Materia Medica

Sepia – Farrington

Sepia
sep

Belonging to the Mollusca is an animal called the SEPIA, or cuttlefish. A hard calcareous substance belonging to the cuttle-fish is, you all know, used for the feeding of birds. The animal itself possesses a little sac or pouch which contains a dark brown, almost black fluid. When pursued by larger fish, it ejects this fluid, thus clouding the water and protecting itself from its foe. This was for a long time. supposed to be the only use of this fluid. It was supposed to be entirely inert when taken into the human system. Since Hahnemann’s experiments have shown the fallacy of this belief, it is safe to suppose that the cuttle-fish uses it also to kill the smaller fry upon which it itself preys. The name Sepia is the common term used to designate this remedy in our materia medica, the juice just referred to being the part employed. This juice is very much used by artists. The history of the introduction of this substance into our materia medica is as follows: Hahnemann had a friend who was an artist, who became so ill that he was scarcely able to attend to his duties. Despite Hahnemann’s most careful attention, he grew no better. One day, when in his friend’s studio, Hahnemann observed him using the pigment made from the Sepia, and he noticed also that the brush used was frequently moistened in the artist’s mouth. Immediately, the possibility of this being the cause of the illness flashed across Hahnemann’s mind. He suggested the idea to the artist, who declared positively that the Sepia paint was absolutely innocuous. At the physician’s suggestion, however, the moistening of the brush in the mouth was abandoned and the artist’s obscure illness shortly passed away. Hahnemann then instituted provings with the Sepiae succus. All the symptoms observed by him have since been confirmed. In 1874, the American Institute of Homeopathy, acting under the notion that our old remedies should be reproved, performed this task for Sepia. There were made some twenty-five provings of the drug in from the third to the two-hundredth potencies. These were reported at the meeting of the Association in 1875. They testify to the fact that the provings left us by Hahnemann cannot be improved upon.

Sepia is a remedy of inestimable value. It acts especially on the female organism, although it also has an action on the male. It is particularly adapted to delicate females with rather fine skin, sensitive to all impressions, usually with dark hair, although not necessarily so; the face is apt to be sallow, and the eyes surrounded by dark rings.

It acts upon the vital forces as well as upon the organic substances of the body. It very soon impresses the circulation; which becomes more and more disturbed as the proving progresses. Even as early as the fourth hour there are developed flushes of heat and ebullitions. These flushes end in sweat, with weak, faint feeling. Any motion or exertion is followed by hot spells and free sweats.

Hand in hand with this orgasm is an erethism of the nervous system, causing restlessness, anxiety, etc.

These two sets of symptoms indicate the disturbing influence of the drug upon the nervous system of animal life, and also upon the vasomotor nerves. Thence arise headaches, various local congestions, etc.

Quickly following these symptoms are those marked by relaxation of tissues and nervous weaknesses. The prover becomes languid, prostrated, faint. The joints feel weak as if they would easily become dislocated. The viscera drag, and thus originate the well-known goneness, etc. Venous congestions still continue, and, indeed, from vasomotor weakness, increase. The prolapsed uterus becomes more and more engorged, the portal stasis augments, and the liver is heavy and sluggish. The bloodvessels are full, and the limbs, hence, feel sore, bruised and tired. The general depressing influence upon the vital powers is further displayed in great weakness, faintness, trembling. Limbs feel heavy as if paralyzed; stiffness and unwieldiness of the legs, especially after sleep.

The sphincters, as well as all structures depending for power upon non-striated muscles, are weak. Hence the rectum prolapses, evacuations of bowels and bladder are tardy and sluggish, etc.; and yet there is no complete paralysis.

Organic changes are produced as exhibited in the complexion, which is yellow, earthy; in the secretions, which are offensive, sour, excoriating, etc.; in the condition of the skin, which has offensive exhalations, and is disposed to eruptions, discoloration, desquamation, ulcers, etc.

Among the conditions which modify the Sepia case, none is so important as the effect of motion. Two or three provers experienced decided relief of the symptoms (one prover excepting horseback riding) from violent exercise. But many symptoms are made worse from exertion; how, then, are we to discriminate? Since many of the symptoms arise from lax tissues, with torpidity, and, above all, with surcharged veins, exercise, by favoring the return of blood to the heart, relieves. The aggravation from horseback riding or from the motion of a ship, since it jars the sensitive parts and even tends to increase venous fulness, necessarily augments the troubles. But the headache, faint, exhausted condition, the sacro-lumbar pains, and often, too, the. prolapsus uteri, are naturally intensified by walking.

Briefly, it has been found that Sepia acts well in men, or, more often, in women who are puffed or flabby, less frequently emaciated; who have a yellow, or dirty yellow-brown blotched skin; who are inclined to sweat, especially about the genitals, armpits and back, suffer with hot flashes, headaches in the morning, awaken stiff and tired, and are the subjects of diseases of the sexual organs. The man has sexual erethism, but without energy; and coitus induces great exhaustion (neurasthenia). The woman is erethistic, with hysteria, or with prolapsed uterus, palpitation, orgasm of blood, faintness, etc. In both cases, there may be portal stasis, with imperfectly acting liver, with atonic dyspepsia, sluggish bowels, uric acid deposit in the urine, and attending evidences of impaired digestion and assimilation. The general attitude is never one of strength and healthful ease, but rather of lax connective tissue, languor, and easily produced paresis.

It is to be further remembered that the Sepia symptoms are notably worse in the forenoon and evening, the afternoon bringing a time of general mitigation. Of this fact there are numerous confirmations.

We are prepared to review the symptoms in detail, and determine if they sustain the assertions thus far made.

To understand the symptomatology of so large a medicine as Sepia, it having in its pathogenesis some two thousand symptoms of more or less importance, we will consider the action of the substance as it affects the various tissues. First of all the blood. Sepia causes great disturbance in the circulation; many of its symptoms seem to depend upon venous congestion, and this is especially noticeable in the portal circulation. Reviewing some of the symptoms based on this pathological condition, we find, flashes of heat which seem to begin about the trunk and go upward to the head, with anxiety, and, of course, an oppressed feeling, ending in perspiration; throbbing all over the body, particularly at the epigastrium, in the hepatic region, in the uterine region, and in the small of the back. This symptom is very common in hysteria and in chlorosis. Nosebleed, epistaxis so called, either from mechanical causes as a blow or fall, from being in a hot room, or from suppressed menses. Throbbing pain in the uterus, the uterus when examined is found to be swollen, engorged with blood, sensitive to the touch, and as we shall see when speaking of the local symptoms, displaced. The hands are hot, and the feet are cold; or, as soon as the feet become hot the hands become cold. This is an excellent indicating symptom for Sepia.

Now we look at the symptoms of the skin. Again, we find its action owing to the defective venous circulation. We know that when the vaso-motor nerves are inactive, the skin is more liable to the effects of irritation, and particularly to herpetic eruptions, and it is particularly herpetic eruptions which Sepia cures. Little vesicles form, particularly about the elbow and knee joints. Ulcers may form about the joints, particularly about the joints of the, fingers. Under Sepia these are generally painless. There are only two other remedies that I know of that have this symptom, and they are BORAX and MEZEREUM. Sepia has been suggested as a remedy in herpes circinata. Sepia also causes yellow-brown spots, itching, redness, vesicles, humidity and rawness, scaling, pustules. The warm room makes the urticaria patient feel comfortable; but the warmth of the bed aggravates the pricking of the skin.

Sepia stands well in the treatment of psoriasis, though inferior to ARSENIC and ARSENICUM IODATUM.

These yellow-brown spots have also been removed by LYCOPODIUM, NUX VOMICA, and SULPHUR. CURARE is used by Dr. Baruch, of New York.

Besides Sepia, CALCAREA OSTR., BARYTA CARB., and TELLURIUM, have been recommended for ringworm. BARYTA CARB. has never been successful in my hands.

TELLURIUM is useful for ringworms which seem to come in clusters.

In scabies Sepia is indicated after Sulphur, when pustules intersperse the itch vesicles.

Sepia has a marked action on the connective tissue, weakening it, and thus producing a great variety of symptoms. Thus, there is weakness of the joints, which give out readily when walking; weakness about the’pit of the stomach, which is not relieved by eating. This effect of Sepia may be utilized in cases in which the joints are readily dislocated.

Now, taking up the organs SERIATIM, we find Sepia to have a marked action on the mind. It produces a mental state which is quite characteristic, and which ought to be present when Sepia is the remedy. The patient, usually a woman, is low-spirited, sad, and cries readily. This sadness is usually associated with irritability. It will not do to find fault with the Sepia woman. At other times she manifests a condition of perfect indifference. She does not care for her household affairs or even for her own family.

This mental state of Sepia is to be distinguished from that of PULSATILLA, NATRUM MUR. and CAUSTICUM. PULSATILLA, however, is the nearest analogue. Both it and Sepia develop a state of weeping, anxiety with ebullitions, peevish ill-humor, solicitude about health, etc. But only Pulsatilla has the mild, yielding, clinging disposition seeking consolation ; but it lacks the angry irritability and the cool indifference of Sepia.

NATRUM MURIATICUM is complementary to Sepia; they agree in causing weeping mood, depression of spirits, persistent recalling of past unpleasantness, irritability, indifference, loss of memory, and alternation of mental states. The former has prominently, “worse from consolation.” Clinically, we may say the same for Sepia. Both remedies, too, have ailments aggravated by vexation or anger. The two are evidently similar in causing weak and irritable nerves, but their complemental relation consists in the fact that Sepia causes the most vascular erethism; hence it is that under Sepia, disturbed feelings induce congestion to the chest and head, animated conversation causes hot face, and sweats follow excitement. In Natrum mur., the symptoms point more to nervous excitement or weakness alone, hence emotions induce tense headache, animated talking and drawing up the spine, and unpleasant thoughts cause sadness, paralytic weakness, or irritability without ebullitions. If hypochrondriacal, it is a state of melancholy from mental depression, caused by inert bowels; while in Sepia the same state depends also upon portal stasis, and therefore is more persistent and associated with more irritable temper. Natrum mur. may be called for when the mental state depends upon uterine disease or menstrual irregularity, but this will only be a prolapsus, never the uterine engorgement of Sepia. The indifference of Natrum mur. is born of hopelessness and mental languor; while that of Sepia includes an undisguised aversion to those nearest and naturally dearest.

CAUSTICUM induces sadness, especially before the menses. The face is yellow; but the anxiety is more a timid, fearful state. She is full of forebodings. She dreads the possibility of accidents to herself and others.

LILIUM TIGRINUM stands very near to Sepia. It affects the circulation, particularly the venous, and as reflex from uterine and ovarian irritation, there are, nervous irritability, must be busy, yet cannot do much; hurried manner. Depressed, full of apprehension of incurable disease, of accidents, etc. Feels that she will go crazy, weeping mood.

There is, however, an essential difference in this, that the Lilium patient finds relief in diverting her mind by busying herself; while the Sepia patient has many nervous symptoms relieved by violent exercise. It is, in the former’ case, a sexual erethism which is thus relieved ; in the latter, relief is general by favoring venous circulation, nervous erethism being but slight, and being associated with lessened venereal passion.

HEPAR develops a mood which it may not be inappropriate to consider: Sadness, unpleasant events return to mind; sad evenings, even to thoughts of suicide; peevish; the slightest thing makes him break out into violence; he does not wish to see the members of his own family.

But this latter condition is not quite the indifference of Sepia. It arises more from a contrary mood. And, further, only Hepar has such violent outbursts of passion.

PLATINA is similar in its depressed moods. “Indifference; he does not seem to care whether his absent wife dies or not.” But the digression is into haughtiness; or into anxiety, with fear of imminent death; or into that contracted mental state, akin to the feeling of personal superiority, in which “everything seems too narrow; with weeping mood.” And, besides, as we shall see anon, the uterine symptoms differ materially.

Let us now consider the head symptoms of Sepia. There is a disease of the head called hemicrania, for which Sepia is one of our main remedies. The symptoms which indicate it here are the following: Pains over one eye (it may be either) of a throbbing character, deep, stitching pains which seem to be in the membranes of the brain, and these pains almost always shoot upwards or from within outwards. The patient can bear neither light, noise or motion. Usually, with women, there are soreness of the face and disturbance of uterine position or of menstruation. We find, too, that the patient may have a jerking of the head backwards and forwards. This has been utilized in nervous women (with hysteria for instance), and also in children with open fontanelles. In this case you should not give SULPHUR, CALCAREA, or remedies of that type. Sepia is also useful in arthritic headaches, especially when, like those of NUX VOMICA, they are worse in the morning, with nausea and vomiting. The liver is of course affected, and the urine is loaded with uric acid.

In hemicrania you may compare Sepia with BELLADONNA, SANGUINARIA, IRIS VERSICOLOR, PULSATILLA, NUX VOMICA and THERIDION.

BELLADONNA is to be selected in hemicrania when there is violent hyperaemia, with throbbing carotids, red face, intolerance of the least jar, light, or noise. It is indicated you will see in plethoric patients, and not in the cachectic as with Sepia.

SANGUINARIA produces a right-sided headache, the pains coming over from the occiput. They increase and decrease with the course of the sun, reaching their acme at mid-day. The paroxysms end with profuse urination (as in SILICEA, GELSEMIUM and VERATRUM ALBUM). They recur every seven days. Sanguinaria also has a menstrual headache which attends a profuse flow. In Sepia the menses are scanty. In Sanguinaria the pains are on the right side; in Sepia they may occur on either.

You will use IRIS VERSICOLOR in hemicrania when the attack begins with blurring of sight and the paroxysms are attended with sour, watery vomiting. The pains involve the infra-orbital and dental nerves, with stupid or stunning headache.

PULSATILLA is very similar to Sepia. Both are indicated with scanty menses, bursting, throbbing or boring, stitching pains on one side of the head, obscuration of sight, white tongue, nausea and vomiting. Pulsatilla has the most vomiting, thickly-furred tongue with clammy mouth and relief from cold air. The pains are shifting in character, and are associated with chilliness. They are worse in the evening. In Sepia, the pains recur in shocks or flashes, with proportionate increase of heat in the head; the blurring of sight is associated with heavy eyelids; and the face, though red with headache in either remedy, is ordinarily yellow with Sepia and pale with Pulsatilla.

NUX VOMICA is more suited to men than is Sepia. It cures a drawing, aching feeling as of a nail driven into the head, or as if the brain were dashed to pieces. The face is pale sallow, or sallow on a red ground. The attacks commence early in the morning, and generally increase to a frantic degree. As under Sepia, the exciting causes may be haemorrhoids, abdominal plethora, or brain fatigue. In general, however, the two drugs are very different.

ARSENICUM ALBUM will cause a throbbing, stupefying headache over the left eye. In this particular it resembles Sepia; but the prostration and restlessness of the two drugs are very different, as is also the intensity of the angry irritability, even to swearing, which Arsenicum induces. The Arsenic headache exceptionally derives a temporary relief from the application of cold water to the head.

THERIDION has, more accurately speaking, flickering before the eyes, then blurring. The nausea of this remedy is made worse by closing the eyes, and also by noise. The effect of noise is more intense than in Sepia. It seems to intensify the pains, and, as it were, penetrates to the teeth, so sensitive are the nerves to this sort of vibration.

Sepia is very useful in diseases of the eyes. You will find it indicated in asthenopia attending uterine diseases. You may differentiate Sepia from other remedies by the time of its aggravation, the patient generally being worse in the evening; in the morning and afternoon she is quite free from symptoms.

In conjunctivitis you will find Sepia indicated when the inflammation is of a sluggish type, occurring generally in scrofulous children. The symptoms are subacute. There is muco-purulent discharge in the morning. The eyes feel comparatively comfortable during the day, while in the evening there is an annoying dryness of the eyes.

The remaining eye-symptoms of Sepia we may summarize as follows: Cataract; trachoma; scaly lids; pustular lids with eruptions on the face; eyes irritable to light, lids close in spite of him; eyelids droop; aching, sticking pains, worse by rubbing. Causes: Uterine or liver diseases, scrofula, tea-drinking. Worse morning and evening, in hot weather, better from cold washing, and in the afternoon.

I have for years employed Sepia in blurring of sight, etc., with prolapsus uteri. (See also, Norton’s OPHTHALMIA THERAPEUTICS.) I have likewise found it efficient in asthenopia, associated with exhaustion dependent upon loss of semen, whether of voluntary or of involuntary occurrence. In these respects the drug is similar to NATRUM MUR., LILIUM TIG., JABORANDI, KALI CARB. The first of these superadds muscular weakness (internal recti), stiff sensation in the muscles of the eyes on moving them, etc. There is running together of letters or stitches, but not the sudden vanishing of sight so marked in Sepia.

LILIUM TIGRINUM causes smarting of the eyes; blurring with heat in the eyelids and eyes; sharp pains over the left eye, thus symptomatically resembling Sepia. It has also burning, smarting in the eyes after reading, better in the open air, like Pulsatilla. Spasm of accommodation. (Study JABORANDI.)

CYCLAMEN and PULSATILLA may also be considered with Sepia in sudden vanishing of sight; the first with profuse and dark menses, the second with scanty dark flow. But the Cyclamen blindness accompanies a semi-lateral headache of the left temple, with pale face, nausea referred to the throat, and weak digestion.

Under PULSATILLA, which you may also use in conjunctivitis, there is a discharge, of muco-pus, but it is bland and is worse at night, with agglutination of the lids in the morning. There are fine granulations on the lids. The patient is subject to repeated highly-inflamed styes.

GRAPHITES you may employ when the canthi crack and bleed, and the edges of the lids are pale and swollen as well as scaly.

THUJA is indicated in eye affections of tea-drinkers. Brown, branlike scales accumulate about the cilia, and there are little tarsal tumors like warts.

NUX VOMICA will be called for in eye affections associated with liver diseases. The symptoms are worse in the morning, and some of them are relieved by cold bathing.

NATRUM MUR., like Sepia, is indicated in eye affections reflex from uterine disease; the lids droop. But under Natrum mur., there is more spasmodic closure of the lids in conjunctivitis, the discharges are thin and acrid; there are cracks in the canthi and also in the corners of the mouth; pains over the eyes worse when looking down.

ALUMINA likewise has falling of the lids, dryness, burning, dim sight; but Alumina has aggravation in the evening and at night. The inner canthi are affected.

Next, the action of Sepia on the abdominal organs: We find it indicated in the form of dyspepsia mentioned a few minutes ago, and also in the dyspepsia incident to uterine diseases, when it is associated with a gone, empty feeling in the epigastrium or the abdomen, Avith sour or bitter taste in the mouth, and with longing for acids, pickles, the gratification of the appetite for which seems to relieve these symptoms. The tongue is coated white, the bowels are usually constipated, the stools being hard, dry, and insufficient, or even if not indurated, are expelled with difficulty. The abdomen is swollen, and distended with flatus; and there is almost always soreness in the hepatic region. On making a physical exploration, you find the liver enlarged, not from fatty or amyloid degeneration, but from congestion.

Haemorrhoids are also an indication for Sepia when there is bleeding at stool, with a feeling of fulness in the rectum as though it were distended with some foreign material, which seems to excite an urging to stool. The urine has a peculiar foetid odor, and is very turbid. When standing, it deposits a lithic acid sediment, which adheres quite tenaciously to the side of the vessel.

LYCOPODIUM is a very worthy rival of Sepia in the condition just described. The distinction between the two remedies may be given you in a very few words.

A sensation of emptiness in the epigastrium is more charapteristic of Sepia; repletion after eating, of Lycopodium. Indeed, with the last-named, the repletion overshadows the other symptoms, often existing without any alterations in the appearance of the tongue. Sour taste and sour or burning eructations are, however, very common.. The abdomen is in a state of ferment. After eating, the circulation is disturbed, with irresistible drowsiness. The urine contains a sediment of free red sand. The bowels are constipated with urging and constriction of the anus. The urine, however, is not so offensive as under Sepia.

SULPHUR resembles the Sepia in many respects. Both are suited in torpid cases with defective reaction. There are abdominal plethora, congested liver, piles, constipation, hunger about 11 A.M. ; bitter or sour taste; eructations, sour or tasting like bad eggs; fulness from little food, etc. In Sulphur the face is more blotched, red, and at times spotted. Saliva nauseates him. He vomits food. He craves brandy or beer and sweets, but the latter disagree. He experiences hunger at 11 A.M.; while in Sepia it is more of a gone, faint feeling. The constipation is attended with ineffectual urging like NUX VOMICA.

For gone, empty feeling in the epigastrium, compare Sepia with CALCAREA OSTREARUM, COCCULUS, KALI CARB., STANNUM, IGNATIA, CARBO AN., SARSAPARILLA, NICCOLUM, OLEANDER, IPECAC, THEA, STAPHISAGRIA, ACTEA RAC, and HYDRASTIS.

COCCULUS has the weakness extending all over the abdomen and chest. It tires her to talk. The feeling is renewed by over-exertion and especially by loss of sleep.

KALI CARB. has empty feeling before eating, out of proportion to the feeling of vacuity caused by hunger, with undue bloating after eating, especially after soup in small quantity.

Under STANNUM, the sensation continues after eating, and extends all over the chest.

With IGNATIA, it is attended by sighing.

Under CARBO ANIMALIS, it arises from loss of vital fluids.

SARSAPARILLA has it associated with rumbling in the abdomen. NICCOLUM, without desire for food.

OLEANDER, with sensation of distended abdomen; the chest feels empty and cold.

ACTEA RACEMOSA is excellent when, with the faint, empty feeling in the epigastrium, there is a trembling, wavy sensation proceeding from the stomach over the body.

HYDRASTIS relieves when there is sinking sensation, palpitation of the heart, and mucus-coated stools.

THEA produces a gone, faint feeling; sick headache radiating from one point, and pains in the left ovary.