Part 25

Headache of brief duration, in single spots, now here, now there, with confusion. Pressure in both temples, harder on one side than on the other alternately, with violent pulsation of the temporal arteries.

Drawing in the forehead in two lines from the frontal eminences to the glabella, where there is a strong outward drawing as if by a magnet.

Red swelling, like a saddle, across the bridge of the nose, painful to the touch, especially on the left side near the forehead, while the cartilaginous portion is cold and bloodless; with red spots on the cheek, on the left little pimples; swelling of the cervical and sub-maxillary glands.

Unpleasant numb sensation in the tongue; cannot project it against the teeth; papillæ elevated; tongue redder, with sore pain at point and edge.

Burning sensation from the fauces down through the chest. With the desire to smoke, tobacco tastes badly.

Pain in the scrobiculus cordis as if something broke loose, on stepping hard.

_Inflation and tension in the abdomen_; bellyache here and there in single spots; on walking, feeling as if the bowels shook, without pain.

Stool earlier (in the morning), frequent, softer.

Urging to urinate; very dark urine.

Painful, voluptuous tickling in the whole of the glans penis.

Violent sneezing, causing pain in the roof of the mouth, the fauces and oesophagus all the way to the stomach, followed by long-continued pains at the cardiac orifice.

Pain in chest and _mediastinum posticum_, less in the _anticum_, with pain under the shoulders, which seems to be in connection with burning in the oesophagus. Pressing pain on the sternum.

Sudden feeling of anxiety, with difficult (or oppressed) respiration and sweat, followed by stool and the subsidence of these and other pains.

Inclination to take deep inspirations with hollow feeling in the chest, later with contraction in the fauces and chest.

The difficulty of breathing is better in the open air.

Pain in the crest of the right tibia.

Rheumatic troubles increased.

Sleepy early in the evening.

All troubles disappear in the open air.

In attempting to analyze this "abstract of symptoms," to see if the internal evidence tends to show that the recorded effects are genuine results of the drug, it is well to remember that these provings--for we infer that three observers participated therein--were made in the light of the empirical history of _Pothos foet._ The said history was on record before the date of these provings, and it cannot have escaped Hering's eye; he was too wide a reader for that. He was, beyond doubt, aware of the pathogenetic effects observed by Bigelow--_headache_, _vertigo_, _temporary blindness_, _vomiting_, _even from small quantities_. Having, then, this clue to its physiological action, these symptoms should reappear in his proving _if his imagination furnished his symptoms_. As only a mild headache is noted in the _Correspondenzblatt_, it is evident that these provers did not _work from a pattern_. It is also evident that the _usus in morbis_ did not suggest the Allentown symptomatology, for the anti-asthmatic virtue of _Pothos foet._ is one feature on which the greatest stress had been laid, and yet the only _pathogenetic_ suggestion of its applicability in asthma is: "_Sudden feeling of anxiety with difficult_ (or oppressed) respiration and sweat, followed by stool and the _subsidence of these and other pains_." Who ever heard of an asthma relieved by stool? Who could have _invented_ such an odd modality? As it stands it is an _unicum_, and by every rule of criticism this single symptom-group gives the stamp of verity to the Allentown "abstract of symptoms." But there is other and singularly convincing evidence of the genuineness of this abstract. As the reader is aware, Thacher had emphasized the efficiency of _Pothos foet._ as an anti-spasmodic in hysteria, although the "key-note" that indicates it in hysteria had wholly escaped his discernment.

Now this very "key-note" appears in the Allentown pathogenesis, but so unobtrusively as to show most conclusively that the prover who furnished it did not recognize its singular import and value. Such testimony is absolutely unimpugnable by honest and intelligent criticism.

It is also apparent that some of the less pronounced of its empirical virtues are reflected in the proving. For instance, Thacher found it efficacious in "erratick pains of a spasmodick nature." Is not this "erratic" feature reproduced in such conditions as:

"Headache, of brief duration, in single spots, now here, now there?"

"Pressure in both temples alternately, harder on one side than on the other?"

"Bellyache, here and there, in single spots?"

Brevity of duration and recurrence "in single spots, now here, now there," are phenomena at once _spasmodic_ and _erratic_. It must be admitted that the trend of its pathogenetic action and the lines of its therapeutical application are parallel, and, therefore, that the latter are confirmatory of the former.

With such an anti-hysterical reputation as the empirical use had given to _Pothos foet._, it might fairly be anticipated that its pathogenesis would be distinguished by a paucity of objective _data_, for only a tyro in pharmacodynamics, or a "Regular," would expect to find a full-lined picture of hysteria in any "proving." And so we have in the "abstract" a flux of subjective symptoms, "erratic" enough for hysterical elements, and still further characterized by an apparent evanescence, as if its phenomena of sensory disturbance were as fleeting and unsubstantial as those of an hysterical storm.

The _will-o'-the-wisp-like_ character of its subjective symptoms, and its physometric property (hinted at in the pathogenesis and emphasized in Thacher's case) are the features that will chiefly impress one in studying this distinctively American remedy.

That the "abstract of symptomes" evinces a cautious trial of this drug, and that more heroic experiments will add to our knowledge of its pathogenetic properties, are plain deductions from the absence in the "abstract" of such pronounced effects as Bigelow observed and also from the evidence of the _usus in morbis_. The remedy needs an efficient proving, especially in the female organism.

AN APPLICATION OF POTHOS FOETIDA.

Miss B----, æt. 20; a tall, spare brunette, and a good specimen of Fothergill's _Arab type_, brainy and vivacious. General health has been good, but she was never robust; could not go to school regularly. Between her thirteenth and fifteenth years grew rapidly in stature, and then she was easily wearied on walking; knees tired and limbs ached. Had good digestion through the growing period, but subsequently became subject to "bloat of wind" in abdomen. These meteoristic attacks came when lying down. A "weight rises from the abdomen up to the heart." She must at once spring up. This condition is relieved by eructating, by liquor, and by drinking hot water. The night attacks of meteorism are by far the worst. _She is now subject to them._

[Her grand-mother had such "spells of bloating;" would spring out of bed at night, lose consciousness, and "bloat up suddenly." If she had such an attack when dressed, they had often been obliged to cut open her clothes.]

Patient has found that apples, tomatoes, cabbage and onions disagree with her; no other food. She is constipated--"wants to and can't."

Her hair is unusually dry; scalp full of dandruff; skin, generally, soft and flexible.

She has frequent epistaxis; has had four and five attacks a day. Blood bright red, "runs a perfect stream," does not clot at the nostrils. Has previously a "heavy feeling" in the head, which the bleeding relieves.

In appearance she is "the picture of health;" good complexion, fairly ruddy cheeks, sparkling eyes--in a word, she is an incarnated protest against "single blessedness."

In the latter part of July, 1886, had her first "fit." She had arisen with a headache, which kept on increasing in severity. Just after a light meal had the attack; "Oh, dear! Oh, dear!" and fell insensible. Stiffened at first, then had clonic spasms. Neither bit the tongue nor frothed at the mouth. No micturition or defecation. On coming to, did not remember that she had fallen, but recollected being borne up stairs. Had a "dreadful nosebleed" after the attack. Left her very weak; could hardly lift her feet from the floor. Before the "fit" the headache had become unbearably severe.

Had her second "fit" on August 7th, 1887. Headache came on and kept growing worse; was in temples, beating and throbbing, and in eyes, "light hurt"--also on vertex, "pressing-down" pain. At 4 P.M. suddenly fell down insensible. No cry. Tongue bitten. Slight frothing at the mouth. First "stiff all over," then clonic spasms. After the "fit" knew that something had happened to her. Was prostrated for nearly a month, but not so much as after first attack.

December 10th, 1887, third "fit." On the night of the 9th her mother had been very ill, and she herself was very uneasy and alarmed. Had the attack before breakfast. Blurred vision, headache, fall; no biting of tongue, nor frothing. First rigid, then clonic spasms; after attack, nose bled profusely, head ached all day, face flushed and dark. Prostrated as usual.

In none of the attacks was there any involuntary micturition or defecation, nor was it ever necessary to use any force to hold her on the bed.

One other fact I gathered from her brother, namely: during her "fits" her abdomen bloated so rapidly and to such a degree that the family had learned to remove her clothing as soon as possible after she fell.

Of course, Thacher's case, wherein the "abdomen was remarkably tumefied and tense," came into memory at once. The old volume was taken down, and that case re-read. Then followed the _Encyclopædia_, and then the English _Symptomen Codex_. No pathogenetic light or corroboration _there_. Then Curie's "Jahr." Ah! "_Inflation and tension in the abdomen._" Only a straw, but a pathogenetic, and I grasped it thankfully. I found also, "_aching in the temples with violent arterial pulsation_."

It was an open winter; my son dug some skunk cabbage roots in a swamp; a tincture was made; ten-drop doses, four times daily, were taken until six ounces had been consumed.

No "fit" up to date; no epistaxis; only once a slight headache.

I never made a diagnosis in this case; have not reached one yet, nor am I grieving over that omission. I did rashly declare that it was not epilepsy, because Sauvages _tympanites intestinalis_ is a feature of hysteria, but not of epilepsy. But not a word of this was said to the patient. It was not a "mind cure," for I have no "mind" to spare; nor was it "Christian science," for I am not up to that. I had an _amnesis_ in which grand-mother and grand-daughter participated. Nature had put the "key-note" in italics, not only in the patient but also in the drug. Thacher stumbled upon it empirically; Hering found it pathogenetically, and that led to its application under the guidance of the only approximation to _a law_ in therapeutics that has yet been discovered by any of woman born: _similia similibus curantur_!

(Anent the foregoing paper Dr. W. C. Campbell sent the following to the same journal:)

POTHOS FOETIDA, HYSTERIA.

November 6, 1889, was called in haste to see Miss N----, aged 19 years. Found her lying upon the floor, exhibiting all the phenomena of epilepsy, clenched hands, frothing at the mouth, clonic spasm, etc.

On questioning the family, I learned that she had been subject to such seizures for about two years, and that they were increasing in frequency. She had been dismissed from the various cotton mills in which she had been employed because of them. The father had been informed that she had epilepsy, and she had been treated accordingly by three old school physicians.

The sister informed me that although she had frequently fallen near the stove she had never struck it. Further questioning elicited the fact of her never having injured herself more seriously than to bite her tongue. It was then I became suspicious, and later felt convinced that it was hysteria and not epilepsy with which I had to deal.

I remembered having read in _The Recorder_ an article by Dr. S. A. Jones, of Ann Arbor, on _Pothos foetida_, with the record of a case in some respects similar to mine. After again reading it up, I made a tincture of the roots and tendrils gathered at the time, of which I gave her a two drachm phial, directing her to take ten drops three times per day.

On the second day she had a slight seizure while at dinner. After two months she again resumed her place in the mill, where she has since been steadily employed, and is strong and well in every way.

Have used _Pothos_ in epilepsy, also in dropsy, with negative results.

PRIMULA OBCONICA.

NAT. ORD., Primulaceæ.

COMMON NAME, Primrose var. obconica.

PREPARATION.--The entire fresh plant in flower with root is macerated in twice its weight of alcohol.

(Dr. E. V. Ross, of Rochester, N. Y., thus summarizes the various papers that have appeared on this remedy--sources of papers named in his article:)

The following summary of the pathogenetic effects of _Primula_ were produced from handling and in otherwise coming in contact with the plant, and so far as known the poisonous properties are wholly confined to the leaves.

The effects bear a close resemblance to _Anacardium_, _Euphorbium_, _Ranunculus_, _Rhus_, etc. It is evidently deserving of a thorough proving, and it is our intention to attempt one as soon as a reliable preparation can be had.

References: (1) _Syme, British Medical Journal_; (2) _London Lancet_; (3) _Homoeopathic World_, March, 1892; (4) _American Homoeopathist_, 1897, p. 429; (5) _New York Medical Journal_, January, 1898, p. 68.

(1) 1. Eczema on face.

2. Eczema on face and arms.

3. Moist eczema on face and forearms, papular and excoriated.

4. Severe cracking over joints and fingers as from frost.

5. Great itching of the skin.

6. Eruption appears at night.

7. Eruption and itching worse at night.

8. The itching was intolerable at night.

(2) 9. Irritable papular eruption on both hands, followed by desquamation.

10. Papular eruption on chin.

11. Eruption of small papules on a raised base with intolerable itching.

(3) 12. Papular eruption (eczematous) on hands, wrists and fingers.

13. Skin red and swollen and itching violently.

14. At night she became feverish, hands and face would burn, then intolerable itching followed by erythema with small papules becoming pustular.

15. Papular eruption itching violently.

(4) 16. Confluent blotches on face resembling urticaria.

17. Eruption between fingers which resembles scabies.

18. Desquamation.

19. Purple blotches on dorsal surface of hands.

20. Palmar surface of hands and fingers are stiff and unusable.

21. Deep-seated blisters form on tip of each finger and above and below each phalangeal flexure.

22. Blisters on fingers from which a clear fluid escapes on being pricked.

23. Intense itching and burning accompanies the eruption.

(5) 24. Eruption preceded by pricking sensation which gradually changes to a smarting.

25. Skin tumefied and diffuse infiltration with a red serosity, with here and there small fullæ filled with a limpid liquid.

26. Eyelids greatly swollen and covered with large fullæ, eyes half closed.

27. Great tension and redness of skin resembling erysipeias.

28. Desquamation sometimes furfuraceous, sometimes lamellar, involving all of the epidermic layer in such a manner that in some places the papillary layer was exposed.

29. Eyelids stiff and immovable, resembling ptosis.

30. Dryness and heat in palms of hands.

31. Deep infiltration of tissues rendering the parts stiff and immovable.

32. Skin symptoms accompanied by pronounced febrile symptoms.

From symptoms Nos. 5, 6, 7, 8, 14, 15, 23 it would appear the time of aggravation is at night, and the most prominent sensation is _itching_ and less prominent is burning. This is characteristic of the _Arsenicum_ eruption, also of _Anacardium_, _Rhus tox._, and some others. The eruption also bears a strong resemblance to these remedies, and if one may judge from the symptoms enumerated ought to prove a potent rival in erysipelas and eczematous complaints. _Rhus_ poisoning will no doubt find a new and efficient remedy in _Primula_.

PYRUS AMERICANA.

NAT. ORD., Rosacæ.

COMMON NAME, Mountain ash.

PREPARATION.--The fresh bark is macerated in twice its weight of alcohol.

(We find the following in the _American Observer_, 1878, credited to _Northwestern Analist_ and written by Dr. H. P. Gatchell. Allen, in the _Encyclopædia_ has not mentioned the drug, and we can find no mention in any of the dispensatories consulted. Dr. Fernie, in his excellent book, _Herbal simples_ devotes some space to it. We quote: "'There is,' says an old writer, 'in every berry the exhilaration of wine, and the satisfying of old mead; and whosoever shall eat three berries of them, if he has completed a hundred years, he will return to the age of thirty.' At the same time it must be noted that the _leaves_ of the Mountain ash are of a poisonous quality, and contain prussic acid like those of the laurel." The following is Dr. Gatchell's paper, the proving, be it noted, is made from a tincture of the bark:)

My memory of details, never remarkable, except as the details belonged to some system, is not as good as in earlier life, and in the matter of disconnected or partially connected incidents, the widow Bedott could, at any time, have given me five points in ten, and then have beaten me easily.

No. 1 of the provers was a married lady; No. 2 and No. 3 were lads. The tincture of the bark was used, several drops being put in a cup of water, of which teaspoonful doses were given and repeated at, I do not remember what, intervals. Myself experienced some irritation of the eyes; no other symptoms.

No. 1. Feels like crying. Feels as if the knees are immensely swollen, as if the toes the same. Knees and toes ache. Feels constricted around the waist, obliged to loosen the clothes at once. Headache begins over the eyes, left side of head aches terribly, like a tooth ache. Aches everywhere, in every joint. Left great toe feels as if torn from the socket. Sense of prolapsus of womb, bearing down and pressing out, as if swollen, and burning all over. Pains in the head knife-like. All the pains intense, acute. Thinks the conditions that of inflammatory rheumatism as if the lungs were congested, especially at the base. Can hardly breathe, as if cold water in the stomach. Thinks mucus accumulated in the cold stomach. Craves hot teas. Headache extends to the right side. Head feels as if it would burst. Great weight on top of head. Toes burn. Aching at heart. Twinging pains in arms, legs and toes. As if rectum were shrunken, dried up. Bearing down pains and pressing out, like labor pains. Feels gloomy and discouraged, but can't cry. Very cold, shivers internally; thinks she must look blue. Cold creeping all over. Pain in knees subsides, and is succeeded by pain as in the tendons and along the calves. "Oh, such a drawing pain, cutting and darting also, like that in the head." Feels resolute, as full of a gloomy determination. Stomach cold again. Thinks meat bad for her, would not digest; needs soft, mild food. Irritation of bladder and urethra; feels as if prolapsus of bladder. Dreads to move, especially on account of the joints. Sensitive to cold. Stomach still feels as if full of cold water. Sick feeling under right scapula. Thinks bile deficient. Shooting pains in forehead. Feeling as if coldness in stomach extends up under the sternum. Same feeling in the gullet. Excessive aching of bones of toes; seems unendurable. Thinks the stomach very weak, as if it would digest nothing; thinks it is dry and wrinkled. Hypochondriac, not nervous. Feels lazy, as if she would like to lie in bed and be waited on. Selfish. Headache penetrating in temples. Thinks she is clairvoyant, can read character and understand motions; can see into herself; thinks the blood dark blue. Feels pains drawing, rending along posterior aspect of thighs and down to toes. Left side most affected. Feels as if the left leg were drawn up, and would never straighten again. Pains seem to move in meandering lines. Seems to be able to go out of herself for a short distance, to walk around and return into the body. Thinks she is looking down upon her own body. Seems to her that the fundus of the stomach is depressed in the abdomen, as if on fire at the pyloric end of stomach. Thinks there is a red spot there, looking like raw beef, as if the stomach burnt up with raw whisky. Exclaims in a plaintive tone, "Don't get out of patience with me" (of which I had given no indications). Cries, feels babyish. Apprehension; fears something terrible is about to occur. Very chilly. Can't talk loud; voice gone. She feels so weak, as if about to die. Moans and groans, calls for help. Oppression about the heart, as if it had stopped beating, as going into convulsions. Feels as if a spasm of the heart, tetanic. As if the blood too thick to circulate. Thinks she would have died but for the _Camphor_ I gave her. Felt as she did when near dying of hemorrhage. Brain is active, intellect clear, thoughts vivid, the whole being intensified. Next morning, sense of constriction at base of lungs. Some cough. Clammy feeling of skin. Very sensitive to air.

No. 2. Causes a glow all over, hands sweat. Some pain in finger joints. Throat feels obstructed. Some hoarseness. Dry cough, as if pharynx stuffed with cotton. It is an effort to talk. Tongue feels partially paralyzed, cannot direct it. Throws the paper down, has lost inclination to read. Feels indolent, indifferent. Feels chills when air strikes. Spasmodic breathing, like a nervous woman--silly, mystical. Pain in finger joints continues. Feels like crying. Sad, weeping mood. Tears will come. Eyes smart. Heart aches, as from some great sorrow. Eyes feel as if had been crying a long time, as if swollen, burning. Very sensitive to cold, easily chilled. Chills down the back and both legs. Ends with a very tranquil feeling, particularly of consciousness. Next morning, tight feeling of patella. Joints all feel constricted and sore.

No. 3. Very chilly. Can't endure cold at all. Other symptoms not recorded.

In all three, pains and chilliness much increased by moving about.

No. 1. Subsequently her muscular condition was much improved. Her muscles did not ache from work as formerly.

A cut bled less freely than usual, bled scarcely any, and healed very quickly.

SALIX NIGRA AMENTS.

NAT. ORD., Salicaceæ.

COMMON NAME, White Willow.

PREPARATION.--The fresh aments are macerated in twice their weight of alcohol.

(Dr. John Fearns writes of this remedy in _Chicago Medical Times_, 1896:)

At this writing I wish to speak not of the tonic and antiseptic properties of this species of _Salix_, but of its usefulness as a sedative to the generative system. As a sedative on these lines I have had very good results from its use.

In cases of acute gonorrhoea with much errotic trouble. Also in cases of chordee with great irritation; for these purposes I have given it in doses of thirty to sixty drops on retiring, and repeat at midnight or towards morning, if needed; in these cases nothing has given me more satisfaction than this remedy. It answers the purpose, it robs night of its terrors, and it leaves no unpleasant consequences in its train.