Cinchona Officinalis

Common name of Cinchona: 

• Peruvian bark[1] 

Synonyms: 

• Cinchona officinalis Linn [1] 

Family / Group / Class / Order: 

• Rubiaceae [1] 

Habit and habitat / Description: 

• Cinchona is a native of South America and is cultivated in Java, India, Jamaica and Sri Lanka.  
• It is a slender tree, 7 to 10 metres high.  
• It is rough,brown, yellow with black and whitish markings on the bark.  
• The bark of Cinchona is obtained from the branches, trunk and roots. [1] 

Name of prover: 

• Dr Hahnemann in 1790 [1] 

Introduction and history: 

• Cinchona is of great interest for homeopaths,  as it is the first remedy with which Hahnemann experimented and discovered homeopathic science.  
• The discovery and history of Cinchona is remarkable.  
• Countess Ann, wife of the fourth Count of Cinchona, was cured of tertian fever by this bark in 1638.  
• Its virtues were known to Europe in 1640.  
• This is of particular interest to homeopaths since Hahnemann was studying the plant when he discovered the law of similars. [1] 

Parts used: 

• The bark of Cinchona is used in the preparation of mother tincture.
• Higher potencies are prepared from the mother tincture.[1] 

Active principles: 

• China contains 25 alkaloids.  
• Main are quinine, quinidine, cinchonine and cinchonidine.[1] 

Mode of Preparation:

• The bark of Cinchona is used in the preparation of mother  tincture. Higher potencies are prepared from the mother tincture.[1] 

Constitution of Cinchona

Physical make up: 

• Face is pale, sunken, very thin, dry [1] 

Temperament: 

• Nervous[1]

Diathesis: 

• Haemorrhagic[1] 

Relation with heat & cold: 

• Very chilly patient [1] 

Miasm: 

• Psora [1] 

Clinical conditions of Cinchona: 

• Abdominal disorders, Alcoholism, Amblyopia, Anaemia, Catarrhal affections, Constipation, Deafness, Diarrhoea, Dropsy, Dyspepsia,  Gall stone colic, Haemorrhage, Headache, Hectic fever,Impotence, Intermittent  fever, Jaundice, Liver and spleen affections, Onanism, Pain, Respiratory troubles,Rheumatism, Sleep disorder, Suppuration, Vertigo. [1] 

Sites of action / Pharmacodynamics: 

• Blood, circulation, brain, mind,nerves, liver, spleen, mucous membranes, thermic center, gastrointestinal tract,respiratory system, cardiovascular system. [1] 

Causation (Causes / Ailments from): 

• Loss of vital fluids, onanism, anger, alcohol, abuse of quinine and mercury, chill, bad effects of drinking tea, fruits, draught of air, mental emotions, tobacco, etc. [1] 

Physiological action of Cinchona: 

• Periodicity: Periodicity is generally found in intermittent fever and neuralgia. Paroxysm for two to three hours, each attack returns every seven or fourteen days, every three months, etc. 
• Flatulence: Whole abdomen enormously distended, with a desire to belch. Belching gives no relief or gives only temporary relief. 

Oversensitiveness:

Body is very sensitive to touch, lightest touch is unbearable to a diseased part; hard pressure relieves the pain of the same. 

• Bleeding: From every outlet of the body. Blood generally dark and clotted,oppressed breathing with a desire to be fanned. 
• Fainting: Ringing in ears, fainting, loss of sight, general coldness, sometimes convulsions.  
• Headache: Headache as if the skull would burst, intense throbbing of head and carotids, face flushed, must stand or walk, after haemorrhage or sexual excesses. 
• Intermittent fever: Paroxysm of intermittent fever, anticipates it from two to three hours, each attack returns every seven or fourteen days; sweats only on the covered parts or during sleep. 
• Weakness: Great debility, trembling, aversion to exercise, sensitive to touch, weakness due to loss of vital fluids. [1] 

Patho-physiological changes / Pathogenesis: 

• Acts upon the ganglionic nervous system producing a condition of general depression and exhaustion. 
• It has a toxic action upon all protoplasm, particularly active in preventing amoeboid movement. It also modifies the digestive functions. It inhibits enzyme action, thus retarding tissue metabolism. 
• Acts upon the heart and circulation, destroying the oxygenation power of blood. The quantity and quality of blood is changed which causes a fall in blood pressure and initiates haemorrhage. Blood becomes thin and watery. 
• Has a special affinity for the spleen and liver.  
• It causes congestion, hyperaemia and produces jaundice. 
•  It reduces hyperpyrexia. 
• It has the power to produce fever of different types, especially intermittent type of fever. [1] 

Characteristic Mental Symptoms (psychology) of Cinchona

• Exalted fancy with slow flow of ideas. Chooses wrong expressions. 
• Cheerfulness alternating with gloom. Excessively anxious, solicited about  trifles. 
• Apathetic, disobedient, taciturn, despondent, great anxiety with despondency. 
• Patient has no desire to live, but lacks courage to die by suicide. 
• Patient of Cinchona is very irritable, does not like physical and mental work. 
• Ideas and projects crowd on his mind, especially in the evening preventing sleep. 
• Patient of Cinchona thinks himself unfortunate and fancies he is opposed by everybody. 
• Dread of dogs and other animals, especially at night time.  
• Patient lost in thoughts. Sudden crying and tossing about in despair.Patient inclined to be angry and disposed to be quarrelsome. 
• Fixed idea that he is unhappy, persecuted by enemies. 
• Delirium after closing eyes, sees figures of people. 
• Compelled to jump out of bed. Wants to destroy himself, but lacks courage.[1]

Guiding Symptoms of Cinchona

1. Generalities: 

• Pains in various parts of the body, paralytic tearings, especially in the extremities, joints, bones and periosteum, sometimes worse in the spine and small of the back.  
• Pain, as after fatigue, or like exhaustion from bleeding or profuse loss of semen.  
• Pain in joints when sitting and lying, with restlessness.  
• Tensive drawing pains in almost all the bones, now one, now another, (>) momentarily by lying, then more violent than ever. Attacks of pain excited even by light touch of the part, and then frequently increasing to a frightful severity. Parts upon which he lies fall asleep.  

Weakness:

• as after loss of the various fluids of the body, with oversensitiveness of all the senses and nerves; an inclination to perspire.  
• Most extreme powerlessness and exhaustion.  
• Nausea; emaciation.  
• Oppression of all parts, as if the clothes were too tight, especially after a walk in the open air. 
• Joints feel heavy in the morning in bed, (>) rising. Aversion to all mental and physical effort.  
• The slightest draft of air brings on the troubles.  
• General aggravation at night.  
• Dropsical swellings. [3]

2. Head: 

• General sensation of confusion and Fullness, as though the blood rushed to the head.  
• Pressing headache, as if the skull would burst.  
• The brain seems to beat in waves against the skull.  
• A feeling as though the brain were pressing together from both sides and out at the forehead, (<) walking in the open air.  

Pain:

• Deep in the brain, (<) walking, with a feeling of constriction, worse in the right side of the forehead and in the occiput. 
• Forehead is not, with cold limbs.  
• Frontal headache worse on turning the eyes, with heat and jerking pain in the temples. 
•  Vertigo on walking at night; cannot sit upright; head inclines to sink backward, (<) motion and walking (>) lying.  
• Pressing headache in the temples, worse at night.  
• Pulsation in the temples, (>) hard pressure, (<) movement.  
• Jerking pains in the temples, extending to the upper jaw.  
• General bruised pain over the whole head, (<) mental effort. Scalp sensitive to touch. [3] 

3. Eye: 

• Sensation of foreign body in the eye, with inflammation and heat, worse in the evening.  
• Whites of the eyes are yellow. Pupils dilated (sometimes contracted).  
• Transient blindness, with flickering before the eyes. 
• Clinical.  
• Retinal asthenopia, with transient blindness or with flickering before the eyes (after sexual excesses).  
• Hemeralopia.  
• Neuralgia above the eyes; ciliary neuralgia, supraorbital neuralgia (Ced.); the neuralgia aggravated by slightest touch.  
• The weakness of vision and the neuralgia above the eyes are frequently associated with spinal irritation and great soreness of the spine, extending into the occiput and even into the eyes; the pains frequently aggravated at night when lying down, but not always. [3] 

4. Ears: 

• RINGING in ears. External ear sensitive to touch. Hearing sensitive to noise. Lobules red and swollen [4] 

5. Nose: 

• Checked catarrh. Easily bleeding from nose, especially on rising. Coryza, sneezing, watery discharge. Violent DRY sneezing. Cold sweat about nose. [4] 

6. Face: 

• Sallow complexion. Face bloated; red. [4] 

7. Mouth: 

• Toothache; better pressing teeth firmly together, and by warmth.  
• Tongue coated thick, dirty; tip burns, succeeded by ptyalism. Bitter taste. Food tastes too salty. [4] 

8. Throat: 

• Soreness in the larynx and trachea; voice hoarse; breathing impeded, wheezing, painful; dyspnoea; oppression of the chest; suffocative fits.  
• Cough; dry, spasmodic, nightly; to suffocation; later blood – streaked expectoration. [5] 

9. Stomach: 

• Tender, cold. Vomiting of undigested food.  
• Slow digestion.  
• Weight after eating.  
• Ill effects of tea.  
• Hungry without appetite.  
• Flat taste. Darting pain crosswise in hypogastric region.  
• Milk disagrees.  
• Hungry longing for food, which lies undigested. 
• FLATULENCE; BELCHING of bitter fluid or regurgitation of food GIVES NO RELIEF; worse eating fruit.  
• HICCOUGH.  
• Bloatedness better by movement. [4] 

10. Abdomen: 

• Much flatulent colic; better bending double.  
• TYMPANITIC ABDOMEN.  
• Pain in right hypochondrium.  
• GALLSTONE COLIC. [TRIUMFETTA SEMITRILOBA.]  
• Liver and spleen swollen and enlarged.  
• Jaundice.  
• Internal coldness of stomach and abdomen.  
• Gastro- duodenal catarrh. [4] 

11. Rectum & Anus: 

• In, the rectum, stitches, also during stool. 
• Tingling in the anus, as from ascarides.  
• Discharge of mucus from the rectum.  
• Bleeding haemorrhoids. [6] 

12. Stool: 

• Undigested, frothy, yellow; PAINLESS; worse at night, after meals, during hot weather, from FRUIT, milk, beer.  
• Very weakening, with much flatulence.  
• Difficult even when soft. [ALUM.; PLAT.]. [4] 

13.Urinary Organ: 

• Pressure in bladder after frequent and almost ineffectual efforts to urinate. [7] 

14.Sexual Organ of Cinchona: 

• MALE

• • Excited lascivious fancy. Frequent emissions, followed by great weakness. Orchitis. 

• FEMALE

• • Menses too early. DARK CLOTS AND ABDOMINAL DISTENTION. Profuse menses with pain. Desire too strong.  
  • Bloody leucorrhoea. Seems to take the place of the usual menstrual discharge. Painful heaviness in pelvis. [4] 

15. Respiratory System: 

• Influenza, With Debility. Cannot Breathe With Head Low.  
• Labored, Slow Respiration; Constant Choking.  
• SUFFOCATIVE CATARRH; RATTLING IN CHEST; Violent, Hacking Cough AFTER EVERY MEAL.  
• Haemorrhage From Lungs. Dyspnoea, Sharp Pain In Left Lung. Asthma; Worse Damp Weather. [4] 

16. Heart & Pulse: 

• Irregular with weak rapid beats followed by strong, heart beats. Suffocative attacks, syncope; anaemia and dropsy. [4] 

17. Neck & Back: 

• Sharp pains across kidneys, worse movement and at night. Knife- like pains around back. (D. MacFarlan.). [4] 

18. Extremities: 

• PAINS IN LIMBS AND JOINTS, as if sprained; WORSE, SLIGHT TOUCH; hard pressure relieves. Sensation as of a string around limb. Joints swollen; very sensitive, with dread or open air. 
• Great debility trembling, with numb sensation.  
• Averse to exercise; sensitive to touch. Weariness of joints; worse, mornings and when sitting. [4] 

19. Skin: 

• EXTREME SENSITIVENESS TO TOUCH, but hard pressure RELIEVES. COLDNESS; much sweat.  
• One hand ice cold, the other warm. 
•  Anasarca. [ARS.; APIS.] 
•  DERMATITIS; erysipelas.  
• Indurated glands; scrofulous ulcers and caries.[4] 

20.Sleep of Cinchona: 

• Drowsiness.  
• Unrefreshing or constant stupor.  
• Wakens early.  
• Protracted sleeplessness.  
• Anxious, frightful dreams with confused consciousness on waking, so that the dream cannot be rid of and fear of dream remains. Snoring, especially with children.[4] 

21. Fever: 

• Intermittent, paroxysms anticipate; return every week.  
• All stages well marked. Chill generally in forenoon, commencing in breast; thirst before chill, and little and often.  
• Debilitating night-sweats.  
• Free perspiration caused by every little exertion, especially on single parts.  
• Hay fever, watery coryza, pain in temples.[4] 

Important characteristic features Of Cinchona

Keynotes / Redline of Cinchona: 

• Much marked periodicity of complaints especially of fevers in Cinchona.  
• Toothache while nursing the child.  
• Diarrhoea only at night < fruits.  
• Pains are < slightest touch > hard pressure. [2]

Guiding of Cinchona: 

• PERIODICITY of all complaints. 
• Profound DEBILITY from exhausting discharges and loss of vital fluids.  
• Haemorrhages with much debility, trembling, ringing, buzzing in the ears.  
• Sensitiveness of the whole system especially to TOUCH physically.  
• Disposition to HAEMORRHAGE from all orifices.  
• Pains < slightest TOUCH > hard pressure.  
• Dropsical condition after anemia, from loss of vital fluids.  
• Headache-due to haemorrhages; sexual excesses, suppressed coryza.  
• Occipital pain with sensation as if the skull would burst.  
• With confusion and dullness.  
• Headache < slightest touch but > hard pressure 
• Assosiated with nausea or vomiting of bile and mucus.  
• Throbbing carotids, head & face flushed. [2] 

PQRS of Cinchona: 

• Pains are relieved by hard pressure but aggravation by slightest touch (Caps., Plumb.). 
• Pain: obliged to move limbs frequently; as motion gives relief.  
• Headache aggravates by sitting or lying, must stand or walk. 
•  Longing for sour things.[8] 

Confirmatory: 

• A/F loss of vital fluids.  
• Persons now debilitated; previously strong and robust.  
• Great sensitiveness to touch but > hard pressure.  
• Flatulence-everything eaten turns into gas, not better by eructation. [2] 

Nucleus symptoms: 

• A/F loss of vital fluids, haemorrhages, sexual excesses, abuse of mercury.  
• Periodicity well marked.  
• Profound debility. Debility and nervous erythrism from exhausting diseases.  
• Flatulent dyspepsia as concomitant to all complaints.  
• Intermittent fevers with periodicity, insatiable thirst and profuse, debilitating sweat. [2] 

Therapeutic Value of Cinchona

Abdominal disorders, Alcoholism, Amblyopia, Anaemia, Catarrhal affections, Constipation, Deafness, Diarrhoea, Dropsy, Dyspepsia, Gall stone colic, Haemorrhage, Headache, Hectic fever, Impotence, Intermittent fever, Jaundice, Liver and spleen affections, Onanism, Pain, Respiratory troubles,Rheumatism, Sleep disorder, Suppuration, Vertigo. [1]

Modality of Cinchona

Aggravation of Cinchona:

• At night, from slightest touch, wet weather, draught of air, loss of vital fluids, after eating, every other day. 

Amelioration of Cinchona:

• Deep pressure, while fasting, by bending double, from warmth, open air, lying down. [1] 

Remedy Relationship of Cinchona

Complimentary:

• Ferr. [2] 

Follows Well:

• Calc-p. , Ferr. [2] 

Inimical:

• Dig. , Selen. [2] 

Antidoted By:

• Aran-d, Ars, Carb-v, Eup-per, Ferr, Ip, Merc, Nat-m, Nux-v, Puls, Rhus-t, Sep, Sulph, Verat. [2] 

It Antidotes:

• Ars, Calc, Cham, Coff, Ferr, Hell, Iod, Merc, Sulph, Verat. [2]

Dose of Cinchona : 

• Tincture to stop craving for alcohol.
• Sixth potency for gall stone colic and jaundice.
• High potencies work when low potencies fail in very acute conditions. [1] 

Potency :

• 3x, 6x, 12x, 30x, 200, 1000. [1] 

Duration of Action for Cinchona:

• 14-21 Days. [2] 

Reference of Cinchona

[1] Textbook of homoeopathic materia medica by Dr. J. D. Patil 

[2] Zomeo Lan chapter > Cinchona Oficinalis. 

[3] A Primer Of Materia Medica By T. F. Allen. 

[4] Materia Medica By Boericke W. 

[5] Therapeutical Materia Medica By Jessen, H.C. 

[6] Text Book Of Materia Medica By Adolph Von Lippe 

[7] Thousand Remedies By Boericke. 

[8]Synoptic Memorizer of Materia Medica Vol. 1 & Vol. 2. 

[9] Concise Materia Medica Of Hom. Remedies By S.R. Phatak 

[10] Lectures On Homoeopathy By Kent J. T. 

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