Black Cohosh. Black Snake-root.
SOME confusion may arise because of the different names applied to this remedy, and therefore, the different parts of Materia Medica where it is to be sought. Hughes says he prefers to call it by its Linnaean name-Actea. Hering (Guiding Symptoms) has it as Actea: he says, “It has received so many improper names that the oldest is preferred.” Clarke, H.C. Allen, Kent and Guernsey call it Actea: Nash, Boericke, Boger, Cimicifuga, which name is more familiar. Allen also, in the Encyclopedia, has it under Cimicifuga.
It seems strange that we should never before have tried to Drug- picture CIMICIFUGA: one of the remedies so very useful to physicians brought up on Hughes, rather than on Hahnemann pure and simple,-that painstaking experimentalist and recorder, whose genius, so far as we have seen, is not improved by modification, or in need of apology. Hughes’ Pharmacodynamics, excellent in its way, got the nickname “Homoeopathic Milk for Allopathic Babes”, for his great object was, evidently, to reconcile Homoeopathy, or at least to make it acceptable, to Old School practitioners of his day. But Old School has recently made great strides in its basal conceptions: so much so that the Doctrines of Hahnemann are found to be rather explanatory than antagonistic to present-day thought, and are quite easily swallowed by the latest qualified: indeed we hear that already it is being said among the science teachers of one of the medical schools, “Homoeopathy is the coming medicine”. But the strong meat as well as the milk of Homoeopathy remain not easy of digestion to most of the older men, some of whom shrink from all this new study” at their time of life”, which means so much unlearning and relearning, not only in regard to prescribing, but the plunge into that vast, unknown Materia Medica homoeopathica. “If I had only come across this forty years also!” But the more earnest seekers after truth, the rebellious against inaptitude, are finding in Homoeopathy the explanation of many difficulties, doubts and misgivings: a something that goes deeper than mere palliation; and proves that good work can be done apart from the daring and often dangerous experimentation of the laboratories. Moreover Homoeopathy leaves them no longer subject to the temptations and dictates of the manufacturing chemists, whose samples pour in by every post, to be tried and adopted for further experiment on a hit, or discarded as useless on a miss. Do such things belong to the Reign of Law?-to any Science of Medicine: that Inspiration to which Hahnemann dedicated his life, and for which he wrestled with God and nature during all those long, weary years? Are they not merely a counsel of despair: a terrible acknowledgment of ignorance and failure?
But, to go back to Cimicifuga:
Nerve, or nerve and muscle-myalgias-seem to be the very special sphere of Cimicifuga: as a very interesting case quoted by Dr. Hughes exemplifies. The drug attacks eyes, in a marked degree, but, it is pointed out, that it is through the eye muscles. As Boger gives it, in arresting type, “NERVES AND MUSCLES, Cerebro- spinal, Eyeballs, Ovario-uterine, Heart” and, like caulophyllum, “in females” joints. And everywhere it is better for warmth in every form; for open air; for pressure, and for continued motion.
It is a remedy of crazy feelings, of chorea, and one of the remedies that affect especially, uterus and all the conditions dependent on uterine abnormalities of function. It is a rheumatic, choreaic, spasmodic, hysterical and uterine remedy. It reminds one, as one reads, now of Ignatia, now of Gelsemium, now, as said, of caulophyllum, now of Lachesis. A very useful drug for more or less superficial conditions-through it has also a reputation in phthisis.
Among its contradictory symptoms are its “relief from flow” – bowels, uterus, etc., yet its aggravation during menstruation. Its relief from flow reminds one of Sepia, Lachesis, Zincum met.
One thinks of Cimicifuga especially in stiff neck and sciatica,- (provided that these are not dependent on small displacements, and therefore only amenable to manipulation); in chorea; in hysteria: as well as in obscure conditions, such as the myalgia of diaphragm, to which Hughes draws attention.
Hering, stressing the importance of provings on men and women of the various drugs, shows that in provings by six women, Cimicifuga produced nausea, vomiting and much gastric irritation; while in forty men, it hardly affected the stomach in the least. He says, being an important remedy in morning sickness of the pregnant, we may conclude that all the gastric symptoms observed by female provers depended on the uterus. He says further, that it has been observed that Cuprum acts more on the female, and Ferrum on the male organs.
BLACK LETTER SYMPTOMS
Thinks she is going crazy.
Mania following disappearance of neuralgia.
Incessant talking, changing from one subject to another.
Feels grieved and troubled, with sighing: next day a feeling of tremulous joy, with mirthfulness, playfulness and clear intellect.
Fear of death.
Fullness and aching in vertex.
Severe pains right side of HEAD, back of orbit.
Brain as if too large; presses from within outwards.
Dull constant pain, especially occiput, extending to vertex.
A pressing upwards and outwards, as if not room enough in upper portion of cerebrum: this pain was very oppressive and almost intolerable. A sense of soreness in occipital region, worse motion.
NAUSEA. Retching, dilated pupils, tremor of limbs.
Aching pain in both eyeballs.
Sharp pain across hypogastrium.
ABDOMINAL muscles sore.
Pains in UTERINE region, dart from side to side.
Menses irregular, delayed or suppressed, with chorea, hysteria, or mental disease.
Shivers of first stage of labour.
Infra-mammary pains, worse left side.
Night COUGH, dry, incessant, short.
Head and NECK retracted.
Rheumatic pains in muscles of neck and BACK; feeling of stiffness.
A severe drawing, tensive pain at the points of the spinous processes of the three upper dorsal vertebrae.
Excessive muscular soreness.
CURIOUS, DISTINGUISHING OR ITALIC SYMPTOMS
As if a black cloud had settled all over her, and enveloped her head, so that all was darkness and confusion: it weighed like lead on her head.
Waving sensation in the brain.
Startled by the illusion of a mouse running from under her chair.
Imagines strange objects about the bed: rats, sheep, etc.
Fear of death: fears those in the house will kill him.
Would not answer, or very loquacious at times.
Mental depression, suicidal, after checked neuralgia.
Suspicious of everything, would not take medicine.
Mind disturbed by disappointed love, business failures, etc.
Feels faint at epigastrium when meeting a friend.
Rush of blood to head: brain feels too large for cranium.
Waving sensation. Opening and shutting sensation when moves head and eyes. Top of head feels as if it would fly off.
As if vertex opened and let in cold air.
Sensation of enlargement, eyeballs, as if they would be pressed out.
As if needles were run into left eyeball through cornea.
Coppery taste. Cannot speak a word though she tried.
Dry spot in throat causes cough.
Alternate diarrhoea and constipation.
Shivers in the first stage of labour: during menses.
Puerperal mania: does not know what is the matter with her head: clutches it. Screams, clutches at breast as though in pain: tries to injure herself.
Acute pain, apex to base of right lung, worse inspiration.
Angina pectoris: pain heart region, all over chest and down left arm: palpitation; unconsciousness, cerebral congestion, dyspnoea, face livid, cold sweat hands; numbness of body: left arm numb and as if bound to side. (Cured case, Hering.)
Heart’s action ceases suddenly; impending suffocation.
A heavy black cloud had settled all over her: weighed like lead on her heart.
Stiff neck from cold air, with pain from moving hands.
Weight and pain, lumbar and sacral, sometimes extending all round the body.
Severe pain in back, down thighs and through hips, with heavy pressing down.
Severe pain down arms, with numbness as if a nerve were pressed.
Left arm feels as if bound to side.
Cold sweat on hands.
Must change position, to quiet jerking, in bed.
Can scarcely walk, from trembling of legs.
Must walk about, when restless and impatient.
Going upstairs aggravates feeling as if top of head would fly off.
Moving head causes opening and shutting sensation of head: and cramps in muscles of neck.
Moving eyes causes opening and shutting sensation in head.
Irregular motion of legs, worse left. Legs unsteady (Chorea).
Epilepsy: Hysteric spasms.
Affects the nerves, especially muscular nerves. Myalgia.
Similar to caulophyllum in uterine and rheumatic affections.
HUGHES (Pharmacodynamics) has a great deal, of great interest, to say about Actea as he prefers to call Cimicifuga. He says, “It causes no febrile symptoms” (this, however, we must question judging by symptoms of provings and by cases of amelioration of fever during its use)” but it is a valuable remedy for some forms of rheumatism, especially where nervous centres and muscles are the seat of the disorder. In the acute and local muscular rheumatisms, such as pleurodynia, lumbago and torticollis Actea has gained commendation from all. In rheumatoid arthritis, where the pains are worse at night an in wet weather, especially if of uterine origin. Another form stimulates gonorrhoeal rheumatism, but without any history of gonorrhoea. Here, not only may the pains be almost immediately relieved, but the joints may become supple and useful again. Then in the sufferings which heart and uterus often undergo from the rheumatic poison. Provings make it evident that Actea affects the heart very powerfully. When rheumatism affects this organ, not setting up inflammation, but as it does other muscles, we have a valuable remedy in this drug. In a case cured, the symptoms resembled angina pectoris, the attacks recurring several times a day. He speaks also of its power over chorea.
Then, cases having the uterus for their starting point :- Actea has an undoubted action on this organ – abortifacient and ecbolic. Its therapeutic virtues in this region are numerous and well established, especially where the uterus is presumably rheumatic. It relieves dysmenorrhoea, checks tendency to abortion and after pains, and facilitates parturition. When morbid uterine conditions show themselves elsewhere than in the organ itself, by the pains and agitations characteristic of the drug, it comes potently to their relief. It cures uterine epilepsy and hysteria; puerperal melancholia; the nervousness of pregnancy, and the restless and unhappy state of mind so often seen in uterine patients, especially the sleeplessness. Then the inframammary pain in unmarried females, which is to the uterus what pain in the shoulder is to the liver. Also pains in the mammae so arising. Also suffering at the climacteric age, relieving sinking at the stomach (one of its marked pathogenetic symptoms), pain at the vertex, and the irritability of disposition, better than any other medicine.
He quotes an interesting and suggestive article by Dr. Madden, in the British Journal of Homoeopathy, Vol. XXV, in regard to Actea for diaphragmatic pain. “Here the doctor was not only physician, but patient.” The pain had its centre in the chest; “it was as if a person were pressing with his fist firmly on the sternum and forcing it inwards towards the spine.” Walking would precipitate an attack. When severe it would spread up the oesophagus and pharynx, causing a peculiar tingling at the back of the throat which extended to shoulder and upper chest, and down the arms to finger-tips. A few moments of perfect quiet would remove the pain. It would never come on when at rest, except on two occasions, during strong mental emotion. It was always worse after food.
The condition persisted, unexplained and resisting all attempts at treatment till something read suggested the idea that it might be a myalgia of the diaphragm; and the explanation seemed to fit. Arnica was rejected; and Actea selected, as producing an effect on nervous system and muscle.
Actea O 3 or 4 minims relieved: unaccompanied by the diuresis that usually followed the cessation of the pain: but the drug had to be stopped since it began to produce the Actea headache and aching pressure on eyeballs. Actea 12 gave no result: whereas the first centesimal could be taken without distress and soon cured.
[Evidently Dr. Madden was one of the low potency prescribers. Probably a higher potency, and no repetition till needed, would have done him even better? But, he was cured!]
Among the things that GUERNSEY specially notes in regard to “Actea”, we find. The Mental craziness, and fear of going crazy: imagines all sorts of strange appearances, and that some one is going to kill her. Her incessant talk, changing from subject to subject. Her despondency and the feeling of being under a heavy black cloud.
Pain in head as if top would fly off: or as if a bolt had been driven from neck to vertex. Or pain shooting from occiput down neck. Headache down to nose.
Pains in eyeballs, shooting into eyeballs so severe it seems she would go crazy. Needles running into left eyeball. While, with regard to nose, every inhalation seems to bring the cold air in contact with brain.
Face bluish. Wild, fearful expression. Forehead cold: deadly pale. Suddenly faint, face ashy white.
Pains, uterine region, darting from side to side. Bearing down: and in small of back, as if something were pressing out labour pains with fainting fits and cramps; convulsions, from nervous excitement. Puerperal mania : feels strange, talks incoherently, screams, tries to injure herself. Similar to Cauloph. in uterine and rheumatic affections.
CLARKE (Dictionary) says, “Given before term it renders labour easier, cures sickness of pregnancy, and prevents after pains and over-sensitiveness”. He says, “According to Lippe a characteristic indication is, `The recently delivered uterus becomes actually jammed in the pelvis with great pain.’ It has ensured living births in women who have previously borne only dead children, from no discoverable cause; given in daily doses of 1X two months before term.”
We will let KENT, as usual, sum up for us; it is often well to let him have the last word.
He says, the remedy is but meagerly proved, but we can perceive that it is similar to diseased states, especially in women, namely hysterical and rheumatic conditions.
The patient is always chilly, easily affected by cold and damp, which rouses the rheumatic state, not only in muscles and joints, but also along the course of nerves.
There is a lack of will, balance, or great disturbance in the voluntary system (the underlying feature of hysterica); the symptoms intermingled with rheumatism. Soreness, trembling, numbness, jerking. Inability to exercise the will over the muscles. Turmoil in the voluntary system, with stiffness. Sensitive to cold, except in the head.
A terrible mental state alternates with the physical states. Overwhelming gloom: bowed down with sorrow. This may pass off instantly, or to be brought on or aggravated by motion or emotion. The rheumatism may change in a day to chorea the physical and mental are all the time changing. Jerking, soreness and numbness often keep on together.
He notes re the chorea: Jerking when in a state of emotion or from becoming chilled. The part pressed on will have jerkings. The whole of the side lain on will commence to jerk, and prevent sleep. She turns over, and soon the muscles that side will in turn begin to jerk: she becomes so restless and nervous that she is driven to distraction. The mind full of imaginations and the body full of uneasiness because she can find no place to rest upon. Sometimes it is soreness, sometimes numbness, sometimes jerking that prevents her from lying in peace.
Fear: anguish: restlessness. Fear of death; excitement, suspicion. Will not take the medicine, because there is something wrong about it. “This remedy belongs especially to women, because its symptoms are so commonly associated with the affections of woman. Mental states following the disappearance of rheumatism is a strong feature. Rheumatism better, mental state worse. Relief from diarrhoea-from flow from uterus: `some flow must be established, otherwise the mind takes on trouble.”
“A routine saying about Actea is that it makes confinement easy but only when the remedy is given in accordance with symptoms. Repeat that over and over again, when the symptoms agree, WHEN THE SYMPTOMS AGREE. It cures and makes labour easy when the symptoms agree, and that will apply equally to all other remedies.”
Then its bearing-down sensations show that it is a very useful remedy in prolapsus of uterus: it has the relaxation of the parts. Remedies will cure prolapsus when the symptoms agree, and at no other times. If it fits the patient in general, these bearing down sensations will go away, the patient will be made comfortable, and examination will finally show that the parts are in normal condition. You cannot prescribe for the prolapsus; you must prescribe for the woman. You cannot prescribe for one symptom, because there are probably fifty remedies that have that symptom.
Here, with menstruation, the more the flow, the greater the pain: many of the conditions of Actea are worse during the menses, rheumatic, jerking, cramping, sleeplessness; epileptic spasms; soreness of muscles or joints. `Rheumatic dysmenorrhoea, is not a bad name.”
During labour; shivering; hysteric manifestations. Pains have ceased or are irregular. A pain comes on, seems to be going to finish satisfactorily, when all at once she screams out and grasps her hip: it has left the uterus and gone to hip, causing cramp. So emotional is she, that if she hears an emotional story in the room, the pain will stop: or the lochia may stop, or milk be suppressed, and she will be sore and bruised and have fever.
Kent says the best results have been from the 30th, 200th, 1,000th and still higher potencies, in single doses.