Spigelia anthelmia — pinkroot — is the great pain remedy of the trigeminal nerve, the eye and the heart. Clarke states its character in one line: "It is a neuralgia remedy par excellence," and gives the note that colours everything else: "Violence is a note of the Spigelia action. The pains are intense, and it produces pains in all parts."
Boericke opens with an unusual testimonial to the quality of its pathogenesis: "Spigelia is an important remedy in pericarditis and other diseases of the heart, because the provings were conducted with the greatest regard for objective symptoms and the subjective symptoms are by innumerable confirmations proved to be correct (C. Hering)." Few remedies carry that kind of provenance statement in their opening paragraph.
The plant, Clarke records, "is a common weed in South America", known in Hahnemann's Europe as an anthelmintic; "Hahnemann's proving (M. M. P.) revealed many other virtues." The remedy is prepared as a tincture of the dried herb. Its territory is compact and easily remembered — Clarke: "Head, eyes, face, teeth, and heart are the principal seats of Spi. action"; Boericke: "Has marked elective affinity for the eye, heart, and nervous system. Neuralgia of the fifth nerve is very prominent in its effects."
This guide profiles Spigelia for clinical study from Boericke's Materia Medica, Boger's Synoptic Key and General Analysis, Kent's Lectures and Clarke's Dictionary. The originals can be read in full — Clarke's Spigelia, Boericke's Spigelia and Kent's Spigelia — through Similia's free digital materia medica.
The Spigelia State
Kent draws the patient in a sentence: "It is indicated in persons who are debilitated from taking cold and who have become rheumatic, run down, victims of pain." Boericke agrees — "especially adapted to anæmic, debilitated, rheumatic, and scrofulous subjects" — and Clarke completes the portrait: suited to "Anæmic, debilitated subjects, of rheumatic diathesis; to scrofulous children afflicted with ascarides and lumbrici; to persons with light hair; pale, thin, bloated, weak; with wrinkled, yellow, earthy skin."
Over this weakened ground runs an extraordinary sensitivity to touch. Clarke: "The body is painfully sensitive to touch, the part touched feels chilly; touch sends a shudder through the whole frame." Boger compresses it to "Shudders; if touched or bruised," and even the pressure of clothing, Clarke notes, "is unbearable" — though steady pressure can relieve the neuralgia itself.
Two general marks orient the whole remedy. The first is left-sidedness: Boger lists "LEFT SIDE" among its regions, and Clarke tells of a country patient whose case he could reduce to nothing more than "that there was neuralgia and that it affected the left side. I ordered Spi., and it speedily cured" — though he adds it is "by no means exclusively" left-sided. The second is the sun rhythm: "Spi. is a sun remedy: headache beginning at sunrise, at its height at noon, declining to sunset." Boger's aggravation column reads "Periodically; with the sun", and his General Analysis gives the curve itself — "increasing slowly, then gradually decreasing, sun pains."
Mental and Emotional Picture
Fear of pointed things. Boericke's entire Mind section is one line: "Afraid of sharp, pointed things, pins, needles, etc." — and it is one of the strangest and most useful symptoms in the materia medica. Clarke relates Meninger's case of severe nausea of pregnancy cured on this single leading symptom: "She was afraid of pointed things and asked her husband to take away a fork, crochet-needle, &c." He adds the differential in the same breath: "Sil. has a somewhat similar symptom, but the Sil. patient hunts for pins although afraid of them."
A mental state only half proved. Kent is candid: "This remedy needs further proving, its mental symptoms are scarcely known." What is recorded he quotes from the Guiding Symptoms: "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." The despondent colouring — Clarke records "Sadness and discouragement" and moroseness reaching, in the old texts, as far as suicidal mania — is noted here as recorded symptomatology for professional assessment, usually arriving with the pains rather than preceding them.
Excitement that cannot settle. Kent describes a patient "full of excitement, cannot keep still, cannot keep control of herself" — and yet the same remedy produces the opposite posture: "He sits in a chair as if transfixed," because every movement, noise and jar aggravates. The stillness is enforced by the pain, not chosen.
Stammering. A small, characteristic oddity from Clarke: "Stammering: repeats first syllable three or four times; with abdominal ailments; with helminthiasis."
Physical Affinities
Head
The classic Spigelia migraine travels a fixed route. Clarke: "A migraine comes from occiput and settles in or over left eye." Boger: "PAIN; in violent attacks; radiating from l. occiput to over l. eye; < stooping." Boericke adds "Pain beneath frontal eminence and temples, extending to eyes", the semi-lateral headache "involving left eye; pain violent, throbbing; worse, making a false step", and the "pain as if a band around head".
Kent supplies the thermal split that separates Spigelia's regions: "The head pains are worse from warmth; better temporarily from cold; the pains in other regions are the reverse" — and again, "Pains in the neck and shoulders are better from heat; those about the eyes are better from cold." A patient who wants cold on the eye and warmth on the neck is speaking pure Spigelia.
Eyes
Boericke: eyes "feel too large; pressive pain on turning them... Severe pain in and around eyes, extending deep into socket. Ciliary neuralgia, a true neuritis." Kent: "Stabbing pains in and around the eye, often radiating in every direction from one point. Eye-ball sensitive to touch" — so painful on motion that the patient "must turn the whole head to see." Clarke's peculiar sensations catch the intensity: "As if needles thrust into eyeball", "As if eye would be pressed out of socket", "Pain in eye as if it would drive him crazy" — and, in the other direction, "stabbing pains through eye backwards into brain."
There is also a characteristic vertigo: Kent describes giddiness from looking downwards, with everything whirling, and Boger records the strange inversion "feet feel higher than the head."
Face and teeth
Boericke: "Prosopalgia, involving eye, zygoma, cheek, teeth, temple, worse, stooping, touch, from morning until sunset" — the sun curve again. Kent describes the pains "burning like hot needles through the face and neck in any direction", and Clarke's sensation is even more vivid: "As if all muscles of left side of face from head to neck and left axilla were pierced with red-hot needles." Toothache is "tearing... worse, after eating and cold" (Boericke); in one prover "the accustomed evening smoke caused violent toothache", and Clarke's causation line is simply "Chill. Tobacco."
Heart
This is the second pillar of the remedy. Boericke: "Violent palpitation. Præcordial pain and great aggravation from movement... Pericarditis, with sticking pains, palpitation, dyspnœa... Angina pectoris. Craving for hot water which relieves... Dyspnœa; must lie on right side with head high." Boger raises the palpitation to its full grade: "HEART; violent, audible PALPITATION, attending other symptoms; violent sticking, or compressive pains radiating to throat, arm or scapula, < least motion."
Kent adds the textures: "Feeling as if the heart were compressed with a hand. Purring feeling over the region of the heart, wave-like motion not synchronous with the pulse", with "trembling of the carotids" and "acute pericarditis with anxiety and weight in the praecordium" — typically at the close of a rheumatic attack or months after it. Clarke confirms from practice: "I have frequently seen cardiac murmurs appearing in acute rheumatism disappear under Spi", and he cured "a case of cardiac neuralgia caused by tobacco."
The signature is the combination of heart and eye symptoms — Boger prints it in bold, and Clarke draws the clinical conclusion: "The combination of heart and eye symptoms marks Spi. as the remedy in many cases of exophthalmic goître."
Worms and the abdomen
Boericke: "A remedy for symptoms due to the presence of worms. Child refers to the navel as the most painful part." Clarke quotes Hering's picture of helminthiasis: "dilated pupils; strabismus; putrid smell from mouth, itching of nose, griping pain in belly... palpitation" — the heart involved even here. "Fetid breath and fetid flatus are marked features of Spi"; Boger writes simply "Fetor oris", and Boericke notes the frequent attacks of palpitation "especially with foul odor from mouth."
Key Modalities
Worse from:
- Touch, motion, noise, turning, washing, concussion (Boericke's list)
- Jar — Kent: riding in a carriage or a hard step "makes the pain unbearable"
- Periodically; with the sun (Boger)
- Stooping; raising the arms
- Tobacco; eating; mental exertion — Kent: "worse from motion, from doing anything, even thinking"
- Cold, damp, rainy, stormy weather (Clarke)
Better from:
- Lying on right side with head high (Boericke)
- Rest — "Rest >. Motion <." (Clarke)
- Steady pressure on the neuralgic part, though touch aggravates
- Warmth generally — but the headache and eye pains are better for cold (Kent's split)
- Hot water, craved, in the heart symptoms
Keynote Symptoms
- Violent left-sided neuralgia — head, eye, face, teeth
- Pain radiating from occiput to over the left eye
- Headache beginning at sunrise, at its height at noon, declining to sunset
- Eyeballs feel too large; pressive pain on turning them; must turn the whole head to see
- Ciliary neuralgia, a true neuritis
- Prosopalgia from morning until sunset, worse stooping and touch
- Violent, audible palpitation, aggravated by the least movement
- Sticking heart pains radiating to throat, arm or scapula
- Combined heart and eye symptoms
- Craving for hot water which relieves
- Dyspnoea; must lie on right side with head high
- Fear of sharp, pointed things — pins, needles
- Painfully sensitive to touch; a shudder through the whole frame
- Foul breath; worm symptoms with pain at the navel in children
Clinical Applications
Trigeminal neuralgia. The remedy's home ground — violent, radiating, left-sided facial pain following the sun, worse touch, jar and stooping.
Ciliary neuralgia and eye affections. Clarke's clinical list includes ciliary neuralgia, iritis, glaucoma and rheumatic ophthalmia where the characteristic stabbing, radiating pains are present.
Migraine. From occiput to over the left eye, throbbing, with the diurnal curve and aggravation from the least motion or noise.
Rheumatic heart affections. Pericarditis, endocarditis and post-rheumatic valvular states with sticking pains, audible palpitation and aggravation from movement — Kent notes it is "seldom indicated in rheumatism of the heart in phlegmatic persons who do not feel intensely."
Angina pectoris. With pains radiating to the arms, anxiety and the right-side-head-high position.
Exophthalmic goitre. Where the heart and eye symptomatology combine.
Helminthiasis in children. With navel pain, foul breath, itching nose and reflex palpitation or strabismus.
Differential Diagnosis
Spigelia vs. Belladonna. Clarke's relations settle it in two clauses: Belladonna's eye pains are "more right-sided; more congestion", and he opposes Spigelia's "neuralgia with pallor" to Belladonna's "with redness". Spigelia is the pale, debilitated, left-sided sun-neuralgia; Belladonna the red, hot, throbbing right-sided congestion.
Spigelia vs. Naja. Boericke's comparisons group "Naja; Spong" under the heart. Both produce serious cardiac states with anxiety, but Naja's territory is the valvular damage of the cobra picture, while Spigelia declares itself by neuralgic sticking pains, audible palpitation, aggravation from the least motion and the accompanying eye symptoms.
Spigelia vs. Gelsemium. Both appear in Boericke's band-sensation comparison — "pain as if a band around head (Carbol ac; Cact; Gels)". Gelsemium's occipital headache comes with heaviness, drooping lids and dull drowsiness; Spigelia's occipital pain shoots forward to the left eye with violence, photophobia and stabbing intensity.
Spigelia vs. Arnica. An unexpected kinship recorded in both sources: Boericke writes "Arnica (Spigela is a chronic Arnica)", and Clarke notes that Teste placed Spigelia in his Arnica group. The bruised soreness of the painful part, intolerant of touch and jar, is the shared thread.
Repertorisation Tips
These rubrics carry Spigelia in high grade:
- Mind; FEAR; pins, pointed things, of
- Head; PAIN; occiput; extending to; eye, left
- Head; PAIN; sun; increasing and decreasing with the
- Eye; PAIN; turning the eyes, on
- Eye; PAIN; extending to; backward into head
- Face; PAIN; neuralgic; left side
- Chest; PALPITATION of heart; audible
- Chest; PAIN; heart; extending to; arm
- Chest; PAIN; heart; motion; agg.
- Generalities; TOUCH; agg.
- Generalities; JAR; agg.
- Generalities; LYING; side, on; right side, with head high; amel.
Anchor the case on the character and route of the pain — violent, radiating, left-sided, following the sun — plus the general sensitivity to touch and jar. In cardiac cases, the combination of heart and eye symptoms with aggravation from the least motion is the deciding confirmation; the fear of pointed things, where present, is almost pathognomonic. Our beginner's guide to repertorisation sets out the method in more detail.
Deepening Your Study
- Boericke gives the tightest clinical summary — the heart section, the modalities and the note on the reliability of the provings
- Boger's Synoptic Key supplies the sun periodicity, the audible palpitation and the radiating attack pattern in high grade
- Boger's General Analysis condenses the aggravations — sun pains increasing then decreasing, stooping, jarring, raising the arms
- Kent's Lectures develop the thermal split between the head-and-eye pains and the rest of the body, and the texture of the pains themselves
- Clarke's Dictionary holds the richest record — the cured cases, the peculiar sensations, and the fullest account of the heart-eye combination
You can read all of these side by side for any remedy through Similia's free digital materia medica. To place Spigelia among its peers, see the guide to the essential polycrest remedies, or read how materia medica and repertory work together in case analysis.
