Ipecacuanha

Old School studies and experiments with and teaches drugs for their physiological action, and lays down the maximum nonlethal doses for adults and for children. Homoeopathy studies and employs, often, the same drugs, but for their exactly opposite effect, and in the fine dosage of vital stimulation.

Old School knowledge of drugs is therefore only half-knowledge, i.e. of their crude toxic and subversive action : and it is only in a few instances that it recognizes and employs them for their homoeopathic action. Ipecacuanha is interesting as being one of the drugs that Allopathy uses to cure homoeopathically : uses both ways, in fact, to provoke and to cure vomiting. It is especially in the vomiting of pregnancy that, forsaking the emetic dose of " grs. XV to XXX ", it is given in one-minim doses of Ipecacuanha wine.

It works for us in the high and highest potencies. Ipecac. 200 is a mighty prescription.

But, in sensitives, as we shall demonstrate later, Ipecac. can cause, and therefore cure, the most terrible attacks of asthma and suffocation, and it is anything but a universally safe emetic. Its poisonings and provings are interesting, graphic, and instructive.

It will be seen that Asthma bulks largely in the poisonings and provings of Ipecacuanha, vide the following condensed quotations from the Cyclopedia of Drug Pathogenesy. Clinical confirmation in the use of the drug has laid special stress on its nauseating properties — provocative and curative : — and the " Nausea not relieved by vomiting ", and the " nausea, constant, with a clean tongue " have come to be the main suggestive symptoms for its exhibition. And yet — in its chest troubles, with agonies of dyspnoea and suffocation, there may be little or no nausea. Or, again, there may be nausea, with violent efforts to vomit and to cough at the same time producing indescribable terrors of suffocation ; seeming to threaten life.

Hale White tells us that the drug affects not only the stomach, but the vomiting centre in the medulla, which may account for the clean tongue ? — in characteristic cases.

Recently we have seen a most interesting case : — asthma of years standing, combined with a skin disease ; the two, apparently, not alternating, but co-existing. A few doses of Ipecac. in highest potency, started almost immediate improvement in the skin condition — which one had not expected : but also greatly improved the asthma, which is " better than for years ". The prescription was consequent on this attempt to produce a Drug-Picture of Ipecac. By the way, a clever old homoeopathic chemist used to say, " The young doctors make good prescriptions, because they are reading up Materia Medica." But — we should all do that — incessantly : and certainly writing up drugs, and teaching drugs, does, or ought to, teach oneself.

Who uses Ipecacuanha for " skins "? Our books say, indeed, that it may be useful to bring out suppressed eruptions. As in scarlet fever, etc., " eruptions suppressed, or tardily appearing, with oppression of the chest ; vomiting and tickling cough ". In erysipelas, " where the redness disappears, with vomiting ". And it has " Itching of the skin, with nausea ; has to scratch till he vomits " And Hale White says, that Ipecac. applied to the skin is a powerful irritant, produces redness, vesication and pustulation.

Now first, we will condense a few cases from Cyclopedia of Drug Pathogenesy, which show the effects of crude Ipecacuanha on sensitives, and thus point to the help it may give in the potencies to patients rendered thus sensitive by disease.

1/ Poisonings : from pulverizing Ipecac. root. Inhaled a quantity of the dust, which caused him to vomit three times and gave him oppression of the chest. He left off pounding it, but one hour later had the most violent attack of suffocation, constriction of windpipe and throat, earthy cadaverous complexion, the most frightful anxiety during the suffocative attack. These symptoms increased every minute . . . after five hours he thought he would be suffocated.

Respiratory symptoms lasted for several days, though in a more moderate degree.

3/ A doctor, putting up a powdered dose of Ipecac., was suddenly seized with a violent attack of asthma, attended with the most distressing dyspnaea and oppression at the precordia. In spite of bleeding and active cathartics it lasted five or six days. . . Much later, having occasion to take an emetic, he chose Ipecac. wine. The moment he had swallowed it, felt in throat and stomach as if he had drunk melted lead . . . the distress settled into one of his worst attacks of asthma, and from that time was subject to them whenever exposed to the drug, or to the fumes of burning sulphur. . . .

He observed in some of his attacks that when expectoration became free, in the mornings, mouthfuls would be thrown up, which any person might have pronounced to be a mass of small nearly transparent worms, but which were thickened mucus, which had collected in the small bronchia during sleep, now thrown off as casts of these tubes, often in such quantity as to surprise him that sufficient air could have passed through the lungs in sleep for the purposes of life.

4/ Another sufferer, a doctor, supposing that it was only the powder inhaled which made him suffer, took some of the powdered root in tepid water, it having been weighed and mixed in a distant part of the house. In about the usual time for an emetic to work there seemed to be a simultaneous effort to breathe, cough and vomit, producing a state of suffocation totally indescribable by words. The whole muscles of chest and abdomen seemed in a state of violent irregular spasm, every effort to vomit being interrupted by an attempt to cough.

Though a cold March wind was blowing he had to open the window, and support himself in the erect position for nearly an hour to prevent immediate suffocation — which was momentarily expected by his friends. The attack suddenly passed and at his request he was laid on the bed : breathing was free, but weakness was extreme, and the whole surface of the body was but .ling and covered with an erysipelatous eruption, covering every part. The patches were circular, from the size of sixpence to the palm of a hand, elevated with thick rounded edges, and of a fiery red colour.

5/ In another case, where a small quantity of Ipecac. powder had been scattered, " I " was instantly attacked by one of the most fearful paroxysms of asthma — extreme sense of suffocation, oppression at the precordia, a most exhausting nausea, convulsive but ineffectual efforts to vomit with simultaneous spasms of the diaphragm and muscles of chest and abdomen, producing a state of suffering which defies description. . . . The quantity of Ipecac. inhaled must have been infinitesimally small.

Hahnemann says, " It will be seen from the following symptoms " (provings), " though they are not complete, that this powerful plant was not created merely for the purpose of causing a forcible evacuation of the stomach by vomiting (which in most cases is to be reckoned as one of the useless cruelties of ordinary practice), but that far higher and more important curative objects are attainable by its means.

We may learn from its symptoms that, as it can relieve some cases of tendency to vomit similar to its own, so it must, as experience has shown, exert a specific curative action more particularly in hemorrhages, in paroxysmal, spasmodic dyspnoea and suffocative spasms and also in some kinds of tetanus — provided that in all these affections the other symptoms of the patient are met with of a similar character among those of Ipecac.

" Certain kinds of ague are so constituted that this root is their appropriate remedy, as is to be inferred from its own symptoms, in so far as they present a greater homoeopathic similarity to those of the case of ague than do those of other medicines. If the selection has not been quite suitable for purpose it generally leaves the fever in a state in which Arnica (in other cases China, Ignatia, or Cocculus) is the remedy."

He gives it as an antidote after long-continued abuse of Cinchona bark, or to the unsuitable employment of Arsenic.

He says only very small doses are indicated : he used to use the millionth of a grain (the third centesimal) : but says that this dose should be still further diminished : and he tells us that it is a short acting remedy — from a couple of hours, to hardly a couple of days. [But we know what a magnificent remedy it is, in asthma cases, for example, in the tooth potency, when it " acts " for a long time.

Guernsey (Keynotes), says, " One of the best guides to the use of this remedy, is a constant but unavailable desire to vomit ; or immediately after vomiting they wish to do so again ; constant nausea.

" Disgust at stomach for fold. . . . No relief obtained by vomiting, the desire still remaining.

" Suffocative attacks of breathing . . . cough without expectoration ; with bloody expectoration ; without waking the patient.

" Threatened abortion ; often with sharp pinching pain about umbilicus, which runs down to uterus, with constant nausea and discharge of bright red blood . . . metrorrhagia, often after confinement, with low pulse, nausea, etc. There is a steady flow of bright, red blood, which may soak through the bed to floor, or run over foot of bed. Where there is this steady flow of bright, red blood, give Ipecac. and don't resort to applications, manipulations, etc."

He gives it for dysmenorrhoea with the characteristic pain about umbilicus running to the uterus.

Kent is especially illuminating in regard to the uses of Ipecacuanha . We will quote — much abbreviating.

Most of its acute complaints commence with vomiting.

All the complaints in Ipecac. are attended more or less with nausea : every little pain and distress is attended with nausea.

The cough causes nausea and vomiting : coughs till face is red, and there is choking and gagging.

With every little gush of blood from any part of the body there is nausea, fainting and sinking.

Hence its value in uterine haemorrhage : bright, red blood, with nausea.

The great overwhelming nausea runs through all the remedy with its symptoms.

Ipecac. does its work best where there is Thirstlessness.

With the Ipecac. fever or chill, pain in back of head : congestive fullness : a crushed feeling in head and back of head : head full of pain.

It has symptoms that look like tetanus.

It has opisthotonos : useful in cerebro-spinal meningitis, where there is head-retraction, the whole body is inclined backwards, and there is vomiting of everything : tongue red and raw and constant nausea and vomiting of bile.

Gastritis, when nothing will stay down--not even a drop of water.

Dysentery, when patient is compelled to sit almost constantly upon the stool, and passes a little slime, or a little bright red blood : tenesmus awful : smarting, burning : with constant nausea. While straining at stool the pain is so great that nausea comes on, and he vomits bile.

Infants with cholera-like diarrhoea, ending in this dysenteric state, constant tenesmus, nausea, vomiting everything, prostration and great pallor.

See its value in Whooping cough : the paroxysmal character ; the red face, thirstlessness, violent whooping, with convulsions, and vomiting of all that he eats.

Re hemorrhages, Kent says, " I could not practise Medicine without Ipecac., because of its importance in hoemorrhages. I do not mean those from cut arteries, where surgery must come in : I mean such as uterine hoemorrhages, hoemorrhages from kidneys, bowels, stomach, lungs. . . . In the severest form of uterine hemorrhage the homoeopathic physician is able to do without mechanical means, except where mechanical means are causing the hemorrhage. This does not relate to hour-glass contractions, it doe's not relate to conditions where the after-birth is retained,* * [Pyrogen has a great reputation in the U.S.

A, for its power of expelling the retained placenta and one has seen it with cows also.] or when the uterus has a foreign body in it, where manipulation is necessary . . . but when it is simply and purely a relaxed surface that is bleeding, the remedy is the only thing that will do the work properly.

" When the uterus is continuously oozing, but every little while the flow increases to a gush, and with every little gush she thinks she is going to faint, or gasps, and the quantity of the flow is not enough to account for such prostration, nausea, syncope, pallor, Ipecac. is the remedy."

But, he reminds us, when with the gushing of bright red blood there is overwhelming fear of death, Aconite. Or Phosphorus, where there is a great thirst for ice-cold water, and though all has gone on in an orderly way, and you have no reason to expect such haemorrhage. Or in lean women, suffering from the heat : want covers off and to be cool ; with an alarming hemorrhage with clots, or only an oozing of dark, liquid blood, you can hardly do without Secale.

" A single dose of one of these medicines," he says, " on the tongue, will check the haemorrhage so speedily that, in your earlier experiences you will be surprised. You will wonder if it is not possible that it stopped itself.'

" Ipecac. is full of hemorrhages " . . . and so on, in regard to colds, nose-bleed, asthma, and convulsions.

In regard to the latter, he says, " As a convulsive medicine, Ipecac. is not well enough known. Convulsions in pregnancy : in whooping-cough ; — frightful spasms, affecting the whole left side . . ." Bell., etc., are more often spoken of in the books and in treatises on spasms ; yet Ipecac. is just as important a remedy to be studied in relation to spasms, and its action upon the spine.

In suppressed eruptions, again, where acute manifestations of stomach and bowels follow, and colds settle in chest from suppressed eruptions. He says it will also cure erysipelas, where there is the vomiting, the chill, the pain in the back, the thirstlessness and the overwhelming nausea.

And now we will let Nash speak from his experience. Here is his summary. . . .

Persistent nausea, which nothing relieves, in many complaints. Headache as if bruised, all through the bones of the head, down to the root of the tongue, with nausea.

Stools as if fermented, or green as grass, with colic and nausea. Haemorrhages from uterus ; profuse, bright blood and heavy breathing, with nausea.

Spasmodic, or asthmatic cough ; great depression and wheezing ; child becomes rigid and turns blue.

Backache, short chill, long fever, heat usually with thirst ; raging headache, nausea ; and sweat last ; nausea during pyrexia.

Better than quinine, in intermittents, or after its abuse, the symptoms agreeing.

With Ipecac. the tongue may be perfectly clean. (Cina.)

He quotes Hering , " Nausea, distressing, constant, with almost all complaints, as if in the stomach, with empty eructations, accumulation of much saliva, qualmishness and efforts to vomit." Nothing Relieves.

In regard to the dyspnoea. ; wheezing, and great weight and anxiety about the precordia ; and the threatened suffocation from accumulation of mucus, he says :

" This excessive accumulation of mucus in the air passages seems to excite spasm like a foreign body, and asthma, or spasmodic cough, or both together ensue. . . ." We may narrow down the respiratory troubles to two conditions : those with excessive accumulation of mucus : those in which spasm is the characteristic feature.

Then haemorrhages . . . and in post-partum haemorrhage, he says, it is not necessary to use it in large and poisonous doses, for it will stop them in the tooth potency, and is quicker in its action than Secale.

One notes also among its peculiar symptoms and modalities.

Shuddering : malaise with shuddering, chilliness, yawning, flow of saliva and eructations.

Asthma that has to stand for hours by the open window.

Pain about the umbilicus, running down into uterus.

(As said) Nausea and vomiting, constant, unrelieved by vomiting : especially with a clean tongue.

Bright red haemorrhages, especially with nausea.

Terrible spasms of respiration.

Simultaneous spasmodic attempts to cough and vomit causing unbelievable suffocative distress.

Black Letter Symptoms

Sulky humour, that despises everything, and he desires that others also should not esteem or care for anything.

Extreme impatience.

Ailments from vexation and reserved displeasure.

Headache as if brain and skull were bruised, which penetrates through all the bones of the head down to the root of the tongue, with nausea.

Nausea : vomiting : better out of doors.

Headache as of a bruise of brain and skull, which pierces through all the cranial bones into roots of teeth ; with nausea.

Gastric headaches, occurring in nervous, sensitive persons, commencing with nausea and vomiting.

Pupils more readily dilatable ; dilatation of pupils. Eye-gum in the outer canthi of the eyes.

Nose-bleed, blood ,bright red ; face pale.

Profuse accumulation of saliva.

Nausea as from the stomach, with empty eructations, and a great flow of saliva.

Nausea and vomiting.

Distressing nausea.

Averse to all food, no appetite ; earthy taste ; stomach feels relaxed ; nausea.

Nausea ; distressing ; constant, with almost all complaints ;

with empty eructations, accumulation of much saliva ; qualmishness, and efforts to vomit.

Nausea, with distension of abdomen and dryness in throat ; after vomiting inclines to sleep.

Indescribably sick feeling in stomach.

Sensation as if stomach hung down relaxed.

Pain most severe in front of abdomen, extending to left hypochondrium, to sides, to back, and base of chest, with swelling of stomach ; great agitation ; constant nausea proceeding from stomach, with empty eructations and accumulation of much saliva ; easy vomiting ; diarrhoea.

Pinching pain in both hypochondria, and in the region of pit of stomach.

Cutting pain about the navel with shivering.

Distressed feeling in abdomen, as though stomach were hanging down relaxed.

Griping, as from a hand, each finger sharply pressing into intestines ; better during rest ; much worse by motion.

Flatulent colic about navel, as though bowels were grasped by hand.

Cutting colic near umbilicus ; sometimes shivering.

Tenderness and pain about umbilicus, towards uterus.

Stools frequent : of greenish mucus.

Diarrheic and as it were fermented stools.

Urine : cloudy, with sediment like brick dust.

Dry cough from a tickle in upper part of larynx.

Cough which arises from a contractive tickling from upper part of larynx to the lowest extremities of the bronchial tubes.

Rattling in bronchi when drawing a long breath ; large accumulation of mucus in bronchi, difficult to raise.

Rattling noises in air passages during respiration.

Cough causing inclination to vomit without nausea.

Suffocating cough, whereby child becomes quite stiff and blue in the face.

Dyspnoea.

Difficulty of breathing from least exertion.

Violent degree of dyspnoea, with wheezing and a great weight and anxiety about precordia.

Spasmodic asthma with great constriction in throat and chest, with which a peculiar kind of wheezing noise is heard.

Loses breath with cough, turns pale and stiffens.

The body of the child is stretched out stiffly.

Whooping cough with nose-bleed ; bleeding from mouth ; vomiting ; loses breath, turns pile or blue, and becomes rigid.

Phlegm rattling on chest, sometimes vomited, in young children.

Hemorrhage from lungs ; bright red ; coming up with slight effort ; < from least exertion ; frequent hacking with expectoration of blood-stained mucus ; with or without cough ; after disturbed catamenia ; after mechanical injuries ; after former bleedings have weakened lungs ; with dry cough in phthisis.

Pain in all the bones, as if bruised.

Pain in all the joints, as when limbs go to sleep.

Starts up in sleep.

Tetanic spasms from swallowing tobacco.

Fever : backache, short chill, long fever ; heat usually with thirst, headache, nausea and cough.

Paroxysms suppressed by quinine.

Hemorrhages ; bright red, from all the orifices of the body ; after mechanical injuries.

She had been feeling well ; was sitting with some light sewing in her hand, when she was taken suddenly with a severe uterine hemorrhage. She was placed on the bed, and I was sent for — to come as soon as possible.

When I arrived, she had fainted two or three times. I found her pulseless, face pale, and so much exsanguinated that she could not speak.

All the information I could get was from some m Amber of the family, and that was very little.

The hemorrhage had run through her clothing, through the bed, and a large pool had collected on the floor.

She was flowing very rapidly ; a large stream war gushing from the uterus, so that there was no time to wait. Whatever was done must be done at once, or death would take place in a few minutes.

The flow was of a bright red (purely arterial), the lower limbs were bathed in a cold perspiration ; hands cold and damp ; abdomen felt hot yet damp with perspiration ; the flow would come in large gushes, and life was ebbing out very rapidly.

The colour of the discharge was of a bright red, and it did not coagulate easily, but lay upon the floor in a liquid pool.

I considered that all the symptoms I could get pointed to Ipecac. A small dose of Ipecac. 10M was placed in a half-glass of water, and one teaspoonful was given as soon as possible.

She was very weak and prostrated after the tremendous flow ; and was given at intervals three doses of China 10M : and she made a good getting up. . . .

Ipecac. 200 in water, a teaspoonful every hour for four doses, or as soon as the hemorrhage " seemed to get low " to throw it away, and take placebo.

At the fourth dose, active haemorrhage ceased ; next day a slight discharge, which grew gradually less but did not entirely cease till the third day. No further trouble.

The doctor adds, " A large number of remedies have a bright red discharge from the uterus ; but so far as I know, none of them have the peculiar characteristics of Ipecac. It seems to stand out very prominently in all its characteristics, and cannot be easily mistaken for any other remedy. One very peculiar characteristic is that the flow in active hemorrhage is the peculiar gushing, which could be compared to that of a pump when the handle is vigorously worked ; the stream does not cease, but at every pulsation of the heart there is a peculiar gush, which is not credited to any other remedy, so far as I am aware. And then the blood does not easily coagulate, but remains fluid for some time, especially when active uterine hemorrhage takes place."