Naja tripudians — the virus of the cobra, the hooded snake of Hindustan — is a remedy with a single address. Boericke: "Its action settles around the heart; valvular troubles."
Clarke preserves the most vivid account of its action ever recorded: the naturalist Frank Buckland, poisoned through a nick in his thumb while skinning a rat killed by a cobra, wrote, "I had not walked a hundred yards before all of a sudden I felt just as if somebody had come behind me and struck me a severe blow on the head and neck, and at the same time I experienced a most acute pain and sense of oppression at the chest, as though a hot iron had been run in and a hundredweight put on the top of it." The blow on the occiput, the hot iron, the crushing weight on the chest — the whole remedy is in that sentence.
Unlike its serpent relatives, Naja does not corrupt the blood. Boericke: it "causes no hæmorrhage but only œdema," and it is not a haemorrhagic or septic medicine in the manner of Lachesis and Crotalus; its venom paralyses — a "typical bulbar paralysis," with speech, swallowing and respiration failing while the victim remains conscious. What that becomes in the proven remedy is a cardio-nervous medicine: "Marked surging of blood upwards, marked dyspnœa, inability to lie on left side. Hypertrophy, and valvular lesions," with the strange general Boericke italicises: "Organs seem to be drawn together."
This guide profiles Naja for clinical study from Boericke's Materia Medica, Kent's Lectures, Clarke's Dictionary and Boger's Synoptic Key and General Analysis. The originals can be read in full — Clarke's Naja, Boericke's Naja and Kent's Naja — through Similia's free digital materia medica.
The Naja Constitutional Type
Boger's opening portrait: "Nervous, excited and tremulous; with cardiac effects" — often reflex. Kent expected exactly this: "We might naturally expect that this patient would be intense and excitable, which is the case."
The defining constitutional fact is Kent's: "a rheumatic diathesis, and tendency of all complaints to settle about the heart. It is used in valvular troubles of the heart, in young persons who grow up with cardiac valvular diseases." Where a case offers almost nothing but the damaged valve, Kent is unusually directive: "Always prescribe Naja unless guided away from it by some specific symptom" — he considered it the most useful remedy in cardiac states presenting very few symptoms.
The circulation is unbalanced upwards and outwards: surging of blood to the head, "the extremities are cold and blue and the head hot" (Kent), with a slow venous return that shows as "fullness and puffiness of the hands and feet." Two small signs are strikingly confirmable: Kent's "copious sweating of the hands and feet causing the gloves and shoes to rot out; but the sweat is not offensive," and Boger's "Sweat on lumbar back and ankles." The patient is "very susceptible to cold" (Boericke).
Sleep is reptilian: "Profound, like a log, with stertorous breathing, a typical reptilian state" (Boericke) — and dangerous, for the complaints are worse after it.
Mental and Emotional Picture
Brooding over imaginary troubles. Boericke's leading mental symptom: "Broods constantly over imaginary troubles." Clarke expands it: the patient "makes himself wretched brooding over imaginary wrongs and misfortunes."
Depression with the heart. The mood and the organ are one picture. Clarke lists among the leading heart indications "Depression and lowness about the heart," and gives grief as the causation — Russell's cured case had "dragging and anxiety in the præcordia occurring in great grief."
Suicidal disposition, recorded with restraint. Boericke: "Suicidal insanity (Aur)" — the cross-reference to Aurum placing it among the gravest recorded melancholias. Clarke's record includes suicidal insanity in the proving material. As always with such symptomatology, the sources state it as data for professional assessment, and so do we.
The divided will. One of Clarke's most precise mental symptoms: sadness "as if everything were done wrong and could not be rectified, with increased perception of what I ought to do and uncontrollable inclination not to do it, causing restlessness."
Dreads to be left alone; averse to talking. Boericke pairs the two: "Aversion to talking... Dreads to be left alone" — silent company wanted, not conversation. Speech itself may blur (Boericke: "Blurred speech").
Fear of rain. Boericke's curious keynote, sitting beside the general aggravation from damp weather that Kent records: Naja, like Lach., is worse in damp weather.
Physical Affinities
Heart
The organ of the remedy. Boericke: "Dragging and anxiety in præcordia. Feeling of weight on heart. Angina pains extending to nape of neck, left shoulder and arm with anxiety and fear of death... Pulse irregular in force. Threatened paralysis of heart, body cold, pulse slow, weak, irregular, tremulous. Acute and chronic endocarditis." He adds the aetiological note prescribers lean on: the damaged heart left behind by infectious diseases, and "marked symptoms of low tension (Elaps, Vipera)."
Boger's schema names the mitral valve, and gives the pain-directions: "shooting to l. scapula, shoulder or neck; cramp ascend into neck; holds hand over it," with visible, excited palpitation and septic endocarditis in the range. A constant concomitant: "With the heart symptoms pain in forehead and temples" (Boericke).
Kent's cardiac cough belongs here: "a dry, hacking cough with sweating in the palms of the hands," in a heart that beats slowly and will not be urged to work — "a cough with every little exertion. It is not catarrhal." Boericke: "Irritating, dry cough, dependent on cardiac lesions (Spong; Lauroc)."
Throat and respiration
The serpent's grip. Boericke: "Grasping at throat, with sense of choking." Boger: "Suffocative choking; grasps the throat. Puffing breathing. Cardiac asthma or cough." Clarke's leading symptom for cardiac cases joins speech to it: "Inability to speak, with choking, nervous, chronic palpitation," with œsophageal spasm — "stricture of the œsophagus; deglutition difficult or impossible."
The dyspnoea is positional and post-somnic: "Suffocative spells after sleeping (Lach)" (Boericke); Kent: "if he goes to sleep, he wakes up suffocating, gasping, choking." In most complaints "there is inability to lie on the left side."
Hay fever is a genuine Naja territory: "Hay-fever, with dry larynx" (Boericke); Kent's "dryness of the air passages of the nose... The patient has suffocative attacks in August"; and Clarke records Mahlon Preston's cures of hay fever and autumnal catarrh — first a flow of water from the nose for a few minutes, then intense sneezing which relieves the breathing, later dryness in the lungs with great difficulty of breathing, worse lying down. Asthma "beginning with coryza" (Boericke).
Left ovary and pelvis
The famous reflex axis. Boger capitalises it: "PAIN FROM L. OVARY TO HEART." Boericke: "Neuralgia of left ovary; often serviceable in obscure pain in left groin, especially in post-operative cases; seems to be drawn to heart." Clarke's provings supply the sensation itself — "Sensation as if heart and ovary were drawn together" — and his case literature confirms it: Waddell's patient whose heart pains rose with the left ovarian pain for a week before each menses; Bunn's dysmenorrhoea with cramp in the left ovarian region, extreme restlessness, and the flow stopping at the height of the pain.
Head
"Pain in left temple and in left orbital region, extending to occiput, with nausea and vomiting" (Boericke) — neuralgic, throbbing, preceded or followed by nausea, from over-eating or from mental and physical exertion. Clarke adds the morning stamp — headache "in morning on waking" — and Kent the wearing-off with exertion of the day. The Buckland blow returns in the provings as a "feeling as of a blow from behind on head and nape" (Boger: "As of a blow on occiput and neck"), and the vertex is sensitive to cold.
Key Modalities
Worse from:
- Lying on the left side — Boger's leading aggravation
- After sleep — suffocative spells on waking (shared with Lachesis)
- After menses (Boger)
- Cold air, draughts — "very susceptible to cold"
- Pressure of clothes about throat and chest
- Alcohol and stimulants — Boericke: "Worse, from use of stimulants"; Clarke notes craving for stimulants which aggravate
- Exertion, mental or physical; damp weather (Kent)
- Night
Better from:
- Riding or walking in the open air — Boericke: "better, from walking or riding in open air"
- Lying on the right side — Clarke records great relief of pain and breathing in that position
- Sneezing (Boger) — in the hay-fever states it relieves the breathing
- Smoking (Boger; Clarke's headache better "smoking and alcoholic liquors" in one proving record)
Keynote Symptoms
- All complaints settle about the heart; valvular lesions, endocarditis, hypertrophy
- Angina pains to nape of neck, left shoulder and arm, with anxiety and fear of death
- Grasping at the throat with sense of choking
- Pain from left ovary drawn to the heart; organs "seem to be drawn together"
- Cannot lie on the left side; great relief on the right
- Wakes from sleep suffocating, gasping
- Dry, hacking cardiac cough with sweating palms
- Pulse slow, weak, irregular in force
- Left temple and orbital pain extending to occiput, with nausea
- Broods over imaginary troubles; dreads to be left alone
- Fear of rain; worse damp weather
- Profound, log-like, stertorous sleep
Clinical Applications
Valvular heart disease, especially the damaged heart following infectious disease, and the symptom-poor valvular cases of young people that Kent singled out.
Angina-type presentations with the recorded pain-radiation to nape, left shoulder and arm, anxiety and fear of death — always for professional assessment within the whole case.
Cardiac asthma and the cardiac cough — the dry, hacking, exertional cough of a labouring heart, with the sweating palms Kent attached to it.
Nervous palpitation — "chronic nervous palpitation; palpitation after exertion of any kind," with choking and inability to speak.
Hay fever and autumnal catarrh on Preston's pattern: watery flow, relieving sneezes, then dry suffocative breathing worse lying down.
Left ovarian neuralgia and dysmenorrhoea with cardiac concomitants, including the obscure post-operative left groin pains Boericke records.
Collapse states. Clarke reports Majumdar's rescues of apparently hopeless cholera collapse — pulselessness with difficulty of breathing — a historical record that underlines the remedy's depth of action on the circulation.
Differential Diagnosis
Naja vs. Lachesis. The essential snake comparison. Shared: aggravation after sleep, intolerance of anything about the throat, left-sided leanings, surging of blood upwards, damp-weather aggravation. The line between them is Kent's: "Naja has more nervous, Lach. more septic symptoms" — in Naja "there is only a shadow of the septic," no haemorrhage, only oedema; Lachesis runs to dark, decomposed blood, sepsis and haemorrhage. When the case is all heart and nerves without corruption of the blood, it is Naja.
Naja vs. Spigelia. Boericke and Boger both list Spigelia among the comparisons. Both are left-sided heart-and-head remedies with violent præcordial pain. Spigelia's palpitation is tumultuous and visible through the clothing, its neuralgias follow the sun, and it lacks Naja's choking, its valvular gravity and its brooding depression.
Naja vs. Lilium tigrinum. The two great heart-with-pelvis remedies. In Lilium the heart is grasped as in a vise, alternately squeezed and released, while the pelvis bears down as though everything would escape, and the mental state is hurried and driven. In Naja the ovary and heart are "drawn together" — drawn up, not forced out — and the mental state broods rather than hurries.
Naja vs. Cactus. Kent notes that "Cactus also has a cardiac cough." Cactus constricts — the iron band tightening about the heart; Naja chokes at the throat, weakens the pulse and settles into the valves, with the nervous, grieving mental register Cactus lacks.
Repertorisation Tips
These rubrics carry Naja in high grade:
- Chest; PAIN; heart; extending to; nape of neck, left shoulder and arm
- Female genitalia; PAIN; ovaries; left; extending to heart
- External throat; GRASPING at throat; choking, with
- Chest; ENDOCARDITIS
- Generalities; LYING; side, on; left, agg.
- Sleep; WAKING; suffocation, with
- Cough; HEART, in complaints of the
- Extremities; PERSPIRATION; hands; palms
- Mind; BROODING; imaginary troubles, over
- Mind; FEAR; alone, of being
- Mind; FEAR; rain, of
- Head; PAIN; temples; left; extending to occiput
Anchor on the cardiac totality — valvular findings or angina-pattern pains with the characteristic radiations — supported by the left-side lying aggravation and the after-sleep suffocation; then let the strange symptoms (ovary drawn to heart, fear of rain, sweating palms) individualise against the other snake and heart remedies. In the symptom-poor valvular case, remember Kent's standing instruction quoted above. Our beginner's guide to repertorisation sets out the method in more detail.
Deepening Your Study
- Boericke gives the toxicological portrait, the valvular and endocarditis indications, the mental keynotes and the dose note ("Sixth to thirtieth potency")
- Kent's Lectures supply the comparative snake study, the valvular-disease-of-the-young indication and the cardiac cough with sweating palms
- Clarke's Dictionary preserves the proving history, the Buckland poisoning narrative, and the case literature — Majumdar, Preston, Neatby, Waddell, Bunn — that extended the remedy's use
- Boger's Synoptic Key and General Analysis compress the directions and modalities: ovary-to-heart, ascending sensations, the blow on the occiput, lying-left aggravation
You can read all of these side by side for any remedy through Similia's free digital materia medica. To place Naja among its peers, see the guide to the essential polycrest remedies, or read how materia medica and repertory work together in case analysis.
