Podophyllum peltatum

Lecture XLIII — The Umbelliferae — Conium maculatum, Ammoniacum gummi, Asafoetida, Aethusa cynapium; the Berberidaceae — Berberis and Podophyllum

Podophyllum Peltatum.

Podophyllum peltatum is the mandrake or May-apple, a plant that grows to the height of some two or three feet, with leaves spread out like an open hand. It is found mostly on the borders of woods. The parts used in medicine are the roots and fruit of the plant. When applied externally, Podophyllum produces a rawness of the skin, resembling intertrigo. If the powdered plant gets into the eyes it produces a severe inflammation and even a perforating ulcer of the cornea. The central point of attack of the drug, however, is in the abdomen. Shortly after it is taken there follow diarrhoea, colicky pains, the wellknown morning stool pouring out like water from a hydrant, preceded by retching and vomiting and spasmodic contraction of the stomach, making the child scream out; a diarrhoea such as would make us think of Sulphur, Dioscorea, Bryonia, Natrum sulph., and a few other remedies. The stools are renewed immediately by eating, like Croton tigHum, etc.

In addition to its intestinal action we find it acting on the liver, and here is the main use that is made of the remedy. It is indicated in the torpid or chronically congested liver. The liver is swollen and sensitive, and friction over the right hypochondrium relieves this sensation. The face and sclerotica become tinged yellow. There is bad taste in the mouth, evidently arising from the degeneration of food in the intestinal tract. The tongue is coated yellow or white, and takes the imprint of the teeth. The bile may become inspissated in the gall bladder, forming gall-stone; thus we find Podophyllum indicated in that tormenting disease, bilious colic. The stools are of the nature already mentioned; or they are constipated and clay-colored, showing the absense of bile. These symptoms of Podophyllum much resemble those of Mercurius. They have won for the drug the name of vegetable mercury. It is much less injurious, however, than is Mercury. In constipation of bottle-fed babies Podophyllum will sometimes relieve. The stools are dry and crumbling.

Of the remedies having the symptom, the tongue takes the imprint of the teeth, Mercurius stands at the head of the list. Next to that we have Podophyllum, and then Yucca jilamentosa, and, finally, Rhus, Stramonium and Arsenicum metallicum.

Podophyllum also produces prolapsus recti with the diarrhoea. The rectum protrudes before stool (JVzcx vom. after), especially in the morning. Podophyllum also seems to have the power of producing and curing prolapsus of the uterus with attendant symptoms of bearing down in the hypogastric and sacral regions worse from motion, and neuralgia in the right ovary, extending down the anterior crural nerve, backache, retarded menses, thick transparent leucorrhcea and often coexisting with these, prolapsus recti.

As concordant remedies to Podophyllum in this prolapsus we have Nux vomica and Sepia, the indications for which I have already given you in a former lecture.

Very few would think of Podophyllum as a remedy for tonsillitis and yet it has some very clear cut indications in this affection. The trouble is apt to start in the right side and extend to the left, like Lycopodium. There is great dryness of the throat, aggravation from swallowing liquids and in the morning and pain going into the ear. Podophyllum is a valuable remedy during dentition. It does not seem to act on the brain, yet it causes reflex cerebral irritation, whether this be from the abdominal symptoms alone or from the teeth. The symptoms which indicate it in addition to those already given are moaning and whining during sleep, not crying out with a sharp, sudden noise, as under Belladonna, but a sick cry; the child grates its teeth; the head is thrown back and rolled from side to side.

Next we find Podophyllum indicated in fevers, usually of a remittent type, particularly in bilious remittent fever. The drug does not produce many characteristic symptoms during the chill, but during the fever the patient is sleepy and sometimes delirious.