Now we shall take up the study of Cinchona, or China. Persons who have suffered much from neuralgias due to malarial influences, who have become anemic and sickly from repeated hemorrhages, are likely to develop symptoms calling for China. China produces a gradually increasing anemia, with great pallor and weakness. It is sometimes indicated in plethoric individuals, but this is the exception, and even in this class we find that the symptoms are tending towards the cachectic state, which is avoided by the prompt action of the remedy.
Throughout the body there is a gradually increasing sensitivity, a gradually increasing irritability of the nerves; the nerves are always in a fret, so that these people will say: "Doctor, what is the matter with me, I am so nervous?" Everywhere there are twining, tearing, cutting pains in the limbs and over the body. And so great is the sensitiveness to touch that the nerves can many times be outlined; as, for instance, the little nerves in the fingers, because of their extreme sensitiveness. The China patient grows increasingly sensitive to touch, to motion, to cold air, so that he is chilled from exposure. The pains are brought on by exposure to the wind, by cold air, and are increased by motion and touch. Old malarial conditions that have been suppressed with quinine; gradually increasing pallor, bloodlessness, cachexia, until the patient is always catching cold, has liver troubles, bowel troubles, disordered stomach is made miserable and sick by nearly everything he does. He cannot eat fruit without having indigestion; he cannot eat sour things. He is debilitated, pale, waxy, suffers " from pains, such as are found in quinine subjects, and breaks out into a perspiration upon the least exertion.
This patient bleeds easily; bleeds from any orifice of the body – from the nose, from the throat, from the uterus. And after hemorrhage complaints come on. Running through the remedy as a general constitutional state is a tendency to congestion and often inflammation in connection with hemorrhages. Inflammation of the part that bleed or of distant parts. For instance, a woman aborts, has a hemorrhage, but with apparently no provocation, inflammation of the uterus or of the lungs sets in. With these inflammations there is also great irritability of the tissues, tearing pains, cramping in the muscles and actual convulsions. When a China patient bleeds a little, for instance, in confinement, right in the midst of the bleeding convulsions come on. You would scarcely need to think of any other remedy. Secale is the one other medicine that has this, but the two do not look alike. Secale wants the covers all off and the windows open, even in cold weather. If a draft of air blows on a China patient, while in labor, she may go into convulsions. In the midst of labor the pains cease and convulsions come on. Another feature about this inflammation is its rapid progress and intensity, quickly going into gangrene. Inflammation after hemorrhage and the parts rapidly turn black.
China has a fullness of the veins. Not exactly a varicose condition, but a sort of paralysis of the coatings of the veins. The veins become full during fever.
All of these complaints are such as we find in broken down constitutions in feeble, sensitive patients, especially in sensitive women. Sensitive to the odors of flowers, of cooking, of tobacco. Weak, relaxed, emaciated, pale, with feeble heart, feeble circulation and tendency to dropsy. Dropsy runs through the remedy; anasarca and also dropsy of shut sacs. A peculiar thing about this dropsy is that it comes after hemorrhage. In the anemic condition, directly following the loss of blood, dropsy appears. This is the typical China patient.
Catarrhal condition of all mucous membranes. Gastroduodenal catarrh, ending in jaundice. Old liver subjects with jaundice. They have lived for a long time under the influence of the malarial miasm. Feeble, sensitive, anemic. We see such cases in the South and Southwest, and along the Mississippi Valley.
Periodicity is regarded as the most important indication for China but it is a mistake. Periodicity is the symptom upon which Quinine is given. China has periodicity, but in no greater degree than many other remedies and is not so frequently indicated as routine prescribers suppose. Allopaths give Quinine whenever there is any periodicity in complaints. Still periodicity is a strong feature in this remedy. Pains come on with regularity at a given time each day. Intermittent fevers appear with regularity and run a regular course.
A part of this periodicity is an aggravation at night and sometimes sharply at midnight. In colic that comes on regularly every night at 12 o’clock, and it may be, perhaps, a week before you suspect it to be a China colic. A lady had colic and bloating of the abdomen every night at 12 o’clock. After suffering many nights a single dose of China prevented any further trouble. Hemorrhage from the nose coming on with regularity. Diarrhea at night. Several gushing, black, watery stools during the night; in the daytime, only after eating. There is a general aggravation after eating.
Remember that this is a chilly patient, sensitive to drafts, sensitive to cold whose complaints are brought on by being exposed to cold air; sensitive to touch, sensitive to motion. Extreme irritability of the tissues.
China is indicated in conditions following the loss of blood and other animal fluids; as, for instance, in those who are suffering from sexual excesses from secret vice. They have become feeble, sleepless and irritable. There is weakness and general coldness of the skin; twitching and jerking of the limbs; drawing and cramping in the muscles; chronic jerking; epileptiform convulsion; paralytic weakness; rush of blood to the head; ringing in the ears; darkness before the eyes; fainting on the slightest provocation. Such is the China cachexia, and with this in view, the mental state will scarcely be a surprise to you. It is just such as you would expect in this nervous, sensitive patient. Weakness of mind. Inability to think or remember. Full of fear at night. Fear of animals, dogs, of creeping things. Wants to commit suicide, but lacks courage. Gradually the mind grows weaker; he uses wrong expressions or misplaces words. Lies awake at night making plans; theorizing, building air castles, thinking of the wonderful things he is going to do some day. In the morning he wonders how he could have thought such foolish things. After sleep his mind is clear and he looks more philosophically on the affairs of life. Unable to entertain any mental proposition that means work. He dreads work. He is apathetic, indifferent, low spirited, silent, disinclined to think. He is unable to control the mind, to make it do what he wants it to do. You see it is not as yet a real insanity.
This state of mind comes on after hemorrhage. Insomnia after hemorrhage. A woman, after having suffered great loss of blood, will be sleepless night after night.
After hemorrhage we may have dizziness. It is a natural consequence; dizziness and fainting. But ordinarily, after the proper diet for a few days, these symptoms will have disappeared. With the China patient they go from bad to worse. The woman after severe hemorrhage does not make blood. There is mal* assimilation, and the vertigo persists for days and weeks. China will restore order.
The remedy is full of headaches. Congestive headaches in broken down constitutions. Extremities cold and body covered with a cold sweat. Rending, tearing pains. Pressing and throbbing. As soon as the air strikes the head those pains come on. Headache better in a warm room; worse from touch; worse from motion; worse from cold. These are the principal features. A slight touch will aggravate the disturbance. But notice the exception. Hard pressure ameliorates the China pains, as light pressure aggravates. Sensitiveness of the tissues; sensitiveness along the course of the nerves; the pains are brought on by touch, by cold air. Stitches in the head with pulsation in temples, which can be felt with the fingers; ameliorated by hard pressure, but aggravated by touch. The jar and motion of walking hurt the head. Even turning over in bed aggravates. Cannot ride in a carriage or anything that jolts. Ameliorated by hard pressure. Throbbing headaches, aggravated by a draft of air, in the open air, from the slightest touch; ameliorated by hard pressure. The scalp feels as if the hair was grasped roughly. It is sensitive to touch. Profuse sweating of the scalp. Headaches aggravated at night. Headaches from sexual excesses; loss of animal fluids.
Now we come to the eye. Photophobia. Yellowness of the sclera. Exposure to cold wind will bring on neuralgia; ameliorated from keeping quiet and from keeping warm. "Nocturnal blindness, dimness of vision. Feeling as if sand were in the eyes. Pains worse from light. Better in the dark."
In the ear and the nose you find the same sensitiveness as in eyes; every Little noise is painful. Ringing, roaring, buzzing, and singing, chirping like crickets in the ears. Dry catarrh of the middle ear. Hardness of hearing is not infrequently the result of this condition. It gradually increases until there is total deafness, and the noises in the ear continue long after the patient has lost the ability to distinguish articulate sound. Hemorrhage from the ear. Offensive, bloody, purulent discharges.
Frequent nosebleed in anemic patients. Here, again, the dryness and catarrhal conditions. Dry coryza; or fluent coryza, suppressed and causing violent head pains. Odors nauseate. Sensitiveness to the odors of flowers. cooking, tobacco
The face is withered, shrunken, sallow, anemic, sickly. Red when the fever is on and sometimes when the chill is on, but in the apyrexia pale, sickly and sallow. Neuralgia of the face; tearing, rending, knife-like pains with the usual modalities. The veins of the face are distended. This is frequently observed during the fever and sweat of the China intermittents.
The teeth get loose, the gums swell. The teeth are painful while chewing; they feel too long. Toothache with every little cold. Rending as if teeth were being pulled out, every time the child nurses at the breast. Exudations about the teeth and gums. Black, and fetid; great putridity in the lower forms of fever.
The taste is extremely acute. Exaggerated so that nothing tastes natural. "Bitter taste in the mouth. Food tastes bitter or too salty. Burning as from pepper on tip of the tongue. Dryness in the mouth and throat. Difficult, swallowing." Sometimes there is canine hunger, but one of the most common features is loathing of every; aversion to all food. The China patient is often passive in regard to eating. Sits down to eat and the food tastes fairly good and he fills up. But it does not matter much whether he eats or not. "Loathing and violent hunger." "Hunger and yet want of appetite. Indifference to eating and drinking. Only while eating some appetite and natural taste for food return. Loss of appetite. Aversion to all food. Aversion to bread." His appetite varies. Thirst is peculiar. The patient will say: "I know my chill is coming on now because I have thirst." Thirst before the chill, but as soon as the chill comes on there is no thirst. But when he begin to warm up he begins to get thirsty; that is, during the period in which the two lap he is thirsty, but when the chill has fairly subsided and the heat is upon him his thirst subsides also and he only wants to wet his mouth. But as the hot spell begins to subside he increases the amount taken, and all through the sweat he can hardly get water enough. Thirst before and after the chill and thirst during the sweat. No thirst during the chill. No thirst during the hot spell. You will cure more cases of intermittent fever with Ipecac and Nux vomica, than with China. China has well-defined chill, fever and sweat.
Gastric symptoms from eating fish, fruit, and from drinking wine. Flatulent distension almost to bursting. There are constant eructations, loud and strong, and yet no relief, so extensive is the flatulence. In Carbo veg. after belching a little, there is relief. Lyc. has both. Tympanitic distension of the abdomen and stomach in low forms of fever. Cannot move on account of soreness in the bowels. Vomiting of blood. Sometimes followed by dropsy of the extremities. "Hiccough Nausea. Vomiting. Eructations tasting of food, or they are bitter, sour. Frequent vomiting. Vomiting of sour mucus, bile, blood." Likely to occur at night. Pulsation in the stomach and rumbling. Cold feeling in the stomach. Fermentation after eating fruit. Acidity. Disorders of the stomach after milk.
Diarrhea. Copious, watery black discharges from the bowels. Gurgling and rumbling in the abdomen. Stool immediately after eating and at night. Great quantities of flatus expelled from the bowels. Diarrhea comes on gradually. Stools more and more watery. Chronic diarrhea, with emaciation and aggravation at night. Petroleum has a chronic diarrhea, but only in the daytime.
Of the male genital organs the most striking feature is weakness. Of the female genital organs there is a different class of conditions. In the woman who has been subject to uterine hemorrhages you may look out at any moment for a sudden, sharp attack of inflammation of the ovaries. Hemorrhage from the uterus. Prolapse. Menses too early and too profuse; black, clotted blood; menstrual colic; metrorrhagia. Pains and convulsions; convulsions come on in the midst of the hemorrhage; cramps in the uterus along with hemorrhage; labor-like pains; ringing in the ears; loss of sight; sliding down in bed. In confinement the lochia is profuse and lasts too long. Deterioration of health from prolonged lactation; toothache; neuralgia of the face.
Difficult respiration, rattling and filling up of the chest with mucus; asthma. "Pressure in the chest, as from violent rush of blood; violent palpitation, bloody sputa, sudden prostration." Dry, suffocative cough at night; profuse night sweats. Pains in the chest, increasing sensitiveness to cold, heat and redness of the face with cold hands.
Along the spine there are sore spots. Tearing, darting pains in the limbs, ameliorated by heat and hard pressure, brought on by touch, by becoming chilled. Worse at night. "Knees weak, especially when walking."
China cures low forms of fever, remittent or intermittent, typhoid or malarial.