Rheum palmatum 200C

- VERMEULEN Frans

Rheum palmatum

Rheum
Play is the exultation of the possible.
[Martin Buber]
Signs
Rheum spp. [Rheum officinale or Rheum palmatum]. Rhubarb. N.O. Polygonaceae.
CLASSIFICATION Rheum is a member of the Polygonaceae, a large family of herbs, some shrubs and trees, most genera of which inhabit the northern temperate region. The family contains a number of ornamentals and plants with edible seeds [Fagopyrum, buckwheat], stalks [Rheum, rhubarb], leaves [Rumex, sorrel] or berries [Coccoloba, sea grapes]. Homoeopathy employs 7 species of this family, which belong to the following genera: Fagopyrum [1 species], Polygonum [2 species], Rheum [1 species], and Rumex [3 species].
GENUS The 50 species of the genus Rheum are native to Siberia, the Himalayas and eastern Asia. They are strong, large-leaved perennial herbs with tough or woody rhizomes and clusters of small, wind-pollinated flowers. Several species are grown as ornamentals for watersides or in woodland settings. Other species are edible or used medicinally. Rheums appear early in spring and thus herald the end of winter. All species require a period of cold weather and like acid soils and lots of water.
RHUBARB "Rheum raphonticum syn. R. rhabarbarum. Rhubarb is sometimes described as a hybrid [Rheum x cultorum] although of uncertain origin. It probably evolved in northern China and eastern Siberia. This and other Rheum species have been used in medicine in China for at least 2000 years. Its use as a fruit substitute began in the 19th century. Rhubarb is now cultivated in many countries with a temperate climate. The plant part utilized is the leaf-stalk or petiole, which is not, of course, a fruit botanically speaking but it is in culinary terms a fruit, being included, with added sugar, in pies, preserves, tarts, crumbles, and wine. Rhubarb contains very little protein, fat, sugar, vitamin C [6 mg/100 g], or ß-carotene. The leaf-stalk contains citric, malic, and oxalic acids, which contribute to the sharpness of rhubarb which is often tempered in food products with added sugar. Cases of poisoning have been associated with consumption of leaf-blade because of high concentrations of oxalic acid and an anthraquinone. For the best leaf-stalks for eating, the rootstocks are unearthed and exposed to the winter frosts, then planted in warm, dark conditions to force growth."1
NAME The ancient Greeks and Romans imported rhubarb from Russia. The Romans called the plant rhabarbarum because it was native to the river Rha [the Volga], then considered a foreign 'barbarian] territory [L. barbarum, from Gr barbaron, foreign] - thus meaning 'from the barbarian [foreign] Rha'. The generic name Rheum derives from Gr rheos, flow, after the habitat of the plant on watersides. Rhubarb refers to any species of the genus Rheum, but also means 'a heated argument', 'a noisy quarrel' or, in theatrical traditions, is a word muttered repeatedly to give the impression of indistinct background conversation, and consequently an expletive meaning 'Nonsense!'.
CONSTITUENTS Anthraquinones [about 3-5%], mainly rhein, aloe-emodin, emodin, and chrysophanol; flavonoids [catechol]; phenolic acids; tannins [5-10%]; oxalic acid / oxalates of calcium, potassium, and sodium. The anthraquinones are responsible for the irritant, laxative and purgative properties of Rheum, but their effect is counterbalanced by the high levels of tannins, so that in small doses of the root the tannins predominate and cause a constipating effect. "Plants containing anthraquinones have been used for millennia as dyestuffs and purgatives. This important commercial dual function led to an early isolation and characterization of the active principles, which were shown to be derived from, or related to, the substance anthraquinone. Notable dyestuffs include madder [Rubia tinctorum] and the insect-derived cochineal. Familiar laxatives include senna pods [Cassia angustifolia or C. acutifolia], cascare sagrada [Rhamnus purshiana], alder buckthorn [Rhamnus frangula], rhubarb root [Rheum palmatum], yellow dock [Rumex crispus] and aloes [Aloe vera]. ... Direct anthraquinone derivatives include the following aglycones: rhein from Rheum, Rumex and Cassia spp.; emodin from Rheum and Rhamnus spp.; aloe-emodin from Rheum and Cassia spp.; chrysophanol from Rheum and Rumex spp. ... From pharmacological investigation we know that the action of the anthraquinones is dependent on the presence in the gut of bile and on the fact that they are ingested in the glycoside form. The isolated aglycone is inactive if ingested although it is potently active if ingested intravenously. ... The anthraquinone laxatives essentially irritate the bowel wall, provoking increased muscle contractions and peristaltic movements. ... The anthraquinone derivative rhein [present in Rheum, Rumex and Cassia spp.] is significantly antiseptic and is esp. toxic to the enteric pathogen Shigella dysenteriae as well as to Staphylococci."2 Chronic consumption of anthraquinone laxatives can turn urine a bright yellow or red colour, and may also cause liver damage. However, the most poisonous part of the plant are the leaves, ingestion of which cause burning of mouth and throat, stomach pain, nausea, vomiting, haemorrhage, and respiratory problems. Severe intoxication may result in kidney damage [due to precipitation of calcium oxalate] or even death from cardiac or respiratory arrest.
MEDICINE Famous for its purging powers, rhubarb had entered Europe in the 16th century as a medicinal herb through the overland trade routes from the East. By the early 17th century, Rheum rhaponticum was the first rhubarb species to be grown in Europe. This plant came from the regions around the Pontus or Black Sea. However, the search continued for the 'true' rhubarb which Marco Polo had reported in 1295 as deriving from China. In 1732 Rheum palmatum [Chinese rhubarb] was introduced into Europe, followed by Rheum officinale [Russian rhubarb] in 1867. The first rhubarb planted in North America was sent to the naturalist Bartram from Siberia in 1770. The cultivation of R. palmatum was given high priority in 18th-century Europe. This species is one of the most widely used Chinese herbs. Other species used medicinally include R. australe [syn. R. emodi; Himalayan rhubarb or Indian rhubarb], and the hybrid R. palmatum x R. coreanum [Japanese rhubarb]. All these rhubarbs vary slightly in chemistry but are used interchangeably, although R. palmatum and R. officinale are the main medicinal species. Known as da huang in Chinese medicine, R. palmatum was employed internally for chronic constipation, diarrhoea, liver and gall bladder complaints, haemorrhoids, menstrual problems, heat-related symptoms [such as nosebleed], and skin eruptions due to the accumulation of toxins. 3 In 1921, the English physician Burkitt, working in British East Africa, wrote in The Lancet that he'd treated dysentery with rhubarb almost exclusively for three years: "I know of no remedy in medicine which has such a magical effect. No one who has ever used rhubarb would dream of using anything else ... in this dreadful tropical scourge."4
EFFECTS "Rhubarb is cathartic, astringent and tonic; as a cathartic, it acts by increasing the muscular action of the intestines, rather than by augmenting their secretions, and affects the whole intestinal canal, esp. the duodenum. Its cathartic effect is succeeded by a mild astringency, which has gained for rhubarb the reputation of being secondarily a calmative, as well as a stimulant of the digestive canal; with its astringent influence, it likewise exerts for the most part, a tonic action on the stomach, improving the appetite and digestive powers. It is absorbed in the course of its operation, making the serum of the blood yellow, the sweat tawny, and the urine red, which may be distinguished from bloody urine by heating it. If blood be present it will coagulate, and remove the red colour, which will not happen if the tint be owing to rhubarb. Rhubarb applied moist to the skin, or when used to dress ulcers, as it sometimes is, has produced its peculiar purgative effects. Rhubarb is much used as a laxative for infants, in many infantile diseases; its mildness and tonic qualities rendering it peculiarly applicable, esp. when enfeebled digestion and irritation of the alimentary canal are present. In acute or chronic diarrhoea or dysentery, in convalescence from exhausting diseases, and in some irritable habits, where the mildest of all other laxatives are apt to excite hypercatharsis, rhubarb is an appropriate medicine. Its combination with soap or an alkali tends to counteract its astringent effects, and it thus becomes valuable in cases of constipation. It is useful in all cases of faecal accumulations, as it produces faecal, more than watery discharges. Sometimes it produces griping, which may be obviated by aromatics."5
PROVINGS •• [1] Hahnemann - 5 provers; method: unknown.
•• [2] Schneller - self-experimentation, 1846; method: increasing doses of an aqueous extract.
[1] Vaughan and Geissler, The New Oxford Book of Food Plants. [2] Mills, The Essential Book of Herbal Medicine. [3] Bown, Encyclopedia of Herbs and their Uses. [4] R.W. Burkitt, cited in Castleman, The Healing Herbs. [5] King's American Dispensatory.
Affinity
Muscles [of bile ducts; duodenum; intestines]. Liver. * Left side. Right side.
Modalities
Worse: Dentition. Eating. Summer. At night. Uncovering. Moving about. Standing. Before, during and after stool.
Better: Warmth. Wrapping up. Lying doubled up. Covering.
Main symptoms
M INDISPOSITION to PLAY [in children], on account of colicky pains.
Asks for nothing.
Anxiety from motion.
CAPRICIOUSNESS.
• "The Rheum state in the Materia Medica falls between Magnesium carbonicum and Chamomilla, and alternates between the feeling of Mag-c., which is that of being an orphan who demands nothing and can do with very little food or sleep, and that of Cham., extremely demanding, irritable and violent, seeking immediate attention. I have seen Rheum to be useful for children whose parents leave the child and go to work. While they are away, the child is like an orphan. He is non-demanding and has symptoms like: Indifference to everything; Aversion to playing in children; Weeping in children. But when the parents are back, he must immediately get what he asks for. Here the symptoms are: Asks for things vehemently, shrieks and shrieks till he gets it." [Sankaran]
M Irritability during perspiration.
M Children TOSS all night.
[Compare "Quarrelsome in sleep."]
G Complaints of nursing women.
G Perspiration on SCALP [sopping wet hair], about nose, mouth or on upper lip.
• "Sweat on the scalp, constant, profuse; whether asleep or awake, quiet or in motion, the hair is always wet; may or may not be sour." [Allen]
G Aversion to food after eating a little [loathing after first bite].
G RESTLESS sleep.
And Whining, crying, twitching of face, fingers, etc.
G < Becoming cold, uncovering.
> WARMTH, doubling up.
G SOURNESS.
[stools, breath, perspiration, vomit]
G BUBBLING sensation.
P Difficult dentition.
P Colic, with cries.
> Doubling up.
< Uncovering any part.
P Diarrhoea during inflammatory rheumatism. [Mathur]
P Stool pappy, sour, brown, green, fermented, slimy or acrid.
Yellow stool turns green on standing.
P Shivering during stool.
Rubrics
Mind
Anxiety < motion [1]. Asking for nothing [1]. Dulness, says nothing [2]. Impulsive [1]. Irritability, during chill [3], during dentition [3], during perspiration [3]. Quarrelsome in sleep [1].
Head
Perspiration of scalp, only the head [1], sour [1]; forehead, easy [1/1].
Eye
Twitching of lids during sleep [1/1].
Nose
Pain, drawing, root of nose extending to tip of nose [1/1]. Cold perspiration around nose [1; Chin.]. Tingling, tip of nose [1].
Face
Perspiration, cold, around mouth [1]. Twitching, during sleep [1]; around mouth [2]; corners of mouth [1].
Mouth
Sweet things taste bitter [1].
Abdomen
Pain, > bending double [2]; cramping, in morning on uncovering [1/1].
Rectum
Diarrhoea, after delivery [1], during exertion [2/1], after magnesia [1], after nursing [in women] [2; Chin.], < standing [1]. Urging on motion [2].
Stool
Yellow, turning green on standing [1; Arg-n.].
Female
Pain, bearing down, uterus, < standing [1].
Limbs
Perspiration, palms, when pressing hands together [1; Sanic.].
Perspiration
From slight exertion [1]. Odour, sour [2]. Single parts, front of body [2], upper part of body [2]. Staining linen yellow [2].
Food
Aversion: [2]: Food, after eating a little. [1]: Coffee; fat; milk; mother's milk; sweets.
Desire: [2]: Sweets. [1]: Refreshing things; tonics.
Worse: [1]: Fruit; fruit, unripe; milk; plums.