In acute situations, CAULOPHYLLUM 12 or 30 may be given every 15 to 30 minutes if need be, and tapered off as soon as there is definite improvement.

It is sometimes useful in the treatment of neuralgias and arthritis or rheumatism, particularly of the fingers and toes, when they arise during or after pregnancy, childbirth, miscarriage, menstruation, or menopause. It is also occasionally effective in the vulvovaginitis of little girls, with a profuse, irritating discharge.

It is difficult to present individual cases of this remedy, which tends to be most useful in the lower dilutions, such as the 12th, and preventively, in common situations, or before they have progressed too far. Because it has few distinctive mental or emotional features, and even its well-known physical symptoms are relatively nondescript and very much what would be expected under the circumstances, its action is most often solid and workmanlike rather than memorable. Yet I would not want to be without it.

CIMICIFUGA.
Tincture of the root, Actaea racemosa or Cimicifuga racemosa, N. O. Ranunculaceae, black cohosh or black snake root.

Syotomatology.

1. UTERINE DYSFUNCTION.
Like CAULOPHYLLUM, CIMICIFUGA produces abnormal uterine contractions closely resembling those of dysfunctional labor, and its other symptoms are likewise intensified during and after pregnancy, labor, and menstruation.

The contractions themselves are similarly brief, sharp, and spasmodic, and just as painful as those of CAULOPHYLLUM, often darting about from side to side, or down the hips and thighs, and also tend to be felt predominantly in the lower uterine segment and the cervix, which remains closed and fails to dilate.

The remedy also resembles CAULOPHYLLUM in other important respects. It too has neuralgias, rheumatic and arthritic pains, trembling, nervous and emotional agitation, and an overall sense of mutability, of symptoms traveling from place to place, or changing from one to another or back and forth.

2. DEJECTION, FEAR, AND MENTAL FRAGMENTATION.
Yet from minutest details to their overall flavor or style, the symptom-picture of CIMIICIFUGA is fundamentally different, and indeed, when fully developed, not easily mistaken for that of any other remedy. This "essence" is perhaps most readily approached through the mental and emotional state, which has two important and interrelated features.

By far the more obvious and easier to recognize is a feeling of moroseness, gloom, or dejection, readily apparent on the behavioral level as a persistent negativism, defeatism, or pessimism that sees the worst side of everything, often with a fixed presentiment of failure or misfortune about the pregnancy, the labor, or the parenting to follow. "I can't do it" or "I can't go through with it" would be an accurate verbal rendition, doubtless easily overlooked in the throes of a difficult labor, when such sentiments are rarely absent.

Case 1. A young woman in her second pregnancy appeared to be sailing through her labor without any problems, except for her bizarre and persistent conviction that she wouldn't be able to finish. In this fashion she achieved full dilatation, and the baby's head was halfway down the vagina, before her labor came to a halt, her prophecy seemingly fulfilled. As if by magic, a single dose of CIMICIFUGA put everything right again, the birth following within a few minutes.