Dioscorea Villosa

[WILD YAM. NATURAL ORDER, DIOSCOREACEiE.]

The wild yam is a delicate, twining vine, which grows in cool, shaded places (thickets and hedges) in the United States and Canada, although it is comparatively rare in New England. Its stem is woolly, reddish-brown, from one to two lines in diameter and from five to fifteen feet long, climbing over bushes and fences. Its leaves are from two to four inches long, three-fourths as wide, distinctly heart-shaped and drawn out into a point. The leaf-margin is usually wavy; its lower surface is downy or glabrous, never villous; its upper surface is glabrous.

The flowers are very small and of a greenish-yellow. The petioles are from two to four inches long. The peduncles are axillary. The ovaries are at first elliptic, finally almost as broad as long.

The plant blooms in June and July. (After Wood.)

76 DIOSCOKEA VTLLOSA.

The family to which the wild yam belongs, is quite extensive. In tropical countries the large, tuberous roots of a number of yams form an important and pleasant article of daily food, and in the Indies they are extensively cultivated for similar purposes, and for the manufacture of a very superior article of starch which they yield. If boiled, some of these varities are said to resemble our potato.

The officinal preparation is made from the root, which is long, branched, woody, of a white color internally, and of a light-brown externally. When bruised, it emits a peculiar odor; it has a sweet- ish-bitter and somewhat pungent taste. If the fractured surface is examined under the microscope, numerous light yellow spots will be perceived. Owing to a peculiarity of the root, viz., flattening out when an attempt is made to pulverize it, triturations of the root itself are not made; its active principle, clioscorein, furnishes the basis for triturations.

We use the tincture of the root. Alcohol does not exhaust the root of dioscorea ; hence we make a decoction of one ounce of the root in ten ounces of water ; after cooling this decoction, wre add to it five ounces of pure alcohol, and filter it. This preparation, from which dilutions may be made in the usual manner, is absolutely reliable.

Among the provers of dioscorea villosa we may mention Burt, Mchol, dishing and others.

Dr. W. H. Burt, during three consecutive days, took nine hundred and thirty drops of the fluid extract of dioscorea, in doses of from thirty to two hundred drops, noting the effects produced during the days of actual medication and the three days follow- ing.

An examination of the symptoms produced, shows that the drug affected the abdominal organs in a remarkable manner. There was throughout the proving a constant dull pain in the epigastric and in the umbilical region, alternating with ex- cruciatingly sharp, keen darting pains, and colicky pains in the abdomen. The stomach suffered severely. Dr.

Burt experienced : constant distress in the stomach ; cutting, tearing pains in the stomach and in the gall-bladder. Burning, sharp, and at times spasmodic pains in the stomach, with much faintness and considerable sensi- tiveness to pressure. There was cutting pain in the liver; dull, heavy ache in the right lobe of the liver. The stools were black, diy, hard, lumpy ; later, soft, white and mushy.

Prolapsus ani and hemorrhoidal tumors also showed themselves, although the prover was quite free from any such difficulty when not under specific drug influence. Obstinate constipation, followed by profuse, thin, yellow stools, accompanied by severe pain in the bowels, which was not relieved by the evacuations, and by great faintness. The tongue was coated whitish and yellowish- white ; there was a flat, pappy taste in the mouth and great dryness in the throat.

Dr. Burt experienced also a great deal of dull pain in the lumbar region, aggra- vated by bending the spine. There was much severe pain in the lingers, hands, wrists and elbows. Also corresponding pains in the lower extremities, with great

LIOSCOREA VILLOSA. 77

stiffness in the fingers and toes. Rheumatic pains in the chest and cervical portion of the back. "Weariness. Trembling. Vertigo. Loss of strength. Faintness. Slowness of the action of the heart. Depression of spirits. All the rheumatic pains experienced were at first aggravated by motion ; if the motion was kept up persever- ingly, it relieved after a time, (one hour).

Dr. Nichol made a proving with the first decimal dilution of dioscorea and later with the first decimal trituration of dioscorein, eliciting symptoms, similar to those experienced by Dr. Burt. He notes also: stitching pain in the region of the heart; bloating of the abdomen ; eructations tasting of rotten eggs ; vertigo, which was per- sistent and well marked, and giddiness.

Dr. Gushing experienced clearly defined effects upon the sexual organs, arranging them as follows : Primary symptoms Stong-smelling perspiration on the genital organs; constant excitement of the genital organs, with frequent erections day and night; erections at night, with amorous dreams; pain in both inguinal regions, ex- tending to the testicles ; pains in the penis. Secondary symptoms

Genitals cold and relaxed ; genitals cold and almost insensible ; sexual desire greatly diminished ; no erections for many days; emissions of semen during sleep, without erections or dreams.

We may find dioscorea of value in tfie treatment of the following: COLIC Dr. Clifton gives the following admirable description of the dioscorea colic : "The colic in which it is especially useful is always attended with a large amount of flatulence, and when accom- panied with biliousness or with vomiting of bile this is only second- ary to the pain, or a sequel to it, and does not appear early in the attack. The patient has neither a large flabby tongue nor a thickly- coated one, nor has he a yellow aspect of the the face ' or bilious diarrhoea.

It is most suitable to persons of feeble digestive powers (old or young) suffering principally from fiatulaiice after meals, in the stomach or bowels, but unattended with any hepatic derange- ment or irregularity of the bowels. These persons, from some excess in eating, or from having fasted too long, or from some error of diet, especially if they are great tea-drinkers, may be suddenly seized with violent colicky pains in the stomach or bowels; the pain does not come on for several hours after eating and is at first generally lkuited to the stomach or bowels, but it gradually extends to other parts as the paroxysms recur; the pains, when located in the stomach, are more or less continuous, but recur in irregular paroxysms of great severity, bend the patient double, cause profuse perspiration, and in some cases make him desire death rather than such prolonged agony.

With this tendency to bend double, with a feeling as if pressure would relieve, pressure actually aggravates, and the only relief obtained, is by stretching the body out, or in some cases by walking about in a very upright position. The pains are variously

78 D10S00KEA VILLOSA.

described as screwing, cramping, lancinating, often shooting through the spine, and as if the patient would like to tear the stomach open, or at least must loosen all clothes, which, however, gives no relief. Much distention of the stomach, with desire for, and loud eructa tions, which afford only partial relief; the eructations are tasteless, unless the pain has continued long, in which case they may he bitter and sour, or followed by vomiting of bile; cold extremities, feeble pulse, or dry, whitish tongue, bat no fever. These symptoms are quickly relieved by dioscorea, in drop-doses of the mother-tincture, or two- or three-drop doses of the first decimal dilution.

" When the pain begins in the bowels, it generally commences in a small spot, and radiates outward, upward and downward. It may extend to the stomach, liver, spleen or uterus, but when it does so, it is at the beginning of the attack. The pains are of the same character as in the stomach, but less continuous and more parox- ysmal. There is often a sensation as of a knuckle pressing inward, or a twisting, screwing pain, with great distention of the abdomen, and difficulty in expelling flatus.

When it is expelled, it is done with violence, and often with a watery evacuation, the expul- sion of flatus affording only partial relief. The pains are aggravated by pressure, and relieved by stretching out the body."

We might add that a jumping of the pain from one part of the body to another, usually distant, part, with a remission of the colic during this metastasis, is characteristic of dioscorea.

Early in the morning of July 27, 1867, I was called to see Mr. , who pre- sented the following condition ; severe, constant pain below and to the right side of the umbilicus, near the head of the colon, greatly aggravated every three or five min- utes. To use the patient's own graphic language, " I can put my finger on the very- spot, which feels as if it was drawn forcibly upward and backward toward the spine." There was constant desire to defecate and to urinate, but without accomplishing much.

He could neither lie down, sit nor stand, though he attempted all by turns. He entreated me to give him morphine, as he expected to die, but did not wish to die in such agony. On inquiring into the history of the case, he told me that on the afternoon of the previous day he had been sitting in the shade on a stone step, and thought he had taken cold. The attack had commenced only a short time before my arrival.

His bowels, on the previous day, had moved freely ; he had taken a seidlitz powder at the commencement of the attack. Prescribed ten grains of the second decimal trituration of dioscorein in a tumblerful of water, of which solution the patient received two teaspoonfuls every five minutes. In less than an hour the remedy was discontinued, permitting the patient to sleep. When I saw him again in three hours he had had a free movement of the bowels and a copious evacuation of urine; and in the afternoon of the same day he was about his usual business.

(Dr. Levi Shafer in Transactions of the Horn. Med. Society of New York, 1878.)

The curative power of dioscorea in colic is probably due to its direct action upon the nervous system of the abdomen, especially upon the coeliac and umbilical plexus, less distinctly upon the hypo-

DIOSCOREA V1LLOSA. 79

gastric plexus. This explains, in part, why the remedy may become of great value in the affections of the pelvic viscera, characterized by severe pain, as, for instance, in

DYSMENORRHEA, although the pathogenetic record of the drug fails to show that it exerts any effect upon the female sexual apparatus.

The patient was a young married woman, who had always suffered terribly with difficult menstruation, without being able to obtain relief. The suffering increased each month. Her symptoms were: Excruciating, tearing, twitching pains in the hypogastrium, with sharp pains radiating in all directions, even up to the shoulders, chest, and down into the thighs; a sensation as if the hips were being torn from the body; great pain in the sacrum; she wants her back pressed upon hard ; a rumbling in the bowels as from flatus; a choking sensation in the throat or, as if flatus were rising into the oesophagus, (the patient was not hysterical).

At times the pains would leave the abdomen, and suddenly an intense pain would appear in the forefinger of the left hand ! The position of the patient was on the side, in bed, with the body bent forward, the knees drawn up, and an expression of anguish in the face. After the unsatisfactory use of lachesis, colocynthis, cannabis indica and mix vomica, an infusion was made of twenty grains of the pulverized root of dioscoiea in six drachms of hot water, of which infusion she took a teaspoonful every fifteen minutes.

The third dose gave great relief and in a few hours she felt free from pain. (Dr. E. M.

Hale in the Am. Jour. Horn. Mat.

Med., Sept., 1872.)

G ASTRALGIA may find its remedy in the wild yam. Hirschel says, it is "one of the few remedies, which are indicated in true gas- trodynia ; dull heavy pains in the pit of the stomach, worse after eating and relieved by copious eructations of air ; severe cutting, tearing pains in the stomach and in the region of the gall-bladder ; burning distress in the stomach with sharp, prickling pains and faint- ness ; flat, pappy taste, dryness of the fauces with frequent inclina- tion to swallow."

DIARRHCEA. — Dioscorea is homoeopathic to diarrhoea, dysentery and, possibly, to

CHOLERA MORBUS.— The stools are usually profuse, thin, deep-yellow, lumpy, preceded and accompanied by very severe draw- ing, writhing, colicky pains, in the sacral region, extending upward and downward, often extorting screams from the patient ; they are followed by faintness ; discharge of hot flatus ; sensation as if the feces were hot. The colic, which always accompanies the discorea- diarrhoea, is aggravated from bending forward and is relieved by an upright position of the body.

CONSTIPATION. — The provings of the drug would seem to suggest its use in constipation, accompanied by characteristic pains in the stomach and bowels, but we have no positive clinical evidence to substantiate this presumption.

RENAL COLIC. — Dioscorea has also been recommended in the

80 DROSERA R0TUND1F0LIA.

treatment of renal colic and of angina pectoris. As far as the use of the drug in the treatment of the latter disease is concerned, it may cover a distress in the chest, originating in a cardialgia, the pain running into the chest, arms and hands, but it can hardly he of use in true angina pectoris.

The symptoms experienced by Dr. Gushing seem to prove that dioscorea exerts a decided influence upon the male sexual organs. I am not aware that other provers have experienced similar symp- toms, but l)rs. Gushing and Pease have used the drug with good effect in a number of cases of

SPERMATORRHOEA, characterized by great despondency and, in several instances, by amorous dreams.