Vol. 23 No. 3 June 2003

by Bruce Barwell

The web site of a Missouri aboretum lists records for trees – the oldest, tallest, fattest, etc. It even tells of the most dangerous tree: the manchineel tree, Hippomane mancinella, of the Caribbean coast and the Florida Everglades. This species has had an evil reputation since the Spanish explorers first feared it in the 16th century. The entire tree exudes an extremely poisonous and caustic sap that was once used as arrow poison. Contact to the skin causes an eruption of blisters, contact to the eye can blind a person, and one bite of the fruit causes blistering and severe pain.

Several homœopathic provings of Hippomane mancinella have been made, and to homœopathy the medicine made from it is called Mancinella.

Botanists had to change its generic name when it was found a marine mollusc had prior claim. The shell is now known as Thais, however.

Here are four Mancinella cases, starting with one reported by George Bute (1792-1876), an early prover of Mancinella; its first proving was published by Hering in 1850, followed by one by Benoit Mure in 1853.

Mrs R, 31 years of age, dark hair, liver spots in the face, mild somewhat melancholic temperament, disposed to homesickness, mother of six children, had on her chin an old dark tetter with red pimples. About midnight she would have attacks of fear and trembling, followed by feverish heat; afraid of evil spirits; of being taken hold of by the Devil; sleeplessness, only somewhat relieved towards morning. Had a good education; never been made superstitious, now fears she is getting crazy.

She has an anxious expression in her face; dark brownish circles around the eyes; throbbing in pit of stomach, pressure in region of heart, hard beats of the heart followed by fainty feelings, with darkening before the eyes; pulse slow and soft. Frequent headache; desire for saltish food; smell of onions before her nose. Catamenia one week too early, with pains in the chest; feet puffed up every morning.

15 January, 1889
Mancinella 6c. In a few days the most remarkable change; her face was brightened up, all the evil spirits were banished, and even the tetter on the chin was better. Living near her I would have heard from her, had she not continued to do well.
from The Journal of Homœopathic Clinics,
edited by Constantine Hering and Henry Noah Martin.

In a review of The Spirit of Homœopathy by Rajan Sankaran, the reviewer, Karl Robinson, reported this case.

One of the hardest things any homœopath faces is knowing what a patient means when he or she says something. Sankaran suggests not taking what the patient says at face value but continually probing deeper and deeper until the underlying feeling or mental state is brought to the surface. I was able at once to employ this methodology with a 50 year old patient whom I have treated for over 12 years. On this particular visit I asked her a question I had never asked before, “What is the worst scenario you can envisage for your life?” With only a few seconds hesitation she replied, “Being abandoned.” I was about to write down “Forsaken,” which is a clear symptom found in the Repertory, when I decided not to accept her answer at face value.

“What does that mean to you?” I asked. “What’s underneath your fear of being abandoned?” She replied, “I feel unprotected.” Puzzled, I asked what she meant. “If I were alone there would be no one to fight off monsters,” she said, much to my amazement. Considering her age and how long I had known her, I had never heard her say anything like this before. I pushed her for details. Monsters, it turned out, meant something evil. “I’m afraid of some slimy, yucky, powerful, cruel thing,” she said.

As she was in my office that day complaining of the skin on her right foot peeling off, I turned to the Extremities section of the Repertory where I found Mancinella in italics under “Eruptions, sole of food, desquamating.” Mancinella also has “Fear of being taken by the Devil” and “Fear of ghosts”.

I gave her Mancinella, and six weeks later she returned to say her fear of monsters had disappeared, a tendency to scary dreams had ceased, and her foot was improving. Had it not been for Dr Sankaran, I would most certainly have missed Mancinella.

Here is a case that Jean Kopp presented to a conference in France. The translation is by the editor with the assistance of Franky Lewis.

A. S. was 7 years old in 1989 when I began to follow her case. She had warts, tired easily, and had difficulty falling asleep in the evening. Headaches were the bane of this bright child, who seemed stirred up, even agitated, finding it hard to stay still.

She does dancing and gymnastics. “I like things with movement.” Her restlessness and insomnia are worse at full moon. She eats like a bird, preferring sweetish things; averse to fish. She likes to please, is considerate, affectionate, and very sensitive to others’ suffering.

She is preoccupied with metaphysical concerns – God and religion . . . In 1991 she told me: “When I fall asleep I always have the image of a dragon in my head. Once upon a time, the Devil used to come and torment me.” Medicines were prescribed, one after the other (Pulsatilla, Phosphorus, Gelsemium, Ignatia and Sulphur) but A. S. became increasingly anxious.

In 1992 the family settled in Syria. A. S., now prepubertal, was confronted with the world of Islam. She became set in a true religious melancholy despite Platina, Pulsatilla, Natrum muriaticum.

I re-examined her in March 1996 (aged 13).

“I have been given a book about angels. I believe in them. I have also started to fast.”

“You can not understand me,” she says, weeping. “The angels are protecting me. I am afraid to do bad things – like drugs . . .”

All the parts of the puzzle are clear to me now: religious melancholy; the Devil who came to annoy her; compassion for others. Prescribed Mancinella 30c.

A postcard sent from Syria some months later tells me the treatment was “miraculous”. Her smile was back, the Bible was put away and she had made friendships. One dose more was given.

In March 1999 I was alerted to these symptoms: A. S. works too hard, does too much jogging, and has withdrawn from others. Given Mancinella 30c. In December 1999 she was back in France. A. S. is studying in Australia, where one of her brothers lives. She said, “It’s okay, the little angels are taking care of me.”

In January 2001 she saw me, while passing through France, about acne spots. Angels? They are over, there is no more need for them.

Here is a case presented by Savitri Clarke in the book, The Complete Idiot’s Guide to Homeopathy (Alpha Books, Indianapolis, 2001). . .

Roberto is a charming but soft-spoken and rather shy five year old. His mother is getting desperate. Roberto will eat very few foods and his mother is worried his nutritional needs could not possibly be met by his diet. He eats only french fries, pancakes, chips, peanut butter, crackers, and tomatoes. In fact he will eat several tomatoes at a time as if they are apples! He won’t try new things.

Roberto has started getting headaches and complains of stomachaches all the time. He gags a lot. “He won’t eat at the table with us. He has to have his own little table cloth and small dish. He won’t sit at the table with the cheese still left on the table.”

“I start gagging,” Roberto says. “I don’t want to look at it. I will see the food I don’t like and gag.”

“He went to a party and started to gag when the pizza was set down next to him. He now has a cough and will frequently gag with the cough.”

“Sometimes I have stomachaches when I get full.”

His mother says, “He doesn’t want to finish eating. He says he has a tummy ache and that it hurts around his belly button. My rubbing it makes it better.”

Roberto is very good at karate and has no fear. Roberto exclaims, “I am not afraid of anything!”

When I asked about his sleep and dreams, he offered, “I sleep good. Once I dreamt of my head cut off. It was a devil. I was not in bed. I was somewhere else. A place where the Devil is, in Hell. I was scared.”

I asked Roberto about his fears. “I am afraid of monsters, some bugs, spiders, scorpions, snakes, termites. The tail of the scorpion is poisonous, snakes bite hard. I am afraid of the dark. It is like I can’t see, and I am afraid I am going to bump into something scary.”

Roberto was allergic to most formulas from birth. He had to go on a predigested formula. On the other formulas he would get very hungry, and when he went to suck, he would start to cramp and cry.

“We always fight over getting him to eat. Every mealtime, especially in the morning. He does like chocolate cake and will eat that in the morning. But not much else.”

Roberto has always vomited with certain smells he finds offensive, like cat poop. He gets frequent coughs with colds and can be up all night coughing and gagging.

Roberto goes to Catholic school and recently got a Bible picture book. He was immediately fascinated by the picture of the Devil. His cousin recently said something about Hell and Roberto repeated it. He started asking questions like, “What is Hell? Who lives there? Why do you go there?” At Halloween he asked about skulls. He ended up being Dracula last Halloween and wanted to know why vampires came out at night and why they are cold. He said, “I am not going there (to Hell), bad people go there.” I asked again about his dreams and he said, “The scariest thing is the devil cutting off my head.”

Roberto’s case was difficult because there was no clear reason why he was such a picky eater, so sensitive to foods and smells, and gagged so easily. The worst time for Roberto was in the morning when he seemed to have no appetite.

I gave Roberto the plant remedy Mancinella. Patients needing this remedy have a strong sensitivity to odours and a tendency to gag with nausea, as well as violent headaches. The remedy picture also includes a strong desire for salt, and Roberto, when he was allowed to eat junk food, would always go for chips. He never gagged from chips!

On follow-up one month later, Roberto’s mother reported he wasn’t having any more headaches. There had been no vomiting and very little gagging. While he still won’t sit at the table with the others, he has tried many new things and likes some of them.

His teacher was impressed that he was eating a snack and lunch at school, which he would seldom do before the remedy. He has also stopped complaining of stomachaches. He still likes tomatoes but the craving (which was quite strong, often eating four or five per day) had decreased. His mother said, “He has let go of the Devil.” She hadn’t heard him speak of that fear in several weeks.

Roberto’s mother wrote me eight months later to let me know that “Roberto has been in good health all winter with no coughs. He is now eating better and trying new things all the time.”

What is it in Mancinella that causes it to be so poisonous? How can it do what it does in potentised form?

Mancinella is a member of the Euphorbia family but its most toxic constituent is a chemical not found significantly in the other Euphorbias. It is physostigmine, present at 200 part per million. (Despite the name, physostigmine is not the most toxic chemical in Physostigma venenosum; that plant’s most toxic component is eseridine, also a cholinergic.)

Acetylcholine plays a major role in the memory processes, so its level in the brain of Alzheimer’s disease patients closely correlates with degree of disfunction. One possibility as a treatment is to increase the level of acetylcholine in the brain by inhibiting the action of the acetylcholine-destroying enzyme acetylcholine esterase by centrally effective inhibitors. The first chemical of this type tested as an Alzheimer’s treatment was physostigmine.

Physostigmine has been shown to improve memory and learning ability, but the changes were usually small and short-lived, and unacceptable side-effects were common. One recent study [van Dyck CH, Newhouse P Falk WE, Mattes JA. Archives of General Psychiatry 2002 (2): 157-164.] involved 850 people with mild-to-moderate Alzheimer’s disease given physostigmine salicylate or placebo over 12 weeks.

It was concluded that the drug demonstrated a statistically significant benefit compared with placebo on a clinical global rating of change and an objective test of cognitive function. Given the frequency of gastro-intestinal side-effects (47%) the role of this agent in clinical use remains to be determined, the authors concluded.

There have been studies of the effect of physostigmine on people with borderline personality disorder, with much the same outcome as those with Alzheimer’s disease patients – improvement but too many serious side-effects, which is what could be expected from a chemical upsetting the running of the nervous system in general.

Other chemicals which act similarly to physostigmine are organophosphorus insecticides and nerve gases. A recent discovery is the toxin fasciculin from the venom of the green mamba snake which may have therapeutic potential.

Why is Mancinella not used by homœopaths to treat the early stages of Alzheimer’s? It would seem from its chemistry and symptoms found in provings that it would be as good for this condition as for borderline personality disorder (as shown in the four cases here).

Here are the Mind proving symptoms as set out in Allen’s Encyclopedia (excluding less-reliable sources):

Emotional. – Silent mood. Profound mental tranquillity in the morning. Cheerfulness, desire to sing. Disposed to take everything in good part. Feelings of tenderness and great compassion. Sadness in morning. Sadness before menses. Fearfulness. Morose mood. Indifference and dullness in the morning.

Intellectual. – Averse to work (5th day). Activity of mind, disposed to work (9th day). Bored by everything. Wandering thoughts. Absence of thought. Great dullness, with indifferent mood. Constant drowsiness.

Note that the frequently cited symptom “Fears will go mad” does not appear. Constantine Hering’s German-language edition, Kurzgefasste Arzheimittellehre, of his Condensed Materia Medica has the phrase: Fürchtet den Verstand zu verlieren. This means “Fears will lose reason” (“reason” in the sense of the ability to think and remember – not fear of going mad). Hering’s Guiding Symptoms has “Fear of getting crazy”- the words of Bute’s patient.

Another remedy with the same symptom is Chelidonium. The wife of the homœopath Buchmann took 90 drops of the tincture and reported 3 hours later that it seemed she could not think, and would lose her reason (Symptom 74 in Allen’s Encyclopedia).

Boger’s Boenninghausen has under Mind “Fearsome, insanity: Chel.” which, I think, puts a wrong spin on what the prover said.

Clarke’s Dictionary has under Actaea racemosa “Thinks she is going crazy” – but I could not find this symptom in provings.

Which gets me round to reporting that my experience with several clients in the early stages of Alzheimer’s has been very encouraging but unfortunately not long enough to see if Mancinella stops the mental deterioration permanently.

NOTE: Some entries for Mancinella in Kent’s Repertory (and its descendants) may be wrong because he seems to have confused the strange horse derived remedy Hippomanes with Hippomane, going by the section giving names of remedies and their abbreviations.