CIMICIFUGA RACEMOSA

Actaea monogynia. C. serpentaria. Macrotys racemosa. Botrophis serpentaria. Black snake root. Black Cohosh (Canada, Georgia, Western States of America). N. O. Ranunculaceae. Tincture of the root. Trituration of the resinoid, Macrotyn.

Clinical.
Abortion, tendency to; angina pectoris; disordered appetite; headache; sciatica; heart, affections of; chorea; delirium tremens; fainting; diaphragm, rheumatism of; dyspepsia; pregnancy, disorders of; epilepsy; back, pains; hyperpyrexia; hypochondriasis; hysteria; insomnia; spinal irritation; side, pain in; lumbago; mamma, affections of; puerperal mania; melancholia; meningitis; cerebro-spinal meningitis; menopause; menstruation, disorders of; myalgia; neuralgia; ovaries, affections of; perichondritis; pleurodynia; gouty rheumatism; rheumatism; sinking sensation; tremor; tinnitus aurium; torticollis; uterus, affections of; vomiting of pregnancy.

Characteristics.
One of the most marked symptoms of Actaea racemosa lies in the mental sphere: a feeling of melancholy and dejection, as if there were a black pall over everything; shows the suitability of the drug in hysteria and hypochondriasis. There is also fear of death, as in Aconite. Incessant talking, passing from one subject to another, as in delirium tremens. Marked benefit has followed in an inveterate case of epilepsy in which the aura was a “sensation of waves in the brain,” a key symptom of the drug. Many symptoms appear in head and eyes. Sensation as if going mad with headache. Reflex headache from pelvic organs. The headache is frontal, lateral, or occipital, and is accompanied by great pain in the eyes; better from pressure; worse from the least movement. Peculiar sensations are: as if the skull were being lifted; as if the top of the head would fly off; as of a screw through the base of skull to vertex. Inspired air seems to penetrate the skull to the brain, causing a sensation of cold. Intense pain in and around the eyes, lancinating, worse on moving head or eyes. In tinnitus aurium it has been found curative in old-school practice in 15 to 30 drops of the tincture, whether due to direct or reflex irritation (L’Art Méd., July, 1898). On the face there is malar neuralgia, ceasing at night. Many symptoms of digestive disturbance; foul breath and bad taste and a coated tongue; sticky saliva, viscid mucus in throat. Sinking at epigastrium is very marked. The reproductive organs of women are particularly affected by Actaea. Uterine and ovarian pains very marked. Inframammary pains. Tenderness of uterine region. Pains cross hypogastrium, extending from side to side. Dysmenorrhoea and irregular menses. Leucorrhoea with bearing-down in uterus. Labour-like pains. Pain in left ovary. Given before term it makes the pains easier; cures vomiting of pregnancy, and prevents after-pains and oversensitiveness. According to Lippe, a characteristic indication is: “The uterus after a labour is caught in the pelvis with great pain.” Puerperal mania has been cured by it. It also secures living births in women who have had previous still-births without discovered cause; given in daily doses of 1x for two months before term. In the respiratory sphere, a dry teasing cough, worse at night and worse at every attempt to speak, is the most characteristic feature. The rheumatic action of the drug shows in heart and chest pains and in joint and limb pains. Pain in the nape of neck has been found very characteristic. Cerebro-spinal meningitis; head and neck retracted. Sharp pains in chest, especially in the region of the heart, extending down the left arm, which is numb (Acon., Puls., Rhus), as if fixed to the side. Palpitations from the least motion. The heart suddenly ceases. A patient taking 6 drops of the tincture complained of a sensation “as if the heart stopped.” The pains of Actaea r. are like electric shocks here and there; sharp, lancinating in various parts; chest and uterine pains go from side to side. There is a general bruised sensation over the whole body, as if sore; worse from touch. Rest better, motion better. Cold air seems to penetrate the body; very sensitive to it. But the headache is better in the open air; worse in a hot room. Symptoms are worse at night (malar neuralgia better at night); in the morning. Pains in arms and Achilles tendon, worse towards approaching evening. Worse during menses. Eating better. Suited to the climacteric; to nervous persons; to children during dentition.

Relations.
Related to Actaea spicata and other Ranunculaceae. Aconite antidotes the insomnia, and Baptisia relieves the headache and nausea of the drug. Resembles Aconite in fear of death and restlessness; Bry. and Puls. in rheumatism; Cauloph. in uterine affections, and also Sep., Nat. m., Lil. t., Ign., Gels. (uterine headache); Lyc. (pains go from side to side), Ars. (fear of being alone); Calc. (visions of rats and mice). In a case of Tanacetum poisoning (taken by a woman in the fifth month to procure abortion), with high fever, rheumatic pains, sensation of prolapse, and abdominal soreness, Act. r. promptly improved after Acon. and Bry. failed. The pregnancy went to term. The resinoid of Act. r., Macrotyn, has been preferred in low triturations instead of the tincture, especially in cases of lumbago.

Cause.
Anxiety; fright; disappointment in love; failure in business; over-exertion; labour.

Symptoms.

Mind.
In all mental symptoms there is want of coherence. Thinks she will go crazy; with vertex headache. Miserable, dejected feeling. Melancholy, as if something black over everything. Feels afflicted and disturbed, with sighing. Mania following disappearance of neuralgias. Puerperal mania. Suicidal. Incessant talking, changing from one subject to another. Visions of rats, etc. Fear of death. No disposition to fix the attention on anything. Irritable. Indifferent, taciturn. Feels faint at epigastrium on meeting a friend. Effects of frights; love disappointments; failures in business.

Head.
Vertigo, fulness and dull pain at vertex. Sensation of waves in the brain. When asleep the head floats. Rush of blood to head; brain feels very large in skull. Head dull and heavy as after a debauch. Dull pain, particularly in occiput, afternoon and towards evening; worse indoors, better in open air. Headache through the whole brain, with bruised feeling in occipital region. Sensation of a screw through base of skull to vertex. Constant dull pain in occiput extending to vertex. Severe pain in head and eyes, increased by the least movement. Very acute pain in right side of head, behind orbit. Top of head feels as if it would fly off. Headache better in open air. Students’ headache. Sensation as if vertex opened and left it exposed.

Eyes.
Intense sore pains in eyes; better from pressure, worse from the least motion. Pain over the eyes, extending to occiput. Ciliary neuralgia; sharp pains in eyes or in temples, extending to eyes, very severe, especially at night; seems as if patient would go crazy. Peculiar wild look.

Ears.
Sensitive to the least noise. Singing on the left side, later in both. (Tinnitus from irritation of auditory nerve, direct or reflex.)

Face.
Pale, eyes large, sunken, surrounded by dark rings. Forehead feels cold; deathly pallor. Neuralgia affecting the malar bone; pain goes off at night and returns next day. Frequent flushes of heat; wants the open air. Lips dry; upper lip fissured as if bitten.

Mouth.
Offensive breath. Mouth and tongue feel dry and hot. Thick mucus on the teeth. Spits thick, sticky saliva. Tongue swollen.

Throat.
Viscid mucus in throat; hawking. Dry spots in throat causing cough; dryness of pharynx with constant desire to swallow; fulness in pharynx; mouth and palate swollen; neck stiff. Throat inflamed; pains wake in the night.

Stomach.
Nausea, eructations, headache and trembling (most in women). Nausea with uterine affections. Sharp pains across the hypogastrium. Sinking or emptiness at epigastrium.

Abdomen.
Periodical colicky pains, better by bending double and after stool. Sharp pains in intestines, lumbar region and limbs. Abdominal muscles sore. Sharp pains across hypogastrium.

Stool.
Alternation of diarrhoea and constipation. Frequent stools, thin, dark and offensive.

Urinary Organs.
Incessant flow of urine. Frequent micturition and increased quantity. Pressure in renal and lumbar regions.

Female Sexual Organs.
Menses profuse, early; dark, clotted; scanty, irregular, delayed or suppressed. Hysterical or epileptic spasms at the time of the menses. Feels strange, talks incoherently, screams, tries to injure herself. Pains in uterine region, go from side to side. Pains in ovarian region, going upwards. Sensation of prolapse in uterine and lumbar regions; limbs feel heavy, clumsy. Severe pain in lower abdomen. Rheumatic dysmenorrhoea. Leucorrhoea with bearing-down in uterus. During pregnancy: nausea; false labour-pains; sharp pains across abdomen; insomnia. During labour chilliness in the first stage; very severe pains; spasmodic cardiac neuralgia; lochia suppressed (from cold or emotions); os uteri rigid; puerperal mania. Tendency to abortion in the third month. Inframammary pains, worse on left side. Burning in mammae.

Respiratory Organs.
Night cough, dry, constant, short; worse every time she attempts to speak. Tickling in throat with violent cough. Pains in right side of chest, worse from motion, extorting cries. (Rheumatism of diaphragm. Pleurodynia.)

Heart.
Pain in region of heart, followed by palpitations; pains extend to left arm, which is numb and fixed to the side. Pulse weak and irregular; or rapid and full. Palpitations from the least movement.

Neck and Back.
Severe pain in nape of neck (rheumatic fever; cerebro-spinal meningitis). Rheumatic pain in muscles of neck and back; a sense of rigidity and retraction. Lightning-like pains in posterior spinal sclerosis. Neck stiff from cold air; worse from moving even the hands. Spine tender; especially cervical and upper dorsal regions. Severe aching in lumbar and sacral regions; extends down the thighs and across the hips, with strong bearing down. Head and neck retracted (in spotted fever).

Extremities.
Rheumatic pains in the joints, with heat and swelling. Soreness in the limbs. Excessive muscular soreness. Rheumatism affecting the belly of the muscle. Trembling of the fingers when writing. Tremor of the limbs, can scarcely walk. Feeling of discomfort in the limbs causing restlessness.

Upper Extremities.
Pains running down the arms with numbness, as of a nerve compressed. Left arm feels as if fixed to the side (chorea). Constant irregular movement of left arm; disabled (chorea). Cold sweat on the hands. Trembling of the fingers when writing.

Lower Extremities.
Soreness in sacrum, lumbar region, and down the left leg. Pressure round hips with pain in sacrum. Towards evening, soreness and stiffness in region of Achilles tendon. Dull, sore, burning in second joint of right great toe, extending up the limb.

Generalities.
Rheumatism. Weakness, tremor, and spasmodic actions of muscles. Nervous shuddering; trembling through the body. Spasms, tonic and clonic, alternate. Hysterical and epileptic convulsions. Sharp, lancinating pains in various parts, associated with ovarian and uterine irritation. Affects the left side most. Pains appear suddenly. Pains like electric shocks here and there. Chorea. General bruised feeling over the whole body, as if sore.

Sleep.
Obstinate insomnia. Sleepless; cannot rest; must change position; twitchings of limbs. Unpleasant dreams, that she is in trouble. Restless sleep.