-GEORGE VITHOULKAS
English: Angustura bark
French: Angusture vraie; Ecorce de Bonplandia trifoliata; Ecorce d’Angusture
German: Angustura rinde
Italian: Angustura
Danish and Swedish: Angusture
Spanish: Quina de Carony
The essential features
Angustura vera has come down to us as a remedy for rheumatic conditions with fatigue and stiffness of the extremities bordering on paralysis. In our texts it is said: “He does not have confidence enough in himself to undertake and perform voluntary motions.” There is a tendency in these patients over several years to progressively develop paralytic stiffness and weakness; the rheumatic complaints tend towards a paralytic state. There is stiffness and tension or a drawing feeling in the joints and muscles, with crackling of the joints.
Some characteristic symptoms or conditions seen in this remedy are: torticolis (drawing of the head to one side), tetanus and tetanic spasms with aggravation from touch, “lock-jaw where the lips are drawn back, showing the teeth;” twitching or jerking in the muscles, worse from touch and noise; electric shocks.
Angustura individuals are overly excitable, overly vivacious people whose strong emotions border on hysteria. Their entire nervous system seems to be in a state of uncontrollable oversensitiveness and excitability. Their will appears to be paralysed; they are unable to bring it to bear to control this exaggerated excitability, an excitability which is especially provoked by the slightest offence (Nux vomica ) or trifle. Offences which would leave anyone else unaffected aggravate these people tremendously. They lose all control if anyone offends or criticizes them.
These lively individuals are very animated when engaged in conversation; they display a great flow of ideas, much as does Coffea. They look cheerful, gay and happy; however, behind this external appearance there is a feeble and effeminate nature lacking in stamina and steadiness, devoid of any real will power or tenacity.
They possess a good and lively mind, especially in the afternoon, but again without stamina. They are so mentally and emotionally excitable that they can reach states resembling ecstasy or hysteria. Their imagination can be vivid, the exaltation of their mind tremendous, but it should be understood that behind this apparent vivacity there lies a weak mind.
Their thoughts easily wander. In our texts we read: “feels cheerful and lively when performing no intellectual labor, but becomes dizzy when reading.” They can become very easily excited about a certain project, and they possess the creativity to envision the project in their mind, but they lack the intellectual power and endurance to concentrate enough to bring it to fruition. They will think and think, conjuring up great accomplishments for the future, but the next day they will do nothing about it. They theorize rather than actually perform.
The stiffness of the joints, the pains and the tension induce restlessness, similar to that of Rhus toxicodendron although to a lesser extent, and this physical restlessness is akin to an Angustura mental dynamic – while mentally excited, they cannot maintain their concentration on one project; many ideas come and go in their mind. In our texts it says: “feels unable to dwell upon his subject, owing to some internal uneasiness, such as is experienced by those who anticipate some great pleasure, or also owing to all sorts of plans crowding upon his mind.” It is interesting to note that this syndrome is strikingly similar to Coffea cruda. Indeed in Angustura vera we see a tremendous craving for coffee. It is when the Angustura mind begins to function even less optimally, with sluggishness and confusion, that the craving for coffee increases as a means of maintaining the pleasant excitability of the mind. Crude coffee has a strong effect on this remedy, bringing about a pleasant excitement; it also antidotes the treatment promptly. These patients are very sensitive to coffee.
In the sexual sphere there is easy excitement and strong desire, but the male is not highly potent. In the female we see violent sexual desire with involuntary orgasms.
Angustura vera is characterised in its emotional sphere by great touchiness. The main keynote in this sphere is a tremendous sensitivity to any kind of criticism causing these persons to immediately take offense at even the slightest remark. The same idea is encountered when the peripheral nervous system is affected with jerkings or spasms and the patient cannot bear to be touched because of the resulting aggravation of the spasms. There is such an emotional touchiness that if somebody makes the least remark against them, they will be devastated and unable to forget it for several days.
In our texts we read: “He keeps bitter feelings for even a slight offence.” Some authors refer to Angustura as resembling Nux vomica because of the similarities between both remedies, including the tendency to take offence easily. Upon analysis of its mental-emotional structure, however, we see that Angustura is totally different from Nux vomica. It lacks the boldness and the “male” irritability of Nux vomica ; in fact, Angustura patients are timid and will not defend themselves. There is an element of cowardice in them deriving from the fact that they are faint-hearted, effeminate, and feeble. They more resemble the Staphysagria personality, but without the tendency to suppress emotions; they are more likely to express them, especially when they feel they are among friends. The irritability is more a form of annoyance than real irritability.
Whereas at one stage of pathological evolution Angustura patients may display overstimulation of the mind and the overexcitement that accompanies it, there is another stage in which they become dissatisfied, displeased, and a form of restlessness and discontent prevail. Subsequently they become absentminded and begin to have difficulties in concentration. Mental confusion supervenes, similar to the effects of intoxication. If they try to exert their mind by studying or even reading, they feel confused – aggravation from mental exertion. The mental state is one of dullness, sluggishnessss, difficulty of thinking and comprehending, all worse in the afternoon. They become serious and averse to telling or hearing jokes. Eventually they feel as if they are living in a dream. They completely lose their self-confidence and become easily discouraged and irresolute, unable to decide what they want in life. They become fearful about little things, taking alarm very easily, and extremely suspicious. They may even suffer delusions. They may come at last to loathe life.
Generalities
General weakness and stiffness as if the marrow of the bones were stiff.
Paralysis of different parts. Tension of muscles while walking feels as if limbs were paralysed. Cracking of all joints.
Tetanic spasms aggravated by touch and by drinking lukewarm water.
Caries and painful ulcers of long bones that perforate them. Flushes of heat with perspiration and anxiety. Orgasm of blood in sleep in the morning. Desire to stretch. Electric-like shocks.
Standing ameliorates symptoms.
Angustura in high potencies 30 or 200 could be used in some cases of Rhus-tox. poisonings where Rhus-tox. symptoms are appearing but not responding to high potencies of Rhus-tox.
Bruised sore feeling as after a blow. Twitching or jerking of muscles, excitability to touch and noise, catalepsy.
Vertigo
Has a vertigo which is very similar to the one we see in Argentum nitricum:: when crossing a bridge and seeing running water. Even has vertigo while walking near running water. Vertigo or dizziness while reading
Head
In the head we have certain keynotes such as: Pain in the head at twilight. Headache alternating with asthma. Pressing headache in occiput in the afternoon.
Pressure in both temples, as if about to faint. Migraine. A stitch as from electricity darting up and down from the temples. Tensive pain in the temporal muscles, when opening the jaws; drawing headache in morning. Shooting headache extending from temple to temple and up and down. Headache is ameliorated on falling asleep.
Raising head ameliorates headache. Air ameliorates headache. Headache in temples is ameliorated from stooping. Laying head on table ameliorates the headache.
Twitching of muscles on the sides of the head. Dizziness in the open air. Head is drawn sideways, first to the right then to the left. Feeling of heat in head during headache. Heat at night; in bed.
Eye
Agglutinated in the morning and also in the night. Redness. Contraction of pupils, dilatation of pupils. Burning, smarting, pain from canthi in the evening. Pressing pain in the evening. Tension and pressure in the morning as if the light was too strong. Vision is acute. Objects seem too far distant must bring them closer. Feeling of dryness under the upper lids.
Ear
Transient drawing several times, now in the right, now in the left ear. Sensation as if something was placed in front of ears. Tearing in a boil over the right mastoid process. Very painful tearing in the interior of the right ear. Heat in ear and both cheeks. Noises in right ear. Ringing in right ear. Stitching in; pinching in ear. Tearing pain in front of ear. Hearing impaired; acute.
Nose
Pain in nose on biting. Smarting, sore feeling deep in the nose.
Face
Pain in the masseter muscles of the cheek, as if he had chewed too strongly and had tired them. Drawing in the facial muscles. Acute pains in both cheeks, occasionally darting through eyeballs and temples, aggravated on stooping, stepping, or by mental excitement. Trismus neonatorum in cases where much mercury had been given. Exostosis of lower jaw. Feeling of heat in both cheeks, without externally perceptible warmth. Cramp-like pain in malar bone. Cramp-like pain near the articulation of the jaw, in the masticator muscles. Sensation of heat on lips. Great dryness of the lips. Itching of cheeks.
Mouth
White; pale discoloration of tongue. Dryness without thirst. Dryness of the mouth and lips. Dryness of tongue at night. Tip of tongue feels burning, raw and smarting as from pepper. Roughness of palate; tongue. Saltish or sour salivation.
Bitter taste after smoking and after dinner. Bread tastes sour. Ulcers on gums. Caries. Toothache in incisors; molars; upper teeth; lower teeth. Cold finger applied ameliorates toothache. Pulsating; drawing pain. Drawing pain from cold ameliorated by finger.
Throat
Mucus in trachea. Tickling in larynx; in trachea. Hoarseness of voice from mucus in the trachea. Low voice.
Stomach
Emptiness, faintness, hungry feeling after siesta. Painful tension at the pit of the stomach. Desires coffee. Desires cold drinks; liquid food; desires also warm drinks but has pains after warm milk. Stitching or cutting pain after warm milk. Thirst during heat. Sensation of thirst without desire to drink. Increased appetite.
Appetite wanting at noon. Aversion to fats and rich food; pork; solid food; meat.
Nausea while walking in open air. Pain while exercising. Gastric derangements, indicated by acidity, coated tongue, pappy, unpleasant taste and loss of appetite.
Abdomen
Pain in umbilicus extending to sternum or to chest. Milk brings about pain, especially warm milk. Rumbling before diarrhoeic stool. Cutting pain in hypogastrium; liver. Distension of belly.
Rectum
External hemorrhoids. Large hemorrhoids. Diarrhea in daytime. Diarrhoea day and night. Chronic diarrhoea, with debility and loss of flesh. Costiveness. Pain, tenesmus during stool. It has all kinds of stool : hard, knotty, nodular, lumpy; mucous, slimy; soft, thin, liquid, watery, white, yellow.
Urinary organs
Frequent urging to urinate with scanty evacuation. Desire to urinate even immediately after urination. Tenesmus. Dysuria. Pale color of urine. Burning.
Cloudy urine on standing. Black; dark; white; yellow, light, orange color. Colorless; copious; scanty. Amorphous sediment.
Genitalia-male
Voluptuous itching of the tip of the glans, which forces one to rub. Itching of penis; of scrotum; of the whole area in genitalia. Drawing pain in spermatic cords; in left testes. Jerking pain in spermatic cord. Shivering.
Genitalia-female
Violent desire with involuntary orgasms. Milky leucorrhea. Pressing pain in right ovary. Sensation as if the uterus is beating against the right ovary.
Chest
Irregular, convulsive respiration. Intermitting spasmodic breathing.
Arrested respiration. Asthmatic respiration alternating with headache. Rattling respiration while walking in open air. Tickling in larynx from cough. Cutting, stinging sensation in larynx from cough. Irritation and pain in larynx from coughing. Whooping cough. Cough with belching. Cough in the daytime; at 3 p.m. ; in open air; while walking in the open air; hacking cough while walking fast in open air. Violent cough. Constriction, tension, tightness. Oppression, tension, tightness on ascending or while walking quickly. Pressing pain in sides of chest during expectoration. Pressure in upper part of chest, like after violent running.
Cutting pressure in both sides of the chest, first only during expectoration; afterwards changed to cutting thrusts, which continue even on holding the breath.
Heart feels suddenly swollen with great fear of dying. Violent palpitation of heart while sitting and leaning forward. Sensation of painful contraction of the heart. Pain in chest on exertion of arms. Motion aggravates the constriction felt in chest. Spasms of chest.
Back
In the back we see pains, twitchings, quiverings etc. The peripheral nervous system seems excitable, always worse with touch. Sensation of tremulousness and uneasiness in muscles of back. The cervical region is primarily affected with drawing pains and stiffness worse raising arms. There is a peculiar quivering in cervical region. Spinal irritation; in cervical region. Painful heaviness of cervical region on waking up in the morning while still in bed. Pains in cervical region extending to the jaws. Back feels as if it is broken in the lumbar region in the morning in bed. Pain in sacrum in bed, at night is ameliorated by rising and walking. Drawing pain in dorsal region between scapulae in the morning in bed. Lameness in lumbar region on stooping. Twitchings like electric shocks. Pain in dorsal region between scapulae. Pain in spine. Pain feels as if cervical region were dislocated when lifting arm. Drawing in the neck.
Extremities
In the extremities we see the potential for paralysis more than actual paralysis. Cramps, heaviness and weakness manifest frequently. Paralysis of the joints of feet.
Cracking in all joints is also characteristic. If he walks a bit more than normal there is easy fatigue and a heaviness in thighs, a kind of paralytic weakness.
After great exertion in posing for an artist, in a difficult position with uplifted and stretched arms, a weakness in arms, disabling him for any work; complained of a stiffness in elbow joints and lamy heaviness of arms. Heaviness in upper limbs; numbness. Hip joint disease. Cramps in knee while standing, while walking.
Pains in the knees. Nosodes on legs and feet. Drawing pains in all extremities.
Jerking stitches in the left thigh, and in the upper border of the ilium, extremely painful, and felt only when sitting. It is a remedy that strongly affects the joints causing easy inflammations. Abscess in ankle joint. Eruptions on foot. Exostoses on tibia. Caries of long bones that perforate them right through to the marrow.
Coldness of the fingers.
Sleep
Many dreams. Unpleasant; vivid; weeping dreams. Sleepiness in the forenoon while reading; while sitting. Sleeplessness. Frequent waking. Spasmodic yawning in the morning.
Fever
Chill at 3 p.m. Chill at 9 a.m. Quotidian. Periodicity regular and distinct.
Chilliness in the morning; on waking. Chill in hot weather, in the summer.
Touch aggravates chill. Chill is ameliorated in the open. Fever at night, 3 a.m. with or without chill. Fever without chill. Fever in the evening after eating.
Fever alternating with chills at night. Warm room aggravates fever.
Coldness, followed by heat same day; recurring now in evening, then at noon, then in morning, with thirst in beginning of fever and vomiting of bile; after traveling through swamps in a hot climate.
Skin
Caries and very painful ulcers that affect the long bones. Goose flesh. Tubercles.
Voluptuous itching of the tip of the glans, which forces one to rub.
Clinical
Arthritic and paralytic conditions. Bone pains. Caries. Diarrhea. Injuries. Intermittent fevers. Myopia. Tetanus.
Relationships
Compare: Ruta, Rhus toxicodendron, Coffea, Ignatia, Nux vomica, Mercury, Silica, Natrium muriaticum, Pulsatilla, Ranunculus bulbosus.
Remedies that follow well: Belladonna, Ignatia, Lycopodium and Sepia
Antidotes
It is antidoted by: Coffea, Bryonia, Chelidonium.
Dosage
From the lowest to the highest.
Cases
1. Stiffness in the elbow joint and paralytic heaviness in arms making him unfit for any kind of work, in consequence of holding the arm for a long time upwards during sitting as a model for a picture. A great many things have been applied without benefit. Angustura 3x gave great relief at once and cured in two weeks by taking five globules night and morning that length of time. -Dr. Landesmann
N.M. Choudhury, A Study on Materia Medica, p. 42
2. A lady ran a pin in to her foot; two weeks after she was taken with tetanic pains, striking from the point injured to the back of the heel, then up the limb and up the back; she had darting spasmodic pains from the nape of the neck to the jaws, both sides; jaws stiff not closed; the pains began to be terrific. Angustura 3x was given every half hour. In an hour the pains abated, and she gradually recovered in the space of four days.- Dr. Hubbard
N.M. Choudhury, A Study on Materia Medica, p. 42
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