEUTICS.
It will be noticed how similar the above symptoms are to those occurring in children harbouring worms, and it is a curious fact that santonin, which has been used almost exclusively by the orthodox profession as a vermicide, should be able to excite the symptoms caused by worms when it is taken internally. It raises the question as to what the expulsion of worms by santonin is really due. That santonin directly kills the worms seems improbable in face of the fact that they are often alive when expelled and that it is not fatal to worms exposed to it outside the body. Also the fact that an infinitesimal dose of cina is often as effectual in expelling lumbricoides as a material dose of santonin, seems to make it likely that it is some substance formed in the tissues by their reaction to cina that is the effective agent. in any case the homoeopathicity of cina to the symptoms caused by worms is manifest. It is well known that worms will often bring on convulsions in children, and we have seen that santonin produces such paroxysms. It is, however, not necessary for convulsions to be due to worms for it to be a suitable remedy for them, it the general conditions indicating cina are present. Thus it has been found useful in certain cases of whooping-cough, with or without convulsions, in convulsions resulting from punishment, in those occurring in some cases of hydrocephalus, as well as those arising from bowel disturbances in children induced by other irritation than worms.
Cina is a remedy for a short hacking cough, worse at night; for intermittents associated with vomiting and canine hunger and the lingering remittents or children; for gastralgia with gnawing, hungry pains unrelieved, or relieved only temporarily, by food; and for nocturnal incontinence of urine due to the irritation of worms or to other causes. In all these complaints the distinctive cina characteristics should be present to warrant its employment as a remedy.
Eyes.- The action of santonin on the retina has led to its successful prescription in cases of retinal hyperaesthesia, such as occurs from over-use of the eyes in doing fine needlework, and it has been used with satisfaction even in cases of choroiditis, retinitis and amblyopia due to retinal anaesthesia.
In abdominal pains and diarrhoea the indications for it are watery, flaky, sour-smelling stools, and relief to the pain from lying on the abdomen. The cina patient is apt to have a sour smell.
Dose.- For worms cina may be given in almost any potency. For their expulsion by santonin in adults it is best first to open the bowels by means of a laxative, then to give one or two grains of santonin in an ounce of castor oil, and to follow this in from two to four hours afterwards by a sharp purge. The smallest dose of santonin that has proved fatal in a child is two grains.
LEADING INDICATIONS.
(1) Hypersensitiveness, mental and bodily.
(2) Alternating red, hot face and pale, pinched face.
(3) Convulsions from reflex irritation.
(4) Rolling of the head in brain troubles.
(5) Yellow vision.
(6) Pale, sickly-looking children with dark hair and bluish colour round mouth and under eyes, worm troubles and irritation of orifices.
(7) convulsive coughs, dry with sneezing, or brought on by talking or moving.
AGGRAVATION :
From touch, jar, vexation, during sleep, after eating, in the sun.
AMELIORATION :
From lying on the abdomen; food (temporary, to gastric pains).
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,