Cimicifuga racemosa

Volume I — Special Symptomatology

(Black Cohosh.)

Botanical Description. — This indigenous plant is very stately in appearance, and is found growing abundantly in shady and rocky woods, on rich grounds, from Maine to Michigan, and southward to Florida. The Cimicifuga is the Macrotys racemosa, or Botrophys serpentaria of Rafinesque; the Actea Racemosa of Linnaeus. It is also known by the common names of squaw root, black snake root, rattle weed, etc.

The stem is simple, smooth, from four to eight feet high. The leaves are fine, alternate, the lower one nearly radical, divided several times, the upper one two-pointed. The leaflets oblong, egg-shaped, with the stem opposite, incised and from three to seven-toothed. The flowers are one styled, white, foetid, in long slender racemes ; sepals four or five, falling off early ; petals white, four to six, and small ; stamens slender, white, about one hundred to each flower, giving to the raceme the appearance of a long slender plume; one pistil with a broad stigma. The fruit is a capsule, ovoid and dry, having only one cell, containing numerous flat, smooth seeds, which are loosely packed, horizontally, in two rows. In the late autumn and winter any motion of the plant causes a rattling of the seeds, so much resembling the alarm of the rattlesnake as to cause the hunter to start involuntarily; hence its name of rattle weed, given by the country people. The root consists of a thick, irregularly bent, contracted body, from one-third to an inch in diameter, often several inches in length, furnished with many slender radicles, and rendered extremely rough and jagged in its appearance by the remains of the stems of succes Bive years. The color is extremely dark brown, almost black ; internally

yellowish white. The odor is feeble but disagreeable; taste bitter, somewhat astringent, leaving a slight sense of acrimony. It yields its virtues partially to boiling water, and wholly to alcohol. The taste of the tincture reminds one strongly of laudanum.

The root is the officinal portion, and should be gathered early in autumn.

An active principle, named at the time it was discovered, Macrotin, is very extensively used by all schools, under the supposition that it contains all the virtues of Cimicifuga. Some of the following symptoms were caused by Macrotin, but it cannot represent all the pathogenesis, nor cure all the symptoms caused by this plant. It stands in about the same relation to Cimicifuga, as Atropine to Belladonna.

The Macrotin is a brown, dry, very bitter powder, and nearly ten times stronger than the tincture, by weight. It should now be called Oimicifugin.

Officinal Preparations. — Tincture, with strong alcohol, of the fresh root; triturations of the dried root. Macrotin (Cimicifugin) ; triturations.

Analogues. — Caulophyllum, Colchicum, Digitalis, Stillingia, Glonoine,etc. Mental Sphere. Miserable, dejected feeling; mind dull and heavy. Delirium, with nausea, retching, dilated pupils Vertigo; impaired vision; dizziness. She feels grieved, troubled, with sighing.

• Great melancholy, with sleeplessness {'primary ;. Exhilaration, with pleasant thoughts {secondary).

• She is often startled by the illusion of a mouse running from

under her chair.

• Delirium tremens, with nausea, retching, dilated pupils,

tremor of the limbs, incessant talking, and changing from one subject to another, sleeplessness, imagines strange objects about the bed, as rats, sheep, etc., with quick, full pulse, and peculiar wild look out of the eyes.

• Apprehensiveness and sleeplessness in pregnant women.

• Mental disorder: — " Sensation as if a heavy black cloud had

settled all over her and enveloped her head, so that all was darkness and confusion, while at the same time it weighed like lead upon her heart." (Cured by 1 x .) {Hale.) She was suspicious of everything; would not take medicine if she knew it; indifference, taciturn, takes no inter est in household matters; frequent sighs and ejaculations. (Cured by Cimicifuga 200th.) (Dunham.)

Head.

• Pain over the eyes, and in the eyes, extending along the base

of the brain to the occiput.

• Severe pain over the left or right eye, extending to the eye

and base of the brain, with dejection of spirits. Sensation as if the temples were compressed. Head feels as if pounded full of something.

• Dullness and heaviness in the head, as if he had been on a

" spree."

Brain feels too large for the cranium; a pressing from within, outward.

Excruciating pain in the forehead, extending to the temples,

on waking at 2 a. m., with coldness of the forehead. ° Severe remittent headache of long standing, occurring every

day at same hour. Moving the head, or turning the eyes, caused a sensation as

if the cranium was opening and shutting. Acute pain through the head during the day. Dull boring pain in the forehead, over left superciliary ridge,

at 10 a. m.

• Severe pain in forehead, extending to the temple and vertex,

with fullness, heat and throbbing; when going up stairs

sensation as if the top of the head would fly off. ° Pain in the head relieved in the open air. 0 Excruciating pain in the forehead, with coldness of forehead;

pain in the eyeballs. ° Nervous, rheumatic and menstrual headaches. 0 Headache, with severe pain in the eyeballs, extending into

the forehead, and increased by the slightest movement of

the head or eyeballs. °Dull pain in occipital regions, with shooting pains down

back of the neck. ° Cerebro-spinal meningitis. {See Therapeutics, Vol. II.)

Eyes.

• Aching of the eyes, which feel heavy, lasting for days. Eyeballs exceedingly painful; with increased secretion of tears. Stinging in the eyelids, with inflammation.

Eyes feel as if swollen ; black specks before the eyes.

• Congestion of the eyes during the headache. 0 Intense and persistent pains in the eyeballs.

20S

Ocular hyper-festhesia

• Severe pain in the centre of the eyeballs, worse in the morning, lasting all day, aggravated by going up stairs.

• Sensation of enlargement of the eyeballs ; they feel as if

they would be pressed out of the head.

• Pain, as if situated between the eyeball and the orbital plate

of the frontal bone. Heat and swelling of the eyelids, with stinging pain. Dilated pupils, with black specks before the eyes.

• Neuralgia of the eyeballs, without much congestion. ° Catarrhal and rheumatic ophthalmia.

The myopia was aggravated by large doses. 0 Amaurosis; amblyopia; double vision.

Jaws.

Yery severe pains in teeth and jaws, worse in under jaw and

its articulations. Pain in right superior maxillary bone and teeth. 0 Rheumatic and neuralgic toothache.

Nose.

Stinging sensation in the nose in the evening.

0 Frequent sneezing and fluent coryza during the day.

0 Catarrhal condition of the mucous membrane.

Very profuse greenish and slightly sanguineous coryza.

Stuffed condition of the nostrils.

Face.

Severe pain in left jaw.

Heat on one side of the face, with lassitude all over. ° Pains in the head and face are constant. 0 Catarrhal-rheumatic prosopalgia.

Mouth and Throat. *

Offensive breath.

Dryness and soreness of the lips, with swelling of the back

part of the tongue. Accumulation of thick mucus upon the teeth. ° Swollen condition of mucous membrane in rheumatism. Dryness of the pharynx, in a small spot, with inclination to

swallow.

Soreness of the throat when swallowing, and on pressure, with stiff neck.

Inflammation of the uvula and palate, worse on the left side;

with copious coryza. 0 Hoarseness, roughness and scraping in the throat. 0 Dry cough, from irritation and tickling at the lower part

of the larynx. ° Rheumatic sore throat.

Stomach.

• Eructations, with nausea and vomiting, with headache. ° Acute, darting pain in the stomach.

Slight pain in the epigastrium, extending to the left hypochondrium.

• Faintness and emptiness in the epigastrium, almost constant;

(a very characteristic symptom.) Sensation of internal tremor in the epigastrium.

Abdomen.

Flatulence, causing sensation of fullness in the abdomen. Acute cutting pains in the umbilical region. Severe pains in the bowels, with weight and pains in the lumbar region.

Dull griping, twisting at the umbilicus, more toward the left. Periodic colic, with inclination to bend forward, relieved after stool.

° Rheumatism of the muscular structures of the abdomen. ° Neuralgia of the abdominal plexuses.

° Puerperal peritonitis, with suppressed lochia, delirium, etc. 0 Abdominal myalgia, after confinement.

Stool.

Disposition to diarrhoea, with large papescent stool.

Constipation; faeces hard and dry.

Scanty diarrhoea with tenesmus.

° Non- inflammatory colics and diarrhoeas of children.

Urine.

Frequent urination, with increased flow.

° Retention for eighteen hours, followed by profuse urine.

Profuse flow of pale, watery urine, {primary.')

Urine scanty and high colored, {secondary.)

c It increases the excretion of the solids of the urine in rheumatism.

Generative Organs.

{Female.) * A sensation of weight and bearing down in the uterine region, with a feeling of heaviness and torpor in the lower extremities.

• The menses appear eight days before the time.

• Troublesome labor-like pains during pregnancy.

• Abortion in the early months of pregnancy. Premature labor, with serious hemorrhage. Prickling sensations in both mammae. Leucorrhoea, with bearing down pains.

0 Yaginal and cervical leucorrhoea, without ulceration.

0 Amenorrhea, with excessive pain in the head, back and

limbs; with dark circles around the eyelids. 0 Retarded menstruation, with pressive, heavy headache, etc. 0 Suppression from a cold; febrile symptoms; rheumatic pains

in the limbs; uterine cramps. c Congestive dysmenorrhoea, and of rheumatic origin. 0 Uterine ailments of a neuralgic type.

0 Dysmenorrhea, with aching in the limbs, severe pain in the back, down the thighs, with heavy, pressing down, laborlike pains, cramps, tenderness of the hypogastric region.

0 Menorrhagia; profuse flow, of a passive character, dark coagulated, with the characteristic pains.

° Uterine inertia during and after labor.

• Spasmodic, painful and intensely powerful but intermitting

contractions.

° Suppression of the lochia, with severe uterine pain and threatened peritonitis. 0 Threatened abortion, and habitual abortion. 0 Prolapsus uteri, from deficient innervation. 0 Ovaritis. 0 Irritable uterus. 0 Post-partem haemorrhage. 0 Spasms of the broad ligaments. 0 Sterility, from various causes.

0 Puerperal melancholy and mania, with sleeplessness. Male. — Pain and tenderness of the testicles.

Larynx.

Constant inclination to cough, from tickling sensation in the larynx.

Hoarseness; short dry cough; fluent coryza.

° Troublesome hacking cough.

° Catarrhal cough of children, especially at night.

Chest.

Acute pain in right chest, extending from top to bottom, about two inches to the right of the sternum, aggravated by inspirations.

Lancinating pain along the cartilages of the false ribs, left

side, aggravated by inspiration. Transient and fugitive pains all through the chest, with cardiac palpitations. ° Aching, wearing pains in under left mammae. ° Neuralgic pains through the chest.

Stitches in the region of the heart, and pain in left side of the chest.

• Pleurodynia, rheumatic or myalgic.

• Pleurisy, sub-acute (after Aconite and Bryonia). ° Chronic cough, dependent on nervous debility.

° Pains in the left side so common to females. ° A sore, aching pain in left side, below the nipple, relieved by a long inspiration, (in a man.)

Heart.

Pain in the region of the heart, with palpitations, and stitches flying through various parts of the thorax.

Pain and anxiety in the heart, with pain in left shoulder; the arm feels bound to the side.

Transient but severe cardiac palpitations.

Pulse weak, irregular, eighty per minute.

0 Paroxysms, several times a day (in a woman at the change of life), of intense pain in the region of the heart; great anxiety; livid or purple color of the face; cold perspiration on the hands; numbness of the whole body, especially the arms; the heart's action seems suspended by spasms; she cannot speak or move; she feels as if suffocating; head forcibly retracted, and unconsciousness.

the left arm into the hand, and great exhaustion).

° Intense anxiety and pain about the heart, with pain in the shoulder, extending down the left arm.

0 Rheumatic affections of the heart.

0 Pericarditis, sub-acute, during rheumatism.

° Cardiac myalgia (with pain, irregular action, etc.)

° Functional disorder, from mental depression.

0 Angina pectoris.

° Palliation in some organic heart affections, hypertrophy, etc.

Back.

• Stiffness of large muscles of the neck. Drawing and pulsating pain in lumbar region.

• Dull, heavy aching in the small of the back, relieved by rest,

increased by motion. Stitches in the back, aggravated by motion or respiration.

• Cramping in the muscles of neck on moving the head.

• Rheumatic pains in the muscles of the neck and back. Trembling and weakness in the back — sacrum.

In the morning, on bending the neck forward, a severe, drawing, tensive pain at the points of the spinous processes of the three upper dorsal vertebrae.

Dull pain in region of lower dorsal and upper lumbar vertebras.

Weight and pain in lumbar and sacral regions, sometimes extending all around the body, somewhat below the crest of ileum.

Feeling of stiffness and constriction in muscles of the back.

° Lumbago — one of the most useful remedies.

° A painful affection known as " crick in the back."

0 Spinal myalgia, falsely called spinal irritation, with pain, soreness, tenderness along the spinal column; a disease seated in the ligaments and muscles of the vertebral column, and generally of a rheumatic origin, or due to weakness of the muscular fibres.

Superior Extremities. Dull pain in right arm, deep in the muscles, from the shoulder to the wrist.

Itching and redness of dorsal surface of the hands.

• Neuralgic pains in all the extremities.

Pains which are cramping, with lameness and numbness. 0 Muscular rheumatism of the extremities.

Lower Extremities. Twitching of fingers and toes.

Dull, aching, burning pain in the great toe, extending up the limb.

° Sciatica, with numb, crampy, and laming paine. ° Rheumatic-neuralgic pains.

c Articular rheumatism; also muscular, especially in the largo muscles.

Skin.

Prickling, itching, and heat of the whole surface.

Eruptions of white pustules over the face and neck, sometimes

large, red, papular. Papular eruption on back of hands and wrists. 0 Varioloid — useful in some cases.

Sleep.

• Sleeplessness, from nervous irritation.

° Sleeplessness of children during teething. 0 Sleeplessness, with melancholy mood.

Fever.

° Rheumatic fever of an acute character.

° Typhoid fever in some cases.

° Night sweats without organic disease.

Generalities.

Nervous system. — * Chorea, from suppressed menses. 0 Chorea, from undue exposure to cold.

° Chorea, from rheumatic irritation of motor nerves, or ante

rior column of spinal cord. ° Chorea, from deranged menstrual functions; always worse at

the menstrual periods. 0 Chorea; the whole body in constant motion, with loss of

speech, and mental depression. 0 Spasmodic jactitation of limbs, or single muscles. 0 Cerebro-spinal irritation, when the motor side is excited and

there exists atony of the muscular system.

It causes first great irritability of the nervous system, and secondarily, great exhaustion of that system.

Nervous exhaustion after the least excitement.

Great sensitiveness to cold air; it seemed to penetrate the system.

Continual restlessness in afternoon; desire to move about, not

knowing what to do, or where to go. General weak, ill, trembling, sinking feeling. Tremors,' so weak and trembling as not to be able to walk or

study.

General lame and bruised feeling, as if sore all over. It affects the left side most.

Severe aching in joints and back, as if attacked with variola

Volume II — Special Therapeutics

We now come to speak of one of the most important of all the new remedies. It is to the new, what Ignatia was, and is, to the Materia Medica of Hahnemann. Its range of action is quite extensive; it has been quite thoroughly proven; the clinical experience with it is already large; and it has large possibilities for future development.

It is known under the common names of black snake-root, black cohosh, and rattle weed. Its former botanical names were Actaea and Macrotys, from which latter came the name of its active principle Macrotin. (Now Cimicifugin.)

Sphere of action. — It is essentially a cerebro-spinal remedy. The brain and spinal cord are directly under its influence, and upon which it acts primarily as a depressing irritant.

Its action on the muscular system is probably not direct, but a result of its effect upon the spinal cord. It differs from Nux and Ignatia, in that they are exciting irritants of the spinal cord. Cimicifuga indirectly affects the vegetative system — the functions of digestion and assimilation. It has but few symptoms of gastric or intestinal derangement not due to reflex irritation.

It has become one of our most potent remedies in disorders of the mental sphere, namely, in melancholy and aberration of mind.

The characteristic symptoms indicating its use are: “Great melancholy ; she feels grieved ; troubled with sighing ; sensation as if a heavy black cloud had settled all over her, and enveloped her head, so that all was darkness and confusion, while at the same time it weighed like lead upon her heart.” (Cured by Dunham with the 200th, and by myself with the 3X dil.)

“She was suspicious of everything and everybody ; would not take medicine if she knew it; indifferent, taciturn; takes no interest in household matters ; frequently sighs and ejaculates ; great apprehensiveness and sleeplessness.”

These symptoms are always promptly removed by Cimicifuga. The size of the dose, if it is above the lx, does not seem to be important. I have treated very many cases of profound melancholy, even from disordered liver, by this medicine, and can assure you that it has cured the majority, and even when the disorder of the mind depended on incurable physical disease its palliative effect was remarkable. One keynote to be remembered, is sleeplessness. Many physicians have informed me that if, in cases of melancholy, sleeplessness was present, Cimicifuga nearly always cured.

Delirium tremens. — In this terrible disorder the Cimicifuga is indispensable. When there is nausea, retching, dilated pupils, heavy pressing-out headache, trembling of the limbs, incessant talking, changing from one subject to another, obstinate sleeplessness, imagines strange objects on the bed, rats, sheep, etc., with quick, hard pulse, and a peculiar wild look in the eyes, the 3X dil. frequently repeated, aided by a good diet of milk, wine, whey, mutton broth, etc., will soon restore the patient.

A lady patient of mine who was taking five drops of the 1* for rheumatism, was annoyed by an illusion of a mouse running from under her chair. This illusion disappeared upon suspending the medicine, and recurred when taking it in the same doses.

I have found it useful in puerperal mania, and in those depressed states of mind and body following the excessive use of tea, valerian, and morphia.

The nerves of sensation are very unfavorably affected by massive doses. It causes a pure neuralgia, and what the older authors called neuralgic rheumatism. The neuralgia is not confined to any

particular set of nerves, as is the case with some remedies. Its depressing irritant action seems to be universal. The pains are aching, pressing, remitting, and are attended with great restlessness and a weak, exhausted feeling. It seems to affect the sensory nerves of the left side most. The nerves of motion are profoundly irritated. In the words of Dr. T. C. Miller, whose experience with it for fifteen years enabled him to judge of its powers : “ It is one of the most remarkable remedies in all diseases of the ganglio-spinal system, particularly when the motor side is excited, and yet, in the whole, prevails an atony in the muscular and nervous system.”

This statement of its pathological action gives us the clue to its wonderful efficacy in chorea. It is indicated in many kinds of chorea, whether arising from rheumatic irritation of the cord, from uterine disease, or from purely psychical causes. The symptomatic indications are chiefly : abnormal movements, uncontrolled by the will, in all those parts of the body supplied by motor nerves ; it affects both voluntary and involuntary muscles. The motions consist of twitching, jerking, twisting actions; they are sometimes attended by pains like neuralgia or rheumatism. The movements abate or are absent during sleep. They are aggravated by emotions ; at the menstrual periods ; or are caused by suppressed menses. They are attended by depression of spirits, and sleeplessness, and often by mental derangement.

The Cimicifuga is useful in many kinds of tremors which resemble St. Vitus’s dance, but due to functional derangement of the nerve-centres. If they are caused by structural changes this remedy is useless, or if they are caused by mercurial or other mineral poisoning.

I do not think the Cimicifuga will be found very useful in convulsions of any kind, unless they resemble chorea ; consequently it will not be available in ordinary puerperal convulsions or epilepsy.

It bids fair to become a prominent remedy in cerebro-spinal meningitis, and possibly myelitis.

Dr. W. S. Searle, of New York city, first called attention to it in the “Transactions of the New York Homoeopathic Society,” and gave his experience of its use in a case of the former disease,

when, after the inflammatory period had passed, the patient was tormented day and night by alternate clonic and tonic spasms and obstinate vomiting. Since Dr. Searle’s observations were published I have used it in many cases of cerebro-spinal trouble, and with unvarying success. Those of you who have been in practice, or have observed the practice of your preceptors, must have noted the prevalence of more or less cerebro-spinal irritation in nearly all fevers and some other diseases, and occurring in the winter and spring months. It is only within a few years that these phenomena were of such frequent occurrence. As the late Dr. Williamson used to say : “ It has become the genius of the prevailing maladies.” Cimicifuga, in the lower dilutions, is indicated in the three grades of this disorder, namely :

Cerebro-spinal meningitis, in the 6X dil.

Cerebro-spinal congestion, in the2x dil.

Cerebro-spinal irritation in the 1* dil.

I will give you the indications for its selection :

Delirium, like mania a potu, with nausea, retching, dilated pupils, tremor of the limbs; quick, full pulse, and wild look out of the eyes.

Headache; pain over the eyes, extending along the base of the brain into the occiput.

Brain feels too large for the cranium, a pressing from within outwards ; or a sense of compression in the temples.

Excruciating pain in the forehead and in the eyeballs, vertex, nape of the neck, and occiput, with fulness and throbbing, as if the top of the head would fly off.

Dull pains in the occiput, with shooting pains down the back; the head is jerked backward.

Intense pain in the eyeballs, with black specks before the eyes; dilated pupils ; double vision ; congested conjunctiva, and lachrymation.

Intense throbbing pain, as if a ball were driven from the neck to the vertex with every throb of the heart.

Tongue swollen; breath offensive; pharynx dry; dysphagia; roughness and hoarseness of the voice.

Nausea and vomiting attend the pain in the head.

Pains in the back, of a drawing, tensive character, or dull and heavy, with tenderness on pressure.

Alternate tonic and clonic spasms, night and day.

Spasmodic jerkings, like chorea.

Rigidity of the muscles of the neck and back.

Intense aching pains in the neck, head, and all the joints of the extremities, like the pains which accompany the fever of variola.

Eruption of white pustules on the face and neck ; sometimes large, red, and papular.

There is a disorder, known at one time as “spinal irritation.” It is now known that in the great majority of cases it is not a spinal but a muscular affection, and its proper name is myalgia. In this disease Cimicifuga is one of our best remedies, rivalling Arnica, Hydrastin, or Nux. This leads us to consider its action on the muscular system. It is curative in two kinds of muscle disease :

(1.) Myalgia, or a loss of tonicity in the muscular fibre, probably from atony with irritation of the nerves which supply them. Myalgia in its various forms includes, certain headaches from an affection of the muscles of the head and nape, pleurodynia, myalgic colic, stiff neck, “ crick in the back,” and burning, cramping, stitching, aching, pains all over the body, and even in hollow internal organs.

(2.) Myositis, or inflammation of muscular structures, either idiopathic or rheumatic. It seems to affect by preference the belly of the muscle. Arnica acts in a similar manner, but it is better for traumatic myalgia and myositis; Bryonia resembles Cimicifuga, but the cause of the Bryonia muscular disease lies more in the state of the blood and secretions than in the state of the nervous centres. Bryonia does not cause reflex muscle disorder. Cimicifuga does (so does Caulophyllum). Hydrastis differs from both and resembles China and Ferrum more nearly.

In inflammatory muscular rheumatism Cimicifuga has always had a deserved high popularity, both with physicians and laymen. The rheumatic fever, for which it is specific, is marked by several very characteristic symptoms, namely, the suddenness of its onset, the severity of its manifestation, and its location in large muscles.

In such cases it often acts with surprising rapidity, relieving the fever, pain, soreness and restlessness in a few days.

It differs from Rhus in not acting on the tendons, or terminal attachments of muscles, and from Colchicum, Bryonia, and Asclepias, in not acting on serous tissues ; at least I do not think it has that affinity for serous tissues which is possessed by other wellknown medicines.

I would not give you the impression that Cimicifuga is not useful in chronic rheumatism, for some of its most brilliant achievements have been in that direction. But in such cases the location of the disease has been in the belly of the muscle, i. e., its longest or middle portion, and its inception was originally sudden and severe.

In my practice, and those of my colleagues, also in the practice of the eclectic and allopathic schools, it has made some surprising cures of chronic inflammation of the cervical and lumbar muscles (“ stiff neck ” and lumbago); in chronic inflammation of the muscles of the upper and lower extremities, and intercostal rheumatism. I remember one case, the mother of Clara Louise Kellogg, the prima donna, who had for many years such stiffness, pain and lameness of the muscles of the thighs that her sufferings were at times intolerable. After trying faithfully Rhus, Nux vom., Bryonia, Turpentine, Sulphur, etc., she took ten drops of tincture Cimicifuga three times a day, which accomplished the removal of the disease within a few weeks.

The febrile symptoms of Cimicifuga are more erethistic or irritative (reflex or sympathetic) than inflammatory or synochal. It will rarely be useful in the fevers, except as an intercurrent remedy.

In the exanthematous fevers, it has not been specially recommended, except by Drs. B. L. Hill and I). S. Smith, who used it in variola and varioloid. It certainly does seem indicated in the first stage of small-pox, for the intense aching in the extremities, head, and back resemble the symptoms of that disease. It even causes “white pustules on the face and neck.” I would advise you to keep this remedy in mind in the treatment of variola.

I have found it useful in the myalgic troubles which often follow scarlet fever. It relieves those intolerable pains in the back and

limbs, the stiff neck, and muscular cramps, which are such painful sequelae of that malady.

Nightsweats , when not due to suppuration or anaemia, but to some fault in the proper supply of nervous energy to the skin, are readily arrested by Cimicifuga.

In the provings, you will observe that cold sweat was quite a common symptom, especially after 3 A.M., sometimes lasting all day, with weak, irregular pulse, and pain under left breast.

You will find these symptoms very common in women, and sometimes men, whose nervous system has been weakened by long illness, trouble or care; and you will find in all such cases that the Cimicifuga, in the 3* to 6th dilution, will prove an admirable restorative.

No drug in our Materia Medica uniformly causes such severe pain in the head, both internal and external.

Internally it causes passive congestion or anaemia, according to the constitution of the prover. Externally it causes pains in the muscles, and the nerves supplying them.

The character of the pains and distress are, internally: “a sensation as if the temples were compressed,” — dulness and heaviness in the head, as if he had been on a “spree;” head felt as if it had been pounded, full of something heavy ; moving the head or turning the eyes causing a sensation as if the cranium was opening and shutting; head feels as if he had been without sleep a long time; brain feels too large for the cranium, pressing from within outward; severe pain in the forehead, extending to the temples and vertex, with fulness, heat, and throbbing; when going up stairs, a sensation as if the top of the head would fly off; excruciating pain in the forehead, with coldness of the forehead, and severe pain in the eyeballs. Nearly all the pains in the head extend to the eyeballs; they are aggravated by movement, relieved by the open air; attended by faintness and “sinking,” at the pit of the stomach.

Externally it has severe pain over the right or left eye, extending into the eye, and back into the base of the brain ; pain over the eyes, extending along (around) to the base of the brain and occiput, and nape of the neck ; pain in the occipital region, with shooting pains down the back of neck ; dull, boring pain

over the left superciliary ridge, at 10 a.m. ; pains in the occiput, extending to the vertex.

All these symptoms are trustworthy, and have been verified by clinical experience.

Cimicifuga is indicated in

Headache resulting from loss of sleep, night-watching, and abuse of alcoholic drinks; from mental strain and worry of mind; and from exposure of the head to draughts of cold, damp air.

It is useful in the following kinds of cephalalgia :

Congestive headache (passive, perhaps active).

Nervous headache (periodical or remittent).

Rheumatic headache (in the muscles — catarrhal).

Hysterical and menstrual headaches (at change of life).

Cereb ro- spinal headaches.

In the cerebral irritation of children during teething, when they are fretful, feverish, sleepless, the 6th or 30th has a soothing effect.

I do not think you will find it useful in acute cerebritis or meningitis, but it may be in the chronic.

Its analogues in head affections are Bryonia, Spigelia, Glonoin, Nux Vomica, and Ignatia.

The eyes are severely acted upon by Cimicifuga. Few drugs cause such intense and persistent pain in the eyeballs. The pains are chiefly aching , extending to different portions of the head. Many of the pains, however, seem fixed in the centre of the eyeball, and simulate rheumatic and neuralgic affections of the eyes. In some cases the eyelids become inflamed. One characteristic of the eye affection is that in the majority of cases no redness of the eyeballs exists; in other cases, as in Dr. Hill’s proving, the “eyes were congested, so as to attract the attention of every one, although there was no disagreeable feeling in them.” This discrepancy is probably owing to some difference in the constitution or idiosyncrasy of the prover.

It will probably be found useful in the painful sensitiveness of the eyes known as “ ocular hypercesthesiafi for which Spigelia is such an excellent remedy. Both should be used in the high potencies for this affection.

It is reported to have cured catarrhal conjunctivitis ; and should be tried in sclerotitis rheumatica.

It causes amaurotic symptoms, “black specks,” and “double vision,” both of which it has cured.

The catarrhal symptoms, especially of the nasal mucous membrane, are very decidedly shown in all the provings. But it has no special reputation in ordinary catarrh or influenza. It affects the laryngeal and bronchial mucous membranes in a similar manner. A study of the provings will show, however, that the catarrhal irritation rarely goes beyond the serous stage.

I think the Cimicifuga catarrh is in keeping with its rheumatic symptoms. In other words it causes a catarrh which precedes a rheumatic attack. Dr. Hill suggests that it causes catarrhal conditions similar to those produced by a sudden change in winter from a cold day to damp thawing by a south wind that melts the snow. Now this is the very atmospheric condition that causes the severest kind of rheumatism.

In rheumatic sore throat , rheumatic prosopalgia, and toothache, when preceded by the above catarrhal conditions, it is clearly indicated.

The older authors recognized a rheumatic bronchitis and pneumonia. Given the other symptoms of Cimicifuga, I should not hesitate to advise it in acute bronchitis and pneumonia, preceded by the characteristic catarrh.

It is indicated for the premonitory symptoms of diphtheria, but does no good afterward.

The action of Cimicifuga on the stomach seems to arise from its depressing effect on the solar plexus and its sympathetic nerve connections. It resembles .the action of Sepia, Digitalis, Murex, and Ignatia, all of which produce, like Cimicifuga, that peculiar sensation of faintness, sinking and emptiness which attended all the provings. This sensation was sometimes attended with nausea and vomiting. This faint sensation alternated during the same day with a sensation of fulness or repletion. Both sensations resulting from a depression of the same nerve.

In the nausea and vomiting of drunkards, tea-drinkers, and pregnant women, when attended by the above morbid sensations, it will act curatively.

It is well indicated in the vomiting which precedes cerebral and

spinal irritations, and the vomiting which is sympathetic with, and resulting from, nervous headache.

There are three diseases of the abdominal structures in which you will find Cimicifuga useful : (1.) Rheumatism of the muscular tissues. (2.) Neuralgia , often mistaken for peritonitis, especially if it occurs after miscarriage and confinement. (3.) Rheumatic neuralgia. It does not seem to be homoeopathic to, or useful in any abnormal discharge from the bowels.

It increases the quantity of urine, which is pale and limpid. Take the symptoms in connection with the general nervous depression, sinking at the stomach, etc., and we have good data for prescribing it in nervous diabetes , or that condition which frequently precedes or follows nervous attacks of various kinds, hysteria, and the like.

The symptoms of the male genital organs are those which might attend general rheumatic irritation, affecting the spermatic cord and testicles. Its curative action in some cases of spermatorrhoea and its consequences is undoubted.

Cimicifuga is one of our most important remedies in many of the diseases of women.

In amenorrhoea, or delayed appearance of the menses in young girls, from deficient nervous energy in the ovaries, and when the abnormal nervous influence is directed to other organs, giving rise to chorea, hysteria, nervous headaches, etc., the Cimicifuga will restore the functions of the reproductive organs to a normal state. Should there be, at the same time, with the above conditions, a chlorotic state, Helonias or Ferrum should be alternated with this remedy.

In retarded menstruation , when Pulsatilla or Senecio are not indicated, and when at the usual menstrual period the discharge does not appear, but in its place comes a pressive, heavy headache, melancholy, palpitation of the heart, and other reflex symptoms, in these cases the Cimicifuga will restore the normal condition of the system and cause a regular return of the menses.

In suppression of the menses from a cold, mental emotions, or febrile conditions, when rheumatic pains in the limbs, or intense headache, or uterine cramps are present, this remedy will be found very useful. In dysmenorrhoea the black snake-root has been used

successfully by all schools. The eclectics consider it a sort of panacea. Many of our own school speak highly of its value. Dr. Hill, in his “ Epitome,” advises it in all cases, in alternation with Caulophyllum. It is not a general specific, yet it will benefit a majority of cases. It is most useful in rheumatic and neuralgic cases, but is often of benefit in congestive dysmenorrhoea, when alternated with Veratrum viride, or Belladonna. The best method of administration in these diseases is to give Cimicifugin, first decimal, or one-hundredth, three or four times a day during the intermenstrual period, and every hour or thirty minutes during the severity of the pain. The Cimicifugin, second or third decimal trituration, will in some cases act more satisfactorily than the tincture. Several of my colleagues have reported cases of dysmenorrhoea cured or very much relieved by it. They think more highly of the Cimicifugin in the neuralgic type than of Caulophyllin. The latter is more indicated in cases complicated with uterine spasms or general hysterical convulsions. Dr. Williams sends me the record of two severe cases of dysmenorrhoea, probably of a rheumatic origin, which were apparently cured under the action of Cimicifugin 1st. I have treated many cases of difficult and painful menstruation, arising from various causes, and while in all there was improvement, in many the morbid condition seemed to be permanently removed. I consider the following symptoms as indicating its use : Before the menses, the peculiar headache similar to that caused by this medicine; during the menses, aching in the limbs, severe pain in the back, down the thighs and through the hips, with heavy, pressing-down, laborlike pains, weeping mood, nervousness, hysteric spasms, cramps, tenderness of the hypogastric region, scanty flow of coagulated blood, or profuse flow of the same character ; between the menses, debility, nervous erethism, neuralgic pains, tendency to prolapsus, etc. It is useful in menorrhagia, when the flow is profuse but of a passive character, dark, coagulated, and accompanied by the above-mentioned pains. The Cimicifuga does not primarily cause haemorrhage like Sabina, Erigeron, or Crocus, but secondarily, by impairing the tonicity and normal vitality of the uterus.

In leucorrlioea, the eclectics speak highly of its efficacy. The late Dr. Morrow, to whom is mainly due the introduction of the

remedy into that practice, gained much celebrity by his treatment of leucorrhoea with the internal and local application of the Black Cohosh. He gave it until it produced and kept up its peculiar action on the brain in slight degree; a decoction of the root as an enema was used every day. Leucorrhoea may be vaginal, cervical, or uterine. In the present state of our knowledge of the action of the drug, we cannot point out accurately the particular form of leucorrhoea for which it is indicated. It may be beneficial in all varieties; the general symptoms must, to a great extent, be our guide. Dr. Hill mentions a “ leucorrhoea of long standing cured during a week’s proving,” and another case of “leucorrhoea, and chronic inflammation and congestion of the uterus, cured during the proving, while no other symptoms were observed on the provers until the disappearance of the uterine disease.” Believing in the local as well as general action of a drug, I would advise it to be used both topically and internally. The lower dilutions seem to act most beneficially. It is now more than sixty years since it was claimed by Stearns, in the “American Herbal,” to have an especial affinity for the uterus, particularly over the menstrual function, and Dr. Tully regards this claim as well established by the experience of New England practitioners.

As a parturifacient it was in general use among the Indians in the early settlement of this country. Bigelow speaks of it as an active agent in facilitating parturition; and Tully says he has known many cases where it has produced abortion in pregnant women, when prescribed for a cough. The evidence on this head is far more full and satisfactory than in regard to its emmenagogue properties. Prof. Lee says : “ It is believed to exert a specific influence on the uterine contractions, lasting longer than that of Ergot, and followed by less torpor and greater susceptibility and capacity for action in the uterus than before its employment. Its operation, also, is not attended by that deleterious and stupefying influence on the foetus which often follows the administration of Spurred Rye.”

It is doubtful if the Ergot acts medicinally on the foetus at all. It is the continued, unintermitting pressure of the uterus upon the child, or the cord, which causes the coma or asphyxia in the infant before birth.

“After delivery,” adds Professor Lee, “it has also been extensively and successfully used for the purpose of inducing firm uterine contractions, expelling the placenta, and checking post-partum haemorrhages. For this purpose a drachm of the saturated alcoholic tincture should be given every half hour, or oftener, until the desired effect is produced.” (This dose is enormously large and unnecessary. Ten drops is sufficient.) A knowledge of the uterinemotor action of Cimicifuga should be appropriated by homneopathists. They are capableof making much more valuable use of such knowledge than the adherents of other schools of medicine. The homoeopathic school gladly avail themselves of the use of Ergot in slow and difficult labors arising from an atonic condition of the uterus, or perverted function. I can not give my assent to those mythical relations of the effects of the Secale third or thirtieth, in causing uterine contractions when deficient during labor ; the proof is not sufficient. I consider the Cimicifuga, as well as Secale, Caulophyllum, and other drugs, possessing similar powers, as being secondarily homoeopathic to conditions of uterine inertia.

To explain : The primary act ion of Ergot in moderate medicinal doses is to cause contractions, more or less persistent, of the muscular tissues of the uterus. Under the continued action of the drug these contractions will become more intense and firm, until, from over-stimulation, an opposite condition or muscular atony obtains. Now, this latter condition, with its accompanying symptoms, is a secondary effect of the drug, as much due to pathogenetic action as was the primary. When, in practice, we meet with similar conditions, i. e., when the uterus, after vain and powerful efforts, becomes exhausted, Ergot is the proper remedy if the primary symptoms correspond with those of the drug, viz., persistent and violent contractions. But if the uterine atony be caused by Ergot, then that medicine will not answer our purpose, and we must resort to Cimicifuga, Caulophyllum, Cannabis, or galvanism. Secondary states of uterine muscular atony may be brought on by all the last-named agents, and for this reason they will all be found useful in similar morbid conditions. The dose which should be used in such cases should be as large as can be given with safety to the patient, and just large enough to arouse the torpid muscular tissue. My theory of dose, which experience strongly substantiates, is, that for symptoms which simulate the primary effects of the medicine selected as the remedy, minute doses should be administered ; but larger doses for symptoms simulating its secondary effects. In resorting to the Cimicifuga in atonic labors, we need not give the massive doses of the eclectic school — doses which tend to bring on secondary exhaustion. I have found five to ten drops of the mother tincture, every fifteen or twenty minutes, to be amply sufficient to bring back or arouse the deficient vitality of the uterus. But there is an opposite condition of the uterus which sometimes obtains during labor, a state of hyperexcitation, in which the normal uterine contractions are spasmodic, painful and intensely powerful, but intermitting; sometimes with cramps in the extremities, and a tendency to general convulsions. Here the Cimicifuga is primarily homoeopathic, and a small quantity of the third or sixth attenuation will suffice to restore the normal parturient action. This medicine will be found useful after labor, in producing firm contraction of the uterus, expelling the placenta, or checking post-partum haemorrhage. But I think for this purpose the Secale is to be preferred, because of its power to cause firmer and more 'persistent contraction.

After-pains are often readily relieved by small doses of Cimicifuga, second or third, or Cimicifugin third. I have used it with signal benefit in those cases which seemed to be kept up by a neuralgic disposition, or mental and nervous irritability, and the patient was sleepless, restless, sensitive, and low-spirited.

Suppression of the Lochia is treated successfully with this remedy. When from a cold or mental emotion the discharge is arrested, uterine spasms and cramps in the limbs sometimes occur, accompanied with headache and even delirium.

A case of this character, which came under my treatment, was relieved in a few hours by Cimicifugin, second trit., two grains every half hour. Warm fomentations were applied to the abdomen and vulva, as should always be the practice in such instances.

It is also useful for the relief of those bearing-down pains, indications for prolapsus, which women frequently suffer from after severe confinement. It is eminently homoeopathic to a tendency to abortion. It has caused abortion in many instances, and is commonly resorted to for that purpose by reckless women, and

advised by still more reckless physicians. It has been successfully used in instances of “ habitual abortion,” with the result of preventing the usual miscarriage in the second and third months. But unless the general symptoms correspond, Caulophyllum, Sabina, Viburnum, or Helonias will have to be selected. When the chill, uterine pain, tenderness of the hypogastric region, and flooding, have already set in, and the loss of the foetus becomes imminent, the Cimicifuga in small doses may arrest the progress of the morbid process, provided the membranes have not become extensively detached. If the separated portion be slight, and the patient be kept quiet, and the proper remedies given (Aletris viburnum), I believe it possible to prevent a further separation. If all hope of saving the foetus be abandoned, and the uterus is deficient in expulsive power, then this medicine may be given, as recommended for uterine atony in labors.

But no physician should rely alone upon medicinal action in such cases. The sponge or sea-tangle tent, placental forceps and blunt hook, should be used early and efficiently, to effect the entire removal of the contents of the uterus.

Sterility , when not due to extensive ulceration, or other structural changes in the uterus, may be cured by Cimicifuga. Among the causes of sterility, by which I mean, inability to conceive, which are removed by this remedy, are congestion of the cervix, thereby closing the cervical canal ; deficiency of nervous energy, accompanied with melancholy ; feeble circulation, scanty menstruation, lack of sexual desire, etc.

Prolapsus uteri is often removed by this remedy, especially when occurring in nervous, melancholy subjects, and is the result of abortions, cervical congestion, or deficient nerve-innervation. Two key -symptoms indicate it in prolapsus, namely, melancholy, and “sinking” at the pit of the stomach. Helonias also has the former and Sepia the latter, but in both I think the pathological conditions are different from those cured by Cimicifuga.

Ovarian disorders, of a nervous rather than inflammatory or structural character, will often find a specific in Cimicifuga. Ovarian neuralgia is perhaps as often cured by it as by any other remedy. In this affection it is specially indicated when the ovarian pains are reflected, or change their location to other portions of the body, as the leg of the same side, the region under the left

breast, or extend up the whole side to the shoulder. It causes congestion of the head, the uterus, and other organs, and, verylikely, the ovaries. As ovarian disorder is usually attended with abnormally depressed states of mind, the Cimicifuga is as often indicated as Platinum, with which it closely affiliates in many respects.

In puerperal mania it has been found curative by all schools. Many cases successfully treated by it have been published in our literature, some in the eclectic, and a few in the allopathic. The late Professor Simpson reports a case called by him “ puerperal hypochondriasis,” in which he had tried all the usual remedies. He gave the enormous dose of fifty drops of the tincture thrice a day. He says : “ In eight or ten days she was altered and changed in a marvellous degree, but all for the better. On the third or fourth day, she informed me that the cloud of misery which had been darkening her existence suddenly began to dissolve and dispel, and in a day or two more she felt perfectly well again, in gayety, spirits, and energy.” He adds that nothing would induce her to give it up, but took it for six weeks longer ! And no pathogenetic symptoms! What will the ultra high dilutionists say to this? Does it not prove that the danger of medicinal aggravations from appreciable doses is very much aggravated? The fact is, that if a medicine is homoeopathic to a case, it will cure in any dose, in a high or low attenuation. (See Dr. Dunham’s cure of just such a case as the above with the 200th.)

Dystocia is one of those abnormal conditions which come clearly under the domain of homoeopathic medication. It is useless to cling to the antiquated superstition that a woman must suffer “ pangs of childbirth.” Dystocia is always the result of an abnormal condition of the tissues concerned in the functions of childbearing. I do not wish to have you understand that a majority of cases of painful labor can be remedied by medicines. I have attended very many women who did not suffer to any degree ; they expressed themselves as caring very little for the pains. Nor were these women all healthy. But this abnormal phase was somehow absent, or nearly so. I have also attended many women whose previous labors had been exceedingly painful, almost unendurable without Ether, but, owing to the administration of Cimicifuga

during the last weeks of pregnancy they suffered very little. So many of these cases have occurred in my practice and in that of my colleagues, that it is not proper to affect skepticism or unbelief. As a rule, first labors are painful and protracted, while subsequent ones are less so; but if five or six are very painful, and each one seems to be more painful than the last, we cannot expect the seventh to be painless, except from some remedial interference. Now, if in such cases Cimicifuga, Caulophyllum, or Viburnum is given, and the woman’s next labor is easy, what are we to think? Evidently, that the medicine effected a change of condition from abnormal to normal.

In such cases give the Cimicifuga at least two weeks previous to the expected date of labor, in doses of one to ten drops, two or three times a day; the doses repeated oftener as the date approaches.

In irritable uterus , that condition once described by Gooch, and lately declared by Hewitt to be a condition of flexion , the Cimicifuga is an admirable remedy when the pains seem like those of rheumatism or neuralgia. If they are decidedly spasmodic — crampy — Viburnum is the specific. In irritation of the uterus, such as occurs at the change of life, when the menses are irregular, and the pains are more or less periodical, in the lumbar regions, or in the side, or in the top of the head, at night, this remedy rarely fails to relieve.

Mammary pains of a reflex character, occurring during pregnancy, with dysmenorrhoea, or at the climacteric, and even after confinement, are also included in the curative sphere of this medicine.

Phlegmasia alba dolens is not always alba. The swelling is sometimes very red, and assumes all the characters of acute rheumatism. In such cases Cimicifuga is the remedy. It is not the remedy alone when it is due to septicaemia or absorption of morbid secretions, in which case Baptisia, Arsenicum, and Carbolic acid should be used. But this disease is sometimes the result of exposure, added to the contusion of the veins and nerves, and calls for Cimicifuga, Aconite, Arnica, Apis, and Ilamamelis.

(I do not advise “Macrotin” in all cases, because I do not believe it contains all the medical properties of the drug, any more than Liebig’s Extract of Beef contains all the nutritious qualities

of beefsteak. It may prove useful in a large proportion of cases, but when it fails yoq will often find that the tincture of Cimicifuga will cure. I adhere to the name of Cimicifugin, because both “Acteea” and “Macrotys” are obsolete according to recent botanists. The active principle, moreover, should be called “Cimicifugin.” Remember, too, that you should not order the “tincture of Macrotin,” as has been done.)

The laryngeal and bronchial irritations of Cimicifuga are either reflex or rheumatic. It has cured the reflex cough of pregnancy and uterine irritation. I can hardly understand the high estimate by which it was held by Drs. Tully, Hildreth and Lee (allopaths) in pulmonary affections. Here is what they say of it:

Dr. Gardner used it in his own case for the following symptoms : Pulse 100 to 120, harassing cough, purulent expectoration, pains in the right breast and side, hectic paroxysms, loss of flesh and strength, frequent haemoptysis, and deranged stomach and liver ; cured in a few months.

Dr. Hildreth says: “In phthisis, in nearly every instance the pulse was reduced to near the natural standard, the hectic symptoms disappeared, and with it the cough and other symptoms.” He also removed “those intermittent congestions and inflammations so frequent in the second and third stages of phthisis, when they arose from atmospheric exposure.”

Drs. Lee, Wood, and Chapman give similar testimony. In homoeopathic practice it has not succeeded in getting a reputation in pulmonary troubles, although it has an excellent one in pleurodynia and intercostal rheumatism , both of which conditions are found to be present in nearly all cases of pulmonary phthisis.

I would suggest its more extensive use in chronic diseases of the lungs, not alone, for I doubt if it affects the parenchyma of the lungs, but in alternation with Sanguinaria, Phosphorus, Kali carb., Stannum, and others.

In pleurisy it may be useful, but I prefer Bryonia. They act very well in alternation, in both pleurisy and pleurodynia.

For those obstinate reflex pains in the left side, occurring in women, generally the unmarried, this remedy is as nearly a specific as can be.

These pains are said to arise from uterine or ovarian irritation.

They occur “under the left mamma, or under both; they often extend up to the left shoulder and down the arm ; they frequently change to other localities, as the back, neck, and head.”

Under the use of Cimicifuga, lx, they are nearly always palliated and cured if no structural lesion exists in the uterus or ovaries.

Diseases of the heart are cured or greatly palliated by Cimicifuga. It is useful in

Endocarditis, especially idiopathic or rheumatic.

Pericarditis, in alternation with Aconite, Spigelia, or Bryonia.

Cardiac myalgia, which is often mistaken for true angina pectoris.

Cardiac debility, characterized by irregular palpitation, with intermitting and weak pulse.

Its symptoms are so similar to Digitalis, that it is often impossible to select between them. The history of the case will decide. If the symptoms of cardiac debility are primary, i. e., arising from nervous atony, the Cimicifuga is primarily indicated. If the condition is a secondary one — arising from previous excitement — Digitalis is better indicated.

Chorea of the heart — a disorder now admitted to exist, even when no other choreic symptoms appear. It is characterized by tumultuous, irregular, unexpected, and strange motions of the heart, aggravated by emotions, and subsiding during sleep.

I have cured with it many cases of cardiac disorders, such as I have just mentioned, and consider that in its sphere Cimicifuga is one of our most potent cardiac remedies. It is a veritable polychrest, with a marked individuality, and will do good service in practice.