Baptisia tinctoria

Lecture XXXVIII — Baptisia tinctoria

Baptisia tinctoria.

Gelseinium.

Rhustox., Bryonia.

Arnica, Muriatic acid, Lachesis, Arsenicum album.

Ailantlius.

I have selected for our study to-day a member of the leguminous plants, namely, Baptisia tinctoria, or the wild indigo. Baptisia is a drug which has a short history, but an exceedingly interesting one. Our journals are replete with glowing accounts of cures of typhoid conditions made with it. Baptisia causes, in general, the changes in the blood, both quantitative and qualitative, w 7hich are exhibited in typhoid fever. The offensive exhalations, the mental and nervous phenomena which it develops are characteristic of this disease. Baptisia is suitable to all stages of typhoid, early or late. Its symptoms I will divide into two classes: first, those which indicate the remedy early in typhoid affections, and, secondly, those which call for it late. The drug may of course be indicated even if all the following symptoms are not present in any one case. But I shall give you the characteristic symptoms of the remedy, and unless several of these are present it would not be proper to give Baptisia. These symptoms are as follows: excitement of the brain, just such as precedes delirium; wild-, wandering feeling; the patient cannot confine his mind to any one subject; restlessness, constant desire to move from place to place; disturbed sleep. The patient awakens at two or three o'clock in the morning, and then is so restless that he tosses about, unable to sleep any longer. During sleep his dreams are of the most extravagant character. He dreams that he is chained to the bed, or that he is swimming a river, or undergoing some ordeal which makes a great demand on his strength. He may suffer from nightmare, from which he awakens with a sensation as though the room were insufferably hot, making breathing almost impossible. If he still has strength he goes to the open window to get air. Now this is not a true asthma; it is not due to a spasmodic contraction of the bronchioles. There is a fulness of the chest, causing the oppressed feeling. One prover described the symptom, not as a true difficulty of breathing, but as a feeling as though he had not strength to lift his chest. The patient makes frequent errors as to his own person, supposing at times that he is double or that his body is scattered about, and that he must toss about the bed to collect the pieces. Now these evidences of nervous excitement are accompanied by excessive prostration; the back and limbs ache; the back feels stiff; the patient feels tired and bruised all over; he complains of the bed feeling too hard; this makes him restless, and he tosses about the bed to find a softer spot; weakness develops, progressing so far that he becomes unable to walk; he suffers from an indescribable weak or faint feeling, with or without vertigo.

The face is hot and flushed and has a heavy, besotted look, as in the case of one intoxicated. The eyes, also, are heavy and stupid in appearance. The tongue is at first white or slightly yellowish; frequently, too, the papillae are raised and project through this whitish or yellow coating. The edges of the tongue are of a deep red color. There is a dull, heavy headache, with the sensation as if the head would be pressed in; sometimes the pressure in the forehead seems to go down into the root of the nose. Again, the patient complains of a sensation which he describes '

' as though the skin of the forehead were being pulled back towards the occiput." This is evidently due to tonic contraction of the occipito-frontalis muscle. At other times the patient simply describes the sensation as though the skin of the forehead were tense, or tight, or drawn. These symptoms of the head are often accompanied by a numb, tingling feeling in the forehead or scalp. At other times the head feels enormously large.

The typhoid type of fever is very characteristic of Baptisia, it being one of the few T remedies which actually produce this type of fever.

There is always an increase of temperature. The pulse is usually accelerated in direct proportion to the intensity of the fever. Even in the early stages of typhoid fever, you may find Baptisia indicated by the abdominal symptoms, slight sensitiveness in the ilio-csecal region, and yellow putrescent stools. These, then, are the symptoms calling for the early exhibition of Baptisia in typhoid fever.

I can say confidently that if you select the drug on its homoeopathic indications as just outlined, you will succeed in aborting a large percentage of typhoid states. I say this despite the assertions of many other physicians who have argued to the contrary. The properlyselected drug will abort typhoid fever. The disease need not run its course, as prominent old-school authorities claim it must necessarily do. Later in the course of the disease, during the second or third week, you will find Baptisia indicated when the prostration is profound. The patient is in a stupor. He falls asleep while answering questions. His face is now dark-red in color and has, more marked than ever, this heavy, besotted look. The tongue has changed its yellow or white coating to one which has a brown streak down the centre, the edges of the organ still remaining red. All the exhalations and discharges from the patient are exceedingly offensive. The teeth are covered with sordes having an offensive odor. The breath is fcetid. The stools are yellowish or dark, and are horribly putrid. The urine and sweat are both offensive. So 3^011 see, Baptisia applies to cases in which there is an evident decomposition of vital fluids and rapid disintegration of tissue.

To give Baptisia its legitimate position among other typhoid remedies it will be necessary to compare it with those nearest like it in symptomatology. The first of these remedies to which I shall call your attention is Gclsemium. This usually precedes Baptisia when there are malaise and muscular soreness, and the patient suffers from chills and "crups," which go down the back. This is on the first day, remember. In the afternoon comes the fever with accelerated pulse, this being full and flowing, not tense and resisting as under Aconite. The fever is usually associated with drowsiness; the face is red in color, uniformly suffused; and even as early in the case as this there may be prostration. Gelsemium causes paratysis of the motor nerves, hence there must be weakness of the muscles. By the next afternoon, if the fever rises, despite Gelsemium, you may change to Baptisia, provided the above-mentioned symptoms develop. The reason I dwell on the relations of these two drugs is because of the great similarity of their symptoms. Both of them have this intense muscular soreness and prostration; both have drowsiness and nervous excitement, with prostration; both have this feeling of expansion, as though the head or some part of the body were enormously enlarged; and both have the afternoon exacerbation of the fever. The relation between the two drugs is one of degree or intensity. Gelsemittm is the milder acting drug of the two.

Another remedy which is not unlike Baptisia is Rhus tox. Like Baptisia, Rhus has restlessness, brown tongue and soreness of the muscles. I must confess that the distinction between the two remedies is not always easy. Formerly, Rhus held undisputed sway in almost all diseases which threatened to assume a typhoid type, whether the disease was diphtheria, scarlatina, peritonitis or pneumonia. Now this honor is shared with Baptisia. The main differences between the drugs, brief!y given, are these: Rhus has restlessness, caused more by rheumatoid pains than by muscular soreness alone. The tongue, under Rhus, has a red, triangular tip, which is not noticed under Baptisia, Delirium is of a muttering character under Rhus, unaccompanied, so far as I know, by these delusions respecting personal identity. Neither are the putrid discharges of Rhus tox. quite so offensive :as those of Baptisia. If diarrhoea progresses to a severe type under Rhus, the stools are watery, .sometimes bloody and involuntary. The pneumonic symptoms which often complicate typhoid fever are more prominent under Rhus.

Arnica claims a relationship with Baptisia. It is similar to the latter remedy in the stupor, in the intolerance of the bed (the patient complaining that it feels too hard), and in the falling asleep while answering questions. Arnica, I think, is more suitable when there is a tendency to apoplectic congestion and when the stupor is so profound that both stool and urine are passed involuntarily. The intensity of the involvement of the brain is shown by the loud, snoring respiration. Then, too, in Arnica we find suggillations, sometimes called ecchymoses.

Lachesis also comes forward as similar to Baptisia. You will recognize the resemblances between the remedies in the oflensiveness of the discharges, in the putridity of the exhalations and in the excessive prostration. I believe that I have seen apparently hopeless cases react under the benign influence of this remedy. As an animal poison, I think it penetrates more deeply than Baptida, and in consequence should be called for in worse cases. It may be distinguished by the following symptoms: trembling of the tongue when attempting to protrude it; the tongue catches on the teeth during the act. When he succeeds in getting it out, it hangs there tremblingly, and he may not even have sense enough to draw it in again. Haemorrhages are frequent in the Lachesis patient. Blood may escape from every orifice of the body. The lips crack and ooze a dark or blackish blood. Dark blood escapes from the bowels. This, after standing awhile, deposits a sediment which looks like charred straw. In severe cases there is marked intolerance to light pressure. Even when the sensorium appears to be perfectly benumbed the patient resists the slightest touch about the neck. In still worse cases, 3'ou have to distinguish it from Baptisia when there are approaching cerebral paralysis, dropping of the lower jaw and involuntary discharges.

Muriatic acid bears some resemblance to Baptisia in the great prostration, in the decomposition of fluids, and in the low form of delirium. But the general character of its sj^mptoms is not sufficiently similar to those of the other remed}' to make a distinction difficult. The Muriatic acid weakness is so great that the patient is unable to make the slight exertion required to maintain the head on the pillow; he therefore slides down to the foot of the bed.

Now, a word about Baptisia in diseases other than typhoid fever. In such affections it is indicated by the symptoms already mentioned. In dysentery you will give it when the discharges are offensive, bloody and are attended by tenesmus, but with a significant absence of pain, showing an alarming depression of vitality.

Baptisia comes into play in the treatment of phthisis. It is especially useful during the later stages of the disease in relieving the fever, particularly when it increases in the afternoon with slight drowsiness, thick speech and bewilderment of mind.

Baptisia has proved itself one of our best remedies in diphtheria when it has assumed a typhoid type. Some of the s} Tmptoms already mentioned will be present. The mouth is excessively putrid. The membrane is dark and exhibits a gangrenous tendency. Sometimes, early in the disease, you will observe this characteristic: the patient can swallow only liquids. Give him milk and he will drink it. Give him solid food and he rejects it at once.

Ailanthus is to be compared with Baptisia in typhoid conditions, in scarlatina and in diphtheria. It produces even more profound stupor than the latter remedy. There is a well-marked, excoriating, watery discharge from the nose, making the upper lip sore. The rash, if any exist, is of a livid purplish hue, thus denoting the poisoned state of the blood.

I wish to impress upon you the need of correlating properly in your mind Gelsemunn, Baptisia, Rhus tox. and Lachesis. These remedies present so inan}^ distinct clinical pictures, which, when recalled in time of necessity and used according to their symptomatic indications, form a quartette invaluable in the treatment of disease.