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Euphrasia officinalis - Eyebright - An acute hay fever remedy

Euphrasia officinalis is commonly known as eyebright. In German, it is known as Augentrost ("Eye-comfort").
     Our remedy is prepared from a tincture of the macerated, whole fresh plant (excluding the root) gathered when in flower. It was first introduced to homeopathic practice by Hahnemann, in his Materia Medica Pura, vol. 5, 1st edition (1819). Hahnemann was assisted in this proving by his son, Friedrich Hahnemann, and by Christian Friedrich Langhammer and W.E. Wislicenus.
     Charles Millspaugh traces the historical medicinal use of Euphrasia in his book American Medicinal Plants, and suggests that it first came into use in professional European medicine in the early 1300s, being absent from the formal medical literature of earlier periods. In Gordon's Liticium Medicinae (1305), it is mentioned among medicines for afflictions of the eyes, both topically and internally administered. It has likely been used in domestic herbal practice since times untraceable, largely as a specific for complaints of the eye.
     In his introduction to its proving, Hahnemann noted:
     "From the following few observations, it may be seen that the ancients did not give it either its German or its Latin name without reason, and that this plant does not merit the neglect with which modern physicians treat it."     —Hahnemann, Materia Medica Pura

Illustration from Bilder ur Nordens Flora, Carl Lindman (c. 1901)

     Euphrasia is indigenous to the circumboreal regions of Eurasia and North America, ranging from coastal Maine and the maritime provinces over the alpine summits of the White Mountains and Adirondacks, northwestward along the northern shore of Lake Superior, to the Aleutian Islands; and similarly across the northern tracts of Siberia, Russia, northern Europe, and across the northern Atlantic through coastal Iceland and Greenland. In the beautiful National Geographic coffee-table book Plants that Heal, you can see a picture of my friend, Maine herbalist Deb Soule, collecting some for her work, on an island off the coast of Maine.
     Euphrasia belongs to the botanical family Scrophulariaceae (the snapdragon family), which contributes several other representatives to our materia medica, including Digitalis purpurea (foxglove), Gratiola officinalis (hedge hyssop), Leptandra virginica (tall speedwell), Verbascum thapsus (great mullein), Chelone glabra (turtlehead) and a handful of rarely-mentioned remedies.
     An examination of the frequency of mention of Euphrasia in the various sections of our repertories (figure 1) reveals a specificity to the mucous membranes, with eye, nose and cough symptoms accounting for 23% of its total symptomatology. In line with the common features of its botanical family, there is also a cluster of symptoms relating to the stomach, abdomen and rectum.
     Consistent with this mucous membrane specificity, Euphrasia finds application as an important acute remedy in treating seasonal allergy syndromes such as hay fever; and hence my choice of it here, for June's Remedy of the Month. In its hay fever symptoms it bears greatest similarity to Allium cepa, Sabadilla, and Hydrophyllum virginicum.
     Guiding symptoms in hay fever include (from A.G. Clarke's wonderfully pithy Decacords):
     "Acute catarrhal affections especially of eyes and nose; profuse acrid lachrymation with profuse bland coryza (reverse of Allium cepa); often associated with soreness and pressive pain behind sternum and hacking cough with free mucus expectoration; cough only during daytime, aggravation on rising in morning.
     "Conjunctivitis; acute with excessive, acrid, watery discharge; sub-acute with profuse, mattery discharge, making cheeks sore; accumulation of mucus on cornea causing frequent blinking to effect removal; photophobia; lid margins swollen, red, burning, even ulcerating.
     "Modalities; aggravation evening or on rising in morning; indoors; warmth; south winds; ameliorated outdoors."
     James Tyler Kent reminds us of the difference between a remedy of acute usefulness in transient flare-ups of chronic disease (such as hay fever) and a remedy of usefulness in treating the chronic disharmony itself, which is founded in a chronic miasmatic disease. Piecing together material from his descriptions of Euphrasia and Allium cepa in his Lectures on Homeopathic Materia Medica:
     "Euphrasia is a short acting remedy of great usefulness in acute catarrhal affections ...
     "You may know that the true nature of hay fever is not generally understood. It is really only an explosion of chronic disease, that is, it is a manifestation of psora, and can be eradicated only by antipsoric treatment. Many a time have I seen hay fever wiped out in one season by a short-acting remedy, only to return the next just the same, and perhaps another remedy will be required ... In a psoric condition a short-acting remedy is insufficient, it may help for one day only, and the deep-acting remedy that includes the patient as well as the hay fever and all the other symptoms will have to be administered."

Figure 1. Frequency of mention of Euphrasia in the various sections of the Synthesis Repertory, extracted using Encyclopedia Homeopathica software.

A "hay fever" case
Here's a case from my practice: A 27-year-old man presents with a longstanding complaint of seasonal allergies, appearing every June and extending through the haying season into late August. He attributes his symptoms to grass pollens and is markedly worse when mowing the lawn, when passing freshly mown fields or mowing operations when driving, or when following a hay truck; he finds some relief from visits to the coast on weekends. Allergy symptoms involve the eyes, nose, larynx, lungs and "sinuses," along with a very disturbing dullness and confusion of thought.
     All symptoms, and particularly the mental confusion and "sinus" headache, are better from washing the face with cold water, and the headache is better with air-conditioning indoors or in the car.
     The eyes may itch horribly, better with aggressive rubbing, and they water profusely, which is irritating, with the eyelid margins often reddened and irritated. He avoids bright light, which bothers him during attacks.
     Nasal discharge is profuse, watery, "like a faucet;" but not irritating (the skin below the nose is never reddened or raw). The discharge is better in the open air, worse in the house or the car.
     In the more severe attacks, he feels a tickling in the larynx, which can progress to wheezing and tightness of breath. Coughing often hurts in the mid-chest, behind the sternum, and is better with cold drinks.
     Head pain is a "constrictive" feeling above the eyes and root of nose, and he attributes this to his sinuses.
     In previous years, he had self-treated with over-the-counter antihistamines, which didn't really work very well and were excessively sedating. This year he discovered a combination herbal tincture which has been helping considerably, and he wonders if further exploration of "natural" alternatives might be of help. His herbal tincture contains osha root, horehound, eyebright, marshmallow root and
mullein leaf.
     The characterizing symptoms of his case can be found in the following repertory rubrics (from the Synthesis Repertory):
Mind: Dullness, coryza, during
Mind: Confusion of Mind, washing the face ameliorates
Mind: Confusion of Mind, cold bath ameliorates
Head: Pain, catarrhal
Head: Constriction, Forehead, Eyes, over the
Head: Pain, cold applications ameliorate
Eye: Discharges, copious
Eye: Discharges, watery
Eye: Discharges, acrid
Eye: Discoloration, Red, Lids, Margins of
Eye: Itching, rubbing ameliorates
Eye: Photophobia
Nose: Discharge, bland
Nose: Discharge, copious
Nose: Coryza, air, open, ameliorates
Respiration: Asthmatic, from hay
Larynx and Trachea: Tickling, in air passages
Cough: Cold drinks ameliorate
Chest: Pain, Sternum, Behind, when coughing

     These symptoms repertorize cleanly for Euphrasia (see repertorization chart, figure 2).

Figure 2. Repertorization chart
prepared with RADAR software.

     The benefit he was experiencing from his herbal tincture was likely attributable to the inclusion of eyebright, his similimum, acting homeopathically even in its crude dose.
     He was treated through the allergy season with Euphrasia 12C, 2 pellets dissolved in one ounce of water in a dropper bottle; 5 drops after 4 succussions of the bottle, as needed; which he used once to 6 times daily throughout the allergy season with great success at managing acute symptoms.
     In early September, he returned in order to address his chronic case, which suggested Sulphur as a simillimum. He was given Sulphur 1M (one pellet, once) at that time. The following spring he returned for a refill of Euphrasia in preparation for his allergy season, but did not end up requiring its use. He has remained allergy-free for the past four years.

About the author:
Will Taylor has a practice devoted to classical homeopathy in a small coastal community in downeast Maine. Initially trained in conventional medicine, he received his MD from the University of Vermont, did a residency in Milwaukee, Wisconsin, and returned to rural Maine to practice as a family physician. His own intractable case of shingles led him in desperation to homeopathy and to the discovery of his own "true and highest calling" as a homeopathic practitioner.