Spigelia

Lecture

Spigelia is especially known by its pains. It is indicated in persons who are debilitated from taking cold and who have become rheumatic, run down, victims of pain. Hardly a nerve in the body escapes ; shooting, burning, tearing, neuralgic pains ; they are most marked about the eyes and jaws, neck, face, teeth, shoulders, burning like hot needles through the face and neck in any direction, stitching, tearing, worse from motion, from doing anything, even thinking, mental exertion, worse from eating. Pains in the neck and shoulders are better from heat ; those about the eyes are better from cold.

Shooting, tearing pains in the extremities like hot wires. Sometimes the pains are worse from lying down, but most commonly better from keeping still ; worse from light, eating, motion, jarring ; so sore in the painful region that any gentle exercise like going up or down stairs, or riding in a carriage that jars, makes the pain unbearable

The Spigelia patient is sensitive to cold, to atmospheric changes, he is a rheumatic patient, but the nerves are attacked by neuralgia.

Violent pains about the eyes. Routine practice limits the use of the remedy to this region. Worse from hard pressure though sometimes better from it, if gentle and prolonged, firm pressure, but any movement of the pressing hand aggravates. The part is turgesced and inflamed. Eyes red and engorged.

Neuralgic affections of the muscles of the chest. Many of the Spigelia pains in the chest are attributed to the heart, but there is intercostal neuralgia ; tearing pains shooting into the shoulders and neck, especially the left side and down the arm. Pains shooting hither and thither.

Irregularity of the heart. Painful complaints associated with valvular troubles, especially growing out of rheumatism. Pericarditis and endocarditis of rheumatic character. Thrusting pains in the chest like a knife, in the eye like a knife.

This remedy needs further proving, its mental symptoms are scarcely known. "‘Weak memory ; disinclination to work ; restless and anxious, solicitude about the future ; gloomy, suicidal mood : afraid of pointed things, pins, etc. ; easily irritated or offended.'' This is all that is thought worthy of admission into the Guiding Symptoms, showing that the mental state has not been well brought out.

Many complaints are manifested the morning ; tired in the morning and full of tearing pains. '•

Old anemic subjects where there has been a transfer of the complaints to the nerves ; broken down, pallid, nervous, with neuralgia, palpitation, irregular pulse. Vertigo on rising ; gets up with violent pains and dizziness. So nervous that she must “fly,” full of excitement, cannot keep still, cannot keep control of herself.

Pulsating and stitching in the head ; sometimes better lying with the head high ; worse from stooping, motion, and from noise. Sometimes better from washing in cold water when the pain is about the eyes and head, but worse after washing ; better while the cold water is applied. With these headaches and neuralgias there is stiff neck and shoulders, an apparent stiffness in that he cannot move on account of pain. He sits in a chair as if transfixed, is aggravated from noise, light, from seeing things move in the room, which he must follow with his eyes. *‘Fine burning, tearing pains in the brain." It seems to be in the brain but is more likely in the nerves of the scalp. “Violent pain in the left parietal bone on motion or walking or making a misstep ; toward evening — violent pressure and pressing outward in the forehead, worse from stooping, worse from pressure with the hand ; tensive tearing pain in the forehead, especially beneath the frontal eminence, extenddeeper in its action than Aconite, Its cardiac diseases tend to develop slowly, with actual tissue changes, enlargement of the heart, it takes on a steady growth and the valves become changed, do not fit, hence, there are blowing and whizzing sounds, regurgitation with the mental symptoms. The two are similar in croup, but Spongia is deeper, slower in onset, taking several days for its development. Aconite from exposure to a dry cold wind takes a cold to-day and, of course, comes down with croup to-night in the first sleep. Before midnight has a dry spasmodic cough ; hoarse cough ; Spongia has taken a cold yesterday or the day before. First there is roughness and dryness of the mucous membranes, sneezing. Both remedies have croup before midnight with dry, hoarse, barking cough, sawing respiration and dry air passages. They are so similar that when Aconite only partially controls the condition and it returns the next night, or lasts on beyond midnight, Spongia becomes its natural follower. Spongia comes in because it was probably the remedy in the beginning. Cases that grow v>orse each succeeding night, hoarse barking and crowing before midnight, though it also has a croup aftci midnight. It is a deep-acting remedy though its complaints sometimes come on suddenly.

Hepar is worse at night and in the morning. And when Aconite has apparently controlled, but the croup returns the next morning, Hepar comes in. Or if it comes on again the next evening with rattling Hepar will also be suitable. Dry, with no rattling is Spongia. If the child wants to be covered or says that it is chilly, Hepar, If it says the room is too warm and kicks the covers ofF, it needs Calc, sul.

The Spongia patient is worse from a warm room, from heat. Wants to be cool like Iodine, but is better from warm drinks, like Ars, Nux, Lyc,

The tendency to affect the glands is striking. As a matter of fact all the glands are affected ; they gradually enlarge and become increasingly hard. Glands that have undergone inflammation and are increased in size become hard, or they take on hypertrophy. Hypertrophy of the heart (Kalmia, Sepia, Naja). Spongia has cured endocarditis cardiac croup and many other inflammatory diseases of the heart resulting from rheumatism. Hypertrophy of the thyroid, goitre, when the heart is affected and the eyes protruding. Cervical glands enlarged ; inveterate cases of enlarged testes ; orchitis from a suppressed gonorrhoea, a cold or other causes ; gradually increasing hardness.

The whole respiratory apparatus is acted upon ; cardiac dyspnoea and the most severe forms of asthma. Dryness of the air passages with whistling and wheezing, seldom rattling, must sit up and bend forward ; at times after great dyspnoea, white, tough mucus forms in the air passages, difficult to expectorate ; it comes up and often has to be swallowed (Arn., Caust, Lach, Kali c, Kali $., Nux mos, Sep, Staph,y

Dyspnoea worse lying down. The modality is common to its other complaints ; violent, basilar headache forces him to sit up in bed and keep still. Holding the head in the upright position relieves the dull pressure in the occiput.

There are many headaches. In the occiput, in the forehead, congestive headaches, but most of them are associated with goitre, cardiac affections and asthma ; they arc due, probably, to sluggish circulation in the brain.

Face distressed in croup ; anxious ; livid ; pale and bloated ; blue, pale with sunken eyes ,* red with anxious expression ; alternating red and pale ; cold sweat. These symptoms are the natural effects of difficult breathing and are, therefore, not essential in the selection of a remedy. As primary symptoms, they would probably indicate Ars.a but when due to cardiac difficulties, they are unimportant.

“Sore throat worse after eating sweet things. Thyroid gland swollen even with the chin ; at night, suffocating spells, barking cough, with stinging in the throat and soreness in the abdomen.” Enlargement of the tonsils. Difficult swallowing.

Spongia is the remedy when dyspnoea and cough are relieved by warm food ; may be better from warm drinks.

Laryngeal troubles with great hoarseness, in individuals tending towards phthisis, with tubercular heredity, cachectic aspect, weak lungs, but no deposit of tubercle. But all at once hoarseness sets in. There is a tendency for the larynx to become involved in phthisical patients that need Spongia. This patient takes an acute cold and it settles in the larynx with hoarseness. Look out for that patient, for there is a tendency for tubercles to deposit where there is inflammation, and the infiltration instead of being fibrinous may become tubercular. Tendency for the larynx to be first involved in phthisical patients.

In Spongia do not look for the exudative, but the infiltrative form of croup.

Hoarseness with loss of voice, great dryness of the larynx from a cold ; coryza, sneezing, the whole chest rings, is as dry as a horn ; voice hissing, croupy, nose dry. There is very little accumulation of mucus, but at a late date ulceration begins and then there may be a copious expectoration of mucus. In proportion to the extent of rattling, this remedy is decreasingly indicated, Hepar has the coarse rattling with much mucus.

At times an adult takes cold and rawness of the larynx and trachea is the result. On going to bed she is taken with a spasmodic constriction of the larynx. Laryngismus stridulus is commonly found in women, fgw.. Gels, Lauroc, and Spongia. Ign, and Gels, will cure eight out of ten cases.

The larynx is sensitive to touch in croup, etc., like Phos,

Dry, spasmodic cough, troublesome cough ; cold things taken into the stomach aggravate. (Veralr. is better from cold water, but the cough is worse.) If the room becomes too warm, there is a dry, tickling, teasing, croupy spasmodic cough.

In cardiac and asthmatic troubles it resembles Lach, in the rousing up from sleep in suffocation ; after the sleep the dyspnoea is worse.

The Phos. dyspnoea is often increased after sleeping, with suffocation. Loch, has it in a marked degree ; in phthisis when the patient is about to die, there is sweat on going to sleep ; dyspnoea on going to sleep and on waking. Lach, palliates and must be repeated.

Cardiac affections accompanied with thick, green or yellow expectoration like pus and dyspnoea on falling to sleep so that he must keep awake as long as he can, fear of sleep in advanced chest troubles. Grindelia robusta will palliate such a case and if the condition is only catarrhal and not tuberculous, it will cure.

Study especially the cardiac symptoms. ‘The symptoms of circulation are worse ; from mental lassitude, from coughing, from lying on the right side, before menses, after lying down, sitting bent forward, from smoking, from going up stairs. Awakens in fright and feels as if suffocating. Falling asleep early at night, suffocation awakens.” I have mentioned these symptoms, but read them for emphasis.

Ebullitions, distended veins ; dropsy in cavities of the body. Especially suits young persons of tubercular parents, who remain weak, are pallid and do not thrive. Tubercular diathesis.

Itching but no eruption. Seems always ready for an eruption to appear. Has only simplest herpetic eruptions. Itching all over and no visible eruption.

In acute endocarditis, the principal remedies are Spongia, Abrot,a Sepia, and Kalmia. Naja in valvular diseases.