Cina maritima — worm-seed — is the classical remedy of helminthiasis in paediatric practice, and its portrait is one of the most recognisable in the materia medica. Boericke draws it in a single line: "The Cina patient is hungry, cross, ugly, and wants to be rocked."
The remedy is prepared, per Clarke's heading, from the unexpanded flower-heads — "commonly called 'seeds'" — of varieties of Artemisia maritima, and it is the source of the alkaloid Santoninum. Clarke states the remedy's logic exactly: "It is pre-eminently a worm medicine, as it causes all the symptoms which characterise helminthiasis both mental, nervous, and bodily. It corresponds more to the effects of lumbrici than to those of other worms."
Yet the masters warn against prescribing it as a mechanical anthelmintic. Kent: "The old routine of giving Cina for worms need not go into your notes, for if you are guided by symptoms the patient will be cured and the worms will go." Clarke agrees — "Cina is much more than a mere worm-medicine. Many symptoms appear to be reflex from abdominal irritation" — and Kent goes further, locating the disorder above the gut: "It is pre-eminently brain in Cina; the orders are not received from the brain and so stomach symptoms develop, and worms hatch out."
This guide profiles Cina for clinical study from Boericke's Materia Medica, Kent's Lectures, Clarke's Dictionary, Boger's Synoptic Key and Lippe's Keynotes. The originals can be read in full — Kent's Cina, Boericke's Cina and Clarke's Cina — through Similia's free digital materia medica.
The Cina Constitutional Type
Boericke's opening frames the patient: "This is a children's remedy — big, fat, rosy, scrofulous, corresponding to many conditions that may be referred to intestinal irritation, such as worms and accompanying complaints." Within its range he places "an irritability of temper, variable appetite, grinding of teeth, and even convulsions, with screams and violent jerkings of the hands and feet."
Kent names the thread that runs through everything: "A marked feature running through is touchiness, mental and physical." The hyperaesthesia is literal — "The skin is sensitive to touch. The scalp and back of the neck, the shoulders and arms are so sensitive, that it is almost a soreness as if bruised" — and it is also temperamental. Boger's summary: "TOUCHY. Nervous. Ugly, cross, petulant and dissatisfied. Wants to be rocked."
The face is the remedy's identity card. Boericke: "Pale, hot, with dark rings around eyes... White and bluish about the mouth." Kent: "Face sunken, pallid, wings of nose drawn in. Blue ring or gray streak around the mouth. 'A sure sign of worms,' the mother says" — though he immediately reminds us the sickly aspect "is representative of brain trouble, central trouble."
Nor is Cina confined to childhood: Kent notes it "is suitable for conditions in adults that are seldom thought of" — his examples are sensitive women with eye-strain headaches, for "the Cina woman must have her hair down in head and nerve complaints."
Mental and Emotional Picture
Cross, ugly, cannot be pleased. Boericke: "Child very cross; does not want to be touched, or crossed, or carried. Desires many things, but rejects everything offered." Clarke: "extreme ill-humour and naughtiness. Nothing pleases them for any length of time," with a "disposition to be offended by trifling jests."
Aversion to touch — and to being looked at. The remedy's sharpest mental modality. Kent: "The child is aggravated by touch and even by being looked at, and is worse from seeing strangers... the first touch aggravates." Clarke: "cannot endure to be approached, touched, or pressed upon; touch induces or aggravates spasms. Child cannot bear to have head combed or brushed." Boger lists "Looked at" among the aggravations.
Yet wants to be rocked and carried. The paradox that completes the picture — Boericke's "wants to be rocked"; Kent: "While this little patient is aggravated by being handled yet he wants to be carried and kept busy."
Night terrors. Boericke: "Night terrors of children; cries out, screams, wakes frightened." Kent describes the dream prolonged into waking: the child "rouses up in a fright, talks excitedly about what he has dreamed, thinks it is real, and sees dogs, phantoms, and frightful things."
A strange guilt. Boericke records among the mentals an "abnormal consciousness, as if having committed some evil deed" — an adult-facing symptom worth remembering.
Physical Affinities
Nose and Face
The most famous gesture in paediatric materia medica. Boericke: "Itching of nose all the time. Wants to rub it and pick at it. Bores at nose till it bleeds." Boger capitalises "PICKS AND BORES AT NOSE"; Lippe's keynote runs "the child bores with his fingers into the nose." Clarke used the sign well beyond worm cases — Nash records typhoid cures on "intense circumscribed redness of the cheeks, and frequent and violent rubbing of the nose," and Boericke's face section confirms the "intense, circumscribed redness of cheeks."
Teeth and Mouth
"Grits teeth during sleep" (Boericke); Boger: "GRINDS TEETH; during sleep. Chews and swallows in sleep," adding "noisy swallowing." Kent notes that before dentition "it has a chewing motion, a side to side movement."
Stomach and Appetite
Ravenous, paradoxical hunger. Boericke: "Gets hungry soon after a meal. Hungry, digging, gnawing sensation... Vomiting with a clean tongue. Desires many and different things. Craving for sweets." Boger sharpens it into a general: "The greater the emaciation the greater the hunger," with "canine or gnawing hunger; after eating; after vomiting; alternating with anorexia." Kent's clinical image: the child "has taken all it can hold yet cries for the bottle, or empties its stomach by spitting up and vomiting the food and then reaches out whining and crying for more."
A singular concomitant: liquids "gurgle down the oesophagus" — Clarke's "difficult swallowing of liquids; clucking noise from throat to stomach," which Kent ties to the brain states.
Abdomen and Stool
Boericke: "Twisting pain about navel... Bloated and hard abdomen," the twisting "> pressure" in Boger. The stool is distinctive: "White mucus, like small pieces of popped corn, preceded by pinching colic. Itching of anus... Worms" (Boericke); Boger's "white, watery stool"; Lippe's "involuntary discharged (urine and whitish diarrhoeic stool)."
Urinary
"Turbid, white; turns milky on standing. Involuntary at night" (Boericke). Boger: "Bed-wetting; < every full moon. MILKY URINE." Clarke conditions the enuresis prescription on the concomitants: "wetting the bed (when accompanied by picking nose, great hunger, restless sleep)."
Respiratory
A true whooping-cough remedy. Boericke: "Violent recurring paroxysms, as of down in throat. Cough ends in a spasm... Gurgling from throat to stomach after coughing. Child is afraid to speak or move for fear of bringing on paroxysm of coughing." Clarke describes the pre-tussive aura: "Before coughing, child raises herself suddenly, tosses wildly about, the whole body becomes stiff, she loses consciousness, just as if she would have an epileptic fit, then follows the cough." Lippe: "Whooping cough with stiffness of the child before it and with great paleness of the face." Clarke adds the curious "reflex cough; caused by writing or reading (to oneself)."
Nervous System
Boericke: "Twitching and jerking distortion of limbs, trembling. Paralyzed shocks; patient will jump suddenly, as though in pain... Nocturnal convulsions. Sudden inward jerking of fingers of right hand. Child stretches out feet spasmodically." Kent's reflex chain: "With a disordered stomach he has convulsions after eating, with the head drawn back and glassy eyes." Boger: "Stiffens out; < if crossed, looked at, during cough."
Eyes
"Dilated pupils; yellow vision... Strabismus from abdominal irritation. Eyestrain, especially when presbyopia sets in" (Boericke). Kent develops the eye-strain use in adults — "always worse from using the eyes... It is like Ruta in that respect" — with the confirming detail that the patient "rubs the eyes and can then see more clearly."
Sleep and Fever
The sleeping posture is a verified indication: "Child gets on hands and knees in sleep; on abdomen" (Boericke); Clarke: "Sherbino has found 'getting on hands and knees in sleep' a strong indication for it." Kent: "Very often the Cina child will flop over on its belly and get to sleep in that way. If it is turned on the side it wakes up again." In fever, Boericke's paradox: "Much fever, associated with clean tongue... In Cina fever, face is cold and hands warm," with "cold sweat on forehead, nose, and hands" and Lippe's "canine hunger, during or before the intermittent fever."
Key Modalities
Worse from:
- Touch — the first touch especially; the larynx so sensitive that "touching it causes suffocative spasm" (Clarke)
- Being looked at; vexation; being crossed
- Worms — Boericke's modality line names them directly
- At night; before midnight the child wakes frightened
- In the sun; in summer — Kent: "the head is hot and the feet are cold in the sun"
- Looking fixedly at an object; staring; yawning — Clarke's causation line is simply "Worms. Yawning."
- During sleep; every full moon (Boger)
Better from:
- Lying on the abdomen — Boger's leading amelioration
- Being rocked and carried
- Pressure — the navel pains; rubbing — the eyes
- Motion
Keynote Symptoms
- Ugly, cross, touchy child — worse from touch, from being looked at, from strangers
- Wants to be rocked and carried despite the touch-aversion
- Bores at the nose till it bleeds; rubs and picks it constantly
- Grinding of the teeth during sleep
- Ravenous hunger soon after a meal; the greater the emaciation, the greater the hunger
- Twisting pain about the navel, better pressure; hard, bloated abdomen
- Pale face, dark rings round the eyes, bluish-white ring about the mouth
- Night terrors — cries out, screams, wakes frightened
- Sleeps on the abdomen or on hands and knees
- Milky, turbid urine; bed-wetting
- Whooping-cough with stiffness before the paroxysm; gurgling from throat to stomach after coughing
- Reflex twitchings and convulsions; child stiffens out when crossed
- Fever with clean tongue; cold face and warm hands
Clinical Applications
Worm complaints of children. The headline use — Lippe's "Worm complaints in children" — always on the totality: the facial signs, nose-boring, hunger, navel colic, restless sleep, night screaming.
Reflex nervous states from abdominal irritation. Strabismus, chorea-like twitchings and "nocturnal convulsions" the sources refer back to intestinal irritation, including Kent's convulsions after eating with head drawn back.
Whooping-cough and spasmodic coughs. With the pre-paroxysmal stiffness, the child's fear of speaking or moving lest a paroxysm start, and post-tussive gurgling.
Night terrors and restless sleep. Lippe's keynote records "violent screaming attacks at night," the patient lying on the back, striking and kicking with hands and feet, with "at night sleeplessness, with restlessness and tossing about."
Nocturnal enuresis. With milky urine and the worm-picture concomitants Clarke specifies.
Intermittent and remittent fevers. With canine hunger, clean tongue and vomiting — Clarke records a cure of infantile remittent fever with Cina 6 and 200 where "the classical symptoms of the drug were present."
Eye-strain and asthenopia. Kent's adult indication: pains in head and eyes from sewing or fine print, better rubbing the eyes, particularly when presbyopia is beginning in middle-aged women.
Differential Diagnosis
Cina vs. Chamomilla. The two cross children of the materia medica, and Kent draws the line himself: the Cina child wants to be carried "like Chamomilla; although not so intensely irritable as that remedy." Chamomilla rages over pain and demands, then rejects; Cina's temper sits on the abdominal-reflex base — nose-boring, teeth-grinding, hunger, worm history — and adds the two modalities Chamomilla lacks: worse from the first touch and from being looked at. Clarke notes the two remedies share "many points of contact... and some opposite conditions."
Cina vs. Cuprum. Both convulse and both whoop. Kent links them twice: the gurgling of liquids down the oesophagus — "Ars. and Cupr. are also prominent" — and the congested coughing face. Cuprum's spasm is the primary disease, beginning in fingers and toes with clenched thumbs; Cina's spasm is reflex, triggered by touch, vexation or being crossed, in a child whose gut symptoms dominate between attacks.
Cina vs. Silicea. Clarke's comparison lists place Silicea beside Cina both for ravenous hunger and for aversion to touch. But Silicea's child is chilly, yielding and lacking grit, with sweaty head and suppurative tendencies; Cina's is robust, hot-headed in the sun, defiant and hyperaesthetic — offended rather than timid.
Cina vs. Santoninum. Boericke devotes his longest relationship note to the derived alkaloid, "often preferable in worm affections; same symptoms as Cina; corresponding to the 'pain in shocks' produced by Cina," with its own signature of yellow vision and saffron-coloured urine.
Repertorisation Tips
These rubrics carry Cina in high grade:
- Mind; IRRITABILITY; children, in
- Mind; TOUCHED; aversion to being
- Mind; LOOKED at; cannot bear to be
- Mind; CARRIED; desire to be; rocked, wants to be
- Mind; CAPRICIOUSNESS; rejects the things for which he has been asking
- Nose; BORING in nose with finger; bleeds, till it
- Teeth; GRINDING; sleep, during
- Stomach; APPETITE; ravenous; eating, soon after
- Abdomen; PAIN; navel; twisting
- Abdomen; WORM complaints; with
- Sleep; POSITION; abdomen, on; knees and hands, on
- Urine; MILKY
- Bladder; URINATION; involuntary; night
- Generalities; CONVULSIONS; touched, when; worms, from
Anchor on the behavioural pair — touch-aversion (including being looked at) alongside the desire to be rocked — plus one hard physical sign: nose-boring, teeth-grinding in sleep, or the milky urine. Then confirm with the appetite paradox and the sleeping posture. Where the repertorisation lands between the irritable-child remedies, the abdominal-reflex concomitants decide. Our beginner's guide to repertorisation sets out the method in more detail.
Deepening Your Study
- Boericke fixes the patient portrait — hungry, cross, ugly, wants to be rocked — and the paediatric particulars from popped-corn stools to the cold-face fever
- Kent's Lectures supply the doctrine: touchiness as the grand feature, the brain-first reading of the worm states, the adult indications, and the warning against routine worm prescribing
- Clarke's Dictionary gives the fullest schema, the helminthiasis logic, the enuresis conditions and the recorded fever cures
- Boger's Synoptic Key and General Analysis compress the confirmables — looked-at aggravation, full-moon periodicity, lying-on-abdomen amelioration, emaciation-with-hunger
- Lippe's Keynotes are practically a bedside checklist for the acute paediatric case, from the night screaming to the pre-paroxysmal stiffness of whooping-cough
You can read all of these side by side for any remedy through Similia's free digital materia medica. To place Cina among its peers, see the guide to the essential polycrest remedies, or read how materia medica and repertory work together in case analysis.
