ANGUST. – Bark of the Galipea-officinalis, or Galipea-cusparia. Duration of Action: from 8 to 4 weeks in chronic affections.
COMPARE WITH.
Bruc., Cantharis, Carb-a., Carb-v., Coffea, Mercurius, Platina
ANTIDOTE.
Coffea
CLINICAL REMARKS.
It has been employed extensively in the malignant bilious intermittent fevers, dysenteries, and dropsies of Angustura and Demerara. It is probable, however, from the testimony of physicians in Europe and in the United States, that it is better adapted to tropical diseases than to those of temperate climates. It seems homoeopathic to nettle-rash, when followed by flat, painful ulcers. It was at one time considerably used in place of Peruvian Bark as a febrifuge; but has not been found successful in the treatment of intermittents in northern altitudes. More recently, Mr. Brande has spoken favorably of its febrifugic properties, and relates instances in which it has proved successful. Alibert, however, gave it a fair trial, and found it of little value; and general experience has pronounced the same verdict. Pereira recommends it, on the authority of Winterbottom, in “adynamic continued fever,” especially when complicated with great disorder of the digestive organs. Merat and De Lens assert that the natives of the country where it is indigenous regard it as superior to Quinine in the treatment of intermittent fevers; they also employ it like Quassia and Columba in dysenteries. Bretonneau, of Tours, used it in several cases, but was unsuccessful. Reydellet and Niel, of Marseilles, have administered the Angustura in powder, in five cases of vernal intermittent with entire success. Fodere has succeeded but three times in eight cases. This is qualified, however, by the reflection that oftentimes the most insignificant remedy will cure an intermittent, more especially one occurring in the spring-a simple stimulant, being sometimes all that is needed to enable the system to throw off the morbific influence. In order to give weight and value to a remedy it should succeed in the case of a tertian or quartan, of marked type, which has lasted from fifteen days to a month. It is usually thought to have no special influence on the brain and nervous system, but is generally regarded as a stimulant tonic, in small doses acceptable to the stomach. Many of the phenomena enumerated by Noack and Trinks as due to this variety of Angustura belong properly to the False Angustura. It has been ascertained that much of the bark which was formerly sold in Europe was composed of a mixture of both varieties, so that we are left in some doubt with regard to the pathogenetic and therapeutic effects peculiar to each kind. It seems to act upon the stomach somewhat similar to Cocculus and Nux-vomica, and may be employed against acidity, nausea, bilious derangement, flatulence, dryness of the mouth and throat, especially when there is an excessive desire for cold drinks, with more or less lassitude and inclination to faint. In the dominant school it is regarded as a valuable remedy in cases of dyspepsia with diarrhoea and loss of appetite. In cases of flatulency attended with nausea, if taken an hour before dinner, it will often restore appetite and digestion. In large doses it evacuates the stomach and bowels, and is often employed for this purpose in South America. It has been recommended in dyspepsia and other diseases in which a tonic treatment is demanded. It has the advantage over Peruvian bark that it is less apt to oppress the stomach. It is said to promote digestion, increase the appetite, expel flatus, and does not cause constipation. In large doses it is apt to vomit and purge; it seems homoeopathic to wind-colic, to excessive formation of flatulence and great rumbling in the bowels, to diarrhoea with or without slimy stools. Many of its pathogenetic symptoms correspond with those of China, and it is therefore now and then employed with advantage in diarrhoea, flatulency, and other abdominal troubles, in which China is indicated, but fails to afford prompt relief. In the last stages of cholera-infantum, it has sometimes been prescribed with speedy benefit. It seems to act powerfully upon the muscles and motor nerves of the arms, and may prove useful in some painful spasmodic or partial paralytic affections of those parts. This medicine, according to Noack and Trinks, has a remarkable specific action on the motor and spinal nerves. The following cases exhibit its curative action in this respect:
A lady, about fifty years old, oppressed with gloom, of a saturnine complexion, suffered much from pain in her spine, at the nape of the neck, and the sacrum especially; at either of these places the pain was much increased by pressure. She had great difficulty in walking, and seemed threatened with paralysis of the lower limbs. She had a sensation of tremulousness and uneasiness in the muscles of the neck. Various means were resorted to for her relief, with little or no effect. Finally Angustura was prescribed, and very materially relieved her. She is cheerful, the pain much less, and she walks with more ease and comfort. Another lady, about the same age, was also threatened with paralysis of the lower limbs. There was a considerable aggravation of her sufferings from a few doses of Angustura, followed by amelioration. It seems to act less specifically upon the lower extremities than upon the upper.
GENERAL SYMPTOMS.
Itching in the evening, when in bed after rubbing the arts, flat, very painful ulcers make their appearance. Sensation in the whole body as if he had lost his strength, and as if the marrow of the bones had become stiff and coagulated. Excessive weariness after walking in the open air, especially of the thighs. Lassitude and weariness of the limbs, without sleepiness. When walking, he feels a painful straining in the muscles, here and there. In the evening, after sitting for an hour, he feels quite stiff and contracted; after rising from his seat he is unable to straighten himself. Lameness of the hands and elbow-joints, without stiffness, accompanied by a drawing in of the limbs, as if the tendons would be strained, in the afternoon.
SKIN.
Ulcers which affect the bones. *Caries.
SLEEP.
When sitting and reading, he falls asleep, but is roused by the slightest noise, and starts up with a shudder which thrills through his body. In the evening, great physical depression, and irresistible inclination to sleep when sitting. Great sleepiness in the evening, until nine o’clock, afterwards he is wide awake until after midnight. Vivid dreams; uneasy sleep, full of dreams. Confused dreams, partly of a terrific nature.
FEVER.
Early in the morning, chilliness in bed, without any subsequent heat. Internal shivering at three o’clock in the afternoon, with violent thirst, without any subsequent heat. Slight heat after a chill increasing warmth over the whole body, towards evening. A good deal of thirst in the afternoon, followed by shivering over the back. Increased warmth of the cheeks and body, accompanied by an aching in the temples and sides of the forehead. Warmth of the body except the head; the cheeks were cold.
MORAL SYMPTOMS.
Discouragement and peevishness. He is easily frightened and starts. Bright mood; confident that he can achieve everything with vigor. Liveliness and activity of the mind. He has not confidence enough in himself to undertake and to achieve voluntary motions. Pusillanimity.
SENSORIUM.
Gloominess and dullness of the head, as after intoxication. Dullness and sense of contraction of the head, when walking rapidly. Great absence of mind; he easily falls asleep when reading. In the afternoon, great animation and facility of intellect.
HEAD AND SCALP.
Vertigo in the open air. Cramp-like headache. Headache; pressure in the forehead, over both eyes, as if the contents would issue forth, both when at rest and in motion. The brain in the forehead feels as if bruised. Headache, as if everything in the brain was moving about, with oppressive and boring pain, especially in the temples; pressure in the forehead. Drawing and oppressive pain in the temporal region. In the evening, drawing and oppressive headache on the right side of the head. Lacerating headache, rather externally, extending from the vertex over the temples. Intermittent prickings in the temporal region; itching of the scalp.
EYES.
Violent burning in the inner half of the eye-balls and in the internal corner of the eyes. Tension in the eyes, from behind forwards. Soreness of the eye-lids. Feeling of dryness under the upper eye-lids. Pressure in both eyes as from a bright light, or weariness. The eyes are red, and burn, with nightly agglutination. Contraction of the pupils. Dilatation of the pupils. Pressure in the right eye and orbit. Itching stitches in the upper eyelid. Early on rising, dimness before the eyes, as if the cornea were obscured. He sees better than usual.
EARS.
Burning in the internal ear, in the region of the tympanum. Sensation as if something were inserted in the ear. Cramp in the external ear. Throbbing pain behind the ears. Heat of the ears and cheeks. Cramp-like pain in the region of the malar bone. Tingling in the ear. Drawings in both ears, which soon go off. Very painful lacerating twitches in the internal ear, gradually assuming the form of stitches. Lacerating in a tumor over the right mastoid process.
