Podophyllum peltatum

Biliousness. .................... Whining. Rolls head. Eyes half open. Bad breath. Burning rough or flabby, indented tongue. Bites gums together; grinds teeth. Bitter taste. As of a lump in œsophagus. Craves acids which <. Vomits hot froth. Constant gagging. Sore, painful liver. Weak, empty sinking or sick feeling in abdomen. Rubs abdomen for >. GURGLING THROUGH BOWELS, THEN PROFUSE, PUTRID STOOLS GUSH OUT PAINLESSLY. Summer diarrhœa. White stools; like dirty water; foaming; with meal-like sediment; runs right through diaper; then weakness. Cholera morbus. Diarrhœa, alternating with other symptoms, head, etc. Pale, hard, chalky stools. Rectum; raw, sore; weak; prolapsed, before stool. Moist, foul piles. Numb ache in ovaries; radiating to r. crural nerve, etc.; < stretching legs. Ischias antica. Generative organs threaten to prolapse, during stool. Rectum, prolapsed after confinement. Burning in small of back. Jaundice, < face and eyes. Moaning and whining during sleep. Loquacity during the fever (Pyro.). Sleepy after the paroxysm (malaria).

EARLY MORNING. Eating. Hot weather. Dentition. Drinking. Motion. Mercury.

Stroking liver. Lying on abdomen.

Liver: Duodenum. Intestines. RECTUM. Right side: Ovary. Scapula. Throat.

Complementary: Nat-m. Related: Alo. Chin. Merc.

Podophyllum peltatum

May Apple. Berberidacece.

Adapted to persons of bilious temperament who suffer from gastro-intestinal derangement, especially after abuse of mercury; ‘‘bilious attacks.”

Thirst for large quantities of cold water (Bry. ).

Pains: sudden shocks of jerking pains.

Depression of spirits, imagines he is going to die or be very ill (Ars.) ; disgust for life.

Headache alternates with diarrhoea (Aloe) ; headache in winter, diarrhoea in summer.

Painless cholera morbus; cholera infantum (Phyt. ).

Violent cramps in feet, calves, thighs; watery, painless stools.

Difficult dentition : moaning, grinding the teeth at night; intense desire to press the gums together (Phyt.) ; head hot and rolling from side to side (Bell., Hell.).

Diarrhoea: of long standing; early in morning, continues through forenoon, followed by natural stool in evening (Aloe), and accompanied by sensation of weakness or sinking in abdomen or rectum.

Diarrhoea of children: during teething; after eating; while being bathed or zvashed; of dirty zvater soaking napkin through (Benz. ac. ) ; with gagging.

Stool: green, zvatery, fetid, profuse (Calc.); gushing out (Gamb., Jat., Phos. ); chalk-like, jelly-like (Aloe) ; undigested (Cinch., Ferr. ) ; yellow meal-like sediment; prolapse of rectum before or with stool.

Prolapsus uteri : frozn overlifting or straining; from constipation ; after parturition ; with subinvolution.

In early months of pregnancy, can, lie comfortably only on stomach (Acet. ac. ).

Patient is constantly rubbing and shaking the region of liver with his hand.

Fever paroxysm at 7 a. m., with great loquacity during chill and heat; sleep during perspiration.

Affects right throat, right ovary, right hypochondrium (Lyc.).

Pain and numbness in right ovary, running down thigh of that side (Lib).

Suppressed menses in young girls (Puls., Tub.).

Merc., Nux, Sulph.

It antidotes the bad effects of mercury.

After: Ipec., Nux, in gastric affections; after. Calc, and Sulph. in liver diseases.

Aggravation.- — In early morning (Aloe, Nux, Sulph. ) ; in hot weather ; during dentition.

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.

Podophyllum

This remedy is seldom used except in acute affections, but it is a long acting and deep acting drug; it produces a powerful impression on the economy; it relates to the deep-seated miasms.

Abdomen: It affects profoundly the abdominal viscera. It shows its symptoms largely on the abdominal organs, the pelvic organs, and the liver. The abdomen seems to be the earliest seat of attack. It produces such an impression upon the stomach and intestinal canal that the healthy action is impaired, digestion and assimilation cease.

Everything taken into the stomach becomes sour. The glands of the stomach are as if paralyzed; there is no digestion; this goes on until we have vomiting and diarrhea. During this there is a wonderful disturbance in the abdomen; rumbling; gurgling as if animals were floundering about; clinically, as if fish were turning and tossing in a pond, as we have seen them before a storm.

Rumbling and rolling. This is attended with severes cramping pains doubling her up. Abdomen is sensitive; so sore she cannot endure pressure. The soreness extends to the stomach, intestines and finally to the liver. The whole abdominal viscera are sore, sensitive to pressure. After this comes a gurgling, watery stool, pouring out of the anus.

A tremendous outpouring so that the patient wonders where all the fluid comes from, and soon it comes on again. Copious, enormous, and very frequent. This soreness, cramping, and rumbling precedes the stool, but sometimes it continues during the stool. Commonly the patient is relieved by the stool. There is much flatus and spluttering, but not so marked as in Aloe. The colic often comes and goes without stool. Painless stools, in which compare China which has stool coming on at night and after eating. Putrid or not, and of inky color. Podophyllum is rarely indicated when the discharge is not offensive. After a while the abdomen again becomes tumultuous, and this is again relieved by a stool.

This process is repeated over and over. It seems as if the blood vessels would empty themselves into the! abdominal cavity, and then into the outer world. Not unlike cholera and cholera morbus, and these two are the common manifestations of disease for which this remedy is used in routine practice. The cholera morbus coming on in the latter part of the night, especially about 3, 4, or 5 o'clock, resembles Podophyllum. Tumultuous action of the bowels with rumbling, pain, and soreness, and the prostration is so marked that if not relieved in a day or two, it seems he must die. Rice-water stools, jelly-like on standing.

Women: With this tumultuous action, she has an indescribable sensation; an all-gone feeling, a deathly sick feeling, described by some as an emptiness, as if fasting, yet averse to food. An awful, hungry, empty weakness, as if the whole intestines would drop out.

No wonder they think so, because this remedy produces an astonishing amount of relaxation. Described by some as a sensation of dragging down. The uterine ligaments become relaxed and there is prolapsus. The rectum protrudes for inches. The sensation of dragging down as if all the parts would be pushed out into the world is a common feature. It seems to begin with the liver, as if all the parts were let down. Weakness attended with soreness.

Dragging down in the region of the ovary and the ovary is congested. The uterus is extremely sore and is enlarged; sore to touch so that light clothing aggravates. Sensitiveness of the abdomen in diarrhea and vomiting; in cholera morbus; in women when menstruating. Indicated if there is a copious diarrhea during the menstrual period, and great soreness in the uterus. Much pain in the ovaries, in one or both, extending down the crural region, down the front of the thigh.

Pain in the ovaries, especially the right; pain in the ovaries during the menstrual period, gripping pain in the bowels during the menstrual period. Great soreness of the abdomen before and during the menstrual period. (Apis, Cimicifuga, Vespa, Lachesis, but these are not so likely to have diarrhea and, if so, it is not as copious.)

Diarrhea: Alternating conditions is a feature of this remedy. If a Podophyllum patient takes cold, has any mental excitement, overexerts himself, eats boiled food, cabbage, fruits, and overloads his stomach with rich food he has a diarrhea, and following this a constipation lasting for weeks, no stool except in lumps; difficult, scanty stool and as soon as lie disorders Ids stomach again comes a diarrhea. This alternating diarrhea and constipation is a Podophyllum state rather than a chronic diarrhea, which is a continued state found in many remedies. The diarrhea is periodic, alternating with constipation.

Headache: Another alternating feature is the headache.

Chronic headache, periodic headache, sick headache, congestive in character, as if all the blood were in the head, as if the head would burst, and the pains most violent in the back of the head, bursting, and then on comes a diarrhea which relieves the head.

Sometimes when the diarrhea slacks up too suddenly, a headache is the result. It is a common feature after giving a high potency of Podophyllum in a diarrhea, that a headache comes, on after the diarrhea is stopped. It means that the medicine has acted suddenly and the headache will pass away soon.

Headache alternating with liver disturbances. The patient lies on the side or abdomen. Rending pains towards the duodenum. You will wonder if it is not gall stone colic. Periodic, violent headaches; alternating diarrhea and constipation; he strokes the region of the liver from behind forward and in this way gets relief, yet the liver is so sore that he can hardly bear the pressure.

Liver sensitive to touch.

Soreness about the liver; pain through to the back; dull aching pain, finally jaundice; becomes extremely yellow. Uneasiness and distress about two or three hours after eating, with jaundice; horrible nausea; aversion to food; empty allgone feeling in the bowels.

Vomiting, greenish, profuse, watery, vomits everything; vomiting of milk (Calc., Aeth. - the latter sometimes retains water); hunger after vomiting; deathly, overpowering nausea and prostration. Prolapse of rectum and anus during vomiting. (Mur. ac.). A condition commonly called duodenal catarrh; a chronic state; rouses into a Podophyllum diarrhea every once in a while.

Mental symptoms troublesome.

A torpid liver is often associated with a torpid fluctuating state of the mind; also a slow, sluggish pulse; palpitation. Great depression of spirits, melancholia, sadness, dejection everything goes wrong; the clouds are very dark; there is no light; thinks he may die or that he is going to become ill; that his disease will become chronic; that he has organic disease of the heart and liver; that he has sinned away his day of grace, and other such delusions. Mind easily fatigued; fidgety and restless; cannot sit still, whole body fidgety.

In this mental state with jaundice, all-gone sensation, aversion to food, even the thought or smell of food; stuffed feeling and distension in the region of the liver. The tongue is covered with thick slime; pasty, yellow coating as if mustard were spread upon it; imprint of the teeth upon the tongue; breath foul. For such a condition the ancients gave Calomel.

Gallstone colic; enlargement of the liver; gastric weakness; unable to digest; duodenal catarrh; catarrh of intestines with copious diarrhea. If you notice the Podophyllum discharge in the commode, you will see a great amount of water, on the bottom a sediment like cornmeal gruel; as if cornmeal had been stirred in. If you see it early it is yellow, muddy, or yellow-green, profuse, offensive, cadaverous; the odor penetrates the whole house; stool gushes away like water from a bung-bole; gurgling and much flatus.

With the stool there is very commonly a prolapse of the rectum; a gush of watery stool and a prolapse of the rectum; a soft stool with great straining and a prolapse of the rectum. Prolapsus of the uterus; prominent are Murex, Sepia, Natrum mur. Sepia is better sitting or lying; worse walking. Aversion to coition; hot flushes; constipation with sense of lump in the rectum, or better by stool. Murex has the following. The only relief is to press on the vulva; not better lying down; she then has pains in the back and hips compelling her to walk, yet his aggravates. Strong sexual desire. Pain in right ovary, which crosses entire body to left breast. Pain shooting up in the uterus.

The word bile is a striking feature in Podophyllum, You must connect the vomiting and the stool with this color. The patient declares he is "bilious;" his liver is out of order;" bitter taste in the mouth; spitting up bile and the color is yellow; in diarrhea it is a green substance. In children subject to copious diarrhea, with prolapsus of the anus no other symptom, Podophyllum often cures.

A feature of infancy is the following: child may not have diarrhea, may even be constipated, but it lies in bed and rolls the head in sleep. Bell. and Apis roll head.

Apis lies on back with the head on its side, Chewing motion of the jaws; sometimes a sucking; a grinding of the teeth in those who are old and have teeth; rolling the head from side to side; if you lift the eyelids you will find a strabisms.

Provers felt as if the eyes were drawn inward. It has cured such a strabismus in congestion of the brain following a suddenly suppressed diarrhea. A child who should have a colored stool has instead a white one like chalk (Calc. c.). in adults, a bileless, white stool.

The body is offensive; offensive sweat; compare Sepia, Merc., Aloe, Sulph., Murex, Nux.