Part 22

_Résumé of Symptoms._--If we boil down the matter, extracting only the symptoms and changes observed during the above experiments with _Parthenina_, we have the following: _Heaviness and dulness of head, tendency to vertigo, malaise, apathy, lassitude, profuse and very fluid salivation, sensation of heat and weight in the stomach, increased appetite, gastric intolerance, nausea and vomiting. Increased stupor, desire to be quiet, refusal of food, and indifference. Excitation of the heart beats, or slow beating of the heart; depressed circulation, or general functional activity; pulse accelerated, or slow, weak, soft, compressible, without dicrotism; progressive slowing of the pulse, followed by syncope, cardiac paralysis_ (and death). _Accelerated, or slow, irregular breathing_ (_Cheyne-Stokes_); _rise and fall of temperature, tremors, shivering, diminished perspiration; dilation of the pupils; convulsions_ (clonic and tonic); _muscular relaxation, anæsthesia and increased urine and saliva. _The kidneys were found enlarged and congested, with evident signs of sanguineous stasis. The process of coagulation of the blood was retarded. The red corpuscles increased in volume. There was a fall of the blood-pressure, and vascular dilatation_ (of reflex origin). _The heart was found arrested in diastole, and the brain anæmic. A marked diminution of reflex action in the hips and extinction of the voluntary movements_, were noticed. Also a transient excitement of the voluntary movements. And finally the sensibility and the muscular contractility were diminished._

CASES CURED BY PARTHENINA.--In regard to the therapeutic value of _Parthenina_, little is known as yet, but the plant from which this alkaloid is derived, as said before, has been employed for years in Cuba, both by the people and profession, against fevers of a paludal origin.

Dr. Ramirez Tovar has reported in several numbers of the _Cronica Médico-Quirúrgica_, of Havana, the following cases treated by him with _Parthenina_, with the best results:

CASE I.--"A lady living in the lower part of the city, where the rain always leaves constant channels of infection, was suffering with _daily attacks of intermittent_, which grew more intense every day. She received 1 gram of the salt, divided in six powders, to be taken one every hour after the attack. The next day she had no chill, and the thermometer indicated the absence of fever. She was nursing at the time, and stated that she had noticed a marked increase of milk in her breasts; 50 centigrams more, in doses, were given to her, and the fever did not return again."

CASE II.--"A tailor, 30 years of age, had moved to the lower part of the city and contracted a _tertian intermittent_. He had four paroxysms before the doctor saw him, the last one being _attended by much pain in the left hypochondrium_. He received 1 gram, in 5 doses. There was apyrexia on the day the attack was due, and this did not return again. This man continued to live in the same house, under the same regimen and hygienic conditions."

CASE III,--"A little girl, 6 years of age, lymphatic constitution, living near the beach of the harbor, was brought to Dr. Ramirez Tovar's clinic, suffering for 17 days with _malaise, loss of appetite, sleepiness and fever_. She had taken quinine, both internally and externally, with little benefit, and _was wasting away notably_. At 4 P.M. she commenced to take 50 centigrams of the salt, in 8 doses, and the next day at the same hour the thermometer indicated a fall from 39.5° C. of the previous day to 38.5° C. The mother was ordered to repeat the medicine at longer intervals, but for want of means the child did not take any more. On the 4th or 5th day the temperature went up to 39.5° again, then she was provided with the medicine, and 3 days later the temperature was normal. The action of the alkaloid was aided here by a tonic wine prepared from the extract of the plant."

CASE IV.--"A man 45 years of age, _of delicate constitution, poorly nourished, with a straw yellow face, yellow sclerotics, enlarged liver and spleen, the latter somewhat painful to pressure_, who had contracted _intermittent fever_ while in Panama, and had taken quinine, was complaining, when Dr. Ramirez Tovar saw him (middle part of December), _of a pain in the right side_ (more severe in some points than in others), which commenced at 1 P.M., with _shiverings_, and which disappeared after two hours to return again the next day at precisely the same time and with the same symptoms. He received 1 gram of _Parthenina_, in 5 doses, one every hour, right after the cessation of the pain. He was seen by the doctor the next day at 4 P.M., and up to that time the pain had not returned. He took then 50 centigrams more, in 5 doses, one every hour, and was free of pain until the latter part of January, when he again consulted the doctor, this time the _pain being located in the stomach_, for which _Parthenina_ was repeated (1 gram in 5 doses, one every two hours). The next day the pain had ceased, but returned on the third, and he again received 1 gram, in the same manner as before, and since then he has been free from pain."

CASE V.--"A young lady, 18 years of age, complained of _facial neuralgia with periodical exacerbations_, from which she was suffering four days. She received 1 gram of _Parthenina_, in 5 doses, one every hour, and on the following day she was entirely free from pain. Fifty centigrams more, in 4 doses, were given to this lady to prevent a relapse, and the result was a complete cure."

And to finish this report, I will mention a case which came under my notice: "A little girl, my niece, 5 years old, living in Havana, who, when seen by the late Dr. Govantes, of that city, had been suffering for some time before from _a continued fever, with periodical mid-day exacerbations, which later on, assumed an intermittent type_. She had been saturated with _quinine_, and complained, at the time, of _malaise_, _lassitude_, _languor_, _headache_, _loss of appetite_, _gastric intolerance_, _etc._ The temperature went up as high as 40.6° C. during the hot stage, which was short and was followed by copious sweats, giving relief. _Parthenium hysterophorus_ in the form of an extract, prepared and sold at Dr. Villavicenci's Pharmacy, in Havana, was prescribed by Dr. Govantes. Three doses a day, each of the size of a pea, dissolved in water, were given for 4 or 5 days, and at the end of that time she was entirely free of fever and made a quick recovery."

If such results can be ascribed to _Parthenium_ and its alkaloid _Parthenina_, I think it would be unjustifiable to set them aside. An early proving of the plant will not only enhance our therapeutic resources, but prevent the non-scrupulous from employing it empirically.

* * * * *

Proving of _Parthenium hysterophorus_, Dr. B. H. B. Sleght.

February 12th.--Until a few days ago had a slight continuous toothache due to a cavity in last molar of lower jaw; cavity recently filled. General health has been excellent for some time.

7:40 A.M. Took 5 drops of tincture. At once have a full feeling in head, especially vertex, pressing from within.

7:45. Ringing in ears, < left.

7:50. Took 10 drops. Ringing and fulness continue and become worse.

7:58. Upper teeth feel "on edge," with slight prickling pains in sockets, which slowly grow more severe.

8:00. Breakfast; above symptoms continue, but grow less severe.

8:10. Loud rumbling in bowels; irrepressible eructations, tasteless.

8:20. 20 drops. A "shivery" feeling runs over limbs and back as this is taken. Singing in ears had ceased but begins again, as does the rumbling.

8:40. "Goneness" in epigastrium, singing ceases; some fulness in head remains.

8:45. Same feeling in teeth as above; singing in ears; head thick, heavy.

8:50. Sharp, aching twinges in upper molars; some sharp pains in ears. Pulse 72.

9:10. 25 drops.

9:15. Stitching pain in left temple, of short duration. Upper incisors tender at sockets when biting.

9:25. Sudden pain in upper teeth with lachrymation, < pressing jaws together.

9:45. 25 drops.

9:55. Aching pain at left supra-orbital foramen. On going into open air no symptoms but taste of drug and fulness of head. A tooth filled yesterday aches slightly, same as before filling.

11:15. 60 drops. Renewed fulness of head. Pulse 76.

11:30. Goneness in epigastrium; vertigo while sitting, with heat of face and blurred vision. Aching at supra-orbital foramen (left), extending to root of nose and becoming more severe there, > eyes closed. Feel dull, stupid. Goneness comes and goes; hunger.

11:45. Aching at lower edge of right ear spreads over side of face; ear feels plugged up. Am drowsy, eyes "heavy;" goneness and unusual craving for food.

11:50. Prickling in skin of back of wrists and hands. A twinge of pain at right infraorbital foramen, gradually increases; cannot fix attention on what I am reading. Hard, painful lump in epigastrium; better after eructations tasting of drug. Slight nausea with some relief.

12 M. 60 drops. Requires much effort to fix attention while counting drops.

12:15 P.M. Head heavy, brain feels loose.

12:30. Stitching pain at lobe of left ear and deep in and above external auditory meatus.

12:45. Dinner.

1:45. 75 drops.

1:50. Hard lump in epigastrium. Head feels as if in a vise. During P.M. only "goneness" and continued taste of drug.

9:00 P.M. 100 drops, followed at once by sudden stitching pains in left frontal eminence, which soon cease.

9:10. Pain in frontal eminence has returned and continues. Teeth "on edge" and tenderness at sockets. Upper incisors ache as after filling. Teeth feel too long.

9:30. Lump in epigastrium. Severe plunging pain in left frontal eminence.

9:45. Stabbing pain runs up rectum after passing flatus.

Mushy stool at 10:30 P.M. (Usually have passage at 10 A.M.; to-day no desire.)

February 13th.--Passed restless night, waking at 3 or 4 o'clock, then dozing and dreaming until 7:30; rose with throbbing deep in brain, as if it would push through top of head; "big" head, > after moving about and washing face. 7:45. 120 drops. 7:55. Breakfast. 8:20. Aching in eyeballs. No further symptoms all day.

9:30 P.M. 5 drops. 9:35. 5 drops.

Same tenderness at sockets of upper incisors when biting.

9:40. 5 drops. Sudden darting pains in right, then in left frontal eminence, with dull heaviness in forehead, gradually increasing.

9:45. 5 drops. Sudden return of pain in frontal eminence. Fulness and aching in ears, coming suddenly. Upper teeth all ache, and feel too long.

9:50. 5 drops. Beating ache in middle of forehead. Bursting pain in right malar bone. Tingling in tip of tongue. Sudden motion increases frontal pain.

9:55. 5 drops. Slight colicky pain at navel. Eructations of drug.

10:00. 5 drops. Same frontal pain, and brief feeling as if blood would burst through face; this returns in a few minutes, especially about nose and root of nose.

10:05. 5 drops. Same frontal pain, and head feels swelled. Pulse, 72.

10:10. 5 drops. Heart-beat all over head, < motion, and over eyes.

10:15. 5 drops. Splitting pain over both ears in spots the size of silver dollar.

10:20. Must look intently to see the words; as I write, letters look pale and eyes ache.

10:25. 5 drops. Eructations tasting of drug. Colicky pains about navel.

10:30. 5 drops. Aching in left lower molars.

10:35. 5 drops. Stabbing pain in left ear. Teeth "on edge."

10:50. All the upper jaw aches, especially at sockets of teeth and on biting. Fulness and pressure in ears. Temples feel as if in a vise. All symptoms < after going up stairs.

February 14th.--Again awoke early, 3 or 4 A.M., and rose at 7:30, after a dreamful sleep, with headache. Felt better after going about. No symptoms during day.

February 15th.--Passed restless night. Fell asleep late, with headache at vertex--a pushing out. Awoke at 4 or 5 A.M. heavy and stupid; then again slept.

February 17th.--5:00 A.M. Took 2-1/2 drachms.

5:02. Eructations taste of drug. Goneness in epigastrium. Pulse, 72. Some rumbling about navel.

5:10. Head heavy; pressure at right frontal eminence, which increases to sharp, penetrating pain, going to root of nose, then to end of nose, where it is most severe. At root of nose, stuffed feeling, as with dry coryza. Pain in nose gets more and more severe; restlessness succeeds; never had such a pain; seems now all in bones of nose and worse on left side. Forehead has ceased to ache. Pain seems to start from supra-orbital foramen now.

5:15. Upper incisors commence to ache. Aching and bursting pain in nose remains; nose feels swollen. Teeth "on edge." Epigastric goneness.

5:25. Sharp pain in left upper and lower molars. Pain in nose has ceased. Bursting pain in left frontal eminence. Upper molars tender at sockets.

February 23d.--12:30. Took 6 No. 40 pills saturated with 6x dil. 2:00 P.M. Same dose. 4:20. Same. 5:00. Sharp, aching pain deep in left ear, gradually grows worse.

5:10. Singing and dull aching in right ear.

5:15. Singing and a pushing out in left ear. Fulness of frontal eminences; thence pains go to root of nose and nose becomes tender to touch. Sharp pain again deep in right ear. Aching of "bridge" of nose and of upper left molars. Hands feel numb, especially dorsal aspects. Rumbling in bowels about navel. Pain again at root of nose. Colic deep in pelvis; pains run down back of thigh to knees.

5:15. Pains again in frontal eminences.

5:25. Aching over eyes; feel like closing them; aching pains run up from above left eye-tooth to eye and over face; occurs by starts and stops. Frontal headache and pains down nose recur at intervals.

5:30. Aching, very severe, at the left side of "bridge" of nose. Sharp stitch deep in left ear. Throbbing in vertex. Sockets of upper teeth tender. Aching at end of nose, which feels full of blood.

5:45. 6 pellets. All pains continue as above. Brain seems loose, < moving head. Front of head feels big.

6:00. P.M. Stabbing deep in left ear, < by pressing teeth together.

6:30. Various pains gradually subside.

PASSIFLORA INCARNATA.

NAT. ORD., Passifloraceæ.

COMMON NAME, Passion flower.

PREPARATION.--The fresh leaves and flowers gathered in May are macerated in two parts by weight of alcohol. A preparation may also be made from the expressed juice of the fresh leaves.

(There has been so much written concerning this unproved remedy that we can only give an abstract of a part of it. Dr. Lindsay, formerly of Bayou Gras, La., was the first to call attention to it a few weeks before his death. He wrote in answer to an inquiry as follows--Hale's New Remedies):

I have much to say. I am satisfied it is no narcotic. It never stupefies or overpowers the senses. A patient under its full influence may be wakened up, and he will talk to you as rationally as ever he did; leave him a moment and he will soon be off to the Elysian Fields again. I have tried it, my friend, in all sorts of neuralgic affections, and have usually astonished my more enlightened patients with it. Many times I have had them to ask me what in the world it was that had such a sweet influence over them.

(Dr. L. Phares, of Newtonia, Miss., states):

I never saw anything act so promptly in erysipelas. I have used it with advantage in ulcers, neuralgias and tetanus. I have seen wonderful effects of it in relieving tetanus, and will mention one case from memory: Some ten years ago I was called to see an old lady, in a distant part of the country, who was reported to be "having fits." I found her to be able to be up most of the time, but, while examining her, convulsions came on, affecting mainly the trunkal muscles, and drawing the head back. I gave her instantly a dose of _Passiflora_. The convulsions subsided, and she has never had one since. I continued the use of the medicine in small doses for a few days. I have used it in treating tetanus in horses--a disease usually considered as inevitably fatal to that noble animal. It has never failed to cure the horse. * * During the late war, my son, Dr. J. H. Phares, had occasion many times to prescribe the _Passiflora_ for tetanus in horses, with one invariable result--prompt, perfect, permanent cure. He fortunately saw no case in man. * * * Since the foregoing was written, I have treated with the hydro-alcoholic extract of _Passiflora_ several cases of neuralgia, and one of sleeplessness, with incessant motion and suicidal mania. With the same extract during the current week, Dr. J. H. Phares has treated, with the most prompt and satisfactory success, a very virulent and hopeless case of tetanus, with ophisthotonos, trismus and convulsions, in a child two years old. Other most potent remedies, in heroic doses, having failed to produce any effect in this case, he thinks that nothing but the _Passiflora_ could possibly have saved the child.

(The editor of the _California Medical Journal_ (1889) says):

We have been employing it [_Passiflora_] in some cases of spinal meningitis after the acute symptoms had subsided, when the patients were unable to sleep, either day or night: could not endure the bed, and were unable to maintain the sitting posture, with highly satisfactory results. It is administered in small doses. Add ten drops of the mother tincture (Homoeopathic) to half a tumbler of water; teaspoonful every two hours.

(At the meeting of the Homoeopathic Medical Society of Delaware and Peninsula, November 14, 1889, Dr. W. D. Troy read a paper on _Passiflora_ (see _Homoeopathic Recorder_, May, 1890), from which we take the following):

My erysipelatous case was a man of some fifty years. When first seen was a-bed, high fever, facial erysipelas of the flaming, rampant sort, the one eye had disappeared, the other was in rapid retreat. Patient in great anxiety; sharp, stinging pains; could not rest. Was about to give _Apis_ when I thought of my _Passion flower_. Gave two-drop doses of the tincture every two hours. Put one-half an ounce of same into one quart of water for local application, to be applied hot by flannels and oiled silk. After six hours patient fell asleep; was awakened for medicine every three hours during the night; went to sleep easily after each dose. Said in morning he had had a night's good rest. Found inflammation markedly reduced. I now changed the remedy--gave _Ham._, both internally and externally. On next visit found patient every way worse. The disease had sneaked across the scalp and invaded the whole face. The case began to look serious. Returned to the _Passiflora_ and kept to it with the most happy results.

My next experience was in a Chorea--a girl budding into womanhood, but in whom the menses had not yet appeared. Child was well developed for her years, fourteen. I learned that for two or three years past the child had "fits," varying at times from moderate to severe. The neurosis was unilateral, the right side alone being affected. The child had had traditional treatment, "off and on," for some time without manifest improvement. I began with the _Passiflora_ 1x dil., 10 gtt. doses every three hours. Kept it up for several days, the Choreic symptoms being not quite so violent; still I was growing anxious--wanted more positive results. Added daily a five-drop dose of tincture. After a few more days the mother informed me that there had been a slight "show"--merely enough to stain the diaper, and that for the last two days there had been hardly any "fits." This was encouraging. I judged that the day of deliverance was nigh. Very little more of the drug was given until about the time for next menstrual flux. Then I resumed it with the most satisfactory results. No nervous symptoms save such as are more or lest common to all women at the "periods" subsequently prevailed.

(The following case was reported by Dr. D. C. Buell Dunlevy, of Port Chester, N. Y.--_Homoeopathic Recorder_, Nov., 1890):

Mr. D----, æt. 52, sent for me to attend him during the month of May. I found him presenting all the prodromal symptoms of delirium tremens, and at once ordered him to bed, and none too soon, as the event proved. For seven days he tossed about in a wild delirium, which was greatly aggravated by marked gastric irritation. I had him carefully watched, both day and night, until the delirium wore off. The treatment up to this time was _Cannabis Ind._ for the mental trouble and _Nux v._, which greatly relieved the gastric symptoms. But the moment he began to improve the old cravings for liquor and morphine returned. Right here let me say that for years he has been a great sufferer from piles, and the only rest he could get was to sit propped up in his chair. His sufferings caused him to seek relief during the day in liquor, and at nights in morphine. And this habit had so fastened itself upon him that try as he might he could not give it up. When he came under my treatment I at once put a stop to all stimulants and narcotics, but not without considerable trouble, for he seemed determined to have them. Night after night he would lie there calling for something to make him sleep, and this kept up until he was bordering on a state of insanity. Fully realizing that something must be done, and that quickly, too, I made up my mind to try _Passiflora_. This I did, and from the time I gave him the first dose improvement set in and has continued ever since. I at first gave him a half teaspoonful of the [Greek: theta] at bed time, but this not proving sufficient I increased it to a teaspoonful. He has now been taking it almost constantly for a period of eight weeks and claims he has not had as natural a sleep for years; and lays particular stress on the fact that when he awakes in the morning he feels so refreshed and his mind remains clear. But what seems even more wonderful is that from the day he first took this drug up to the present he has never felt the slightest desire to return to his former habits. The mere mention of liquor or opium seems to sicken him, and I am fully satisfied that he is now cured and will (so far as liquor and opium are concerned) remain so. He now takes special delight in praising the drug to his friends, and really seems never to tire talking about the wonderful help it has been to him. I have also prescribed the drug to others for insomnia and always with success, one case excepted, in which I gave it for hemicrania, and here, although it quieted the patient, it failed to produce the desired sleep.

(The following is extracted from a paper on _Passiflora_, by Dr. C. A. Walters, of Brooklyn. _Homoeopathic Recorder_, July, 1890:)

In April, 1888, was called to an infant, 14 months, convulsions, caused by dentition; symptoms called for _Belladonna_, of which the 1x dil., 5 drops in half a glass water, teaspoonful every fifteen minutes until better, then once an hour. The child improved from start, and the convulsions ceased in one hour from commencing the medicine. The next day the child appeared in usual health, and the _Belladonna_ was given once in eight hours and discharged from further attendance.

Thirty-six hours after I was recalled, the child was in another spasm. No _Belladonna_ symptoms being present I gave 5 drops of _Passiflora_ tincture, every fifteen minutes, with the result that it never had another spasm from that day to this. The child slept soundly all through the night and awoke the next morning in its usual good health.

Since then I have prescribed it for the sleeplessness of dentition without a failure, giving it usually in from 5 to 10 drops a dose, to be repeated every fifteen minutes until sleep. I never give it during the day for this purpose, but begin at bedtime.

In the insomnia of adults, from whatsoever cause, I always give 60 drops at bedtime, and if not asleep in half an hour I give the same dose.