Santoninum

Volume I — Special Symptomatology

(The active principle of Wormsced.)

Botanical Description. — Santoninum. Santonin, or Santoninic acid, is a crystalline principle, obtained from Levant Wormseed, or Artemisia contra, which is the same as the "Cina" of our Materia Medica. It occurs in colorless, pearly, four-sided orthorhombic tables, soluble in from four to five thousand parts of cold and two hundred and fifty parts of boiling water; freely soluble in alcohol and chloroform; moderately so in cold ether; insoluble, or nearly so, in glycerine. It has a neutral reaction, but unites with alkalies to form salts, and hence is freely soluble in alkaline solutions. On exposure to light, the colorless crystals of Santonin acquire a golden-yellow tint. If this change is a chemical, and not a mechanical one, the alteration must be very slight, since, according to Kruss, the yellow crystals conduct themselves in their chemical relation precisely as do the colorless crystals, aad are precipitated by the addition of acids to their alkaline solutions, as colorless crystals.

Officinal Preparations. — Triturations.

Analogues- — Artemisia, Chenopodium, Curcubita, Cina, Felix ma$.t Gelseminum, Kousso, Spigelia, Teucrium.

Mental Sphere.

• Light febrile paroxysms, with delirium.

• Wandering delirium, with great agitation.

• Depression of spirits, and inability to follow his work.

• Epileptiform convulsions. Confused state of the mind. Dizzy feeling, lassitude, prostration.

Head.

Violent headache, with vomiting.

Intense headache, in its most aggravating form.

Numbness in the head.

Dull aching in the right temple.

Severe pains in front of the head.

Hot perspiration on the occiput; more clammy in front; head very hot.

Abnormal feelings and pains in the head. 0 Brain symptoms, simulating hydrocephalus, when caused by worms. (Hale.)

Eyes.

Yellow appears red/ yellow-sight in all; violet-sight in all;

visions, like shadows. Sunken eyes, with pallor around the nose and lips. Eyes glowing, and convulsive movements of the eyelids. Loss of vision; dimness of the eyes; giddy feeling. Dilatations of the pupils, and troubles of sight. Convulsive twitching of the eyes. Men appear like ghosts walking.

[The phenomena of visual illusion in persons poisoned by it, are reducable to distinct classes. Every one, however small the quantity taken could not recognize violet light Some the spectrum, as if curtailed at the violet end, overlooked everything of a pure violet color, whilst in all mixtures containing violet and yellow, the complimentary yellow appeared to predominate. This has been called yellow-sight. (Gelbachen.)~\

Quite different is the next higher degree of intoxication. The subject of it is then unable to distinguish colors which in the healthy make a different, even an opposite impression, such as lilac and dark gray, or violet and black; he not only confounds these colors with one another, but a great many dissimilar seem all alike to him. The colors which are mistaken for each other had always a different degree of purity and stiength, which, however, continues unalterably the same for each color, so that when one has exactly determined by measurement the purity and strength of two colors that are thus mistaken, one can with perfect certainty and precision determine, a priori, by calculation with which two of all the other colors these two may be confounded. There is hardly a single color which can with certainty be distinguished from the rest; each one resembles an endless number of others; and thus the infinite host of colors which a healthy person can appreciate is reduced to an extremely small number. This stage manifests itself in the fact that all colors, the darker they really are, so much the more resemble a tint between violet and ultramarine, with the determination of which tints all other changes of color are determined alike. The yellow-sighted cannot at all perceive certain impressions of light; violet rays are no more to him than the invisible thermic and actinic rays; he is color-blind. The violet-sighted, on the contrary, sees every color, is susceptible to every stimulus of light; but ever so many of them invariably make the very same impression. He is not color-blind; he merely confounds the colors. In one of my early experiments, when I knew nothing beyond yellow-sight, my colleague went, when the narcotism seemed to have disappeared (i. e., when ho had got used to it), to dine at a restaurant. The experiment was over and forgotten;

during lively conversation in a friendly circle, in comes the waiter with yellow egg soup. It smelt peculiar to him, and looked quite red. Perfectly shocked, he sent the soup back as entirely spoilt. To the amusement of his friends, he persisted obstinately in asseverations which to them were inexplicable. They came to words, and my hot-headed colleague left the good-for-nothing eating house in a pet. No doubt the waiter thought he was " not all there." Now we know that in this delusion the first symptoms of olfactory hallucination and violet-sight were setting in, of which, then, no one as yet dreamed.

It is the opinion of Dr. Itoce, of Berlin, who has made the most extensive experiments with Santonine, that the various colors which cover the field of vision is "not due to any actual change in the color of the media, by which the rays of light reach the retina, but to an altered perceptivity in the nervous organ of vision itself." If such is the case, the Santonine ought to prove curative in some internal disorders of the eye, when such disorders show similar symptoms. As might have been expected, it has been found

curative in some cases of defective vision and weakness of sight. Dr. ,

in the reports of an English hospital, records its curative action in

° " Nervous failure of 'sight, ."

It appears that the discovery of its curative power was accidental. An old man, quite blind, was given Santonine for worms. Under its influence his sight partially returned. This led to its administration in 36 cases of weakness of vision — or, as the writer terms it, " nervous failure of sight," a kind of paralysis of the optic nerve. Of the 36 cases, 27 recovered more or less perfectly, the rest were not much benefitted.

It was also used in nine cases of

° Cataract.

Of these nine cases, four were cured, and the rest not benefitted.

Nose.

Very offensive smell experienced; hallucinations of smell. Bluish pallor around the nose; pinched expression of nose. * Intense itching of the nose; the child rubs and bores into the nostrils.

Face.

Face puffy and congested ; convulsive movements of the face

and lips ; twitching in the facial muscles. Heat and flushed face. Pinched and distorted countenance.

Mouth and Lips. Pinched expression of the mouth. Lips very much swollen. Bitter taste; foaming at the mouth.

Burning and stinging sensation of the mouth and lips. Bluish pallor around the mouth and nose. Drawing in of the lips over the teeth. Hallucinations of taste.

Throat.

• Choking feeling in the throat, very severe at times; complete

loss of appetite.

• Dry, hacking cough, tickling in the larynx and windpipe. Continual thirst.

Nausea, Vomiting, etc.

Gastric oppression, nausea, with vomiting. Vomiting of yellowish, slimy mucus.

Vomiting, with intense headache, vertigo, dilated pupils and

abnormal vision. ° Vomiting from worms — lumbriei, etc.

Stomach.

• Nausea, which disappears after eating.

Severe pain in the stomach and side, with vomiting.

Nausea, increased after eating; gastric derangement.

Dull, throbbing pains, worse on stooping.

Pressure in pit of stomach, with distension and tenderness.

Vomiting, purging and prostration.

Dull pain in the pit of the stomach.

° Bloated stomach, in worm affections.

Bowels and Abdomen. The bowels constipated and require gentle purgatives. Dull, throbbing pains in the abdomen. Abdomen very sensitive; tumid, but soft. Intense abdominal pains, with profuse diarrhoea. Purging of watery, flaky, foul-smelling stools. 0 Bloated abdomen, hard or soft, especially when occurring in

worm affections. 0 Verminous affections, (worms in the intestines, etc.)

[Santonine is one of the most powerful parasiticides, and will destroy the life of almost any species of intestinal parasite. It seems to have the most decided power over lumbriei, (long, round worm,) less on oxyuris, (pin worm,) and least on tania, (tape worm.)

For the destruction of lumbriei, no better remedy is known. It should be given in two or three grains of the l-10lh trituration, in a spoonful of

sweetened milk, at, a time when the stomach is empty, as before each meal, or, in infants, before nursing. In young infants the 2d and 3d triturations should be prescribed. A few days of this treatment will remove the worm symptoms. It must not be expected that the worms will be seen in the evacuations, for when they die in the stomach, they are digested. If the child has diarrhoea, then the worms, or portions of them, may be discovered in the alvine evacuations.

In some cases of oxyuris, Santonine will prove useful, but it should be injected into the rectum, as well as given by the mouth. It is a late discovery that if injections of warm lard are used, for a few nights, the pin worms disappear — their propagation is arrested. If a few grains of Santonine in the lowest trituration is added to each injection of lard (one-half or oue ounce,) the destruction of these parasites is rendered still more certain. 1 do not know that this medicine has ever destroyed a tapeworm, although instances may have been placed on record.

Urinary Organs. The urine is always colored a peculiar green or orange-green. ° "Waking up suddenly with urgent desire to urinate; a few

drops voided each time. ° Chronic cystitis .'(chronic catarrh of the bladder.) It causes an immediate increase in the volume of the urine; and an amelioration of the worst symptoms; the bladder loses its sensitiveness and sense of fullness; the urine flows free and easy, and a cure is soon effected. Dose, half a grain, three times a day. {Dr. E. O. Davis.) 0 Suppression of urine. ° Incontinence of urine. {Derger.) 0 Dysuria. ° Scanty urine, with brick-dust sediment. {Ib.) "Wetting the bed at night. {Ib.) ° Milky urine. {Hale.) ° Burning, scalding, tenesmus, and other unpleasant sensations in the urinary passages. {Scudder.) ° Vibriones in the urine. (In some cases these organic forms are found in urine just voided. It denotes a bad state of vitality in the patient. In such cases Santonine removes this condition, and prevents their formation. {Hale.) Skin.

Burning of the skin.

Rash-like eruptions appear on the body.

Skin of a corpse-like hue.

Chills and Fever. 0 Violent fever, with great frequency of the pulse, and dry. burning heat of the skin.

Lowering of the pulse.

° Worm fever. ° Remittent fever, from worms. {Hale.)

[All the fevers of children are liable to be aggravated by intestinal paia sites. In such cases a few doses of Santonins 1-10<A removes the cause of irritation, after which, other remedies act better, and the fever is now easily combatted.]

Sleep.

Very restless, sleeping only a few moments at a time. Unnatural wakefulness; sleep disturbed by colic. During restless sleep, light delirium manifested itself. Abnormal sleep, when caused by worms; also such symptoms

at night as grinding the teeth, wetting the bed, crying

out in affright, etc.

Tongue.

Loaded tongue.

• Tongue deep red, without coating.

Teeth.

• Grinding and clenching of the teeth together during sleep.

Upper Extremities. Convulsive movements of the hands and arms. Jerking of the upper limbs. Coldness of the hands.

Lower Extremities.

Extremities cold, with great restlessness. Body nearly curved, with the legs set back (opisthotonos). Generalities.

The following is what happened in thirty cases in which Santonine was given.

Yellow sight in all, 30

Violet sight, 19

Nausea and vomiting, 14

Dizzy feelings, lassitude, prostration, 9

Visions, > g

Hallucinations of smell, q

Hallucinations of taste, 5

Abnormal feelings and pains in the head, 8

Lowering of the pulse, < 2

(1.) Santonine produces a sort of parlysis, accompanied by rigidity of the muscles.

(2.) Its effects are produced in a manner analogous to the mode of action of Atropine and Physostigmine (Calabar bean).

(3.) It entirely destroys the irritability of muscles, rendering them completely rigid.

(4.) Its therapeutical properties deserve more fully to be inquired into.

In doses of more than three grains, Santonine sometimes occasions nausea and vomiting, with abdominal pains, great thirst, giddiness, and profuse diarrhoea. Decidedly poisonous effects sometimes arise from doses which are quite insignificant in comparison with those some experimenters have taken without serious inconvenience. In one case it is stated that a child six months old and convalescent from small-pox, took five grains of Santonic acid, instead of three, which had been prescribed. It became amaurotic, and did not recover its sight for two months. In another case, two grains of this substance were taken at a dose, by a healthy child of two years. In a quarter of an hour it was seized with convulsions, and within one hour it lay unconscious, with a hot head and congested face, the eyes twitching convulsively, the pupils largely dilated and insensible, the mouth foaming, the teeth clenched, the breathing stertorous, and the upper limbs occasionally jerking. On the morrow, recovery was complete. This resembles two cases in which Hoffmann witnessed such alarming cerebral symptoms, after the administration of Santonica, that he was obliged to apply leeches to the temples and cold compresses to the head. These examples are sufficient to illustrate the somewhat uncertain operation of Santonic acid, both in degree and in kind, and to suggest caution in its administration.

° Convulsions, when caused by worms. [It may be found useful in cerebro-spinal convulsions. — Hale.}

Volume II — Special Therapeutics

This powerful agent has superseded the Oil of wormseed. Both are prepared from the plant which is called in our Materia Medica u Cina.” It has a double action when given to the human subject. It is a direct poison to any intestinal parasite

with which it comes in contact, and at the same time it exerts a powerful effect on the general system.

You are probably aware that Hahnemann’s provings of Cina developed the curious fact that its pathogenetic symptoms simulated in a wonderful manner the symptoms caused by the irritation of worms.

The same may be said of Santonin, which gives it a double value, for, when given in appreciable doses, it destroys the parasites which are causing the direct and reflex irritation, and at the same time acts dynamically in removing those irritations by its homceopathicity.

In cases where it is necessary to expel as well as to destroy the worms in the intestines, it is advised to give it mixed with Castor oil. I remember to have seen in Braithwaite’s “Retrospect” an account of some very interesting experiments, for the purpose of ascertaining the relative toxic power of various anthelmintics.

The Santonin was tested, with many other drugs, and it was found that when it was dissolved in Castor oil, in very minute proportions, it destroyed the life of the common round worm sooner than any other agent. The time occupied was but a few minutes.

As I have stated in Volume I, the Santonin is one of the most powerful parasiticides , and will destroy the life of almost any species of intestinal worms. It seems to have the most decided power over lumbrici (long, round worm) ; less on oxyuris (pinworm), and least on taenia (tapeworm).

For the destruction of lumbrici, no better remedy is known. Two or three grains of the one-tenth trituration should be given in a spoonful of sweetened milk, at a time when the stomach is empty, as before each meal, or, in infants, before nursing. For young infants, the 2d and 3d triturations should be prescribed. A few days of this treatment will remove the worm symptoms. It must not be expected that the worms will be seen in the evacuations, for when they die in the stomach they are digested. If the child has diarrhoea, then the worms, or portions of them, may be discovered in the alvine evacuations.

In some cases of oxyuris, Santonin will prove useful, but it should be injected into the rectum, as well as given by the mouth.

It is a late discovery, that if injections of warm lard are used for a few nights the pinworms disappear — their propagation is arrested. If a few grains of Santonin, in the lowest trituration, is added to each injection of lard (one-half or one ounce), the destruction of these parasites is rendered still more certain. I do not know that this medicine has ever destroyed a tapeworm, although instances may have been placed on record.

You will often meet with cases in practice where children present symptoms which resemble those caused by worms, yet no worms have ever been discovered in the evacuations. Some of these symptoms simulate cerebral irritation, and it will not be safe to give material doses of Santonin, unless you are certain that such symptoms are actually caused by worms, for Santonin, in large doses, has caused intense cerebral irritation, with spasms.

In such cases give this medicine, or Cina, in the high or middle attenuations. The 10th of Santonin is about equal to the 3d of Cina.

By consulting the symptomatology of Santonin you will see that it presents a magnified picture of the pathogenesis of Cina, and may be used instead for more serious symptoms.

Santonin is homoeopathic to many other conditions and disorders than those caused by or which simulate the effects of worms.

It has been used successfully in some forms of headache, with vomiting and delirium, and in cerebral congestion. It may prove useful in cerebral and cerebro-spinal meningitis.

It affects specifically the eyes, causing singular abnormalities of vision, which you will find described in Volume I.

Dr. Rose, of Berlin, who has experimented largely with Santonin, says these abnormal deviations of sight are caused by “ an altered perceptivity in the nervous organ of vision itself/’ i. e., a dynamic effect.

Its homoeopathic relation to disorders of the internal eye is proven by the fact that it has been found to be curative in amaurosis and blindness. In the reports of an English hospital it is recorded that Santonin cured many cases of “ nervous failure of sight.”

It appears that the discovery of this curative power was accidental. An old man, quite blind, was given Santonin for worms.

Under its influence his sight partially returned. This led to its administration in thirty-six cases of weakness of vision, or, as the writer terms it, “ nervous failure of sight,” a kind of paralysis of the optic nerve. Of the thirty-six cases twenty-seven recovered more or less perfectly, the rest were not much benefited.

It was also used in nine cases of cataract, of which four were cured, the rest not benefited.

It has cured many disorders of the urinary organs, namely, urging to urinate at night; enuresis nocturna ; dysuria; strangury; chronic cystitis; chronic catarrh of the bladder. In this last affection it has made some very brilliant cures. You will find it useful in infantile remittents, whether from worms or from ordinary gastro- enteric irritation. Lately the Santonate of soda has been much used in place of Santonin. It has the advantage of being more soluble in any menstruum.