Ignatia amara

Lecture XVII — Ignatia

Ignatia Amara, or, more properly speaking, Strychnos ignatia, is a large climbing shrub growing in the Phillipine Islands and in Cochin-China. The fruit is spherical or ovoid, and about four inches in diameter. Its shell is smooth and brittle, and encloses some twenty or thirty seeds. Its name is attributed to the Jesuits, who called it St. Ignatius' s bean, in honor of its virtues. Though chemically and botanically similar to Nux vomica, Ignatia differs materially from that remedy in symptomatology, and this, too, despite strong family resemblances.

Ignatia is preeminently a spinal remedy, as is also Nux vomica. Like the latter, it seems to intensify the impressionability of all the senses, perhaps even more than Nux does. Under Nux, however, this over-excitability is exhibited by anger, vehemence and irascibility; in Ignatia, by melancholy with tendency to weeping. Now, while there is this melancholy tearful mood, yet the patient smothers her grief. The Ignatia patient nurses her sorrows, keeping them from others, while the Nux vomica patient is vehement and angry; he strikes any one who may oppose him; he is so overbearing that one can scarcely live with him. You must separate this melancholy mood of Ignatia from that of Pulsatilla.

The Pulsatilla woman is tearful, sad, and melancholy like Ignatia, but there is not that introspective mood which develops in the Ignatia patient. She makes her grief known to every one who comes near her. She seeks sympathy. She is timid and yielding in her disposition.

We find Ignatia indicated in nervous women who are burdened with grief, particularly when they dwell upon their troubles in secret. Such cases find relief in Ignatia, especially when of recent origin. For the chronic or long-lasting effects of grief, we have Phosphoric acid and Natrum muriaticum. Often when the former remedy is indicated, the patient complains of night sweats, not from organic disease, but from sheer exhaustion. She has little or no appetite, and complains of a sensation as of heavy pressure on the top of the head, as though a great load lay there. Emaciation, .ennui, and night sweats are characteristic symptoms. In some cases the symptoms are such as to make Phosphorus preferable to Phosphoric acid. Natrum mur. is very similar to Ignatia in its mental state but shows more of irascibility with its melancholy. Consolation aggravates and elicits an angry rebuff. There is headache in the vertex, emaciation and tremulous palpitation from every strange noise. When Ignatia fails to remove the symptoms entirely Natrum muriaticum frequently comes in to complete the cure.

Ignatia we find, then, to be useful for the ill-effects of grief, and also, by reason of this great sensitiveness to external impressions which it produces, greater even than that of Nux vomica, we find it indicated in hysteria, especially when the patient alternately laughs and cries, or, in other words, exhibits a changeable mood. The face flushes at every emotion. Sometimes the laughing becomes spasmodic and ends in screams and even spasms of the chest with blueness of the face. We have also globus hystericus or feeling as if a ball were rising in the throat. This is often relieved by belching, while drinking water causes an aggravation of the convulsive action in the throat. The patient may fall into a half unconscious state, with clenched thumbs and blue face, as we find under Cuprum. Finally a sigh and a long-drawn breath announces the return to consciousness. Now let us consider some of the concordant remedies of Ignatia in these hysterical states.

Platina is indicated in hysterical women with violent mania or lofty, supercilious mood.

Hyoscyamus is called for when the mental condition of the patient exhibits marked jealousy. She is full of suspicions. She fears that she will be poisoned, and may on that account refuse all food and medicine.

Asafcetida, like Ignatia, has the globus hystericus; flatus accumulates in the abdomen and, pressing up against the lungs, produces oppression of breathing. It is especially useful in hysterical convulsions after suppression of discharges.

Moschus is particularly suited when the patient faints readily. She sits down to her meals and faints dead away from taking even a small amount of food into the stomach. She also has violent spasms of the chest, in which it would almost seem that she must die. She turns blue in the face and foams at the mouth. She may be of a scolding disposition, and even this causes fainting.

Valerian is useful in these hysterical women, when the slightest exertion causes violent headache. They often complain of a sensation as if a string were hanging down into the throat. In the latter part of the evening, they exhibit a tendency to flushes of heat. The slightest pain causes fainting. They complain of a warm sensation rising from the stomach into the throat with the globus hystericus. You will often have to use Valerian for pains in the limbs, which simulate those of rheumatism. They are worse while the patient sits and better when she walks about.

Cocculus has a mood somewhat like that of Ignatia, Sensitive, anxious, with frightened look; loss of memory, mental confusion, vertigo; spasms of the uterus; great weakness and nausea even to fainting. A sort of semi-paralytic condition pervades the whole body: choking constriction in the upper part of the fauces with difficult breathing; hysterical palsy. These symptoms in Cocculus are usually the result of night watching or loss of sleep. Nux moschata is indicated in hysteria, associated with frequent emotional changes and enormous bloating of the abdomen after a light meal. The patient complains of an overpowering drowsiness and of excessive dryness of the mouth, even when that cavity exhibits the normal degree of moisture. There is also a marked tendency to faint. Belladonna is indicated in hysterical states, when the patient is boisterous and wild, with red face, etc.

The Valerianate of Zinc I have used for a common symptom of hysterical persons and of nervous patients generally, and that is, what has been termed the fidgets. They cannot sit still, or the}' must keep the legs in constant motion. I have used it, and I do not remember to have failed to cure in a single instance. This uneasiness of the feet is not an uncommon symptom in old cases of uterine disease; I usually give the remedy in the second or third potency.

The headache of Ignatia is usually situated in one spot in the head, just as though a nail were being driven into the skull at that point. Any little mental work, or in fact any work that is irksome or more severe than usual, any strong odor, whether pleasant or otherwise, any emotion which would be borne without trouble by one whose nervous system was in a natural state, may bring on this headache. The attack often ends with vomiting. These headaches are often periodical, returning every two days. They often terminate with a copious flow of pale, limpid urine. Several other remedies have headache, relieved by copious urination. They are: Aconite, Gelsemium, Kalmia, Melilotus, Sanguinaria , Silicea and Veratrum album. Sometimes the Ignatia headache is of a throbbing character, worse in the eyes, and about the eyebrows and the root of the nose; it is relieved for a time by a change of position. Again, Ignatia may be indicated in headache, when the head feels heavy, as if from congestion, and yet the pain is better from leaning forward; sometimes aggravation occurs from stooping, thus giving us what Hahnemann calls an alternate effect. The Ignatia headaches are aggravated by talking or listening intently, and by coffee.

The power of Ignatia to produce increased excitability renders it useful in spasms, not only of hysterical origin, but also in those occurring in delicate women who are not hysterical, and in children. The spasms are excited by emotions, such as fright or fear. For example, the child has a convulsion after being punished. Afterward, when the child goes to sleep, there is whimpering in the sleep. Under ordinary circumstances the child will get over the trouble without any treatment; but if it happens to be extremely delicate, or if the trouble occurs during the period of dentition, or there is some reason for fearing convulsions or hydrocephalus, Ignatia may prevent a great deal of trouble. During the convulsions in which Ignatia is the remedy, you will usually find the face deathly pale, although at times it is flushed. There is twitching of individual muscles, particularly those about the eyelids or the mouth, and the child stiffens out. As was said before, Ignatia is especially indicated when the convulsions have appeared after grief, fright, or some violent emotion.

Nervous women in labor may require Ignatia for spasms. These spasms, however, are to be distinguished from those calling for Belladonna, Stra?nonium, etc., by the absence of fever or severe congestion, and from Hyoscyamus by the absence of unconsciousness or mania.

In these convulsions produced by emotions, unless you have clearly in your mind the distinctions between several remedies, you may not make so prompt a cure as you should. Opium, like Ig?ialia, is a remedy for the immediate effects of emotions. It does little or no good for the protracted effects. It, too, is worse after punishment, fright or fear. The body stiffens out, and the mouth and the muscles of the face twitch. Thus far it is exactly like Ignatia. The distinction lies in this particular: under Opium the face is dark red and bloated, and the spasms are more frequently associated with loud screams than under Ignatia.

Glonoin produces sudden violent congestions of the head, as does Opium. Like Opium and Ignatia, it may be used for the sudden effects of violent emotions. In the convulsions the fingers are spread asunder and extended, a symptom which you also find under Secale. Veratrum album also is suitable for convulsions after sudden violent emotions, but the face is cold and blue, with cold sweat on the forehead.

Hyoscyamus has sudden starting and twitching of the muscles, more so than Ignatia; one arm will twitch and then the other. The motions are all angular. There is a great deal of frothing at the mouth. The patient seems to be wild.

Belladonna is probably more frequently indicated than any other remedy for convulsions following violent emotions, anger, etc., with bright red face, wild straining eyes, hot head, and spasms of the glottis.

Opium is probably the best remedy when, from fright of the wetnurse, the child has retention of urine.

Cuprum is indicated in convulsions where the fingers are clenched. There is marked blueness of the face and mouth. Any attempt to swallow fluids causes gurgling in the throat.

Chamomilla is useful in convulsions of children after any emotion. It is easily distinguished from Ignatia by the petulant angry disposition of the child. One cheek is red and the other pale, and there is hot sweat about the face and head.

There is a sore throat curable by Ignatia. The patient complains of a sensation as though there were a plug in the throat, worse when not swallowing. Examining the tonsils, you find them studded with small superficial ulcers having a yellowish-white color. There is a constricted feeling about the throat, with a great deal of nervousness and insomnia.

The cough of Ignatia arises from constriction of the larynx, or from a sensation as of a feather there. The more the patient coughs, the worse does the tickling become.

Ignatia may be used in chills and fever when there is thirst during the chill, and when the warmth of the stove or other artificial heat relieves the chill. This is not a common symptom. It is very different from Nux vomica, which usually finds no relief from covering up or from the heat of the stove. Capsicum has relief from applying the hot water bottle. Lachesis has longing for the heat of the fire, yet the chill is not shortened thereby. Arsenicum has chill relieved by warmth. Other remedies are Rhus fox., Menyanthes, Nux moschata and Sabadilla.

The action of Ignatia on the genital organs must also be mentioned, as we find it indicated in dysmenorrhcea, associated with what is termed menstrual colic; that is, when there is a great deal of bearing down in the hypogastric region. The patient exhibits hysterical symptoms. The pains are labor-like in character, and are seemingly relieved by pressure, by lying down, and by change of position. The menses are dark, frequent and copious.

The nearest remedy here is Cocculus Indicus. This has uterine spasms and dark menstrual flow, but the backache always enables you to differentiate this drug from others. It has a weak, lame feeling in the small of the back, as though the patient were about to be paralyzed. The limbs tremble when she begins to walk. In addition to this, she often complains of a feeling of emptiness or hollowness in various cavities of the body, especially in the chest andabdomen.

Pulsatilla is at times indicated for this menstrual colic, particularly when the menses are dark in color and delayed. The flow is usually fitful. The patient is apt to be chilly, and the more severe the pains are, the more chilly does the patient become.

Chamomilla is a third drug similar to Ignatia in uterine spasms. It is indicated by the mental symptoms. The patient is so cross that she can scarcely answer any one civilly.

I would like you to remember also Magnesia mur., which is indicated in uterine spasms accompanying induration of the uterus, whether of a scirrhous nature or not.

Actea racemosa is called for in uterine spasms when the pains fly across the hypogastrium from side to side.

In disorders of digestion Ignatia is useful when the patient complains of bitter or sour-tasting mucus in the mouth and copious salivation. There is fanciful aversion to certain foods. He asks for a certain food, but after tasting, refuses it. Food may be regurgitated. Gastralgia is present. He has hiccough, aggravated by eating and smoking, and, especially in children, by emotions. There is an empty, gone feeling at the epigastrium, with qualmishness. In some cases there is empty retching, relieved by eating. The patient vomits at night the food taken in the evening. The bowels are disordered. Hyoscyamus is one of our best remedies for hiccough occurring after operations on the abdomen.

Stramonium and Veratrum album for hiccough after hot drinks, and Arsenicum and Pulsatilla after cold drinks.

Teucrium marum verum is useful in jerking hiccough after nursing. Cajuputum suits hiccough coming on the slightest provocation {Sulphuric acid). There is spasmodic stricture of the oesophagus, the tongue feels swollen. Flatulence is present.

Ammonium muriaticum is characterized by hiccough with stitches in the chest, and empty, gnawing sensation in the stomach after a full meal.

Igjiatia is useful in prolapsus ani, which may or may not be accompanied by haemorrhoids. You have as a characteristic symptom sharp stabbing pains shooting up into the rectum. This prolapsus ani may annoy the patient, even if there is soft stool. There is distressing constriction at the anus, aggravated after stool, and better while sitting. Itching and creeping at the anus as from ascarides, in which condition Ignatia is sometimes an excellent remedy.

Indigo is said to be a good remedy for ascarides, especially in melancholy children. Honey given night and morning will act as a palliative. Teucrium should also be thought of in this connection. Ignatia produces a variety of symptoms referable to the eye, making it a useful remedy in several diseases of that organ. Like Agarzcus, it has nictitation of the eye-lids, with spasmodic action of the facial muscles. There are neuralgic pains about the eyes. These are exceedingly severe, and are often associated with the globus hystericus. Ignatia may also be useful in phlyctenular ophthalmia, when there is intense photophobia and a feeling of sand in the eyes. The toothache of Ignatia is worse between than during acts of eating. Now this is in perfect harmony with the throat symptoms of the drug; that is, there is a feeling as of a lump in the throat which is not felt during but between the acts of deglutition. The "lump" may feel sore while swallowing, but it is felt more markedly between acts of deglutition. This symptom has led to the selection of Ignatia in aphthous sore-throat (the tonsils being swollen and studded with white flat patches), and even in diphtheria.

Zincum holds a very peculiar relation to Ignatia and to Nux vomica. It follows Ignatia well, while it is inimical to Nux vomica. Natrum muriaticum follows Ignatia well, especially in mental ailments.