Sometimes the dejection seems almost tangible or palpable to the patient: she may use words like "I feel as if I were enveloped by a black cloud," and convey by her gestures or body language that an actual physical presence is meant. Indeed, this kind of somatization or extension of mental states into physical symptoms is a striking feature of the remedy in all its guises. The "black cloud" sensation in particular has been verified repeatedly in headache, depression, and many other circumstances.
But, underlying these depressive phenomena, strange and disabling fears may also be revealed -- e.g., the fear that something terrible is going to happen, that she will die or be poisoned by the remedy you are about to give her, or that she will lose her mind and never be the same again. Sometimes these fears may only be hinted at by speech, gestures, actions, or physical symptoms incoherent or freaky enough to make the people around her fear for her sanity as well.
In either case, the CIMICIFUGA state implies the threat or actuality of a mental breakdown, in which the indefinable substratum or framework of experience dissolves away, leaving behind a mere jumble of fragmented thoughts and feelings, a truly pitiable state, justly to be feared by doctor and patient alike.
Case 2. A young woman who became pregnant again soon after an abortion was still not in labor after 42 weeks, when the threat of a hospital birth seemed to unnerve her. Recalling that the pain of her abortion had been unbearable, with the even greater intensity of labor still to come, she could not dispel the premonition of a breakdown. When she appeared at the office a few days later, already six centimeters dilated, she was indeed out of control: wild-eyed and capable of mere fragments of speech, her gestures disconnected and woeful. Although remaining psychotic throughout labor, she progressed rapidly with the help of CIMICIFUGA 200, and made a complete recovery soon afterwards.
An alarming and sometimes prophetic fear of insanity, arising out of some unforgettably painful or tragic experience of pregnancy, labor, abortion, or menstruation in the past, is in my experience a valid and important keynote of this remedy, repeatedly verified in practice, and often helpful in explaining other symptoms as well. On the other hand, it cuts so deep as to be well guarded by most patients, even from themselves, and will seldom be volunteered or elicited readily.
Case 3. An intelligent and sensitive woman had her second child at home without any difficulty, but at six months of age the child developed acute leukemia and died, suffering horribly from both the disease and the chemotherapy that nobody could bear to withhold from her. She was soon pregnant again and had another successful home birth, but one week postpartum developed a severe, disabling arthritis in one wrist that had no definite keynotes or modalities and failed to respond to any of the usual remedies. Although no one dared voice the obvious fear that her new baby would also die, I tried CIMICIFUGA 200 as a last resort, purely on the inference, and her wrist cleared up as if by magic.
3. FRAGMENTATION AND ALTERNATION OF PHYSICAL SYMPTOMS.
Much the same fragmented quality is characteristic of the physical symptoms. While the pains and nervousness of CAULOPHYLLUM are just as severe, they tend to be rather finely-textured and delicate, and to change into or follow one another quite easily, resembling PULSATILLA in this respect. The corresponding symptoms of CIMICIFUGA, on the other hand, are coarser, involving larger fragments or "chunks" of experience that replace one another abruptly and in a seemingly jumbled or random fashion.