Sepia – Cuttle-fish

The attenuations are prepared from the dried secretion of the inkgland of the cuttle- fish, Sepia officinalis L., which inhabits the Mediterranean, the North Sea and the Atlantic Ocean. N.O. Sepiidae.

Sepia is one of the most frequently needed homoeopathic remedies, and is mainly suitable for the treatment of chronic or longer lasting conditions and also of dyscrasias (i.e. both cellular and also chronic humoral phases, e.g. chronic eczemas, chronic discharges such as leucorrhoea and post-gonorrhoeal). There is also a typical weakness and exhaustion running through the whole remedy.

Complaints are generally worse in the warmth, in rooms which are hot and crowd- ed, and in hot weather. An amelioration occurs in the course of the afternoon, whilst otherwise there are aggravations in the morning and evenings, making Sepia to some extent a combination of Nux Vomica (morning aggravation) and Pulsatilla (evening aggravation). The general state of the patient is better on motion (as in Pulsatilla), whilst certain complaints, such as headaches and lower abdominal complaints with the typical bearing-down sensation, are worse on motion.

A prominent symptom is the indifference towards business and family, as is also found in Sulphur; another symptom which it has in common with Sulphur is the sen- sation of weakness in the stomach, which is not relieved after eating.

In common with Pulsatilla, Sepia has a burning, throbbing pain in the stomach, and also the sensation as of a dumpling or stone in the stomach. Sepia frequently has a sensation of general heaviness, and that of a large lump, e.g. in the rectum, this symptom not being relieved after defaecation. In the uterus there is also a bearing- down sensation and feeling of heaviness, so that female patients feel the need to cross the legs, to prevent prolapse. In many cases there is a yellowish-green, foetid and excoriating leucorrhoea.

In the lower abdomen there may also be pains similar to labour-pains, with respi- ratory constriction and bearing-down, associated with erosions of the uterus. Gener- ally there appears to be congestion in the pelvic organs, which may find expression not only in uterine but also in rectal prolapse. This sensation of bearing-down and fullness may also be found in the urinary organs, with the symptom of pressure on the bladder and frequent passing of urine with flatulence in the lower abdomen. The urine contains a sediment like clay, and may also be very offensive. In enuresis, the bed-wetting which requires Sepia usually takes place during first sleep.

Although the characteristic Sepia sensations are of fullness or of a ball, the stom- ach pain may however also have an unpleasant sensation of emptiness, or a “gone” sensation, with faint weakness, the patient feeling deathly and wretched. Hypereme- sis gravidarum also frequently responds fabourably to Sepia if (as in Colchicum), even the smell of food causes nausea.

In constipation Sepia has a characteristic feeling as of a weight or a ball in the rec- tum. Often the stool cannot be passed without manual assistance. Nash describes as

a symptom a seeping of moisture from the anus, which is also covered by Antimoni- um Crudum.

Sepia also has a degree of aggravation from milk, e.g. when milk leads to vomit- ing with diarrhoea.

Worthy of particular note are the skin symptoms of Sepia, namely soreness, itch- ing which is frequently transformed into burning as a result of scratching (cf. Sul- phur), and above all, localisation in the creases of the knees. There may also be large, suppurating pustules, which repeatedly relapse, and also, particularly, brown patches, on the face, chest and abdomen, such as occur in chloasma gravidarum. However, other types of eruption also respond favourably to Sepia, such as vesicles and scabies-like conditions – particularly if Sulphur has previously been given and has not completed the cure. The skin symptoms do not need to be expressed solely in the form of pustules, eczema, neurodermitis or herpes, but may be of a weaker character, such as yellowish-brown scaly patches, or sloughing of the epidermis in round patches on the hands and fingers, possibly associated with painless ulcers.

As is obvious from the foregoing symptoms, Sepia is a gynaecological remedy, and also particularly indicated in the menopause. Hot flushes with sweating and weakness are characteristic of Sepia (likewise Sulphur and possibly Lachesis), the typical symptoms of pelvic congestion often being found in Sepia, while the hands and feet tend to be alternately hot and cold. Thus Sepia is one of the most important remedies for the complaints of the menopause, especially as further symptoms, such as the great exhaustion, are also typical of climacteric neuroses.

Sepia can also have a very favourable action on hemicrania and migraine-like states, e.g. also in cervical migraine, where the factor of exhaustion is also involved. Indifference towards business and family is chracteristic of Sepia, and is likewise often found in the menopause. There may also be a hypersensitivity in various parts of the body, with a tendency to strain oneself by lifting things awkwardly or to- wards sprains. This may result in avoidance of energetic movements or of physical and mental activity. Comparatively short walks may also result in severe exhaustion. In spite of the great sleepiness, especially during the daytime, so that the patient sometimes falls asleep while sitting up, at night there may be restless sleep with fre- quent waking, lively dreams and starting up in fright. Apart from angry irritability, there may possibly be deep despondency (especially in the evenings), with a depres- sive tendency and worried brooding over one’s own state of health. With all this there may also be unsociability, loss of interest, and indifference, and possibly also nervousness, intensity of feeling, and timidity with feelings of fear. In the mornings, when the patient wakes unrefreshed, the eyelids may be stiff and heavy and there may be ptosis.

Sepia has typically copious sweating, e.g. after the hot flushes, but also on the genitalia. Also characteristic of Sepia are acute and chronic catarrhs of the nose, pharynx and larynx with a violent tickling cough and possibly considerable dis- charge of mucus or else stopped coryza with a sensation of dryness in the nose.

If we sum up the main symptoms of Sepia, the result is the following remedy- picture:

1. Complaints aggravated in warmth and hot weather and in crowded rooms, also first thing in the morning and in the evening. Amelioration in the course of the af- ternoon and generally from motion (except complaints of head and lower ab- domen).
2. Menopausal complaints with hot flushes, emotional depression and irritability (alternating). Tearfulness, hypersensitivity, and indifference (to business and fam- ily). General weakness, every movement causing outbreaks of sweating. Feeling of faintness.
3. Sensitive skin with severe itching and eurptions, especially in the creases of the joints, dry or moist or herpetic eruptions. Skin of the hands is sloughed off in great patches. Brown patches. Chloasma gravidarum with yellow “saddle” across the nose. Pityriasis. Yellowish, wan, pale complexion with yellow patches and yellow discoloration of the sclera.
4. Offensive sweat on the genitalia with bearing-down in the lower abdomen (sensa- tion of a ball), must cross the legs to prevent protrusion. Uterine prolapse.
5. Yellowish-green leucorrhoea, offensive and excoriating in cervical erosion. Menses mostly late and scanty. Menopause.
6. Various types of catarrh with discharge of purulent and bloody, foul-smelling masses. Expectoration of salty-tasting mucus. Stopped coryza. Tickling cough in catarrhs of the nose, pharynx and larynx. Post-gonorrhoeal leucorrhoea.
7. Pulsating, bursting headaches, pains shooting upwards and from within outwards, possibly only in the occiput or above one eye. Migraine, worse from movement, bending down, noise and in the morning. A possible sensation of coldness on the vertex, and of dryness in the eyes (in the presence of other Sepia symptoms).
8. General exhaustion and weakness; restless limbs, never still, with neuralgic com- plaints. (Osteochondrosis.)
9. Nocturnal enuresis.

The German Monograph-Preparation Commission for the Homoeopathic Field of Therapy has, under the Preparation Monograph for Sepia officinalis, published the following indication(s) in the German Bundesanzeiger (German Federal Gazette) for sepia: various skin diseases, especially of chronic nature; inflammations and other disorders of the digestive organs; an extensive variety of disturbances of the female reproductive organs; inflammations of the urinary organs; disorders in voiding from the urinary bladder; rheumatic diseases; varicose veins; headaches, insomnia; condi- tions of exhaustion, disorders of emotional or otherwise psychological nature; de- pressive emotional discord or upset.