Spigelia is especially known by its pains. It is indicated in persons who are debilitated from taking cold and who have become rheumatic, run down, victims of pain. Hardly a nerve in the body escapes; shooting, burning, tearing, neuralgic pains; they are most marked about the eyes and jaws, neck, face, teeth, shoulders, burning like hot needles through the face and neck in any direction, stitching, tearing, worse from motion, from doing anything, even thinking, mental exertion, worse from eating. Pains in the neck and shoulders are better from heat; those about the eyes are better from cold.

Shooting, tearing pains in the extremities like hot wires. Sometimes the pains are worse from lying down, but most commonly better from keeping still; worse from light, eating, motion, jarring; so sore in the painful region that any gentle exercise lie going up or down stairs, or riding in a carriage that jars, makes the pain unbearable.

The Spigelia patient is sensitive to cold, to atmospheric changes, he is a rheumatic patient, but the nerves are attacked by neuralgia. Violent pains about the eyes. Routine practice the use of the remedy to this region. Worse from hard pressure though sometimes better from it, if gentle and prolonged, firm pressure, but any movement of the pressing hand aggravates. The part is turgesced and inflamed. Eyes red and engorged.

Neuralgic affections of the muscles of the chest. Many of the Spigelia pains in the chest are attributed to the heart, but there is intercostal neuralgia; tearing pains shooting into the shoulders and neck, especially the left side and down the arm. Pains shooting hither and thither. Irregularity of the heart. Painful complaints associated with valvular troubles, especially growing out of rheumatism. Pericarditis and endocarditis of rheumatic character. Thrusting pains in the chest like a knife, in the eye like a knife.

This remedy needs further proving, its mental symptoms are scarcely known. "Weak memory; disinclination to work; restless and anxious, solicitude about the future; gloomy, suicidal mood; afraid of pointed things, pins, etc.; easily irritated or offended." This is all that is thought worthy of admission into the Guiding Symptoms, showing that the mental state has not been well brought out. Many complaints are manifested in the morning; tired in the morning and full of tearing pains.

Old anaemic subjects where there has been a transfer of the complaints to the nerves; broken down, pallid, nervous, with neuralgia, palpitation, irregular pulse. Vertigo on rising; gets up with violent pains and dizziness. So nervous that she must "fly," full of excitement, cannot keep still, cannot keep control of herself.

Pulsating and stitching in the head; sometimes better lying with the head high; worse from stooping, motion, and from noise. Sometimes better from washing in cold water when the pain is about the eyes and head, but worse after washing; better while the cold water is applied. With these headaches and neuralgias there is stiff neck and shoulders, an apparent stiffness in that he cannot move on account of pain. He sits in a chair as if transfixed, is aggravated from noise, light, from seeing things move in the room, which he must follow with his eyes. "Fine burning, tearing pains in the brain." It seems to be in the brain, but is more likely in the nerves of the scalp. "Violent pain in the left parietal bone on motion or walking or making a misstep; toward evening violent pressure and pressing outward in the forehead, worse from stooping, worse from pressure with the hand; tensive tearing pain in the forehead, especially beneath the frontal eminence, extending towards orbitis." Notice the intensity of the pains. Burrowing, tearing pain in the occiput, in the left side of the vertex and forehead, worse from motion, from loud noise, and when he speaks loudly or even on opening the mouth slightly; better when lying down. Pressive pain in the right side of the forehead, involving the right eye, in the morning in bed, but still more after rising; pain deeply seated, unaffected by pressure, very acute on motion, on suddenly turning the head, the brain seemed to be loose; worse from every jar, step, or straining at stool. When moving the muscles of the face, there is a sensation as if the head would burst. Sensation as if a band were about the head. Neuralgic pain settles in and above the left eye, or below it, from cold in damp, rainy weather; hyperaesthesia of the filaments of the fifth pair.

On the pain first beginning, there is not so much hyperaesthesia, but as it goes on this increases and the eye becomes congested. I have seen the pains so severe that they produced perfect prostration, cold sweat, vomiting. The Hepar patient is so sensitive to pain that he becomes unconscious; faints with the pain. Chain. feels pain with such intensity that he gives way to violent frenzy, irritability, and outbursts of anger.

The Spigelia patient suffers intensely and the pain leaves its mark, the part becomes red and inflamed and sensitive. The head pains are worse from warmth; better temporarily from cold; the pains in other regions are the reverse.

The Phos. head and stomach symptoms are better from cold ; the chest and body are better from warmth. In Ars. the head is often better by washing in cold water, while the patient himself is sensitive to the cold and wants warmth in the rest of his complaints.

Spigelia is full of visual symptoms; visual symptoms bring on complaints; at times he can do nothing but look straight ahead, for he has vertigo even when there is no pain, from looking downwards, everything goes round in a whirl. Such a state is common to many people when they look down from a height, but Spigelia has it from looking down along his nose, so he sits and looks straight ahead.

Esophoria; exophoria; disturbances in accommodation; all sorts of tiny spasmodic conditions; it is most difficult to fit glasses; no settled focus, no fixed vision. Spigelia has- from a- mere neuralgic state what Ruta has from eye strain. Latent errors of vision.

Eyes that are always changing need a remedy. Stabbing pains in and around the eye, often radiating in every direction from one point Eye-ball sensitive to touch. Eyes worse when thinking about them. Worse at night. Intolerable, pressing pain, worse on turning the eye, dizzy on attempting to move the eyes, must turn the whole head to see. Pain radiates to the frontal sinuses and head. Sensation as if the eyes were too large for its orbit.

I remember a patient who had been travelling about from oculist to oculist, who had many visual troubles and no glasses would suit. She had one sharp, stinging pain over the left eye day and night and she could only sleep when worn out. Lac fel. cured. Constant, fine, stinging pain over left eye was brought out by the provers of cat's milk.

This medicine has cured a pterygium, probably a false pterygium, that came from violent neuralgia, prolonged and lasting for months.

Stitching pains in the chest, worse from the least movement, breathing, sensation of tearing in the chest; trembling feeling in the chest when moving the arms or from any movement. Can lie only on the right side with the head high. Rheumatic troubles especially in the left side of the chest. Feeling as if the heart were compressed with a hand. Purring feeling over the region of the heart, wave-like motion not synchronous with the pulse. Waving palpitation not synchronous with the pulse. Trembling of the carotids. Acute pericarditis with anxiety and weight in the precordium. These troubles following a rheumatic attack, at its close or many months after the fever has subsided. Spigelia is seldom indicated in rheumatism of the heart in phlegmatic persons who do not feel intensely.

When a rheumatic affection attacks the venous side of the heart, and there is a sense of stuffiness, of fullness through the whole body, limbs swollen, but do not pit on pressure, face mottled, it is a serious case and may end in Bright's disease and death.