10 / 13
SPECTRUM OF HOMEOPATHY
Jürgen Hansel
¦ BRYONIA ALBA
8
RHEUMATISM
Along with Ruta, Hahnemann proved a second but less well-known remedy from the Rue family. It is extracted from the bark of
Angustura trifoliata, a South American tree. The currently valid botanical name is Galipea officinalis, although homeopathically
it is still generally known as Angustura.
The outstanding symptom, which we often use in our practices as an indication for this remedy, is a pronounced desire for cof
fee. In the corresponding repertory rubric since Kent it is the only three-grade remedy. With such excessive coffee consumption
it is not surprising that those affected show typical Coffea symptoms such as 'great irritability, tense cheerfulness and mental
activity'1. They often have extravagant ideas and constantly enthuse about new projects that never get implemented. The coffee
also encourages the particular quality noticed by Scholten in Rutaceae patients of going through the day in an energetic way
and in a good mood, persevering despite being at the brink of exhaustion.
Angustura is one of the most bitter substances in the homeopathic materia medica and indeed the bitterness can be seen in the
remedy picture: the bitter taste in the mouth, bitter eructations, but above all a deep-seated feeling of bitterness. In Hahnemann’s
Materia Medica Pura we find the symptom: 'Minor slights fill him with bitterness'1. This bitterness is not, however, expressed
in outbreaks of rage and aggression similar to the equally bitter Nux vomica but rather like that found in the other Rutaceae:
'Moroseness, discontent with his position, displeasure at jokes'1.
At the physical level we find a similar affinity to muscles, tendons and joints as seen in Ruta. In the muscles there is stiffness and
cramps at a level like that found in tetanus. But Angustura is, precisely like Ruta, 'a remedy for rheumatic states with fatigue
and stiffness of the limbs approaching paralysis'2. And just as pronounced as in Ruta, there is the vital sensation of Rutaceae
described as: 'Crushed, squeezed, shattered'3. In the repertorisation4 of the case in this article, Angustura covers the joint
symptoms even better than Ruta.
If we only look at the physical symptoms, Angustura would certainly have been an option in this case. The decision was made
to give this patient Ruta, however, due to the Ruta-specific cause at the mental level, with the double experience of deep disap
pointment and the feeling of being betrayed and cheated.
Sankaran’s miasmatic classification also helps with the differential diagnosis in this case between the two similar Rues. Ruta is
assigned to the cancer miasm whereas Angustura is assigned to the malaria miasm. The latter is associated with severe but inter
mittent attacks whereas the cancer miasm is characterized by chronic progressive disease, against which one is relatively impotent
despite one’s best efforts, hence the feeling of powerlessness and loss of control. In the malaria miasm the patient complains
and moans about their miserable situation whereas in the cancer miasm the emotional expression tends to be blocked. Even
though these aspects point to Ruta, in this case it is not possible to make a clear differential diagnosis based on the miasmatic
classification, since the patient’s feeling of being blocked in his activity and unable to function can just as much be an aspect of
the malaria miasm as the bitterness that we see in him, which is very typical of Angustura.
DIFFERENTIAL DIAGNOSIS ANGUSTURA VERA