Spigelia

A tropical American herb (Loganiaceae) long used as a vermifuge (“anthelmia”), the whole herb/root supplying the tincture. Crude-drug action includes gastro-intestinal irritation, vertigo, visual/ocular pain, palpitations, and neuralgic pains, with toxic over-dosing causing tremor, stupor, vomiting, and sometimes convulsions—a pattern which prefigures the homeopathic picture of trigeminal and ciliary neuralgia, left-sided supraorbital headaches, and cardiac neuralgia/pericarditis with violent palpitation [Hughes], [Clarke], [Allen], [Hering]. [Toxicology]

Widely used in folk and early eclectic medicine as a worm-expeller (particularly in children); mixed results and notable toxicity led to decline in crude use. Historical topical applications for toothache and neuralgia appear sporadically in early sources [Hughes], [Clarke].

Hahnemann’s school and later provers (Hering, Allen) recorded violent, stitching, thread-like neuralgias, left-sided supraorbital pains, ciliary pains with eye-movement <, palpitations with visible impulse and dyspnoea, cannot lie on the left side, must lie with head high and on the right; worm-symptoms and colicky abdomen were also elicited. Clinical confirmations for angina pectoris, pericarditis, trigeminal/ciliary neuralgia, and left frontal hemicrania are abundant in Kent, Clarke, Farrington, Nash and later authors [Hahnemann], [Hering], [Allen], [Clarke], [Kent], [Farrington], [Nash]. [Proving] [Clinical] [Toxicology]

• Heart and pericardium (primary): Palpitation violent and visible, anginal stitches, pericardial pains radiating to left arm/shoulder, cannot lie on left side, must lie on right with head high, least motion aggravates; sense of heart stopping and then starting with a shock appears in some cases. Cross-ref. Heart, Chest, Respiration, Modalities. [Clarke], [Kent], [Boericke], [Farrington]
• Trigeminal nerve (V) — supraorbital/maxillary (left > right): Stitching, burning, thread-like neuralgia, from temple and eye to cheek and teeth, touch and motion aggravate, warmth and rest relieve. Cross-ref. Head, Face, Teeth, Modalities. [Hering], [Allen], [Clarke]
• Ciliary body/eyes (ocular neuralgia): Intense pain on moving the eyes, photophobia, as if the eye were too large, tearing from orbit to occiput; ciliary neuralgia after suppression of discharge. Cross-ref. Eyes, Head. [Allen], [Hering], [Clarke]
• Intercostal nerves & precordial region: Stitching intercostal pains, left chest wall tenderness, heart region sore to touch; cardiac neurosis pictures. Cross-ref. Chest, Back, Modalities. [Clarke], [Boger]
• Gastro-intestinal (vermifuge heritage): Borborygmi, colic about the navel, pinworms, sour taste, morning nausea; nervous children with worm signs and cardio-neurotic palpitations. Cross-ref. Abdomen, Rectum, Generalities. [Allen], [Clarke], [Hughes]
• Cervico-occipital & nuchal nerves: Occipital–nuchal drawing pains, neck stiffness accompanying eye/temple neuralgia; worse motion. Cross-ref. Head, Back. [Hering], [Allen]
• Autonomic/vaso-motor: Startings, faintness on rising, cold sweat during anginal waves; palpitations from emotion. Cross-ref. Mind, Generalities. [Kent], [Clarke]
• Left-sidedness: Many complaints especially left eye, left temple, left chest/arm, guiding selection when modalities agree. Cross-ref. throughout. [Hering], [Clarke]

• Absolute rest; avoidance of the least motion in heart or neuralgia states. [Kent], [Clarke]
• Lying on the right side with head high; cannot lie on left. [Hering], [Clarke], [Boericke]
• Warm applications and wrapping to face/eye for neuralgia; dry heat to precordia. [Allen], [Clarke]
• Closing the eyes; keeping them still (ciliary pain abates). [Allen], [Hering]
• Gentle pressure to the painful nerve-track or over the heart (hand supports). [Hering], [Boger]
• Silence and dark room for head/eye pains. [Clarke]
• After perspiration or after a quiet sleep, pains remit somewhat. [Nash]
• Warm drinks; small sips to ease faintness. [Clarke]
• Steady posture; sitting propped in cardiac dyspnoea. [Kent], [Clarke]
• Expiring slowly rather than taking deep breaths during anginal stitches. [Clinical]
• Firm bandaging of chest during intercostal neuralgia. [Boger]

• Least motion—walking, turning, stooping, stepping, raising the arms, deep inspiration—brings palpitation/angina or neuralgic stitches. [Kent], [Clarke], [Hering]
• Lying on the left side; lying flat; first turning in bed. [Clarke], [Boericke]
• Touch and pressure on nerve/heart region (except light, comforting pressure). [Hering], [Allen]
• Cold air, drafts, washing with cold water on face/eyes; wet weather in neuralgias. [Clarke], [Allen]
• Noise, bright light, moving the eyes, reading. [Allen], [Hering]
• Morning to noon for supraorbital neuralgia; forenoon exacerbations; also before a storm. [Clarke], [Hering]
• Emotion, fright, surprise—pulse becomes irregular, palpitation violent. [Kent], [Clarke]
• Tobacco/coffee in sensitive hearts; stimulants aggravate palpitations. [Hughes], [Clarke]
• Stooping (rush to head) and ascending (dyspnoea with palpitation). [Boger], [Clarke]
• Jar of the bed or floor during neuralgic attacks. [Hering]

• Cardiac neuralgia/angina; pericarditis with motion-worse palpitation
  • Cactus — Constrictive “iron band” about heart; less left-sided neuralgic stitch; Spig. guided by motion-worse stitches and right-side posture need. [Farrington], [Clarke]
  • Kalmia — Sharp pains shoot down left arm with numbness; rheumatic base; Spig. has more precordial soreness to touch and eye/face neuralgia concomitants. [Farrington], [Kent]
  • Naja — Constrictive throat/heart, left carotid throb, moral depression; less thread-like neuralgia. [Clarke]
  • Digitalis — Slow, weak pulse, icy surface, faintness; motion feared from weakness, not from stitch; lying left not so decisive. [Kent], [Clarke]
  • Latrodectus — Extreme tearing pains to left arm, impending death, collapse; storms more violent, continuous; Spig. less overwhelming, posture-sensitive. [Clarke]
  • Aconite — First hours, feverish panic; Spig. later, mechanical motion-worse neuralgia with posture rules. [Kent]
• Trigeminal/ciliary neuralgia (left >)
  • Magnesia phosphorica — Cramping neuralgia better firm pressure and heat; less stitching thread-like quality and less eye-movement <. [Clarke]
  • Mezereum — Burning, bone-deep pains, eruption; not so strictly left supraorbital nor eye-movement <. [Hering]
  • Cedron — Clock-like periodicity; often left supraorbital with eye-watering; Spig. lacks fixed clock but has eye-movement < and cardiac links. [Farrington]
  • Paris — Sensation “eye on a string” with neck sensations; less cardiac accompaniment. [Clarke]
  • Ruta — Asthenopia/strain pains; lacks neuralgic stitch and cardiac axis. [Farrington]
• Intercostal neuralgia (left chest)
  • Ranunculus bulbosus — Sharp intercostal stitches, weather-change <, motion <; Spig. when precordial and cardiac signs co-exist. [Boger], [Clarke]
  • Bryonia — Stitching chest pain worse every motion, better pressure; more pleurodynia than cardiac. [Farrington]
• Worm colic with nervous palpitations
  • Cina — Grinding teeth, boring nose, cross; less cardiac neuralgia. [Allen]
  • Teucrium — Crawling in rectum, thread-worms; no heart picture. [Clarke]

• Complementary: Kalmia—rheumatic heart cases with left-arm shooting; often follows Spig. or alternates when numbness predominates. [Farrington], [Kent]
• Complementary: Cactus—when constriction remains after Spig. has calmed motion-worse stitches. [Clarke]
• Follows well: Aconite—after first fright and vascular storm, the mechanical motion-worse neuralgic phase calls for Spig. [Kent]
• Precedes well: Digitalis in failing hearts with weakness/collapse after Spig. has quelled neuralgic storms. [Clarke]
• Related (family): Gelsemium (Loganiaceae) has drowsy paresis, not neuralgic stitch; Ignatia has paradoxes and globus, not cardiac stitch. [Farrington]
• Antidotes/Avoid: Coffee, tobacco, sudden exertion, cold drafts aggravate; counsel strict posture-rest during treatment. [Hughes], [Clarke]

Spig. unites thread-like neuralgia and cardiac motion-intolerance into one coherent field. The patient is left-sided, stabbing, exquisitely sensitive to movement, touch, light, noise, and above all to posture. He cannot lie on the left side; turning in bed or raising the arms brings palpitation and stitches through the heart; he must lie on the right side with head high, sit propped, and keep still. The same mechanical sensitivity governs the head and eyes: a left supraorbital pain shoots like a wire into the cheek and teeth, the ciliary region flares with the least eye-movement, and only warmth, darkness, rest, and closing the eyes bring respite. The neuralgic pains are fine, stitching, thread-like, travelling along nerve-tracks; the precordium is tender to touch, and the apex-beat is visible when the least motion sets the heart careering [Hering], [Allen], [Clarke], [Kent], [Farrington], [Boericke]. Differential insight hangs on posture and motion: Cactus constricts irrespective of side; Kalmia shoots down the left arm with numbness and a rheumatic stamp; Digitalis fails for weakness and coldness rather than stitch; Naja constricts with a moral gloom; Latrodectus tears mercilessly without the precise right-side, head-high relief. In the neuralgia cohort, Mag-phos. and Mez. lack the eye-movement trigger; Cedron binds pain to the clock; Paris dramatises the globe without the heart. Clinically, Spig. earns trust in pericarditis with posture rules, angina pectoris where every step stabs, trigeminal/ciliary neuralgias (especially left), and nervous worm-children whose palpitations abate as stillness and warmth are enforced. Management is practical: posture discipline, silence/dark, dry heat, avoid stimulants and drafts, and graduated resumption of motion as the remedy knits the system back to steadiness.

• Pericarditis/angina with “cannot lie on left; least motion brings stitches & palpitation”: Spig. 30C–200C acutely (single or spaced doses); strict right-side, head-high posture; no exertion; compare Kalmia if left arm numbness predominates. [Clarke], [Kent], [Farrington]
• Left supraorbital/trigeminal neuralgia with eye-movement <, warmth >: Spig. 6C–30C every few hours during flares; insist on dark, warm compress, eyes at rest; review dental/ocular triggers. [Hering], [Allen]
• Ciliary neuralgia after suppression of discharge/dental work: Spig. with warmth, mydriatic rest avoided; alternate with Ruta/Paris only if strain dominates rather than stitch. [Clarke], [Farrington]
• Children with worms + palpitations/colic: Spig. 3x–6x, hygienic worm measures; if rectal crawling is foremost, consider Teucrium or Cina. [Allen], [Clarke]
• Intercostal neuralgia (left): Spig. plus firm bandaging and dry heat; avoid twisting and deep inspirations until pain track is quiet. [Boger], [Clarke]

Mind

• MIND — ANXIETY — heart; about — motion from — aggravates. — Motion dread tied to palpitation.
• MIND — FEAR — to move — lest heart fail. — Mechanical vigilance.

Head

• HEAD — PAIN — SUPRAORBITAL — left — stitching; thread-like — forenoon — aggravates. — Spig. keynote.
• HEAD — JAR — slightest — aggravates — touch — aggravates. — Hyperaesthesia of scalp/nerve.
• HEAD — EYE MOVEMENTS — aggravate — pains extend to occiput/teeth. — Ciliary trigger.

Eyes

• EYES — PAIN — ciliary — motion of eyes — aggravates — warmth — ameliorates — dark room — ameliorates. — Core ciliary rubric.
• EYES — SENSATION — eyeball — too large — as if. — Spig./Paris motif; Spig. with cardiac axis.

Face / Teeth

• FACE — NEURALGIA — left — infraorbital — touch — aggravates — warmth — ameliorates. — Tic douloureux strand.
• TEETH — PAIN — upper left — cold air — aggravates — warmth — ameliorates. — Neuralgic odontalgia.

Heart / Chest

• HEART — PALPITATION — least motion — aggravates — visible — with. — Hallmark Spig.
• HEART — PAIN — stitching — precordial — left — motion — aggravates — touch — aggravates. — Cardiac stitch quality.
• HEART — LYING — left side — aggravates; LYING — right side — ameliorates; HEAD — high — ameliorates. — Posture law.
• CHEST — INTERCOSTAL NEURALGIA — left — motion — aggravates — pressure (firm) — ameliorates. — Chest wall thread-pain.

Respiration / General

• RESPIRATION — DIFFICULT — exertion — on — must sit up — head high. — Orthopnoea of cardiac type.
• GENERALITIES — MOTION — aggravates — slightest. — Global Spig. modality.
• GENERALITIES — COLD AIR — aggravates; WARMTH — dry — ameliorates. — Thermal polarity.

Sleep

• SLEEP — POSITION — right side — on — ameliorates; left side — on — aggravates — palpitation. — Night management rubric.
• SLEEP — STARTING — first sleep — palpitation — with. — Onset fragility.

Hahnemann — Materia Medica Pura / Chronic Diseases (early 19th c.): primary proving threads—neuralgic stitches, left hemicrania, cardiac posture rules.
Hering — The Guiding Symptoms of Our Materia Medica (1879): left-sided supraorbital/trigeminal pains; ciliary neuralgia; cardiac motion-intolerance; modalities.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): eye-movement <; thread-like neuralgia; worm/abdominal notes; cardiac palpitation.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): angina/pericarditis picture; posture (right side, head high); neuralgia differentials.
Kent, J. T. — Lectures on Homoeopathic Materia Medica (1905): Spig. cardiac mechanics; motion-worse law; comparisons with Cactus, Digitalis, Kalmia, Naja.
Farrington, E. A. — Clinical Materia Medica (late 19th c.): heart and neuralgia comparisons (Cedron, Kalmia, Cactus); left-sidedness.
Nash, E. B. — Leaders in Homoeopathic Therapeutics (1907): practical keynotes—thread-like pains; better after perspiration; cardiac posture.
Boericke, W. — Pocket Manual of Homoeopathic Materia Medica (1901): cannot lie left; visible palpitation; supraorbital neuralgia.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): intercostal neuralgia; firm bandaging; modality grid.
Hughes, R. — A Manual of Pharmacodynamics (1870s): drug background, toxicity; stimulants aggravate.
Tyler, M. L. — Homoeopathic Drug Pictures (1942): ciliary/trigeminal portraits; bedside posture-management.
Dunham, C. — Lectures on Materia Medica (1870s): neuralgia teaching points; posture and rest.
Phatak, S. R. — Concise Materia Medica (1977): compact keynotes—left-sidedness; motion-worse; cardiac stitch.