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Sunday, November 6, 2011

Podophyllum peltatum 200C

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Podophyllum peltatum

Podophyllum peltatum. May Apple. American Mandrake. N.O. Berberidaceae.

People can die of mere imagination.
[Geoffrey Chaucer]
Signs - VERMEULEN Frans
CLASSIFICATION Podophyllum belongs to the family Berberidaceae, a widespread family comprising 18 genera of trees, shrubs [mostly], and herbs, widespread in north temperate regions, South America, and mountainous regions in the tropics. The family is in homoeopathy represented by four members: Podophyllum, Berberis vulgaris, Berberis aquifolium [= Mahonia aquifolia], and Caulophyllum. Podophyllum is placed in the subfamily Podophylloideae, and the other three in the Berberidoideae.
GENUS A genus of 9 species of rhizomatous herbs with large, peltate, palmately lobed leaves which spring directly from the roots and solitary or clustered red-yellow or white flowers that bear 6 sepals, 6-9 petals, and 6-18 stamens. The fruit is a large, fleshy berry. Several species are grown as ornamentals. The rhizomes are used medicinally.
SPECIES Native to North America, it can be found, usually in large patches, in moist woods and pastures from Quebec to Florida, and west to Ontario and Texas. "The creeping rhizome, which often attains a length of 1 to 6 feet, and is about one-fifth of an inch in thickness, sends up a stem to the height of about 1 foot. This stem then forks at the top and each petiole so created bears a single peltate leaf of palmate variety, having 6 or 7 lobes. Flowerless plants have only 1 leaf, generally centrally peltate, with from 7 to 9 lobes. In the fork of the stem the flower appears a single, fragrant, beautiful, waxy-white blossom, about 2 inches wide. The flowers are eagerly sought for by the children of cities, and on account of their beauty and delightful fragrance, find ready purchasers among the lovers of 'wild beauties.' The bloom, which appears in May, hence the names May flower and May apple, is followed in August and September by a small, yellowish-green, lemon-like, succulent berry, about the size of a plum. Its flavour is agreeable to many persons, and its taste is sub-acid and sweetish. It may be eaten with impunity, though all other parts of the plant produce pronounced physiological effects. It is, however, slightly laxative, and possesses diuretic properties."1
NAME The name Podophyllum derives from Gr. podos, foot, and phyllon, leaf, which is a contraction of anapodophyllum, duck's-foot-leaved. The specific name peltatum describes the structure of the leaf blade which has the leaf stalk inserted in the middle.
TOXICOLOGY The rhizome contains lignans [esp. podophyllotoxin], flavonoids, resin [podophyllin] and gums. Within a few minutes to a half hour after ingestion of large amounts of the plant or topical application of the resin, poisoning symptoms occur, consisting of headache, gastroenteritis, and collapse. When combined with alcohol the intoxication can be fatal within 14 hours. Some tribes of American Indians used the poisonous parts to commit suicide. "The root is a very effective poison which the Savages used when they cannot bear their troubles," wrote the French botanist Sarrazin-Vaillant in 1708. Two years later, Raudot reported that Huron women "are very subject to poisoning themselves at the least grief that betakes them; the men also poison themselves sometimes. To leave this life they use a root of hemlock or of citron [May apple], which they swallow."2
MEDICINE Native Americans widely used the May apple as a purgative, emetic, and worm-expelling herb. A favourite prescription among many 19th-century physicians was a combination of calomel [mercurius dulcis] and podophyllum. It was also used as a spring tonic because it was thought to cleanse the liver by increasing the flow of bile. Applied externally as a poultice, lotion or ointment, the rhizome is effective against warts. Crude extracts of the plant have been shown to have a direct effect on herpes simplex, influenza A, and vaccinia viruses. The lignans in the plant have been extensively researched for their anti-tumour potential. Lignans are highly toxic to cells and cause foetal death if ingested by pregnant women. Derived from Podophyllum root, the drug etoposide is used in the treatment of refractory testicular tumours and small cell lung cancer. Its mode of action is not clearly known but may be due to inhibition of mitochondrial function. Side effects of etoposide include nausea and vomiting, myelosuppression, and hair loss.
EFFECTS "Physiologically podophyllum acts as a certain, but slow cathartic. Small and repeated doses short of catharsis may induce ptyalism; on this account both podophyllum and podophyllin have been called 'vegetable mercury' and 'vegetable calomel.' Under the influence of a cathartic dose, the intestinal and hepatic secretions are augmented and after a considerable time copious alvine evacuations result. Considerable pain and griping may attend its action, which, however, may be modified by such agents as leptandra, hyoscyamus and belladonna. Common salt increases its purgative power. Unlike other cathartics, its effects are permanent and leave the bowels in an improved condition. If the dose be too large, violent emeto-catharsis may result . Although the cholagogue value of this drug was asserted by our practitioners for years, it took extensive physiological investigations, conducted by Rutherford and Vignal, to convince our regular friends that it really possessed such a property. The green root internally administered, acts as an irritant poison, causing hypercatharsis, hyperemesis, gripings, and other unpleasant symptoms; even the recently dried root, in doses of from 30 to 60 grains, is a drastic cathartic and emetic; but the violence of its action is materially modified by age, or roasting. Either the green or the dried root continuously applied to the cutaneous structure, occasions irritation, followed by suppuration. Irritation of the mucous membrane is the result of contact with the powder, and workers in this drug and its resin are liable to conjunctival inflammation. Overdoses of podophyllum have produced death, and the drug, when contraindicated, may give rise to prolonged gastrointestinal irritation and even inflammation. As a cathartic, very little tormina [griping pains in bowels] is produced by it when compared with the completeness of its purgative action. It acts somewhat like jalap, though more slowly. To render its hydragogue, it should be administered with potassium bitartrate on which account it has been found serviceable in dropsical affections."3
PROVINGS •• [1] Williamson - 4 provers; method: 1x, 3x, and 15x; manner not stated.
•• [2] Smith - 2 provers, c. 1869; method: increasing doses of crude drug [resin] for 4 days.
•• [3] Moore - self-experimentation, c. 1872; method: tincture.
[1] King's American Dispensatory. [2] Erichsen-Brown, Medicinal and Other Uses of North American Plants. [3] King's American Dispensatory.
Affinity
Liver; duodenum; intestines. RECTUM. * Right side [ovary; scapula; throat]. Left side.
Modalities
Worse: EARLY MORNING. Eating. Hot weather. Dentition. Drinking. Motion.
Mercury. Bathing or washing. Overlifting or straining. During stool. 2-4 a.m.
Better: Rubbing liver. Lying on abdomen. Evening. Bending forward. External warmth.
Main symptoms
M Great, even delirious loquacity during heat and during chill.
M Imagines himself sick; thinks he was about to die; is going to be sick.
DEPRESSION in GASTRIC affections.
M Moaning in sleep.
Rolling with head.
G Weakness from PAIN in STOMACH.
G PERSPIRATION during PAINS.
G < SUMMER [esp. headache, diarrhoea]. G < Early morning [diarrhoea]; 4-5 A.M. G > Lying on ABDOMEN [diarrhoea, bellyache].
• "In the early months of pregnancy, can lie comfortably only on the abdomen." [Allen]
G RELAXATION of tissues [abdominal, pelvic, rectal].
• "As if all the parts were let down." [Kent]
P Headache ALTERNATING with diarrhoea.
Headache alternating with liver disturbances.
Constipation alternating with diarrhoea.
P Migraine.
Preceded by blurred vision.
Gradually increasing pain.
< Lying down. > Pressure; bathing head in cold water.
And Nausea and vomiting. [Gibson]
P Entire loss of taste.
• "I have frequently remarked a singular effect of podophyllin on the sense of taste when administered in small repeated doses. Patients have told me that they could not distinguish one food from another during treatment. Last week a gentleman, for whom I had prescribed it in doses of one-thirtieth grain 3 times a day, returned to me, after 3 doses had been taken, with his tongue and neighbouring glands greatly swollen, profuse salivation, and entire loss of taste. A larger or purgative dose of the drug has not produced these effects." [Hughes]
P Difficult dentition.
[BITES GUMS together; grinds teeth; diarrhoea].
And Diarrhoea, < after eating or drinking, or < being bathed or washed. P Gall stone colic. Pain localised in epigastrium, extending to liver region. Twisting pains; < taking any food. • "After the acute pain of a biliary colic has left, "Podophyllum patients lie stroking the liver area, which gives them a great sense of comfort." [Borland] P PROFUSE, FORCIBLE [runs right through diaper] and FETID diarrhoea. • "Odour penetrates the whole house." [Kent] • "In Podophyllum patients the stools tend to be much larger [than in Aloe patients], much more fluid, and the flatus is mixed up with the fluid stool so that it is expelled noisily. Aloe patients, as a rule, are more peaceful for a while after the bowels have acted. In Podophyllum, the colic continues for some time after the bowels have acted, with a feeling of exhaustion. The stool is very forcibly expelled. Often the patients feel cold, alternating rapidly with flushes of heat that spread over their backs. Another distinguishing point about Podophyllum patients with patients is that quite frequently, just before the bowels act, they are not quite sure whether they are going to have an action of the bowels or whether they are going to vomit. They may start retching and gagging, and then have a sudden violent, watery stool. Cramps in the thighs may accompany the abdominal colic." [Borland] Diarrhoea < sour fruit, coarse vegetables, or milk. [Gibson] P Copious diarrhoea during menses. And Great soreness of uterus and abdomen; < pressure, even of clothing; > rubbing or massaging abdomen.
P Diarrhoea PRECEDED by:
soreness [< pressure], cramping [must bend double], rumbling and GURGLING ["as if fish were turning and tossing in a pond"], nausea and palpitation [in adults], paleness of face [in children]. P PROLAPSE rectum. Before or with stool; with diarrhoea. After parturition. During vomiting. When stooping or lifting. P PROLAPSE uterus. From overlifting or straining. From constipation. After delivery. P Amenorrhoea in young females. And Bearing down in hypogastrium and sacral region. Pain < motion, > lying down. [Hale]
Rubrics
Mind
Anxiety in evening in twilight [1]. Delusion, he has an incurable disease [1], has sinned away his day of grace [1]. Fear, of impending disease, of being incurable [1], in liver affections [1; Mag-m.]. Irritability in liver trouble [2]. Loquacity, during chill [2], during fever [2]. Sadness after eating [1].
Vertigo
With sensation of fulness in the eyes [1*].
Head
Pain, > diarrhoea [1], > lying in a dark room [1].
Vision
Blurred, before headache [1].
Stomach
Heaviness after cold drinks [1; Acet-ac.; Ars.]. Nausea, from smell of food [1], before stool [2]. Thirst, for large quantities at long intervals [1], before stool [1]. Vomiting, after drinking cold water [1], after milk [2]; of bile at night [2]; bitter, after drinking cold water [1/1].
Abdomen
Pain, liver, > rubbing [3/1].
Rectum
Diarrhoea, < buttermilk [1/1], after cabbage [1], after cider [2], after solid food [2], < lying on back [1], > lying on side [1/1], after oysters [2], after vegetables [1], > warm application [1], immediately after drinking water [2].
Stool
Odour, offensive, sticking to the patient [1].
Chest
Palpitation, with a clucking sensation rising up to throat [1*], with rumbling in ascending colon [1*].
Limbs
Numbness fingers during headache [1/1].
Sleep
Deep, from excitement or exertion [2/1]. Sleepiness after excitement [2].
* Repertory additions [Hughes].
Food
Aversion: [2]: Food, smell of. [1]: Milk.
Desire: [2]: Cold drinks, sour.
Worse: [2]: Fruit; oysters. [1]: Buttermilk; cabbage; cider; cooked food; fats; fruit, sour; milk; solid food.

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