Colchicum autumnale - No other pain is more severe than this.
- VERMEULEN Frans
Colch
No other pain is more severe than this, not iron screws, nor cords, not the wound of a dagger, nor burning fire.
[2nd-century Greek physician Aretaeus, describing the pain of gout]
Signs
Colchicum autumnale. Autumn Crocus. Meadow Saffron. Naked Ladies.
N.O. Colchicaceae [Liliaceae].
CLASSIFICATION Different authorities have recognized between 12 and 28 tribes within the Liliaceae. Formerly placed in the Lily family [Liliaceae], Colchicum is now generally included under the Colchicaceae, a family comprising 16 genera of cormous herbs or climbers, Gloriosa, Iphigenia and Ornithoglossum among them. The genus Colchicum contains some 60 species.
FEATURES Widespread in the Old World, Colchicum is a native of the temperate parts of Europe, where it grows wild in moist meadows. The plant goes against the general rhythm of the lilies by flowering in the autumn. Pollinated during a period when otherwise nature is dying [autumn], it bears within itself death as well as procreation. [The ancients took it as an aphrodisiac, but they could also use it for public or secret death-sentences.] Self- or cross-pollination occurs above ground, and the pollen tubes grow down through the extraordinarily long style, which often reaches a length of 15-20 cm, until they meet the ovary below ground. This takes many months, through the whole of autumn and winter. The fruit ripens slowly during the summer. It takes almost nine months from fertilization to ripeness, for a plant a disproportionately long time. 1
NAME The name Colchicum derives from Colchis [now Georgia], an ancient kingdom near the Black Sea where the plant grew abundantly and home of the enchantress Medea. Various common names, such as 'Naked Lady', 'Naked Maiden', and 'Naked Boys', refer to the fact that the stalkless, unprotected flowers develop before the leaves in the autumn, to be followed in the next spring by the leaves and seeds. Hence it is also called Son before the Father. The German name for the plant is Herbstzeitlose, literally 'autumn timeless'. Zeitlose is thought to be a corruption of the Latin citola, maiden, and osa, naked, but might as well be an expression of the 'timeless' character of a plant that seems to go against the rhythm of nature.
MEDEA Medea was not infrequently called Colchis, from the place of her birth. She was the daughter of Aeetes, king of Colchis, and the Oceanid Eidyia, and thus the granddaughter of Helios, the Sun-god. Like her aunt Circe, Medea was an enchantress, although she was also considered the 'Wise One' because she was named from the Sanskrit concept of medha, 'female wisdom'. An adept in the feminine art of healing, Medea could restore the dead to life in her magic cauldron, as shown by the myth of Aeson, father of Jason, who was magically restored to youth by the sorcery of Medea. Medea wandered nine days and nights through dark forests and mountains to collect the herbs for her rejuvenating elixir. The plant Colchicum sprang from the soil where she had spilled a few drops of the elixir. When Jason came with the Argonauts to Colchis in quest of the Golden Fleece, Medea fell head over heels in love with him and helped to complete the seemingly impossible tasks set him by Aeetes, e.g. by giving him a magic salve that made him invulnerable to the two fire-breathing bulls he had to yoke. Medea seems to have been associated with dismemberment. When the ship Argo, of the Argonauts, hastened away with its prize - the Golden Fleece - she suggested that they cut up her brother Apsyrtus and throw the bits overboard in order to slow down their pursuers. However, her magic could also have a happier outcome, as when she cut an old ram into pieces, threw the parts into her cauldron, and a young lamb came forth.
MEDICINE "It was from the East that Colchicum was introduced as a cure for gout into the Byzantine Empire. About 600 AD the great physician Alexander of Tralles mentioned Colchicum in this respect in his textbooks of medicine. Whether the early Greeks knew it is in some doubt although it may be that their Hermodactyles [Mercury's fingers] was Colchicum. It seems that there is some confusion in ancient writing between this and the white hellebore. All through the Middle Ages Colchicum had a fluctuating career as a treatment for a long list of ails including gout, cholera, fevers, syphilis, convulsions, asthma, leucorrhoea and many other diseases. Around 1650 Culpeper used it for tertian ague, as a purge and as a diuretic. Some physicians who feared its poisonous effects would apply the macerated root as a plaster to gouty joints. At the beginning of the 19th century Colchicum enjoyed great success and popularity as a gout cure in the form of 'Eau d'Husson' a patent medicine introduced by a French quack! As a result of this medical interest quickened and it was not long before Pelletier and Caventou isolated the active alkaloid, colchicine, in 1820. "2
COLCHICINE The major alkaloid of Colchicum autumnale is colchicine. The colchicine content is highest in the seeds [up to 1,3%], followed by the corm, while the leaves and flowers have the lowest content. Pure colchicine consists of pale yellow scales or powder, darkening on exposure to light. Its biological activities include antimitotic, anti-inflammatory, and antifibrogenic actions. It also acts on liver functions: it modifies membrane fluidity, and increases membrane enzymes activities and glycogen levels. Colchicine is used to treat acute gout, familial mediterranean fever, and, less frequently, leukemia, and Behçet's syndrome. More recently, the use of colchicine has expanded to include such indications as primary biliary cirrhosis, alcohol-induced cirrhosis, sarcoidosis, and scleroderma. Because it inhibits collagen transport to the extracellular space, it is employed in the prevention or treatment of amyloidosis and scleroderma. Colchicine has been shown to be more toxic in the elderly, especially those with liver or kidney dysfunction. Patients are advised to consume a large amount of fluids while taking colchicine. Although research is inconsistent, colchicine is believed to prevent vitamins A and B12 absorption. It has also been associated with impaired absorption of beta-carotene, fat, lactose, potassium, and sodium. Acidifying agents inhibit the action of colchicine, while alkalinizing agents potentiate it. Highly toxic, death has resulted from single oral doses of 3 to 13 mg colchicine, although the estimated lethal dose is 20-65 mg. In laboratory animals, this alkaloid has caused both birth defects and damage to the reproductive system.
GOUT Colchicine has a specific effect in gouty arthritis and is used both to prevent and to relieve acute attacks. In acute attacks the response to colchicine is usually dramatic. Given orally, colchicine reaches peak concentrations in about an hour, resulting in the subsiding of joint pains after 12 hours of treatment and in their disappearance within 36 to 48 hours. The dose of colchicine is 1 mg orally every 2 hours until a response is obtained or until diarrhoea or vomiting appears. Colchicine prevents migration of neutrophils into the joint by binding to tubulin, and interferes with cell motility. Colchicine-treated neutrophils develop a 'drunken walk'. Severe diarrhoea may be a problem and with large doses may be associated with gastrointestinal haemorrhage and kidney damage. Rashes sometimes occur, also peripheral neuropathy. Colchicine is also given intravenously if the gastrointestinal tract is intolerant of oral medication; not more than 2 mg should be given in 24 hours. "Severe bone marrow suppression and death may occur in patients receiving oral colchicine prophylactically who are also given intravenous doses of this drug. Severe electrolyte imbalance can accompany many colchicine-induced diarrhoeal episodes with disastrous consequences, especially in elderly patients."3
HIGH LIVING Associated with affluence and high living, gout is often called the 'rich man's disease.' "Throughout history, the sufferer of gout has been depicted as a portly, middle-aged man sitting in a comfortable chair with one foot resting painfully on a soft cushion as he consumes great quantities of meat and wine. In fact, the traditional picture does have some basis in reality, as meats, particularly organ meats, are high-purine foods, while alcohol inhibits uric acid secretion by the kidneys. Furthermore, even today, gout is primarily a disease of adult men; more than 95% of gout sufferers are men over the age of 30 years. Approximately 3 adults in 1,000 have gout, and 10-20% of the adult population has elevated uric acid levels in the blood. Several dietary factors are known to cause gout: consumption of alcohol, high-purine foods [organ meats, meat, yeast, poultry, etc.], fats, refined carbohydrates, and overconsumption of calories."4
STOICISM While gout has been associated with high living and its consequences, the "archetypal medicine's investigation of rheumatic stiffening of the joints probably leads at some point to the philosophy of the Stoics, where patience, pliancy, obedience, and altruism play significant roles." "Stoicism was primarily an ethical doctrine: the effect of a way of thinking as a way of life. The purely philosophical aspects were secondary. Stoicism was a philosophy of deed, action as the measure of all wisdom, intended to make more bearable the loathsomeness of the condition humaine in general and in particular the mean living conditions of the Roman Empire. At this time a number of men appeared on the scene who could best be described as 'moralizers'. They lived mostly in Italy and Greece but were also found in Asia Minor and Syria. They lived as simply as possible, renouncing material possessions and taking pride in bearing outer poverty with dignity. They wore only a sleeveless garment, extending barely to the knee and wrapped twice around their bodies leaving the right shoulder bare. Barefooted, carrying only a staff and knapsack, they wandered indefatigably from place to place, living from the alms of their contemporaries. Wherever they were, they discussed questions pertaining to daily life and morality. Preaching virtue, peace of mind, true freedom, and much more, they spoke about death, poverty and wealth, about honour, and against pleasure of the flesh. They displayed defiant disdain for the body. It was filth for them by nature and for the immortal soul a cumbersome dungeon. Accordingly, they were also spartan in their nourishment: pearl barley, lupines, figs, and water were more than sufficient. They slept in temple porticos and in the baths; they bore heat and cold, hunger and thirst in almost superhuman fashion. Philosophical moderation was the order of the day and was taken for granted. Otherwise, though, one is left with a feeling of the Stoics' awkwardness toward everything and everyone. They were 'self-sufficient' and, insofar as this attitude extended to their inner lives, they were apathetic. In other words, they were untouched by their emotions, impulses, and desires. Assuming that awkwardness and rigidity find expression as a painful stiffening of the joints the more fanatically that obedience and submission are preached, it is not surprising that one of the most famous of these moralizers, Epictetus, was rheumatic [if the account of his pupil Suidas can be believed]."5
FEVER Colchicine taken prophylactically daily provides complete remission or distinct improvement in about 85% of cases of familial mediterranean fever [FMF], also called benign paroxysmal peritonitis, familial paroxysmal polyserositis, familial recurrent polyserositis, mediterranean fever, and familial paroxysmal peritonitis. FMF is an inherited disorder of unknown aetiology, characterized by transient recurrent attacks of fever and abdominal pain [peritonitis], and less frequently by pleuritis, arthritis, pericarditis, and rash. FMF occurs most frequently, but not exclusively, in persons of Mediterranean origin. The disorder usually begins between ages 5 and 15 but sometimes starts at a much later age or even during infancy. Attacks have no rhythm or regular pattern of recurrence and vary somewhat in the same patient. They usually last 24 to 48 hours, but some last for a week or so. The most common interval is 2 to 4 weeks. Severity and frequency tend to decrease with age, during pregnancy, or with development of amyloidosis. Nephropathic amyloidosis, a complication reported much more frequently in the Mediterranean region than in the USA, is much less common since the introduction of colchicine treatment in 1973. A daily dose of 1-2 mg colchicine on a continuous basis has been found to prevent attacks in most patients and amyloidosis in all patients. Fever as high as 40o C [104o F], usually accompanied by peritonitis, is the major manifestation. Abdominal pain occurs in about 95% of patients and can vary in severity from one attack to the next. The pain usually starts in one quadrant, then spreads to the whole abdomen. Decreased bowel sounds, distension, guarding, and rebound tenderness are likely to be present at the peak of an attack, making the event indistinguishable from a perforated viscus on physical examination. Consequently, many patients have undergone urgent laparotomy before the correct diagnosis was made. With diaphragmatic involvement, there may be splinting of the chest and pain in one or both shoulders. Other symptoms include acute pleuritic pain [75%], acute arthritis involving the large joints [25%], and an erysipeloid rash of the lower leg. 6
TOXICOLOGY All parts of the plant, but especially the corms, are toxic. Within two or six hours after ingestion, symptoms start to develop which are similar to those of arsenic poisoning: burning throat, intense thirst, vomiting, difficulty in swallowing, bloody diarrhoea, stomach pain, sensory disturbances, muscle weakness, delirium, cardiovascular collapse and respiratory failure. There is continual profuse vomiting, which is accompanied by profuse secretion of saliva, tears, and mucus from the nose. An ascending paralysis with consciousness maintained to the end occurs in most victims, death taking place in 24-48 hours. Colchicum poisoning is fatal in 50% of cases, although it may not occur until three days after ingestion. Chronic colchicine poisoning includes loss of hair, and blood and protein in the urine. Colchicine is slowly excreted; victims are often ill for a long time. Symptoms of a fatal overdose are similar to those of severe radiation poisoning. Poisoning has also been reported in cattle, goats, horses, sheep, and swine, as well as in dogs and cats. Colchicine can be excreted through the milk of lactating animals, thereby poisoning young animals and humans. Cattle and, to a lesser extent, goats and sheep can develop complete resistance to colchicine.
MITOSIS Colchicine is a mitotic poison; it inhibits cell division and slows it greatly, in all cells including neoplastic cells. Used in botanical, cellular, and genetic research, colchicine is capable of stopping cell division at the stage when the chromosomes have divided and are fully formed but have not yet pulled apart to form two separate nuclei. It inhibits spindle formation and thus the condensed chromosomes are scattered rather than aligned on the spindle. The cell's chromosomes remain double in number, altering the genetic pattern, a phenomenon used by plant breeders to create new create new varieties of fruits, vegetables, and flowers.
CYCLE "The plant has a subterranean rhizome which forms new internodes every year. Two things are significant and remarkable in this: the plant, flowering and sprouting below ground, has, like Demeter's unhappy child Persephone, taken refuge in the darkness of the earth. But Colchicum does not, like Persephone, rise up in the spring, but in the autumn. It begins to flower at a time when other plants are dying. ... Everything here is, as it were, out of place; the flower rushes ahead before the leaves can unfold and, instead of in the spring, breaks through in the preceding autumn. The leaves follow at their convenience and at the right time. The fruit, however, is particularly late and out of time. ... The autumn crocus does not only grow underground, it also develops against the periodicity common to its family. ... The early autumn, or Indian summer, is a period when for a very short time a kind of second blooming occurs in temperate regions. ... Into this time of Indian summer the Colchicum has sneaked. It takes part in it and uses it for pollination and thus for its perpetuation. But because it misuses an environment which does not belong to it, it turns into a plant which produces poison. For poison arises only where otherwise disease would develop. A natural process arising at the wrong site and at the wrong time is poison in the plant. ... Pollinated during a period when otherwise nature is dying, it bears within itself death as well as procreation. ... There where growth originates and creates anew, in the formation of new cells, this poison strikes. It takes its revenge at the very place where it is not allowed to appear. The spring forces of sprouting cell-growth are struck by the deadly breath of the plant which flowers in the autumn. The spindle formation comes to a standstill and instead of forming daughter cells the mother cells remain distorted. This same deathly autumnal breath appears in Colchicum where it acts as an anti-allergic and antiphlogistic agent. For inflammation is a heightened defensive force of the organism; it is an enhanced life force, either concentrated on a certain region of the body, or displayed over the whole of the organism. This defensive power is dampened by colchicine and often extinguished altogether."7
PROVINGS •• [1] Stapf - 5 provers; method: unknown.
•• [2] Lewins - 6 provers, 1837; method: tincture or wine of colchicum, 15 to 70 drops.
•• [3] Maclagan - 4 provers, 1851; method: [repeated] doses of 1-30 drops of tincture.
•• [4] Reil - 13 provers [9 males, 4 females], 1853-54; method: repeated doses of tincture, 1x, 3x, 12x, and 15x.
•• [5] Schulz - 8 provers, 1896; method: repeated doses of tincture.
•• [6] Raeside - 17 provers [10 males, 7 females], 1964-65; method: three experiments of two weeks each, first with 30c, second with 6x, third with 6c; twice daily doses for 14 days, unless 'symptoms became too disturbing.'
"The greatest collection of symptoms came during the first term, to our considerable surprise. The first term is usually the least harvest of signs and symptoms, and the third term is usually the most. Quite the reverse happened here, as it was the autumn term on 30c which was the most effective; the second term was quite productive, but the last term was a very poor experiment. One cannot help wondering whether the autumn crocus acts better as a remedy and as a poison in the autumn, for this was certainly the time which produced most results in our provers."8
[1] König, Indian Summer, The Autumn Crocus, and Colchicine; BHJl, April 1958. [2] Raeside, A proving of Colchicum autumnale; BHJ, April 1967. [3] Merck Manual. [4] Murray, The Healing Power of Herbs. [5] Ziegler, Archetypal Medicine. [6] Merck Manual. [7] König, ibid. [8] Raeside, ibid.
Affinity
DIGESTIVE TRACT. HEART; pericardium. Circulation. Kidneys. Tissues [MUSCLES; ligaments; fibrous; serous; JOINTS; small joints].
* Left side. Right side. Left to right.
Modalities
Worse: MOTION. Touch. Night. Stubbing toes. Vibration. WEATHER [cold; damp; cold rooms; changing; Autumn]. Slight exertion. Checked sweat. Stretching. Sundown to sunrise. Extreme heat of summer. STRONG ODOURS. Eating. Loss of sleep.
Better: Warmth; wrapping up. Rest; lying quietly. Doubling up. Sitting. After stool. Open air.
Main symptoms
M Sensitive persons, more or less unprotected from external impressions [popular name of Colchicum is "Naked Ladies"], both mental and physical.
c Sensitive to RUDENESS of OTHERS.
Wildness from misdeeds of others.
c Oversensitive to all external impressions [mostly on account of PAIN; gouty persons with extreme irritability of temper].
• "The smell of pork [which he formerly liked], a bright light, a touch, the naughtiness of a child, put him almost beside himself; such extreme depression of spirits, weakness, pain and sensitiveness of the whole body that he can hardly move without moaning." [Hughes]
c OVERSENSITIVE TO:
* ODOURS [cooking odours; fish; fat; eggs]
So sensitive to odours that he smells things which others do not smell.
Odours cause headache, nausea, vomiting, faintness.
• "After 4 days, the smell of a newly beaten-up egg almost made him faint. ... The smell is so morbidly exalted that something quite indifferent, e.g. soup, makes him almost sick." [Hughes]
* Bright light.
* Noise [talking of others].
* Pain.
* Touch.
M Fear of mice; delusions; = sleeplessness or disturbed sleep.
M Loss of perception.
• "The consciousness of logical connection was entirely destroyed, and his perceptive faculties were impaired by the slightest circumstances which interrupted the sequence of ideas." [Allen]
No fear; appears unconcerned about condition.
M Feeling as if mind is a jig-saw puzzle with all the pieces there but not interlocked. [Raeside]
G Sensitiveness, susceptibility and <: COLD, COLD and DAMP [Autumn; Colchicum autumnale]. G WEAKNESS, internal coldness and tendency to collapse. Wants to be undisturbed because of weakness. • "She feels such weakness in muscles of extremities that she thinks they will fall off; all muscles, especially of lower extremities, as if paralysed; quite powerless and as if paralysed in all the body, esp. the arms; the painful muscular paralysis, esp. in knees, causes them to buckle under him often, esp. when he lifts his legs to step over an elevated object, e.g. the doorstep." [Hughes] • "You must know that Colchicum tends to produce great prostration, and from this arises the great danger in administering it in large doses as a routine remedy in gout and rheumatism. ... We find Colchicum indicated in debility, particularly in debility following loss of sleep; for instance, when one does not retire as early as usual in the evening, so that he is deprived of a portion of his accustomed sleep, he awakens next morning feeling tired and languid; he can hardly drag one leg after the other; the appetite is gone; bad taste in the mouth and nausea are present. The debility, then, starts from or involves digestion as a result of loss of sleep. You can see how close this comes to the Nux vomica condition. The debility, however, is greater even than that of Nux vomica. There is, at times, an aversion to all food; the odour of food cooking makes the patient feel sick; he becomes irritable; every little external impression annoys him; here it is precisely like Nux vomica." [Farrington] G Extreme DISINCLINATION to MOVE [similar to Bry.]. But weak, restless and very chilly. [Combination of Ars. and Bry.] G < MOTION of AFFECTED part. < WALKING. > While sitting.
G TOUCH = electric-like shocks through body.
< SLIGHT touch. G > On WAKING.
G LIVER or digestive DISORDERS.
And Forgetfulness , dullness, weakness of memory.
G LIVER AFFECTIONS and GOUT.
Or: LIVER AFFECTIONS and RHEUMATIC affections.
G Pains go from left to right, except headache, which goes from right to left.
G Weather.
• "Tingling in many parts of the body, as if frostbitten, whenever the weather changes." [Lippe]
P Nausea and vomiting.
< Every motion. > Lying quietly.
P Diarrhoea in AUTUMN.
P Dropsical conditions; affections of kidneys with urine with black sediment [like INK].
P Gout of BIG TOE.
< Motion, touch or stubbing the toe [patient screams with pain]. FIBROUS TISSUES / JOINTS. • "Stands in close relation to fibrous tissues: redness, swelling, heat, etc., not tending to suppuration; quickly changing location. Inflammation of joints with excessive HYPERAESTHESIA, slightest concussion of air, floor or bed renders the pains unbearable ... Large joints intensely red and hot ... acts more on the small joints. ... Attacks of rheumatism break forth suddenly and disappear suddenly. Pains shifting: acute attacks merging into chronic form, or during chronic form acute attacks set in. Great irritability with the pains: very sensitive to touch: the least vibration makes pain unbearable." [Tyler] • "He goes to Bed and sleeps well, but about Two a Clock in the Morning, is waked by the Pain, seizing either his great Toe, the Heel, the Calf of Leg, or the Ankle; this Pain is like that of dislocated Bones, with the Sense as it were of Water almost cold, poured upon the Membranes of the Parts affected, presently shivering and shaking follow with a feverish Disposition; the Pain is first gentle, but increases by degrees [and in like manner the shivering and shaking go off], and that hourly, till towards Night it comes to its height, accompanying it self neatly according to the Variety of the Bones of the Tarsus and Metatarsus, whose Ligaments it seizes, sometimes resembling a violent stretching or tearing those Ligaments, sometimes the gnawing of a Dog, and sometimes a weight; moreover, the Part affected has such a quick and exquisite Pain, that it is not able to bear the weight of Cloaths upon it, nor hard walking in the Chamber; and the Night is not passed over in Pain upon this Account only, but also by reason of the restless turning of the part hither and thither, and the continual Change of its Place. Nor is the tossing of the whole Body, which always accompanies the Fit, but especially at its coming, less than the continual Agitation and Pain of the tormented Member. There are a Thousand fruitless Endeavours used to ease the Pain, by changing the Place continually, whereon the Body, and the affected Members lie, yet there is not ease to be had." [Description of gout by Thomas Sydenham - 1683 -, who suffered from the affliction himself.] Rubrics Mind Ailments from rudeness of others [2]. Anger, < bright light [1/1], < odours [1/1]. Confusion, from interruption, logical thinking impossible [1/1]. Delusions, someone is under the bed [1], sees mice [1], of hearing noise [1]. Despair, with the pains [1]. Discouraged, from pain [1], with rage [1; Nit-ac.]. Dulness, when interrupted [1/1]. Fear, of being touched [2]. Ideas, abundant, clearness of mind alternating with dulness [1; Alum-p.]. Indifference, doesn't complain, says nothing of his condition unless questioned [1/1]. Irritability alternating with indifference [1]. Wants to be quiet [1]. Wildness, from bright light, strong odours, touch [2/1]. Vertigo After cold drinks [1/1]. From looking steadily [1]. Head Pain, from fat food [1], > heat [1], from strong odours [2], > after sleep [1], from loss of sleep, from night watching [1]. Feels as if tied [1; Desm-g.].
Eye
Pain, extending backward [1], to occiput [1].
Vision
Colours, objects appear with iridescent borders [1*], objects appear yellow [1*]. Lost, on standing [1].
Nose
Odours, sensation of fish-brine [1], of smoked ham [1/1].
Mouth
Salivation, with sensation of dryness [1]; during stool [1; Rheum; Vip.].
External throat
Tension, sides, on swallowing [1/1].
Stomach
Vomiting, > lying on right side [1; Ant-t.], while riding in a carriage [2], from swallowing saliva [1/1].
Abdomen
Pain, > bending double [2], must bend double [1].
Kidneys
Pain, renal region, can only lie on the back [1/1].
Urine
Where there is diminution of constituents, there is increase of stools [1/1].
Male
Sexual desire increased after eating [1; Aloe; Lyss.].
Chest
Feeling as if sternum and spine were screwed together [1*].
Limbs
Itching, around large joints [1*]. Pain, rheumatic, on becoming cold [1].
Sleep
Disturbed by fear of mice [1/1].
Generals
Ailments from radiation therapy [1*].
* Repertory additions.
Food
Aversion: [3]: Food, smell of. [2]: Eggs, smell of; fats and rich food; fish; food, sight of; pork..
Desire: [1]: Carbonated water; coffee; cold drinks; eggs; mustard; wine.
Worse: [3]: Broth, smell of; food, smell of; food, sight of. [2]: Eggs, odour of; fat; fish, smell of; meat; pork; pork, smell of; soup, smell and thought of. [1]: Alcohol; butter; coffee; cold drinks [= vertigo]; eggs; fruit; meat, odour of cooking.
Colch
 |
| Colchicum autumnale |
[2nd-century Greek physician Aretaeus, describing the pain of gout]
Signs
Colchicum autumnale. Autumn Crocus. Meadow Saffron. Naked Ladies.
N.O. Colchicaceae [Liliaceae].
CLASSIFICATION Different authorities have recognized between 12 and 28 tribes within the Liliaceae. Formerly placed in the Lily family [Liliaceae], Colchicum is now generally included under the Colchicaceae, a family comprising 16 genera of cormous herbs or climbers, Gloriosa, Iphigenia and Ornithoglossum among them. The genus Colchicum contains some 60 species.
FEATURES Widespread in the Old World, Colchicum is a native of the temperate parts of Europe, where it grows wild in moist meadows. The plant goes against the general rhythm of the lilies by flowering in the autumn. Pollinated during a period when otherwise nature is dying [autumn], it bears within itself death as well as procreation. [The ancients took it as an aphrodisiac, but they could also use it for public or secret death-sentences.] Self- or cross-pollination occurs above ground, and the pollen tubes grow down through the extraordinarily long style, which often reaches a length of 15-20 cm, until they meet the ovary below ground. This takes many months, through the whole of autumn and winter. The fruit ripens slowly during the summer. It takes almost nine months from fertilization to ripeness, for a plant a disproportionately long time. 1
NAME The name Colchicum derives from Colchis [now Georgia], an ancient kingdom near the Black Sea where the plant grew abundantly and home of the enchantress Medea. Various common names, such as 'Naked Lady', 'Naked Maiden', and 'Naked Boys', refer to the fact that the stalkless, unprotected flowers develop before the leaves in the autumn, to be followed in the next spring by the leaves and seeds. Hence it is also called Son before the Father. The German name for the plant is Herbstzeitlose, literally 'autumn timeless'. Zeitlose is thought to be a corruption of the Latin citola, maiden, and osa, naked, but might as well be an expression of the 'timeless' character of a plant that seems to go against the rhythm of nature.
 |
| Colchicum autumnale |
MEDICINE "It was from the East that Colchicum was introduced as a cure for gout into the Byzantine Empire. About 600 AD the great physician Alexander of Tralles mentioned Colchicum in this respect in his textbooks of medicine. Whether the early Greeks knew it is in some doubt although it may be that their Hermodactyles [Mercury's fingers] was Colchicum. It seems that there is some confusion in ancient writing between this and the white hellebore. All through the Middle Ages Colchicum had a fluctuating career as a treatment for a long list of ails including gout, cholera, fevers, syphilis, convulsions, asthma, leucorrhoea and many other diseases. Around 1650 Culpeper used it for tertian ague, as a purge and as a diuretic. Some physicians who feared its poisonous effects would apply the macerated root as a plaster to gouty joints. At the beginning of the 19th century Colchicum enjoyed great success and popularity as a gout cure in the form of 'Eau d'Husson' a patent medicine introduced by a French quack! As a result of this medical interest quickened and it was not long before Pelletier and Caventou isolated the active alkaloid, colchicine, in 1820. "2
COLCHICINE The major alkaloid of Colchicum autumnale is colchicine. The colchicine content is highest in the seeds [up to 1,3%], followed by the corm, while the leaves and flowers have the lowest content. Pure colchicine consists of pale yellow scales or powder, darkening on exposure to light. Its biological activities include antimitotic, anti-inflammatory, and antifibrogenic actions. It also acts on liver functions: it modifies membrane fluidity, and increases membrane enzymes activities and glycogen levels. Colchicine is used to treat acute gout, familial mediterranean fever, and, less frequently, leukemia, and Behçet's syndrome. More recently, the use of colchicine has expanded to include such indications as primary biliary cirrhosis, alcohol-induced cirrhosis, sarcoidosis, and scleroderma. Because it inhibits collagen transport to the extracellular space, it is employed in the prevention or treatment of amyloidosis and scleroderma. Colchicine has been shown to be more toxic in the elderly, especially those with liver or kidney dysfunction. Patients are advised to consume a large amount of fluids while taking colchicine. Although research is inconsistent, colchicine is believed to prevent vitamins A and B12 absorption. It has also been associated with impaired absorption of beta-carotene, fat, lactose, potassium, and sodium. Acidifying agents inhibit the action of colchicine, while alkalinizing agents potentiate it. Highly toxic, death has resulted from single oral doses of 3 to 13 mg colchicine, although the estimated lethal dose is 20-65 mg. In laboratory animals, this alkaloid has caused both birth defects and damage to the reproductive system.
GOUT Colchicine has a specific effect in gouty arthritis and is used both to prevent and to relieve acute attacks. In acute attacks the response to colchicine is usually dramatic. Given orally, colchicine reaches peak concentrations in about an hour, resulting in the subsiding of joint pains after 12 hours of treatment and in their disappearance within 36 to 48 hours. The dose of colchicine is 1 mg orally every 2 hours until a response is obtained or until diarrhoea or vomiting appears. Colchicine prevents migration of neutrophils into the joint by binding to tubulin, and interferes with cell motility. Colchicine-treated neutrophils develop a 'drunken walk'. Severe diarrhoea may be a problem and with large doses may be associated with gastrointestinal haemorrhage and kidney damage. Rashes sometimes occur, also peripheral neuropathy. Colchicine is also given intravenously if the gastrointestinal tract is intolerant of oral medication; not more than 2 mg should be given in 24 hours. "Severe bone marrow suppression and death may occur in patients receiving oral colchicine prophylactically who are also given intravenous doses of this drug. Severe electrolyte imbalance can accompany many colchicine-induced diarrhoeal episodes with disastrous consequences, especially in elderly patients."3
HIGH LIVING Associated with affluence and high living, gout is often called the 'rich man's disease.' "Throughout history, the sufferer of gout has been depicted as a portly, middle-aged man sitting in a comfortable chair with one foot resting painfully on a soft cushion as he consumes great quantities of meat and wine. In fact, the traditional picture does have some basis in reality, as meats, particularly organ meats, are high-purine foods, while alcohol inhibits uric acid secretion by the kidneys. Furthermore, even today, gout is primarily a disease of adult men; more than 95% of gout sufferers are men over the age of 30 years. Approximately 3 adults in 1,000 have gout, and 10-20% of the adult population has elevated uric acid levels in the blood. Several dietary factors are known to cause gout: consumption of alcohol, high-purine foods [organ meats, meat, yeast, poultry, etc.], fats, refined carbohydrates, and overconsumption of calories."4
STOICISM While gout has been associated with high living and its consequences, the "archetypal medicine's investigation of rheumatic stiffening of the joints probably leads at some point to the philosophy of the Stoics, where patience, pliancy, obedience, and altruism play significant roles." "Stoicism was primarily an ethical doctrine: the effect of a way of thinking as a way of life. The purely philosophical aspects were secondary. Stoicism was a philosophy of deed, action as the measure of all wisdom, intended to make more bearable the loathsomeness of the condition humaine in general and in particular the mean living conditions of the Roman Empire. At this time a number of men appeared on the scene who could best be described as 'moralizers'. They lived mostly in Italy and Greece but were also found in Asia Minor and Syria. They lived as simply as possible, renouncing material possessions and taking pride in bearing outer poverty with dignity. They wore only a sleeveless garment, extending barely to the knee and wrapped twice around their bodies leaving the right shoulder bare. Barefooted, carrying only a staff and knapsack, they wandered indefatigably from place to place, living from the alms of their contemporaries. Wherever they were, they discussed questions pertaining to daily life and morality. Preaching virtue, peace of mind, true freedom, and much more, they spoke about death, poverty and wealth, about honour, and against pleasure of the flesh. They displayed defiant disdain for the body. It was filth for them by nature and for the immortal soul a cumbersome dungeon. Accordingly, they were also spartan in their nourishment: pearl barley, lupines, figs, and water were more than sufficient. They slept in temple porticos and in the baths; they bore heat and cold, hunger and thirst in almost superhuman fashion. Philosophical moderation was the order of the day and was taken for granted. Otherwise, though, one is left with a feeling of the Stoics' awkwardness toward everything and everyone. They were 'self-sufficient' and, insofar as this attitude extended to their inner lives, they were apathetic. In other words, they were untouched by their emotions, impulses, and desires. Assuming that awkwardness and rigidity find expression as a painful stiffening of the joints the more fanatically that obedience and submission are preached, it is not surprising that one of the most famous of these moralizers, Epictetus, was rheumatic [if the account of his pupil Suidas can be believed]."5
FEVER Colchicine taken prophylactically daily provides complete remission or distinct improvement in about 85% of cases of familial mediterranean fever [FMF], also called benign paroxysmal peritonitis, familial paroxysmal polyserositis, familial recurrent polyserositis, mediterranean fever, and familial paroxysmal peritonitis. FMF is an inherited disorder of unknown aetiology, characterized by transient recurrent attacks of fever and abdominal pain [peritonitis], and less frequently by pleuritis, arthritis, pericarditis, and rash. FMF occurs most frequently, but not exclusively, in persons of Mediterranean origin. The disorder usually begins between ages 5 and 15 but sometimes starts at a much later age or even during infancy. Attacks have no rhythm or regular pattern of recurrence and vary somewhat in the same patient. They usually last 24 to 48 hours, but some last for a week or so. The most common interval is 2 to 4 weeks. Severity and frequency tend to decrease with age, during pregnancy, or with development of amyloidosis. Nephropathic amyloidosis, a complication reported much more frequently in the Mediterranean region than in the USA, is much less common since the introduction of colchicine treatment in 1973. A daily dose of 1-2 mg colchicine on a continuous basis has been found to prevent attacks in most patients and amyloidosis in all patients. Fever as high as 40o C [104o F], usually accompanied by peritonitis, is the major manifestation. Abdominal pain occurs in about 95% of patients and can vary in severity from one attack to the next. The pain usually starts in one quadrant, then spreads to the whole abdomen. Decreased bowel sounds, distension, guarding, and rebound tenderness are likely to be present at the peak of an attack, making the event indistinguishable from a perforated viscus on physical examination. Consequently, many patients have undergone urgent laparotomy before the correct diagnosis was made. With diaphragmatic involvement, there may be splinting of the chest and pain in one or both shoulders. Other symptoms include acute pleuritic pain [75%], acute arthritis involving the large joints [25%], and an erysipeloid rash of the lower leg. 6
TOXICOLOGY All parts of the plant, but especially the corms, are toxic. Within two or six hours after ingestion, symptoms start to develop which are similar to those of arsenic poisoning: burning throat, intense thirst, vomiting, difficulty in swallowing, bloody diarrhoea, stomach pain, sensory disturbances, muscle weakness, delirium, cardiovascular collapse and respiratory failure. There is continual profuse vomiting, which is accompanied by profuse secretion of saliva, tears, and mucus from the nose. An ascending paralysis with consciousness maintained to the end occurs in most victims, death taking place in 24-48 hours. Colchicum poisoning is fatal in 50% of cases, although it may not occur until three days after ingestion. Chronic colchicine poisoning includes loss of hair, and blood and protein in the urine. Colchicine is slowly excreted; victims are often ill for a long time. Symptoms of a fatal overdose are similar to those of severe radiation poisoning. Poisoning has also been reported in cattle, goats, horses, sheep, and swine, as well as in dogs and cats. Colchicine can be excreted through the milk of lactating animals, thereby poisoning young animals and humans. Cattle and, to a lesser extent, goats and sheep can develop complete resistance to colchicine.
MITOSIS Colchicine is a mitotic poison; it inhibits cell division and slows it greatly, in all cells including neoplastic cells. Used in botanical, cellular, and genetic research, colchicine is capable of stopping cell division at the stage when the chromosomes have divided and are fully formed but have not yet pulled apart to form two separate nuclei. It inhibits spindle formation and thus the condensed chromosomes are scattered rather than aligned on the spindle. The cell's chromosomes remain double in number, altering the genetic pattern, a phenomenon used by plant breeders to create new create new varieties of fruits, vegetables, and flowers.
CYCLE "The plant has a subterranean rhizome which forms new internodes every year. Two things are significant and remarkable in this: the plant, flowering and sprouting below ground, has, like Demeter's unhappy child Persephone, taken refuge in the darkness of the earth. But Colchicum does not, like Persephone, rise up in the spring, but in the autumn. It begins to flower at a time when other plants are dying. ... Everything here is, as it were, out of place; the flower rushes ahead before the leaves can unfold and, instead of in the spring, breaks through in the preceding autumn. The leaves follow at their convenience and at the right time. The fruit, however, is particularly late and out of time. ... The autumn crocus does not only grow underground, it also develops against the periodicity common to its family. ... The early autumn, or Indian summer, is a period when for a very short time a kind of second blooming occurs in temperate regions. ... Into this time of Indian summer the Colchicum has sneaked. It takes part in it and uses it for pollination and thus for its perpetuation. But because it misuses an environment which does not belong to it, it turns into a plant which produces poison. For poison arises only where otherwise disease would develop. A natural process arising at the wrong site and at the wrong time is poison in the plant. ... Pollinated during a period when otherwise nature is dying, it bears within itself death as well as procreation. ... There where growth originates and creates anew, in the formation of new cells, this poison strikes. It takes its revenge at the very place where it is not allowed to appear. The spring forces of sprouting cell-growth are struck by the deadly breath of the plant which flowers in the autumn. The spindle formation comes to a standstill and instead of forming daughter cells the mother cells remain distorted. This same deathly autumnal breath appears in Colchicum where it acts as an anti-allergic and antiphlogistic agent. For inflammation is a heightened defensive force of the organism; it is an enhanced life force, either concentrated on a certain region of the body, or displayed over the whole of the organism. This defensive power is dampened by colchicine and often extinguished altogether."7
PROVINGS •• [1] Stapf - 5 provers; method: unknown.
•• [2] Lewins - 6 provers, 1837; method: tincture or wine of colchicum, 15 to 70 drops.
•• [3] Maclagan - 4 provers, 1851; method: [repeated] doses of 1-30 drops of tincture.
•• [4] Reil - 13 provers [9 males, 4 females], 1853-54; method: repeated doses of tincture, 1x, 3x, 12x, and 15x.
•• [5] Schulz - 8 provers, 1896; method: repeated doses of tincture.
•• [6] Raeside - 17 provers [10 males, 7 females], 1964-65; method: three experiments of two weeks each, first with 30c, second with 6x, third with 6c; twice daily doses for 14 days, unless 'symptoms became too disturbing.'
"The greatest collection of symptoms came during the first term, to our considerable surprise. The first term is usually the least harvest of signs and symptoms, and the third term is usually the most. Quite the reverse happened here, as it was the autumn term on 30c which was the most effective; the second term was quite productive, but the last term was a very poor experiment. One cannot help wondering whether the autumn crocus acts better as a remedy and as a poison in the autumn, for this was certainly the time which produced most results in our provers."8
[1] König, Indian Summer, The Autumn Crocus, and Colchicine; BHJl, April 1958. [2] Raeside, A proving of Colchicum autumnale; BHJ, April 1967. [3] Merck Manual. [4] Murray, The Healing Power of Herbs. [5] Ziegler, Archetypal Medicine. [6] Merck Manual. [7] König, ibid. [8] Raeside, ibid.
Affinity
DIGESTIVE TRACT. HEART; pericardium. Circulation. Kidneys. Tissues [MUSCLES; ligaments; fibrous; serous; JOINTS; small joints].
* Left side. Right side. Left to right.
Modalities
Worse: MOTION. Touch. Night. Stubbing toes. Vibration. WEATHER [cold; damp; cold rooms; changing; Autumn]. Slight exertion. Checked sweat. Stretching. Sundown to sunrise. Extreme heat of summer. STRONG ODOURS. Eating. Loss of sleep.
Better: Warmth; wrapping up. Rest; lying quietly. Doubling up. Sitting. After stool. Open air.
Main symptoms
M Sensitive persons, more or less unprotected from external impressions [popular name of Colchicum is "Naked Ladies"], both mental and physical.
c Sensitive to RUDENESS of OTHERS.
Wildness from misdeeds of others.
c Oversensitive to all external impressions [mostly on account of PAIN; gouty persons with extreme irritability of temper].
• "The smell of pork [which he formerly liked], a bright light, a touch, the naughtiness of a child, put him almost beside himself; such extreme depression of spirits, weakness, pain and sensitiveness of the whole body that he can hardly move without moaning." [Hughes]
c OVERSENSITIVE TO:
* ODOURS [cooking odours; fish; fat; eggs]
So sensitive to odours that he smells things which others do not smell.
Odours cause headache, nausea, vomiting, faintness.
• "After 4 days, the smell of a newly beaten-up egg almost made him faint. ... The smell is so morbidly exalted that something quite indifferent, e.g. soup, makes him almost sick." [Hughes]
* Bright light.
* Noise [talking of others].
* Pain.
* Touch.
M Fear of mice; delusions; = sleeplessness or disturbed sleep.
M Loss of perception.
• "The consciousness of logical connection was entirely destroyed, and his perceptive faculties were impaired by the slightest circumstances which interrupted the sequence of ideas." [Allen]
No fear; appears unconcerned about condition.
M Feeling as if mind is a jig-saw puzzle with all the pieces there but not interlocked. [Raeside]
G Sensitiveness, susceptibility and <: COLD, COLD and DAMP [Autumn; Colchicum autumnale]. G WEAKNESS, internal coldness and tendency to collapse. Wants to be undisturbed because of weakness. • "She feels such weakness in muscles of extremities that she thinks they will fall off; all muscles, especially of lower extremities, as if paralysed; quite powerless and as if paralysed in all the body, esp. the arms; the painful muscular paralysis, esp. in knees, causes them to buckle under him often, esp. when he lifts his legs to step over an elevated object, e.g. the doorstep." [Hughes] • "You must know that Colchicum tends to produce great prostration, and from this arises the great danger in administering it in large doses as a routine remedy in gout and rheumatism. ... We find Colchicum indicated in debility, particularly in debility following loss of sleep; for instance, when one does not retire as early as usual in the evening, so that he is deprived of a portion of his accustomed sleep, he awakens next morning feeling tired and languid; he can hardly drag one leg after the other; the appetite is gone; bad taste in the mouth and nausea are present. The debility, then, starts from or involves digestion as a result of loss of sleep. You can see how close this comes to the Nux vomica condition. The debility, however, is greater even than that of Nux vomica. There is, at times, an aversion to all food; the odour of food cooking makes the patient feel sick; he becomes irritable; every little external impression annoys him; here it is precisely like Nux vomica." [Farrington] G Extreme DISINCLINATION to MOVE [similar to Bry.]. But weak, restless and very chilly. [Combination of Ars. and Bry.] G < MOTION of AFFECTED part. < WALKING. > While sitting.
G TOUCH = electric-like shocks through body.
< SLIGHT touch. G > On WAKING.
G LIVER or digestive DISORDERS.
And Forgetfulness , dullness, weakness of memory.
G LIVER AFFECTIONS and GOUT.
Or: LIVER AFFECTIONS and RHEUMATIC affections.
G Pains go from left to right, except headache, which goes from right to left.
G Weather.
• "Tingling in many parts of the body, as if frostbitten, whenever the weather changes." [Lippe]
P Nausea and vomiting.
< Every motion. > Lying quietly.
P Diarrhoea in AUTUMN.
P Dropsical conditions; affections of kidneys with urine with black sediment [like INK].
P Gout of BIG TOE.
< Motion, touch or stubbing the toe [patient screams with pain]. FIBROUS TISSUES / JOINTS. • "Stands in close relation to fibrous tissues: redness, swelling, heat, etc., not tending to suppuration; quickly changing location. Inflammation of joints with excessive HYPERAESTHESIA, slightest concussion of air, floor or bed renders the pains unbearable ... Large joints intensely red and hot ... acts more on the small joints. ... Attacks of rheumatism break forth suddenly and disappear suddenly. Pains shifting: acute attacks merging into chronic form, or during chronic form acute attacks set in. Great irritability with the pains: very sensitive to touch: the least vibration makes pain unbearable." [Tyler] • "He goes to Bed and sleeps well, but about Two a Clock in the Morning, is waked by the Pain, seizing either his great Toe, the Heel, the Calf of Leg, or the Ankle; this Pain is like that of dislocated Bones, with the Sense as it were of Water almost cold, poured upon the Membranes of the Parts affected, presently shivering and shaking follow with a feverish Disposition; the Pain is first gentle, but increases by degrees [and in like manner the shivering and shaking go off], and that hourly, till towards Night it comes to its height, accompanying it self neatly according to the Variety of the Bones of the Tarsus and Metatarsus, whose Ligaments it seizes, sometimes resembling a violent stretching or tearing those Ligaments, sometimes the gnawing of a Dog, and sometimes a weight; moreover, the Part affected has such a quick and exquisite Pain, that it is not able to bear the weight of Cloaths upon it, nor hard walking in the Chamber; and the Night is not passed over in Pain upon this Account only, but also by reason of the restless turning of the part hither and thither, and the continual Change of its Place. Nor is the tossing of the whole Body, which always accompanies the Fit, but especially at its coming, less than the continual Agitation and Pain of the tormented Member. There are a Thousand fruitless Endeavours used to ease the Pain, by changing the Place continually, whereon the Body, and the affected Members lie, yet there is not ease to be had." [Description of gout by Thomas Sydenham - 1683 -, who suffered from the affliction himself.] Rubrics Mind Ailments from rudeness of others [2]. Anger, < bright light [1/1], < odours [1/1]. Confusion, from interruption, logical thinking impossible [1/1]. Delusions, someone is under the bed [1], sees mice [1], of hearing noise [1]. Despair, with the pains [1]. Discouraged, from pain [1], with rage [1; Nit-ac.]. Dulness, when interrupted [1/1]. Fear, of being touched [2]. Ideas, abundant, clearness of mind alternating with dulness [1; Alum-p.]. Indifference, doesn't complain, says nothing of his condition unless questioned [1/1]. Irritability alternating with indifference [1]. Wants to be quiet [1]. Wildness, from bright light, strong odours, touch [2/1]. Vertigo After cold drinks [1/1]. From looking steadily [1]. Head Pain, from fat food [1], > heat [1], from strong odours [2], > after sleep [1], from loss of sleep, from night watching [1]. Feels as if tied [1; Desm-g.].
Eye
Pain, extending backward [1], to occiput [1].
Vision
Colours, objects appear with iridescent borders [1*], objects appear yellow [1*]. Lost, on standing [1].
Nose
Odours, sensation of fish-brine [1], of smoked ham [1/1].
Mouth
Salivation, with sensation of dryness [1]; during stool [1; Rheum; Vip.].
External throat
Tension, sides, on swallowing [1/1].
Stomach
Vomiting, > lying on right side [1; Ant-t.], while riding in a carriage [2], from swallowing saliva [1/1].
Abdomen
Pain, > bending double [2], must bend double [1].
Kidneys
Pain, renal region, can only lie on the back [1/1].
Urine
Where there is diminution of constituents, there is increase of stools [1/1].
Male
Sexual desire increased after eating [1; Aloe; Lyss.].
Chest
Feeling as if sternum and spine were screwed together [1*].
Limbs
Itching, around large joints [1*]. Pain, rheumatic, on becoming cold [1].
Sleep
Disturbed by fear of mice [1/1].
Generals
Ailments from radiation therapy [1*].
* Repertory additions.
Food
Aversion: [3]: Food, smell of. [2]: Eggs, smell of; fats and rich food; fish; food, sight of; pork..
Desire: [1]: Carbonated water; coffee; cold drinks; eggs; mustard; wine.
Worse: [3]: Broth, smell of; food, smell of; food, sight of. [2]: Eggs, odour of; fat; fish, smell of; meat; pork; pork, smell of; soup, smell and thought of. [1]: Alcohol; butter; coffee; cold drinks [= vertigo]; eggs; fruit; meat, odour of cooking.
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