Sepia is indicated almost as frequently in men as in women, and yet, like Pulsatilla, we continue to refer to it as a womans remedy. Careful use of the repertories will tend to prevent such unwarranted and unhomoeopathic generalizations. Any remedy in the entire materia medica may be indicated in either sex at any age and in any so-called disease.
The Sepia type is said to be spare, sallow and dark and such is often the case, but by no means always. A most clear-cut case from a symptomatic standpoint occurred in a middle-aged man of plethoric build and definitely blonde complexion. The curative action of the remedy was unmistakable and wholly satisfactory. Sepia sometimes has extreme venous congestion to the head, face and neck, worse after eating and from any sudden cold change in the weather.
Belladonna has arterial congestion to the head and neck, whereas Ferrum phos. has both arterial and venous congestion. In Sepia it is more of a venous stasis and may be associated with the sensation of a plug or block, wedged in at the base of the brain. Vigorous exercise in the open air will relieve the sensation and the congestion.
Purple is a color that is as definitely Sepia as is the sallowness, purple discoloration of the face and particularly of the hands. This color is more of a violet and should not be confused with blueness. It is due to venous stagnation and is associated with marked coldness of the extremities. Carbo veg. and Lachesis are also purple remedies. In Carbo veg. it is a true cyanosis and is frequently accompanied with air hunger and a desire to be fanned. In Lachesis the color and character of the blood are altered.
Sepia is one of the remedies having icy coldness of the nose, cold hands and feet and distressing coldness of the knees. On sitting in even a moderately cool room the extremities soon become chilled. Vigorous exercise will restore the circulation.
Sepia sometimes craves ice cold drinks and ice cream as markedly as does Phosphorus. There is frequently noted also a craving for acids, lemons, vinegar, etc. We may infer from this that with the external coldness there is probably internal heat.
Persistent empty eructations after eating is an observed and verified feature of Sepia. Associated with this there may be a plug or ball sensation in the gall-bladder region and fullness in the liver area.
Clinically Sepia has given grateful relief in some cases of complete inguinal hernia with distressing dragging and bearing down sensation. The size of the hernia has been considerably reduced and the pressure symptoms largely overcome. In these cases the cross-legged sitting posture of Sepia was habitual, although the value of this symptom in the case of hernia may be questioned as this posture tends to reduce the hernia and may therefore be entirely of mechanical origin.
Ptosis of the abdomen in fat, flabby subjects may find its remedy in Sepia when the dragging and bearing down sensation is strongly marked and the symptoms agree.
One of the important uses of this remedy is in traumatic affections of the heart associated with annoying empty eructations. Often there is the history, perhaps years back, of cardiac involvement in some severe, acute fever. Compensation has taken place and but slight evidence of the old lesion remains. Over-lifting, running or over-strain may suddenly affect the heart and it is just this combination that Sepia fits, especially where there is an uncertain, unsteady feeling about the heart, aching down the left arm and the persistent eructations.
A Sepia patient had no trouble in promptly falling asleep on first going to bed. He would sleep perhaps a half hour to an hour and then would wake up feeling restless and nervous and lie awake for two or three hours. He tried varying the time of retiring to see if that would make a difference but invariably that first sleep was followed by a long period of wakefulness and nervous restlessness.
Finally he found that by promptly getting up after waking and taking a vigorous dry towel rub and some calisthenics and deep breathing exercises he could return to bed and promptly go to sleep again the characteristic amelioration from violent motion and continued active exercise. Sepia is decidedly nervous. We often find restless, fidgety feet like Zinc and Kali phos. There is aversion to people and often a strange indifference and coldness to those nearest and dearest. There is apt to be perversion of the affections and considerable apprehension of mind. Hurry and impatience are frequently marked symptoms of this remedy.
The heart is related to the affections not only physically but metaphysically as well. Sepia acts strongly on the heart and therefore tends to normalize the affections. Its timely homoeopathic use will soften hard feelings and perchance save a home from disruption.- E. UNDERHILL, JR.
The first examination of a patient is the most important proceeding, and the measure of success depends mainly upon its exactness and scope. Hahnemann devotes fifteen paragraphs of the Organon to this subject, in which he clearly shows that it is the foundation of all homoeopathic prescribing. Upon its accuracy depends wholly the physicians ability to select the most appropriate remedy. If it is inadequate, the remedy selected will be inadequate, for the entire natural disease must be like the entire medicinal disease, or as nearly like it as it is possible to discover.
The time spent in the first examination is always well spent, as it saves much time later on, and the more characteristic points we have elicited, the easier becomes the choice of the remedy. If the hour spent in the first examination is insufficient to get a full history and detailed account of the case, it is wise to give a placebo and continue the examination later, always bearing in mind that it is safer to do nothing than to do wrong, and your patient has usually been wronged to the bone before you get him. WHen we read in the Aphorisms of Hippocrates, by Boenninghausen, how this master of the materia medica devoted hours to the examination of a case, and hours to the selection of the appropriate remedy in difficult cases, we may be sure that there are no short cuts for the selection of a homoeopathic remedy in a chronic disease.