Sabadilla — Homeopathic Remedy Profile

Sabadilla officinalis is prepared from the seeds of the Mexican cevadilla, a plant of the Melanthiaceae in the order Liliaceae. Stapf introduced the remedy into homeopathic practice through his additions to the Materia Medica Pura, with Hahnemann among the provers. Its affinities lie with the mucous membranes of the nose, the lachrymal glands, the throat and the intestinal tract, and with a chilly, sensitive nervous system prone to spasmodic reflex actions. The picture is one of paroxysmal sneezing, fluent coryza, oddly literal imagination and an intolerance of odours.

At a Glance

Source and Preparation

The plant was first described by Monardes around 1572. The seeds were long used in domestic pharmacy to destroy lice on the body and worms in putrid ulcers; Veratrine, the alkaloid isolated from these seeds, was later applied locally in neuralgias and for the removal of dropsy at material doses of five grains to two drachms.

This history matters at the point of prescribing, because a single Latin name covers two different registers. In the tincture (Ø) and low decimals the alkaloid content is real and pharmacologically active; the older use for lice belongs there. Classical homeopathic prescribing begins at 30C, where no molecule of the seed remains and the remedy acts through the dynamic preparation on the totality of the case. Toxicological cautions about cevadilla belong to the herbal register and do not migrate upward to the potentized preparation. What acts at 30C and above is not the alkaloid.

The Essence of Sabadilla

Sabadilla suits sensitive persons of light hair and fair complexion, with a weakened, relaxed muscular system — children and old people especially, according to the older writers. Chill predominates, running upward from the feet, and the patient is thirstless through the cold stage. The nervous system reacts sharply to trifles. Mental exertion produces headaches and sleeplessness. Thinking itself becomes an aggravating factor. The smallest fright can throw the patient into hysterical paroxysms.

Onto this background is written a peculiar habit of erroneous impressions about the body: a woman convinced she is pregnant when the abdomen distends with flatus, a patient who imagines he has cancer, another who feels one side of himself is longer than the other or that his chin has grown out of proportion. The organism, chilly and vulnerable, throws up spasmodic responses at every mucous surface it owns. Sneezing at the nose. Cough at the larynx. Tenesmus at the rectum. Itching at the anus that alternates strangely with itching in the ears or the ala nasi.

Clinical Portrait

Mind

The Sabadilla mental picture is not an emotional storm but a chronic fragility. The patient is nervous, timid, easily startled. Fixed and erroneous ideas about the state of the body are the mental keynote, and imaginary diseases proliferate — pregnancies that have not happened, cancers that are not there, limbs turning crooked or shrunken. In one recorded observation the patient loses consciousness briefly, then jumps up and runs recklessly through the room. Mental exertion aggravates everything: the headache, the insomnia, the sense of misery. Sleep is put off by a multitude of thoughts, then broken by anxious dreams and the sensation of starting up as from a fright.

Nose, Sneezing and the Odour of Flowers

The unmistakable feature of Sabadilla is spasmodic sneezing with copious, watery, fluent coryza. The nostrils itch, tickle and burn, driving the patient to rub or pick at them. Frontal pain accompanies the discharge, the eyes redden, the lachrymation worsens with every paroxysm of sneezing or coughing. The sensitivity to odours is unusually developed. The smell of flowers sets off the discharge, and even the thought of flowers has been observed to intensify it. The patient cannot bear the smell of garlic, an aversion carried into the digestive sphere as well.

The discharge may be watery at one moment and thick and yellow at another, or one nostril may stuff up while the other runs. A tickling begins in the nose and spreads over the whole body, ending in dyspnoea. Compared with Allium cepa, whose acrid coryza excoriates the upper lip and improves in open air, and with Arsenicum album, whose burning discharges are worse after midnight and driven by restless anxiety, Sabadilla is characterized by its reflex quality: the sneeze that will not stop, provoked by odour or thought as much as by inhaled dust.

Skin, nose and anus stand in close relation in this remedy. Asthmatic breathing accompanied by itching of the skin, of the nose and of the anus points strongly to Sabadilla, as does the hawking of bright red blood that comes down from the naso-pharynx during a violent coryza. Common indications for the remedy in this sphere are hay fever, allergic rhinitis and the ordinary common cold that begins with an explosive fit of sneezing and lands in the throat.

Sore Throat, Left to Right

Sabadilla is a classical remedy for chronic sore throat and for tonsillitis that follows a coryza, particularly where the inflammation begins on the left and travels to the right. The characteristic sensation is of a lump, or of a piece of loose skin hanging in the throat, that must be swallowed away; the patient swallows constantly to be rid of it. Empty swallowing hurts. Hot drinks and warm food relieve. Pressure on the larynx from outside brings on the pain. Kent wrote of Sabadilla as suited to "old, chronic sore throats that are worse from cold air. The patient is sensitive to cold air. Every time he takes cold it settles in his nose and throat. Tonsillitis going from left to right." The desire for hot drink is the plainest possible contrast with Lachesis, which shares the left-to-right progression but cannot bear anything hot at the throat.

The cough that comes on immediately upon lying down, and the violent, muffled coughing attacks that are worse after anger and accompanied by lachrymation, extend the throat picture downward into the chest. A cold, empty feeling at the stomach and spasmodic pain there with dry cough and difficult breathing belong to the same catarrhal descent. Pleurisy with great paralytic debility is on record.

Chill, Fever and Periodicity

Stapf noted that the provings gave strong febrile symptoms, and Sabadilla has kept its place as a leading remedy in intermittent fevers and neuralgias. The chill predominates and rises from below upward. The head and face are hot, sometimes fiery red, while the hands and feet stay icy cold. Thirst is absent during the cold stage and appears only after the chill has passed. Lachrymation accompanies the chill, and shivering runs through the case as a concomitant of almost any pain. Periodicity is unusually clock-like: every week, every two weeks, every four weeks, at the same hour, worse at new and full moon, worse in the forenoon. Murphy places it beside Cedron for regularity.

Head, Vertigo and Sleep

Headaches in Sabadilla are unilateral or alternate sides. They are worse from thinking and, remarkably, better from eating. Schoolgirls' headaches — brought on by concentration and application — belong here. Vertigo is prominent: things appear to turn around each other, or the eyes seem to whirl with the world. The patient feels she would fall if she did not hold on to something. Sitting aggravates the giddiness, rising from stooping brings it on, and resting the head on a table relieves. Blackness before the eyes and the sensation of fainting can accompany the vertigo. Sleep is heavy and unwanted by day, particularly during reading or meditation, and agitated and unrefreshing at night.

Appetite, Digestion and the Worm Symptoms

Thirstlessness is the rule and canine hunger the exception, and the hunger is for sweets and farinaceous food, with an active desire for hot things and for milk. Meat, sour things, coffee and garlic are all disliked. In pregnancy the patient has no relish for food until the first mouthful; after that she makes a good meal.

The mouth carries its own oddities. A sweetish taste in the absence of thirst. Copious, jelly-like saliva at one hour and parched dryness at another. The tongue as if burnt, as if full of blisters, with pricking and soreness at the tip. The lips burn as if scalded. In the mouth the patient cannot bear anything hot or cold, a peculiarity that sits beside, not against, the throat's relief from hot drinks, since the local sensitivity is at the palate and tongue while the swallowing relief is at the fauces below.

The sensations in the abdomen are among the most idiosyncratic in the materia medica. As of a lump. As of a ball of thread turning rapidly through the belly. As if the abdomen were shrunken or empty. Croaking as of frogs. As of something alive within.

From this abdominal picture the worm symptoms open naturally. Sabadilla has kept a real reputation for pinworms, for lumbrici and for tapeworm. Itching and crawling in the rectum and anus, as though from ascarides, is the local marker. What makes the picture unmistakable is the alternation: the itching at the anus alternates with itching in the nose or in the ears, and scratching the scalp relieves the itch of the head while producing burning at the anus. Kent describes giving Sabadilla to a pet dog with severe irritation of the anus; shortly afterwards the animal passed a very large number of worms. Children's diarrhea with constant cutting pains, and reflex nervous symptoms of twitching, trembling and even catalepsy, connect back to the same worm substrate.

Female, Skin and Extremities

Menses come too late, by fits and starts, sometimes stronger and sometimes weaker, an intermittence that recalls Kreosotum and Pulsatilla. Nymphomania from worms is on record. The skin is parchment-dry, with hot, creeping, tingling sensations shooting under it; red bands, spots and points appear in various places. On the scalp the itching is violent, and one prover left the phrase "violent itching of hairy scalp, compelling her to scratch until blood comes"; another described "itching of the vertex as if a quantity of vermin had collected there." In the limbs there is upward jerking of the arms, cutting pains in the bones, thickened and deformed horny nails, and inflammation under the toenails. Cracking of the jaw joint on opening the mouth wide accompanies the sore-throat picture in a proportion of cases.

Modalities

Worse:

• Cold air
• Forenoon
• Mental exertion, thinking
• Odours, especially of flowers and of garlic
• Wine
• Periodically — every week, two weeks, four weeks
• New and full moon
• Undeveloped rash

Better:

• Heat
• Warm food and warm drink
• Swallowing (throat symptoms)
• Being wrapped up
• Quick motion of the affected part
• Resting the head on a table (vertigo)

The patient as a whole is chilly and sensitive to cold outdoor air, so the coryza generally worsens on going out. The exception, noted in the older comments, is the thick yellow catarrhal discharge, which may resemble the Pulsatilla picture in being relieved by fresh air and worse in stuffy rooms.

Relationships

Antidoted by Camphor, Lycopodium, Lachesis, Pulsatilla and Conium. Sabadilla follows Bryonia well in pleurisy and is itself followed well by Arsenicum album, Belladonna, Mercurius solubilis and Nux vomica. Sepia is its complementary.

For comparison in the sneezing and hay-fever field, Colchicum, Arundo, Pollens, Cuminum and Phleum pratense (Timothy grass, potentised to 12C and used as a desensitizer) all belong to the same terrain. Veratrine, the alkaloid, is used locally in neuralgias and does not belong to the potentised prescribing at all.

Clinical Uses

Hay Fever and Allergic Rhinitis

Where the case turns on paroxysmal sneezing, streaming watery discharge, tickling that spreads from the nose over the whole body and provocation by odour, with flowers above all as the trigger, Sabadilla is often the closest remedy. 30C is a common working potency during the season, given as needed through the attack and repeated as the pattern demands. In long-standing hay asthma, higher potencies are chosen under supervision, and the constitution behind the episode is taken into the case.

Chronic Sore Throat and Tonsillitis

For the sensitive, chilly patient whose every cold settles in the tonsils and travels from left to right, with the constant swallowing of a felt lump, worse for cold air, worse for empty swallowing, better for hot drinks. 30C or 200C on the return of the pattern.

Intermittent Fevers and Neuralgias

The clock-like periodicity, the thirstless chill from below upward, the hot head with icy hands and feet, the lachrymation with the chill, and the aggravation at new and full moon justify the remedy. A single dose is often enough where the picture is clear, and its reputation in this sphere has stood beside Cedron for regularity.

Intestinal Worms

For the alternation of itching at the anus with itching in the nose or the ears, for the ball-of-thread sensation, for the child whose diarrhea comes with cutting pains and reflex twitching. Classical prescribing here favors 30C, and the case is revisited only after the crawling sensations return.

Frequently Asked Questions

What is the best potency of Sabadilla for hay fever?

Older practitioners kept to the tincture and the low decimals for the local, drainage-type action, where the alkaloid content still has a hand in the effect. Classical prescribing settles at 30C for the ordinary hay-fever attack, repeated as the sneezing returns. 200C is used where the pattern is chronic and reliably reproduces itself, and higher potencies belong to constitutional work in the hands of an experienced homeopath.

How does Sabadilla differ from Allium cepa and Arsenicum album in hay fever?

Allium cepa produces an acrid, excoriating nasal discharge together with a bland lachrymation; the patient is often better in the open air. Arsenicum album drives burning discharges with midnight aggravation and restless anxiety, and the patient wants sips of warm water. Sabadilla's coryza is fluent and non-excoriating, the sneezing is spasmodic and set off by odours — flowers especially — and the patient is chilly, thirstless and oversensitive at every mucous surface.

Is Sabadilla used for worms in children?

Sabadilla has kept a real place in the classical treatment of pinworms, lumbrici and tapeworm, particularly where the itching at the anus alternates with itching in the nose or the ears and cutting abdominal pains and reflex twitching are present. At 30C and above the remedy contains none of the seed's alkaloid content and acts through the dynamic preparation on the totality of the child's symptoms.

What are the classical modalities that identify Sabadilla?

Chill from below upward, thirstlessness through the cold stage, worse from cold air and from mental exertion, worse from the odour of flowers or of garlic, worse periodically at intervals of a week or its multiples, and worse at new and full moon. Better from heat, from warm food and drink, from being wrapped up, and — for the sore throat — from hot drinks and from the act of swallowing.

References

• Boericke, W. Pocket Manual of Homoeopathic Materia Medica.
• Clarke, J.H. A Dictionary of Practical Materia Medica.
• Hahnemann, S., in Stapf's additions to the Materia Medica Pura.
• Kent, J.T. Lectures on Homoeopathic Materia Medica.
• Murphy, R. Nature's Materia Medica.
• Phatak, S.R. A Concise Repertory of Homoeopathic Medicines.