Sanguinarinum nitricum

Volume I — Appendix

Description. — This preparation is a very fine brownish-red powder, pungent, acrid, bitter, and inodorous. Soluble in alcohol, ether, and water and oils, but not in all proportions. Alcohol and water separately will dissolve about half a grain to each one hundred minims, while dilute alcohol (equal parts of alcohol and water) will dissolve about one-fourth of a grain more.

Preparation.— Triturations up to the third centesimal ; then it may be carried higher in alcohol.

Head and Neck.

Pain in the supra-orbital region, proceeding from pain in the right eyeball, of a sore, aching character. It soon extended

across the forehead, and seemed to be deep in above the root of the nose. Burning pain in the forehead and the root of the nose, with aching and soreness in eyeballs, worse on pressure ; the pain became more severe on the left side of the head, through the left temple. Slight aching sensation, with soreness all over the head and scalp. Slight dizziness through all of the proving. The pain in the left side extended to the parietal ridge and back to the mastoid process, attended with sensation of stiffness in the muscles of left side of neck and top of left shoulder, as if from exposure to a draft of cold, or damp, raw air. Sensation of obstruction and fulness in head, which was relieved by a discharge of a large quantity of thick, yellow, sweet-tasting mucus. Heat in the forehead; bathed in warm water gave some relief. Uncomfortable feeling about the head all day; worse at night. ° Catarrhal and sick-headaches.

Eyes.

Pain in right eyeball, extending to the supra-orbital region; pain of a sore, aching character. Profuse lachrymation ; the tears gush from the eyes. Dimness of sight, as if looking through gauze or mist, as if a thin film of mucus was spread over the sight. Redness and soreness of the inner corners of the eyes, which feel as if swollen. Pain in the left eyeball, extending over the orbit and left side of the head.

Redness of lids and conjunctiva. Heat and burning of the eyes, which was quite severe. Burning, pressing, aching, and sore pains in the eyes.

Ears.

• Obstruction of the Eustachian tube; difficulty in distinguishing sounds; roaring in the right ear.

Nose.

fifteen minutes after taking first dose, observed water trickling from right nostril. * Watery mucus flowed freely from both nostrils, attended by a violent sneezing, repeated every few minutes, with profuse lachrymation. Sensation arising to nostrils as if he had taken strong horseradish. Burning pain in both nostrils. Accumulation of mucus, obstructing

nose and bronchial tubes. Dry, sore, and raw feeling in nostrils. * Free discharge from posterior nares, tinged with blood, especially from left side.

Mouth and Fauces.

Bitter taste, extending back to the root of the tongue. Slight acrid burning sensation on the tongue, lioughixss and dryness in the mouth and throat, with sensation of constriction in the throat, which passed off in fifteen or twenty minutes. Increased flow of mucus and saliva, with sneezing and burning in the forehead.

Soreness, rawness, and roughness on right tonsil, with difficulty in swallowing, as if the throat indicated diphtheria, but on examination there was only a red and irritable spot.

In the morning raised large quantities of thick, yellow, sweet-tasting mucus. This continued all day. Heat in the mouth, as if pepper had been taken. Great accumulation of mucus in the throat and bronchi. Awoke frequently with dry mouth and throat, from breathing with mouth open, the nose being obstructed. Everything tasted dry, like chips. Coffee did not taste natural; wanted something succulent, not pungent, but soothing te the mouth and throat, which was hot, dry, parched, and raw. ° Catarrh of fauces and pharynx. Chest.

• Heat and tension behind centre of sternum; sensation of tightness in the chest, inducing a short hacking cough; the cough became harsh, leaving soreness and rawness in the throat and chest, with scraping, raw sensation in the pharynx. Coughing up large quantities of thick, yellow, sweet-tasting mucus several times during the day.

Tension, burning, and accumulation of mucus behind centre of sternum.

In forty minutes after taking, the tension and heat behind the sternum had increased, with desire to cough, — a short hacking cough; raised a clear mucus; the cough became deeper and rattling; the pressure extended to both lungs, greatly increasing the sense of suffocation, feeling as if the air-passages were lined with thick, stiff mucus or pus.

Stomach.

Sensation of burning in stomach and cssophagus. Belching up of putrid-smelling gas, though she had eaten nothing since morning. Little appetite.

Urinary Organs. Passed urine nearly every hour during the night, which, on standing until morning, weighed twenty-eight ounces, and deposited a white sediment.

Abdomen.

Borborygmus and pains in abdomen, as if diarrhoea would set in, with sharp cutting pains.

Volume II — Special Therapeutics

This preparation is a very fine brownish-red powder, pungent, acrid, bitter, and inodorous. Soluble in Alcohol, Ether, water, and oils, but not in all proportions. I find upon experiment that both Alcohol and water separately will dissolve about one-half grain to each one hundred minims, while dilute Alcohol (equal parts of Alcohol and water) will dissolve about one-fourth of a grain more, each solvent giving a very fine brownish-red solution.

Pure Sanguinarina is a pearly-white substance, but when combined with any of the acids the result is a salt with some shade of red, crimson, or scarlet. From this fact it would appear that the red color of the blood-root may be owing to the presence of some native salt of Sanguinarina, which is decomposed by Ammonia in the separation of the organic alkali.

The centesimal scale would appear to be the best for this remedy, as in the low decimal attenuations it would produce local irritations of the mucous membrane. It is best prepared by triturations up to the third ; then it can be carried higher in Alcohol.

The following pathogenesis is taken from provings reported by Professor Owens, of Pulte Medical College, Cincinnati, at the meeting of the American Institute, held in 1878.

Head and Neck.

Pain in the supraorbital region, proceeding from pain in the right eyeball, of a sore, aching character. It soon extended across the forehead, and seemed to be

• Bute proposes Sanguinaria as the quickest antidote to Rhus radicans.

deep in above the root of the nose. Burning pain in the forehead and the root of the nose, with aching and soreness in eyeballs, worse on pressure ; the pain became more severe on the left side of the head, through the left temples. Slight aching sensation, with soreness all over the head and scalp. Slight dizziness through all of the proving.

The pain in the left side extended to parietal ridge and back to mastoid process, attended with sensation of stiffness in the muscles of left side of the neck and top of left shoulder, as if from exposure to a draft of cold or damp raw air. Sensation of obstruction and fulness in head, which was relieved by a discharge of a large quantity of thick, yellow, sweet-tasting mucus. Heat in the forehead ; bathed in warm water gave some relief. Uncomfortable feeling about the head all day ; decidedly worse at night.

Eyes.

Pain in right eyeball, extending to the supraorbital region ; pain of a sore, aching character. Profuse lachrymation ; the tears gush from the eyes. Dimness of sight, as if looking through gauze or mist, as if a thin film of mucus was spread over the sight. Redness and soreness of the inner corners of the eyes, which feel as if swollen. Pain in the left eyeball, extending over the orbit and left side of the head. Redness of lids and conjunctiva. Heat and burning of the eyes, which was quite severe. Burning, pressing, aching, and sore pains in the eyes.

Ears.

Obstruction of the Eustachian tube ; difficulty in distinguishing sounds ; roaring in the right ear.

Nose.

In fifteen minutes after taking first dose observed water trickling from right nostril. Watery mucus flowed freely from both nostrils, attended by violent sneezing, repeated every few minutes, with profuse lachrymation. Sensation arising to nostrils as if he had taken strong horseradish. Burning pain in both nostrils. Accumulation of mucus obstructing nose and bronchial tubes. Dry, sore, and raw feeling in nostrils. Free discharge from posterior nares, tinged with blood, especially from left side.

Mouth and Fauces.

Bitter taste extending back to the root of the tongue. Slight acrid, burning sensation on the tongue. Roughness and dryness in the mouth and throat, with sensation of constriction in the throat, which passed off’ in fifteen or twenty minutes. Increased flow of mucus and saliva, with sneezing and burning in the forehead. Soreness, roughness, and rawness on right tonsil, painful, with difficulty in swallowing, as if the throat indicated diphtheria, but on examination there was only a red and irritable spot.

In the morning raised great quantities of thick, yellow, sweet-tasting mucus. This continued all day. Heat in the mouth, as if pepper had been taken. Great accumulation of mucus in throat and bronchi. Awoke frequently with dry mouth and

throat, from breathing with mouth open, the nose being obstructed. Everything tasted dry, like chips. Coffee did not taste natural ; wanted something succulent — not pungent — but soothing to the mouth and throat, which was hot, dry parched, and raw.

Chest.

Heat and tension behind centre of sternum ; sensation of tightness in the chest, inducing a short hacking cough ; the cough became harsh, leaving soreness and rawness in the throat and chest, with scraping raw sensation in pharynx. Coughing up large quantities of thick, yellow, sweet-tasting mucus several times during the day. Tension, burning, and accumulation of mucus behind centre of sternum. In forty minutes after taking, the tension and heat behind the sternum had increased, with desire to cough, a short hacking cough ; raised a clear mucus ; felt a strong desire for fresh air ; slept poorly on account of pressure in chest ; the cough became deeper and rattling ; the pressure extended to both lungs, greatly increasing the sense of suffocation ; feeling as if the air-passages were lined with thick, stiff mucus or pus.

Stomach.

Sensation of burning in stomach and oesophagus. Belching up of putrid-smelling gas, though she had eaten nothing since morning. Little appetite.

Urinary.

Passed urine nearly every hour during the night, which on standing until morning weighed twenty-eight ounces and deposited a white sediment.

Abdomen.

Borborygmus and pains in abdomen, as if diarrhoea would set in, with sharp cutting pains.

The following clinical verifications were also reported :

Case I. — I. I. B. ; merchant ; aged forty ; dark complexion. Chronic posterior nasal catarrh, chronic bronchitis, and chronic laryngitis ; voice altered, deep, hoarse ; catarrhal phonation, as if speaking from the chest with effort ; severe pressure from behind the sternum. Had been thus affected for eight years past. Had been treated by various physicians in Cincinnati, Philadelphia, and New York, using inhalations of various substances, Tartar emetic ointment, and Croton oil at various times, without benefit, leaving the surface only dryer than before. He seldom raised anything except a few balls of gray mucus.

From New York he was advised to go to the pine regions of the South, particularly to Florida. He spent two winters on the St. Johns River, with, for the time being, some relief; but each time the trouble returned again in the North.

Through persuasion of a friend he was induced to try homoeopathic treatment. Nitrate of sanguinarina, 6th trituration, was given, one grain every two hours. All hot and stimulating drinks and food were interdicted. He had already in

one year lost eighteen pounds in weight, and his relatives, who were all strongly opposed to his change, said he then would surely die. In one week he reported that his throat felt better and that there was more moisture in it than there had been for two years before. There was also marked improvement in his voice. In ten days he received his third prescription : Nitrate of sanguinarina 6th, one-grain dose every four hours. Improvement was now apparent to all. He was urged to take all the exercise in the open air that he felt he could during the autumn. At the end of ten weeks he had regained six pounds of his loss, and felt stronger and better than for five years before ; voice not improved in proportion ; gave Causticum 6th every two hours for one week, and Drosera 3d. In sixteen weeks from the time he took the first dose he reported himself a well man, and endured the winter without any unusual trouble.

Case II. — Mrs. S. ; city missionary ; aged forty-nine ; much exposed to severe weather ; daughter of one and sister of two allopathic physicians ; was by the patient I. I. B. prevailed upon to try this medicine. She had a constant hacking cough, raw, sore feeling in the throat, and sore aching and pressing behind the sternum. She was constantly exposed to the raw, cold winter winds, which induced coryza and irritation. Her occupation required that she should talk a great deal under all conditions of exposure. I gave her one-grain doses of the 6th trituration every two hours, required her to rest a few days in the house during very stormy weather, and to avoid exposure at night. In ten days she reported herself decidedly better. She continued her occupation without further interruption, until at the end of ten weeks her recovery was complete.

Case III. — O. W. ; aged fifty-five ; subject to frequent attacks of cold, affecting the head, throat, and bronchia, and catarrhal affections.

January 20th, 1878, contracted a severe cold from a long drive in an open buggy. This cold affected the head, throat, and lungs ; felt very sore and lame all over, with copious1 discharge of mucus from nose ; frequent sneezing ; lachrymation. On the 21st soreness of' throat very marked ; constant tickling in the throat-pit, exciting cough, at first short and hacking, but in two days became violent and convulsive. Bell, and Drosera seemed of little use. On the 22d pressure behind the centre of sternum became very severe. Gave Nitrate of sanguinarina 6th every two hours. In four hours a copious perspiration made its appearance, attended with frequent sneezing. On 23d soreness of the throat appeared in the morning after waking from a rather troubled and restless sleep; constriction of the throat, with difficult deglutition, was present; tension across the chest, which seemed to radiate from behind the sternum.

I gave the medicine every hour, and in one hour a quite free discharge from the nose set in, followed in three hours by moisture and relaxation of the constriction across the chest. The discharge was quite yellow and sweetish-tasting. This continued all day. At night he slept well, and awoke in the morning feeling quite free. But little cough or coryza during the day, and he was entirely relieved by the next morning.

OBSERVATIONS.

It is evident from a study of the above pathogenesis that we cannot expect to obtain from the provings of the isolated constituents of drugs, or the salts of other alkaloids, all the symptoms which we could obtain from the whole drug. I am convinced from a study of the provings of alkaloids and resinoids, also from their use in disease, that we should have provings of them all. Sanguinarina cannot represent the whole of the medicinal power of the root of Sanguinaria, for the root is a complex substance, and contains in addition to Sanguinarina another alkaloid called Porphoroxin (Huseman), also Puccin (Wayne).

It also contains Chelidonic acid, Sanguinarinic acid, besides resin, gum, and other inert substances. The alkaloids exist in the root in combination with its acids, the most important compound being Chelidonate of sanguinarina.

A proving of a trituration of the root, if fresh, will give us a complete pathogenesis of the whole, and probably a hydroalcoholic tincture of the fresh root would be as good. But if we are to use any of its isolated constituents or their salts, we should have them proven. In practice I find that there are many head, hepatic, and uterine symptoms which will not yield to the Sanguinarina, or the nitrate, but when I prescribe the nitrate for any of the above symptoms from Dr. Owen’s provings, they disappear promptly.

Dr. Newman, Lecturer on Pharmacology and Medical Chemistry in the Chicago Homoeopathic College, arranged the above symptoms with excellent judgment, with a few hints from myself, relating to the importance of keeping connection of the above symptoms. Further proving is needed, especially upon women; also some pathological provings on animals.

The hepatic symptoms of Sanguinaria are probably due to Chelidonic acid it contains, for we miss them in the nitrate; as also some of the head symptoms of Chelidonium, which appears so prominently in Sanguinaria.

Many of the local symptoms of the nitrate referred to the nasal passages, throat, and larynx, were doubtless due to its local irritant action. They are, however, of value in practice as guides to the local application of the triturations by inhalation.

A medical friend suggested to me whether any of the symptoms of the nitrate could be due to Nitric acid. This query brings up a question which is going to be a puzzling one for our school.

We may ask, (1) What becomes of the Nitric acid? (2) Is it separated from the alkaloid in the stomach as free Nitric acid ? (3) Do we get mixed symptoms of Nitric acid and Sanguinarina? or (4), Do we get an entirely unique array of symptoms from this salt? I cannot answer these questions. Possibly some scientific chemist who also understands symptomatology may some time answer them.

A few words as to the use of this salt : Locally it is very useful to repress exuberant granulations on ulcers, or diseased mucous surfaces. The nitrate is so powerful, that the third trituration (decimal) is sufficiently strong to effect a change for the better, acting homoeopathically, for the undiluted salt applied to a healthy surface causes ulceration with abnormal granulations.

Used locally as above, and at the same time internally, it is of value in polypi situated in the nose, uterus, or urethra.

This salt, as well as the Sanguinaria, is doubtless indicated in irritation of the coats of the stomach, even to the extent of acute gastritis. But its chief value will be found to be in the treatment of catarrhal headaches (possibly also nervous gastric headaches), nasal catarrh, conjunctival catarrh, catarrhal disease of the inner ear and Eustachian tube, pharyngitis, laryngitis, bronchitis, and possibly in broncho-pneumonia or pneumonia in the stage of hepatization. Nor should I hesitate to prescribe it in the chronic bronchial catarrh of old people and children, nor in croup, catarrhal or pseudo membranous.

But until we have further provings we are not justified in using it unless experimentally in the treatment of hepatic or intestinal disease ; in uterine affections, or in disease of the male genital organs, characterized by impotence or relaxation from diurnal losses of semen, or irritability, causing inaptitude for coitus, for which conditions the tincture of Sanguinaria is so useful.