back Cinchona officinalis

Synonym- Cinchona officinalis. Cinchona Calisaya. Natural order. - Rubiaceae. Common names. - China. Yellow Peruvian Bark. Habitat.- A tall, stately tree growing in Bolivia and Southern Peru. Preparation.- Tincture and triturations from the powdered bark.

Cinchona acts upon the ganglionic nervous system, more especially upon that portion which presides over the functions of vegetation, producing a condition of general depression and exhaustion, diminishing the vital turgor, and modifying the digestive functions. The quantity and quality of the blood are altered. It becomes thin and watery, the circulation lacks energy, and, as a consequence, we have general debility and erethism, while various functional disturbances are manifest, such as haemorrhage, profuse sweat and urine, watery diarrhoea, etc. In the vegetative sphere Cinchona shows a special affinity for the liver and spleen, and here may be said to exist its most important relations. In the liver it produces hy perse mia and congestion, prostrating all functional performance, and giving rise to a long train of biliary symptoms, of which jaundice is one of great importance. In the spleen it also produces hyperemia, which tends to congestion, and finally to enlargement of the organ. Through the ganglionic nervous system, and in connection with the disturbances of the system above set forth, Cinchona has a fever-producing power in an eminent degree, the latter almost invariably partaking of that character which in disease would indicate a malarial origin, periodicity being one of its most essential features. The chief characteristic of Cinchona is an excessive sensitiveness of the nervous system, all symptoms being aggravated by the slightest contact, by motion, and by physical or mental effort. Also prostration, with neither thirst nor hunger.

Mind. - Ideas and projects crowd on his mind, especially in evening and at night (Coff. c). Cheerfulness alternating with gloom. Sudden screaming and tossing about during cheerful mood. Excessively anxious solicitude about trifles. Excessive excitability, with despondency and intolerance of noise. Indifference and apathy (Berb., Merc, Phos., Phos. ac). Inconsolable anxiety; fearful; apprehensive (Acon., Aur., Bell., Ign., Phos.). Peevish, ill-humored, easily angered {Bry., Cham.). Slow flow of ideas, cannot arrange his thoughts; makes mistakes when writing or speaking, reverses words; easily disturbed by the talking of others. Dislike to all mental or physical exertion.

Head.- Dullness and confusion of head in morning, as from intoxication (Coccul., Nux v., Puls., Rhus tox.); or coryza; or from sitting up at night, and sleeplessness. Confusion with tensive pain iu the forehead and orbits. Vertigo; head inclined to sink backward (Agar.); on waking at night; on raising head (Bry.); after loss of animal fluids from anaemia. oIntense throbbing headache after excessive haemorrhage. oHeadache from suppressed coryza. oHeadache in occiput after sexual excesses or onanism (Plios. ac, Staph.). Headache as if the skull would burst (Bry., Merc, Natr. mur.); the brain beats in waves against the skull (Glon.). Pressive headache, from within outward. Acute jerking, tearing pains in the head; worse on motion and walking; better when lying down. Aching deep in the brain when walking, with constriction; worse on right side of forehead and in occiput. Aching in forehead when sitting, changing to temples on bending backwards. Spasmodic pain in vertex, then bruised sensation in side of head, worse from motion. Contractive pain in scalp on left side of occiput; as if drawn to one point.

Headache worse from draught of air; in the open air, from slightest touch; better from hard pressure (Bell.). Scalp sensitive to touch (Acon., Bell., Merc.); roots of hair hurt when hair is moved. Profuse sweat on head (Sil.)> especially when walking in open air.

Eyes. - Dimness and weakness of sight. Yellow color of the eyes (Canth., Chel., Iodi., Plumb.). Eyes sensitive to bright light (Acon., Bell.). Motion of eyes painful with sensation of mechanical hinderance. Lachrymation, with crawling pain in eyes and on inner surface of lids. Pupils dilated; contracted.

Ears.- Ringing in the ears (Calc. c, Merc, Nux v.). Humming, roaring, or tickling in the ears (Acon., Bell.). Hardness of hearing.

Nose.- Frequent nosebleeds, especially mornings (Agar., Amb., Bry.); also with anaemia; ringing in ears; fainting, etc. Pressive pain in root of nose (Acon., Kali bi., Hep. s.), extending to side of nose.- Fluent coryza, with sneezing and lachrymation; attacks of stopped coryza.

Face.- Complexion pale; sometimes earthy, grayish-yellow, or black (Ars.). Face pale, sunken, pinched; eyes sunken (Ars., Verat. alb.); and surrounded by blue margins (Ipec, Kali iod., Seo. c, ttulph.). Pale, sickly appearance, as after excesses. Lips dry, coated black, wrinkled and chapped (Ars.). Submaxillary glands swollen (Calc. c, Baryt., lodi.). oPeriodical prosopalgia; pains excessive; skin sensitive to touch; mostly in infra-orbital and maxillary branches (Spig.):

Mouth. - The teeth are loose and painful only when chewing Carb. an. , Merc, Nitr. ac. ). Throbbing toothache; jerking; digging. Toothache worse from least contact; from draught of air (Sulph.); better from pressing teeth together. Tongue coated yellow (Chel.), white dirty. Painful swelling posteriorly on side of tongue. Burning stitches on the tongue. Dryness of the mouth (Ars., Bry., Nux v., Puls.). Taste flat, insipid; first sweetish, then sour; slimy, bitter (Acon., Bry., Coloc, Nux v., Puls., Sulph.); everything tastes bitter, even tobacco smoke. Salivation oday and night, years after mercury; great weakness, especially of stomach.

Stomach. - No desire for eating or drinking; only while eating that appetite and natural taste returns. Desires for various things without knowing what. Longing for acid (Ant. crud., Ant. tart.), fruit, wine (Bry.). Aversion to coffee and beer (Nux v.). Violent thirst for cold water (Acon., Bry., Op.); drinks often but little at a time (Ars.). Empty eructations; sour (Kali c, Nux v.), after milk (Carb. v., Sulph.); bitter (Bry., Nux v.); taste of food (Ant. crud., Calc. c, Phos., Puls.). Sensation of emptiness and qualmishness of stomach. Heavy, long continued pressure in stomach, after even a small quantity of food ( Nux v. ) , which seems to fill him up full (Lyc..). Milk deranges stomach easily (Carb. v., Sulph.). Pulsations in pit of stomach (Puls., Sep.). Stomach feels sore, as if ulcerated; cannot bear the slightest touch. Cold feeling in stomach; constant satiated feeling, yet can eat, but feels worse afterwards. oSlow digestion; food remains long in stomach, especially if eaten too late in the day. oH8ematemesis; great loss of blood; weak, pale; stomach very sensitive to touch. oGastralgia after depletion; acidity; bloating.

Abdomen. - Distension of the abdomen (Ant. crud., Bry.), with wish to belch up; or a sensation in the abdomen as if it were packed full, not in the least relieved by eructations. Abdomen tympanitic (Arn., Brom.). Fermentation in abdomen from eating fruit. Pain in hepatic region, as from subcutaneous ulceration, very sensitive to touch (iEsc,Bry., Chel.j Merc). Swelling and induration of liver (Phos., Sulph.). Swelling, inflammation, induration of spleen (Phos.). Internal coldness after every swallow of drink, renewed on every inspiration. Colic; with shivering; with thirst; before stool; before passage of flatus. Flatulent colic, especially after eating and at night (Coloc.); much rumbling. Emission of large quantities of flatus (Aloe. Carb. v.), sometimes with griping pains; offensive.

Stools.- Diarrhoea; painless (Ars. Podo.); debilitating (Phos.); from eating fruit (Cist.); undigested fceces {Ant. erud. y Calc. c, Phos., Podo.); black (Ars., Lep.); yellow (Chel.); thin, watery; involuntary (Ars., Hyos.); white with dark urine; after eating; frequent, with biting burning pain in anus, and colic before and after every stool. Difficult passage of even a soft stool (Alum., Carb. v. Nux m.).

Urinary Organs. - Frequent micturition (Arg. met., Cepa, Phos. ac). with pressure in bladder. Urine dark, turbid, scanty; brick-red sediment (Arn., Lyc., Natr. mur., Nuph., Phos.); copious.

Male Organs.- Sexual desire; lascivious fancies; impotence (Agar., Phos. ac, Camph.). Nocturnal emissions, frequent and debilitating (Aur., Gels., Phos., Phos. ac). Consequences of excessive seminal losses; onanism (Agar., Nux v., Phos. ac, Staph.).

Female Organs.- Congestion to the uterus; fullness, pressing, and heaviness, worse when walking (Bell.). oOvaritis from sexual excess or haemorrhage, parts very sensitive to touch. Metrorrhagia; blood dark; fainting. oDischarge of bloody serum, alternating with pus. Leucorrhcea, instead of or before the menses; with spasmodic uterine contractions. Nymphomania of lying-in women (Plat., Vera/t. alb.). ( Dterine haemorrhage, ringing in ears, fainting, cold, loss of aighl : discharge of dark clots; uterine spasms; twitches; jerks; wants to be fanned. oLong-lasting lochia; sometimes foetid, cheesy, or purulent.

Respiratory Organs.- Hoarse, rough voice (Carb. v.). Spas- modic cough from irritation of larynx, as from fumes of sulphur (Ars., [gn. ); at night and in mornings. Cough with granular expectoration during day or evening; none night or morning. Cough worse after eating (Nux v.); from laughing (Phos.); talking (Phos., Psor.); lying with head low; lightly touching larynx; draught of air; loss of fluids. Oppression of chest; also evenings when lying down. Nightly suffocating fits (Acon., Ars.); from mucus in larynx (Ant. crud., Samb.). Wheezing and whistling in bronchi during respiration (Ant. tart., Ipec). Pressive drawing pain across the lower portion of the chest while sitting, causing anxiety; disappearing while standing and walking, haemoptysis, with subsequent suppuration of lungs; stitches in chest, worse from slight touch. Pain in side of chest, as if beaten (Arm, Apis. Sil.). Stitches in (left) sides of chest, not affecting respiration.

Heart.- Palpitation, with congestion to chest and face (Acon.); cold.aands, intermitting pulse.

Neck and Back. - Pain in nape of neck, as if glands were swol- len. Sticking in left side of back. Pressure as from a stone be- tween the scapulae. Pain in small of bach, as from a heavy load, or after long stooping (Arm, Dulc, Puls.). Intolerable pain in small of bach, as from cramp, or as if bruised, and crushed; worse from least motion. Sweat on back and neck from least motion.

Limbs. - Laxity of all the limbs, and trembling of the hands. Numbness and deadness of the limbs. Heaviness in limbs, especially thighs. Sensible though invisible trembling of limbs, combined with cooling sensation. Paralytic stiffness in all joints on rising after sleeping, causing mental depression.

Upper Limbs. - Paralytic, jerking, tearing pains in bones of upper limbs; increased by touch. Hand trembles when writ- ing (Caic. c). Swelling of back of left hand.

Lower Limbs. - Drawing pain in bones of thighs, as if perios- teum had been scraped with a dull knife (Phos. ac. ). Hot swelling of right knee. Sensation as if garters were too tight and leg would become stiff and go to sleep. Arthritic swelling of the feet. Jerking, tearing, rheumatic pains in left thigh; in metatarsal bones and phalanges, worse from motion and contact. Stitches in tibiae when walking. Weakness as if bruised. Legs feel as after great fatigue from a long journey (Arg, nit., Calc. c, Nitr. ac.}.

Generalities.- Great debility (Alum., Sulph.); sensitiveness of the nervous system (Nujg v.); special senses too acute (Bell.); very sensitive to pain (Cham., Sep.); to draughts of air (Am 1., Coff. c). Excessive sensitiveness of all the nerves (Asar.); with a morbid sensation of general weakness. Weakness; after eating, with sleepiness; on rising from a seat or walking. Numbness of the parts on which he lies. Oppression of all parts of the body, as if clothing were too tight. Body sore all over (Am., Bapt.); joints; bones and periosteum feel as if sprained. Pains, with lameness or weakness of affected parts.

Skin. - Yellow color of the skin (Bry.); jaundice (Merc).

Sleep.- Sleepless from crowding of ideas, making plans. Sleepless with pressive pain in head; anxiety on waking, from frightful dreams; confused, senseless dreams after midnight. Constant sopor or unrefreshing sleep (Arm, Op., Lach.).

Fever.- Pulse small, hard, rapid and irregular. Shivering and shaking chill over the whole body; increased by drinking; thirst before or after but not during chill. Internal violent chill, with icy-cold hands and feet, and congestion of blood to the head. Heat with dryness of the mouth and lips, which are burning; redness of face; headache (Bell.). General heat with distended veins (Puls.). No thirst during chill or heat; after heat violent thirst. Thirst increased during sweat. Perspiration very profuse (Chin, sulph.), and debilitating (Aloe.); especially at night (Phos., Phos. ac, Sil.). Profuse sweat during sleep (Chin, sulph., Phos.); or on being covered up. Perspiration on the side on which f/r lies.

Aggravation.- From slightest touch; from draught of air; in morning; at night; after eating or drinking; from milk; from walking; from motion; every other day.

Compare- Arm, Ars., Bell., Calc. c, Ced., Coff.,* Ferr., Graph., Lyc., Merc, Natr. mur., Nux v., Phos. ac, Puls., Sulph., Tarranl.

Antidotes.- Ainu., Am., Ars., Bell., Calc. c, Carb.v., Eupat. perf., Ferr., Tpec, Lach., Merc, Natr. mur., Nux v., Puls., Sep., Sulph., / 'erat. all).

Cinchona Antidotes.- Ars., Ipec, Ferr., Cupr.

THERAPEUTICS,

Anaemia with debility or other complaints after loss of blood, or other vital fluids; particularly from nursing or salivation, bleeding, etc.; or from leucorrhoea, night sweats, seminal emissions, onanism, etc. Leucocythemia. Chlorosis. Throbbing, even hammering headaches from above causes. Also retinal asthenopia from same causes. A valuable remedy in dropsical affections, with anaemia, etc. Haemorrhages of dark clotted blood from nose and other parts in anaemic subjects, with ringing in the ears, great weakness, etc. Cinchona is invaluable in neuralgia, especially of the head, face and eyes; periodical prosopalgia; pains excessive; skin sensitive to touch; mostly infra-orbital and maxillary branches. In all diseases characterized by periodicit,y Cinchona is an often indicated remedy, especially in intermittent, remittent, bilious, gastric and other fevers. In intermittent fever the three stages are well developed, but the paroxysms do not recur with the same clock-like regularity that they do in Quinine; there is also less cachexia, though the patient may have a sallow look and be very weak and anaemic. The type may be either tertian or quartan. The chill and heat are ordinarily unaccompanied by thirst, but there is usually violent thirst and sometimes headache preceding the chill, and may be thirst during the hot stage, and nearly always thirst after it. During heat the face is fiery red, and there is headache and often delirium. The sweat is very profuse and debilitating. The apyrexia is marked by anaemia, great prostration, loss of appetite or canine hunger, soreness of the liver and spleen, etc. Cinchona is also very useful in hectic fever accompanying long lasting suppurative processes, either in the lungs or elsewhere, the patient being very weak and anaemic, with night sweats. Cinchona is frequently the remedy for dyspepsia. Like Lycopodium it is oftenest indicated when flatulence predominates, and a small quantity of food seems to fill him full; the abdomen is distended with flatulence, and there is a desire to belch it up, but the eructations do not relieve; desire for acids and fruits, but they only increase the fermentation; heavy pressure in stomach; slow digestion; food remaining long in stomach; milk disagrees; cold feeling in stomach; weak and drowsy after meals. Chronic gastritis in children. Gastralgia. Haemorrhage of the stomach. Enlargement of the liver; also of the spleen; especially from chronic malarial poisoning; region of liver and spleen sore and very sensitive to the touch; stitching pains. Hepatitis. Splenitis. Probably the most valuable remedy for gall-stones, to prevent their recurrence and overcome the conditions they have caused. A most important remedy in jaundice; from loss of fluids; in drunkards from gastro-duodenal catarrh; liver enlarged and sensitive as if ulcerated. Diarrhoea, painless and very debilitating; flatulent colic; undigested or watery stools; worse at night or after eating; great fermentation in abdomen; from eating acid fruits, especially in hot weather. Involuntary, offensive stools in the course of other diseases. In the sexual sphere Cinchona is often useful. As has been noted, it is of great use for the debility following sexual excesses or onanism - loss of semen; impotence; nocturnal emissions. In the female the drug is especially useful in uterine haemorrhages, or profuse menses; blood dark and clotted; atony of the uterus; ringing in the ears, coldness, blindness, wants to be fanned, etc. Bloody, purulent leucorrhcea in place of the menses; uterine contractions; anaemia. Metritis. Ovaritis from sexual excess or haemorrhage, parts very sensitive to touch. Nymphomania in lying-in women. Long lasting lochia, foetid and purulent; with anaemia and debility. General anaemia from nursing. In the respiratory sphere Cinchona is especially useful in bronchor rhoea, with great debility; patient appears as if in the last stage of phthisis. Often valuable in phthisis, especially when resulting from loss of fluids; profuse and debilitating night sweats. Sometimes useful in asthma. Haemoptysis, with anaemia, etc. In later stages of inflammatory rheumatism; fever intermittent; joints swollen, parts exquisitely sensitive to touch; jerking tearing pains. In hip disease for the anaemia and exhaustion resulting from prolonged suppuration. Chronic synovitis. Arthritic swelling of the hands and feet.


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