ACTAEA RACEMOSA.
Introduction
(Cimicifuga – cimex, bug; fugare, to drive away, a genus of drugs containing the bugworts or bugbanes. Racemosa -racemus, cluster, as of grapes-in reference to its fruit. Actea-aktea, aktea, the elder tree, the leaves looking like those of the elder.)
The two names, Cimicifuga and Actea racemosa, we must know, as they are often used indiscriminately. In Hering it will be found under Actea racemosa, the reason he gives for it being, that the drug “has received so many improper names that the oldest one is prepared.”
Macrotis is another names that pharmacists used to put on our bottles of Cimicifuga. It is a wrong term and we want to remember that Macrotin or Cimicifugin is an impure resinoid, and not an alkaloid of Cimicifuga.
As various scientists have seen fit to call this plant by different names, laymen have felt privileged to do the same, and we find Black cohosh, Black snake-root, Squaw, root and Bugbane some of the terms by which it is known.
Cimicifuga, a native plant and “common over the eastern half of the United States and Canada, was a favorite remedy among all
tribes of out Indians, being used in rheumatism, disorders of menstruation and slow parturition. It was also used as a remedy against the bites of venomous snakes, with what success history does not relate, but we can easily judge” (Millspaugh).
Hale, in his introduction to Cimicifuga, says: “We now come to speak of one of the most important of all the new remedies. It is to the new, what Ignatia was and is to Materia Medica of Hahnemann. It range of action is quite extensive; it has been quite thoroughly proven; the clinical experience with it is already large and it has large possibilities for future development.”
It was perhaps first proved under the direction of Dr. C. J. Hempel, of Philadelphia, about 1856. Cimicifuga seems to exert a marked action on the spinal nerves, especially at the upper part of the cord, with symptoms of meningeal irritation, inflammation, neuritis and neuralgias, with muscular spasms, tremors, etc.
Symptoms
It has been found to control many conditions of the uterus and ovaries, such as neuralgias and even inflammations, and especially reflex neuralgias in various parts of the body depending on ovarian and uterine troubles.
We find the following in Hering: “The observation that a drug may produce different symptoms on the different sexes, is of the utmost importance for the scientific development of our Materia Medica. Professors Hill and Douglas state in their valuable report of provings with Actea racemosa: `It produced nausea, vomiting, and much gastric irritation in the six women, when in forty men it was hardly noticed as affecting the stomach in the least.’ 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.”
Another sphere of usefulness in Cimicifuga is for muscular rheumatism, with aggravation from motion, but with great restlessness (160).
Mentally we find Cimicifuga useful in “mental depression associated with uterine diseases or accompanied by rheumatic pains, and it is indicated in general paresis (149) when the patient is weak and exceedingly tremulous (192) throughout the whole body, and particularly in the melancholic stage of the disease” (Talcott).
It is to be thought of in puerperal melancholia (131), with sleeplessness, sighing (25) and moaning all the time, and in insanity in the from of melancholia, she is suspicious, apprehensive and talks of becoming crazy (131).
It is useful in delirium, with excessive restlessness, twitching of tendons (183) and sudden startings up. He sees rats or vermin where there are none (54), “cannot sit long in one place as it makes him frantic” (Lilienthal) and is constantly talking (55) and changing from one subject to another.
With these symptoms Cimicifuga is useful in delirium tremens (54) and in puerperal mania (129), but the two marked characteristics of the remedy in delirium or insanity are the pronounced mental and physical restlessness (160); the patient talks continually but never for long at a time on the same subject, and is constantly shifting his position and moving about.
Cimicifuga is an important headache remedy and has pronounced and characteristic symptoms. The headaches may be rheumatic, as fro being in a draft, neuralgic, or a reflex neuralgia (103) due to some uterine disturbance, such as menstruation (95), or they may be associated with symptoms of inflammation of the meninges of the brain and spine.
In general, the headaches affect the base of the occiput, or they begin at that point (100). Sometimes the pain shoots from the occiput up to the vertex and down the spine, and usually we find an aggravation from bending the head forward (98), as it seems to pull upon the spine, and with relief from bending backward, or from pressure in the back of the neck from the hand or from something hard (92). Sometimes there is a feeling as if a bolt were driven from the neck up to the vertex, with every beat of the heart. With the neuralgic headaches we may have a feeling as if the top of the head would fly off, or as if it were being lifted up (103).
Usually with the headaches of Cimicifuga there is rheumatic stiffness of the muscles of the neck, with distress on moving the head and it is useful is stiff-neck from catching cold (174), with or without the accompanying headache.
It is useful in ciliary neuralgia (75) with a feeling as if the eyeballs were enlarged (77) and with pains shooting into the head. These pains are very severe, and especially worse at night; the pains may extend from the occiput to the eyes, or from the eyes to the top of the head.
In facial neuralgia, either of rheumatic origin or associated with uterine disturbances, the “pain goes off at night” (Hering) and reappears again the next day (79).
Cimicifuga is the first remedy that I think of in rheumatic sore throat (162). The pains are worse in the morning on waking and on first swallowing, better after repeated swallowing or towards the end of the meal. If the l. side of the throat seems to be the most painful, it is an additional indication for this remedy.
We have said but little under Cimicifuga concerning the side of the body for which the drug seems to show a preference and while either side, in many conditions, may be affected, we can look upon it as a l. sided remedy (125).
This is especially noticed in the chorea (31) for which we prescribe the remedy, where the muscles of the l. side are particularly affected, and if in the stiff-neck the pains are worse on the l. side, or run down towards the l. shoulders, it is an additional reason for thinking of this remedy.
Cimicifuga is useful in nausea and vomiting in uterine affections, including pregnancy (153), or when caused by pressure on the spine (171) and cervical region.
It is of value in neuralgia of the uterus (202) and ovaries (147), with great tenderness and bearing-down sensation, and pains shooting up the sides, down the thighs and across the lower part of the abdomen. The left ovary (147) is especially affected and along with great tenderness (148), we have pains shooting up the side and particularly down the l. thigh.
Menstruation under Cimicifuga may be irregular or suppressed, with great pain, and hysterical symptoms (120) or epileptiform spasms (67) at the period; or the menses may be too early and too profuse (135), the blood dark and clotted (136), and with severe pain in the back, extending through hips and down the thighs.
During the latter part and termination of pregnancy, we find Cimicifuga a frequent indicated remedy.
It is useful in threatening miscarriage (13), the pains fly about and across the abdomen, associated with fainting spells, and Lilienthal advise it for “habitual abortion in women of rheumatic tendencies.” It is valuable for the false pains (153) before parturition and for the pains during labor when they do not force downward, but extend across the abdomen and upward into the sides.
During labor there are many nervous or hysterical symptoms, along with rigidity of the os (154). Hering speaks of nervous shuddering, “shivers,” during the “first stage of labor.”
Dr. W. A. Dewey in his lecture to us in 1904, made this valuable differentiation between Cimicifuga and Caulophyllum:
” Cimicifuga pictures tonicity, tonic spasms; the labor pains are tonic, they are the kind that occur during the first stage, and they are located more in the back.
“Caulophyllum picture more of a clonic condition which gives way at once to atony; there may be some spasm and cramping above the pubes, but it soon passes off and there is weakness and inertia. This condition is found later in labor, and the atony makes haemorrhage likely to occur.”
Cimicifuga is very frequently called for in after-pains (153) which are severe and apt to run down the thigh. The patient becomes very sensitive, grows extremely nervous and declares that she cannot bear them.
